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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4635
Experience:  MD Psychiatry
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I take 100mg of lamictal, 300mg of lithium, and 100mg of provigil

Resolved Question:

I take 100mg of lamictal, 300mg of lithium, and 100mg of provigil in the morning.

I take 300mg of lithium and 10mg of zyprexa in the evening.

I have all they symptoms of severe ADD.
My mind wanders all the time. I can't conentrate very well.

What doses of ritalin and risperdal or other combination of add drugs and anti psychotic drugs can i take?
Submitted: 5 years ago.
Category: Mental Health
Expert:  Dr. Kaushik replied 5 years ago.

Hi there,


Welcome to Just answer !


Kindly tell me what is your diagnosis ? because i see that you have been put on many drugs in substandard doses ?


also using certain combinations like that of a psychostimulant which causes increase in dopamine neurotransmitters levels , with that of an anti psychotic drug like zyprexa or risperdal which lower the dopamine levels , are not advised to be used together..


I will get back to you once you reply to my query..






Customer: replied 5 years ago.
I am bipolar, however I am sure I am ADD being ADHD as a child. My mind wanders when people speak. I can't read because of my innatention. I have low self esteam with social fobias excepty when I m hypo manic. I would love to "catch" the hypo manic feeling of being attentive, happy, smiling, laugh, confident... When I was younger I used to hold a pink blanket, no pillow, a s sheet over my head, sang songs to go to sleep. This happened every night until about 12. Why didn't my parents ask someone why?Would a small does of ritalin with riperdal to keep down pshycosis the unreal thought be in order?
Expert:  Dr. Kaushik replied 5 years ago.

No ... i am afraid but answer is i would not recommend this combination..

my reasons are below..


1) you are already on an anti psychotic in the form of zyprexa , so adding one more anti pscyhotic would open the shore for distressing side effects such as extrpyramidal side effects , weight gain , seizures , increased blood pressure and sugar levels.. increase cholestrol ,etc ..


2) you are already on 1 psychostimulant drug which works to improve concentration and attention in the form of provigil , which still i think you can tolerate , because of its different mechanism of action as compared to ritalin or adderall , but ritalin / adderall ,id at all used then even a minor dose would react with anti psychotic drugs that you are on making the drug efefcts ineffective and thereby leading to worsening of the clinical picture i am sorry but i cannot suggest you something which is going to bring adverse effects to you ..


3) While i am open to the idea of you being add , but i strongly feel that the difficulty in concentration that you suffer from could very well be from unattended unaware depressive phase that you could be in which you might have not been noticed it and which can simulate symptoms of add..


4) My remedy for you would be to ask your doctor to raise the dose of lithium to 900 mg/ day , to be taken as 300 mg does , three times a day , morning , afternoon and evening , roughly in a gap of 6-8 hrs ..


5) another change that i will recommend is to raise the dose of provigil by 25 mg, that is by taking a separate dose of 25 mg in the afternoon other than the morning 100 mg dose , this will help with your cognition and concentration .


6) Add lexapro in the morning at dose range of 5-10 mg in the morning ...this is an anti depressant which will help you with your depressive cognition and also in improving your concentration an clear thinking ...


So, discuss these changes with your doctor and start on them and observe the symptoms for atleast 3-4 weeks , i am sure that you will no longer have complaints with your concentration and feel better ..


I hope this helps..


Wish you all the best..






Customer: replied 5 years ago.

could I take ritalin in place of provigil and keep the zyprexa.? the provigil doesnt do anything for me. i just cant get ouf bed in the morning. i dont sleep; i just there.


Nothing works except for a day or two hypo mania.


I would like to feel happy, smiley, funny, confident...all the time.

Expert:  Dr. Kaushik replied 5 years ago.

Yes you shall take ritalin in place of provigil... but maintain at low dose of 10 mg / day .. and stop provigil..


I hope this helps..




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