meeting psych today to try meds for ADD, so confused/helpless/frustrated

[Amber98]

My psychiatrist and I have tried over 30 medications for my Generalized Anxiety, NONE of which have even remotely helped and my symptoms (mainly insomnia and trouble focusing) have disabled me when ALL i want to do is be able to work like a normal person.

My psychiatrist has given up on me and feels I do more research then him so he allows me to bring my medication suggestions and he tries me on whatever I come up with. Now that i have convinced him I might have had ADD/ADHD all along, he has no problem with me trying those meds. I NEED help, I know meds are different for everyone and you cant tell me what to try, but I am HOPELESS and I simply cannot keep doing this trial and error game, im exausted and have given up 99%. I NEED a suggestion to bring to my doctor at our appt today or else he is going to put me on some crap that is not going to work. Here are the biggest issues i need addressed. My insomnia, which ive had since I was 5, has been the worst case any doctor has ever seen so i need a med that wont make it worse OR a good sleep aid i can take with an ADD med. I NEED a med that will

Hopefully calm my racing thoughts down to the point where a stimulant might actually help me sleep, if I can shut down my over active brain
Need a sleep aid I can take with a stimulant, currently amitriptylne is the only med that has been sedating enough to help my insomnia
Need a medication that will calm my random racing thoughts and let me focus and concentrate at work. Today I made a big mistake at work as my co worker caught that I didnt do something I was supposed to do, and when asked, I honestly cant remember if i did it or not. This was like half hour after the incident, i could not remember whether I did it or not. Then i couldnt rememeber whether i even entered the area where i was supposed to complete the task, my memory is always hazy, i try to repeat things in my head several times so i will remember but still forget everything. And i generally cannot remember any rules or regulations at work, even though ive been there 2 years.

Advice for my appt today, please!

[Sandman2]

    I would also talk to your psyc about the Amitriptyline.  It is in a group of drugs called tricyclic antidepressants.  Which means that you were on two strong antidepressants at the same time!  No wonder you were feeling groggy.   You also had a huge imbalance between seratonin uptake and lack of dopamine.  Check out those videos I recommended on Sept. 11.
   Also, don't rush this.  If you do have ADD - the antidepressants have been masking the symptoms for years.  It will take awhile to undo this.
   I don't know if this psyc is the same one who put you on Clonazepam and Amitriptyline.  If it is not, he should be looking other meds for you.  If it is the same psyc then hopefully, he can start making adjustments.
  But whatever you do - do not suddenly stop taking any med (except stim meds) with talking with your doc.

[Sandman2]

Hi Amber, sorry I did not get back to you right away.  They changed the order of postings - usually the latest post is last and I just did not notice the date.
    Anyway,  did your doc cut back on the Clonazepam. ?
   Second, make sure you are not taking any Orange Juice or citric acid product before the new med.  It will really cut down its effectiveness.
   Yes, the right dose of adhd med will help with concentration.  so could cutting back on the Clonazepam (I think).
   Just saw your journal posts.  Is the amitriptyline a new med for you?  How long have you been on it.  
   I do know that constipation will cause problems with adhd effectiveness.  Dr. Parker has written about that.  I will have to look it up.

[Amber98]

Hi, thank you for your reply. I have already stopped all clonazpam. I will only use it when I go to work if in an emergency, and I have a week off right now.

Amitriptylne is something I have been on for 2 years to help with sleep, it only helps sleep, no other symptoms. I have also had severe constipation from it, and really nothing helps so I do feel like it's affecting the ADD meds, screwing up my metabolism for sure.

I have increased the amitriptylne a few days before starting the ADD med, that might be another issue.

I went in to see my psyciatrist today, and told him I want to try adderal or the V one. He said not yet, he wanted me to continue trying concerta first, and to take the ER pill I have and crush it up and take it??? He is supposed to be a brilliant psych, I cant believe he told me to do that as I have been reading and have learned never do that.

But he wants to see if it will help if its more of an instant release, I guess that's why he's thinking.

Anyways, I am too scared to do that, thats too much drug at one time. I see him again next week at which time we will try adderal.

