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Dr. Keane
Dr. Keane, Therapist
Category: Mental Health
Satisfied Customers: 1768
Experience:  Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
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I am 27 yrs old - i have add and need to be on medication

Customer Question

i am 27 yrs old - i have add and need to be on medication for my job. I took adderall for years in college and was up to 80mg a day - i loved the spike it have me and the longevity - but i hated that it sucked the soul out of me, i had no personality and normally ihave a huge personality - i tried vyuvanse and concerta - both do nothing for me,in fact vyvanse made me want to cry all the time, i tried 30 mg 40mg and 50mg. I need something that gives me the joly that adderall gives without taking away my personality - stimulants work well for me bc ritalin did nothing. I was on wellbutrin at one point up to 450 mg which worked well but i felt numb. I have a littler anxioety so the idea of wellbutrin was appealing. ideally i would like something that will help with focus, help w decreasing anxiety and while also assisting with weight loss. Stimulants work well but not if they are too much - is there a blood test or something i can get done to effectively measure what dosage of what type of drug will work best with me instead of constantly acting as a ginny pig trying new drugs every week? Right now im doing vyvanse which is so low and mild its ridiculous and xanax at night to sleep sometimes- please help
Submitted: 6 years ago.
Category: Mental Health
Expert:  Dr. Chip replied 6 years ago.

So have you asked a doctor about this specific question before?

Customer: replied 6 years ago.
the most recent medicine suggested to me has been cymbalta bc it takes off anxiety and acts as stimulant - i need to get back in the gym, ive been an athlete my whole life, and the adderall helped me stay focused - but now that im not on adderall i am not motivated bc my anxieties overwhelm me - so i need something that will allow my personality to shine thru while taking a little anxiety off and direct my energies to focused work - and help me withnot overanalyzing so that i can actually physically get INTO the gym, right now my thoughts are so running wild that i cant focus enough to stay on a machine at gym for 30 minutes etc. is cymbalta the answer?
Expert:  Dr. Chip replied 6 years ago.
Was this a psychiatrist that did this?
Customer: replied 6 years ago.
no my general practioner - ive had add my entire life which was diagnosed at age 8 with tests and given ritalin - i stayed on ritalin for a year then went off. in high school i needed to focus and my gp gave me adderall - which helped tremendously. After college i made changes as noted above in an effort to get away from the 'no personality' side effect of adderall. My dr is great and has been trying to helpbut i am trying to see other opinions to be more time efficient and not continue taking things. I want to beetter understand cymbalts, the most common side affects and if cymbalta or what drug will best fit my needs
Expert:  Dr. Chip replied 6 years ago.
you don't want to go back on the Adderall?
Customer: replied 6 years ago.
no. it made my personality completely different - i couldnt even be funny on it and it made me not social
Expert:  Dr. Chip replied 6 years ago.
to recap, exactly what would you like this new medication, if there is one, to do for you?
Customer: replied 6 years ago.
to help me focus for the ADD that i have, a stimulant factor to it while also not robbing me of my personality and additionally providing the extra gusto for motivation that i had when on adderall. I believe the correlation of motivation with the adderall was a result of the fact that adderall made me less anxious bc i was focusing my energy on being productive rather than overanaluzing things - so a medicine that will help me focus and calm my anxieties and drive my energy to productve things/motivation while allowing me to have a personality.
Expert:  Dr. Chip replied 6 years ago.
Have you tried Strattera or Provigil?
Customer: replied 6 years ago.

no - i have been told they will not be strong enough for me. I have an abnormal amount of energy and high tolerance to these types of meds. I would be interested in trying dexadrine or cymbalta if they seem to be a fit but again, i cannot stress enough that i need something that will help me w motivatio/calm my anxiety enough so i can get in gym and help w appetite control - which stiumulants tend to do with metabolism. Ritalin, a non stimmulant did nothing for me.

What are the pros and cons of reasons u would suggest provigil and or strattera for me?

Do u think these are better than combing an adderal with a wellbutrin lets say hypothetically? Is adderall still the #1 reccomended?

Expert:  Dr. Chip replied 6 years ago.
Ritalin is a stimulant, as are everything we've mentioned except the Cymbalta. Why had your doctor taken it on himself to fully diagnosis and treat this problem?
Customer: replied 6 years ago.
dr chip - i was under impression that both psychiatrists and general practioner handle ADD cases - if there is a specific type of dr like a neurologist or something where i can get a brain scan or blood tests to wuantifiably diagnose me the most efficient way possible then pls let me know what type of dr i should search for. What are ADD dr specialists called? How do I find one? regardless of my doctor taking this case on - it is bc she is my only dr - and she deals with this with hundreds of people. What are you suggesting i do?
Expert:  Dr. Chip replied 6 years ago.
I'm not saying a GP couldn't handle this, but I think first you need a full evaluation to get at the diagnosis or diagnoses here. The two medications I mentioned could at least be tried, but I worry about the exuberance you got from the Adderall, since that's above it's ADHD capacity and hints at the euphoria that can lead to addiction. A psychiatrist or a psychologist could interview you and do a battery of tests to help sort out what all is going on here, but it would take a psychiatrist to prescribe appropriate medication. Scans and blood tests wouldn't likely help with the diagnosis or choice of medication.
Customer: replied 6 years ago.

is ther a psychiatrist on here i could speak withabout this then? I am still trying to get an answer using this service that is why i paid the $50 -not to be rude but i need answers

Expert:  Dr. Chip replied 6 years ago.
What more can I add?
Customer: replied 6 years ago.
if you are a psychiatrist or if there is one i can speak to using this service who can help me better assess?
Expert:  Dr. Chip replied 6 years ago.
OK--I'll switch you over to mental health, but I seriously doubt they'll be able to tell you any more that I have as to how to proceed with this. Hope you appreciate all the time I've spent with you.
Customer: replied 6 years ago.
thank you - i do.
Expert:  Dr. Keane replied 6 years ago.
Hi, Dr. Chip gave you good advice and I will add my suggestion. That would be to find a good psychopharmacologist, that is someone who can work with you on the medications, adjust, add, remove and find the right thing that works for you. Anxiety can be help best by therapy, cognitive behavioral therapy as well as help you handle your ADHD behaviors. Medication works in conjunction with with therapy and therapy can help you with your motivation issue, so look for a someone who is up to date on medications and try a few sessions of therapy. Your internist may not be well versed no matter how many people she sees. The medication component in treating ADHD is individual specific, what works for one may not work for another (as you found out) however you have to decide what you want out of your experiences, learn how to deal with the ADHD without the medication and have your old personality back or take the meds and deal with less enthusiasm. I understand you want the best of both and you need to take a good look at a possible addiction problem, part of your question asks about metabolism/energy/weight, you should look into this more closely once you find the psychopharmacologist. I hope this helps. Please click accept and leave feedback. If you are a subscription or free customer you still need to click accept so I get credit for my response.