[Sandman2]

I think what the psyc said is worth trying.  I also think the clonazpam could be messing with how the stim med is working for you and thus it might take a bit longer to find out how the stim med is working.  Below you will find some info on withdrawal of clonazpam.  You should ask your psyc about that.  If the stim meds do start working for you, I would look into a light anti-anxiety medication.  Any way this is the info:
    Tolerance and Withdrawal

Even though benzodiazepines can be very helpful, they are habit-forming drugs. If you take them daily for several weeks or longer, you may develop a tolerance to them. This means that your body adjusts to them and you may need a gradual dose increase for the same effect. This also means that you will experience withdrawal — physical or psychological symptoms — if you suddenly stop taking them.

Symptoms of withdrawal include:

    rapid heart rate
    insomnia, agitation
    increasing anxiety

For this reason, talk to your doctor if you want to try to reduce your dose or discontinue the medication. Your doctor can work with you to help you slowly taper off the medication.  

[Sandman2]

   I am sorry to say that this will take some trial and error to correctly dial in the doses.   And, of course realize, this is just an opinion - not medical advice.
   I would slowly begin to drop off the clonazepam.  It, really sounds like you are on too high a dose.  If I remember correctly you have to slowly get off it.  Your psyc can tell you about that.
  Vyvanse has gotten really good results for many people because it lasts so long and is so smooth.   When the dose is right it will last 10 to 12 hours.  Your problem will be hitting the correct dose (if the med works for you) and then when to take it.  If it works it will calm those racing thoughts.
   I would also look into Melatonin to help you get to sleep.
Hope this helps.
   Keep in touch.

[Sandman2]

    Oh, if you want to start off easy, then any one of the Methylphenidate  meds like ritalin.  They will only last for 4 or so hours, but can be dialed in time wise easier.   They are not as strong as the Adderall type of meds however.
   But certainly try getting back on the Clonazepam with your docs consent.

[Sandman2]

opps meant to say cutting back on the Clonazepam.

[Amber98]

Hi Sandman, first off thank you for all your help, you have been amazing.

So my psych prescribed me Teva-Methylphenidate er-c. I take 18mg X 2. I have taken it the last 3 days but I feel absolutely nothing and no difference. He gave me extended release because I told him my experience with an add med once and he knows my anxiety is bad so he didnt want me to get a hard crash PLUS i work 12 hour shifts.. Here is the strange part:

5 or so years ago after going through 4 or 5 psychiatrists, I met a different doctor who i only saw 2 visits, who was the ONLY doctor to bring up the idea of ADD with me, noticing how many anti-depressants were not working. At that time, I thought he was crazy and didnt even take it seriously. BUT he literally give me 2 pills, out of his own pocket, no prescription, just in his desk lol. I wish i knew WHAT he gave me. They were add meds, he told me to try them and if i felt any better then id know if I had add.

Well they must have been the instant release because I took one and I felt amazing, started focusing got so much done, felt so much confidence, however it was probably way too high of a dose because i could not stop cleaning/working/reading  for about 3 hours then I crashed VERY hard and started throwing up. I never went back to the doctor because that crash was very bad, and for someone who had depression, i felt like ****. Looking back now, the med still DID work, it helped me focus which is all I want and need.

The point to this story is, that one ADD drug i tried years ago, helped me instantly and the affects were SO noticeable and actually were too strong. However, with this med, its been 3 days and I dont feel ANYTHING.

Should I try something different? I dont want a 3/4 hour crash. and that drug i tried years ago, was way too strong like taking speed, but with this there is nothing.

Thank you for your help

[Amber98]

Sandman2,

One more thing I wanted to add, I thought my worst symptom was forgetfulness. I keep losing my purse, keys, phone, wallet. Also at work, major errors in a job in law enforcement! Giving something to someone, then not remembering where it went. After reading other posts, I have come to realize, I am not forgetting these things, rather, I am not paying attention to where I am placing them in the first place. Knowing this is helpful for me and again feels like an epiphany. I kept wondering why I was forgetting all the rules and regulations of my job, but now im realizing, im not taking the information into my brain in the first place. Does this sound like something a specific type of add med would help?

Thank you thank you!!