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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 2 of 2. This is the beginning of the thread.
Posted by Nonocebo on November 27, 2018, at 17:48:58
Crashing from the stimulants: I was told that if the bipolar is adequately treated that would make the stimulants work better and would prevent the crash. So I need clarity in terms of 1) how I could more adequately treat the bipolar and 2) I need to know if this is in fact sound science or just a way for the psychiatrist to try to get me to go on more mood stabilizers or anti manic agents. The reason I need to know this , aside from just ethically something Im entitled to know so I can make an informed decision, is that I saw a doctor who said this so he raised the trileptal to higher than it Im on now, (albeit still sub therapeutic) and kept going up. I agreed to this simply for the sole purpose that I hoped it would prevent the crash and make the Vyvanse work better. My experience was that what it did was make me more sedated, impaired and slowed down even more and it didnt help the Vyvanse work better but seemed to do the opposite. I want to be mistaken because I want to try an approach that would prevent this terrible crash so if there is some literature explaining the science behind it then that would be greatly appreciated. I want to clarify that I dont have intractable mania. The issue is depression, memory, cognitive and profound word finding problems. Its bipolar in as much as that when I go on anti depressants I get into confused states where I get disoriented and I cycle, all within a depressive state. So antidepressants are problematic and we are using stimulants instead. But there is no reason for me to be on higher and higher amounts of anti manic agents unless the end result improves my cognition, mood and functioning because Im not manic. I also want to say that Ive tried Lamictal, Li, and other mood stabilizers at therapeutic doses and they made me totally non functional I got so impaired and slowed down. So
Im not sure if the solution is to keep going up on these medications.This is my medication
Vyvanse 30 twice a day
Lamictal 75
Zyprexa 5
Trileptal 150 twice a day
Ashwaghanda (sensoril) 125
NAC 3000
Posted by rjlockhart37 on November 27, 2018, at 21:19:03
In reply to Stim crash prevented w/ moodstabilizers in bipolar, posted by Nonocebo on November 27, 2018, at 17:48:58
when your taking a stimulant - vyvanse or amphetamine med, mood stablizers will decrease their effect, but they can....provide a stable mood, but even when dexedrine wore off.i still had the mild dyphoria, or the unpleasant feeling after dexamphetamine wore off, i would tired and irrtible, i would have to prep myself to be ready when it wore off. That sounds weird, but i had to tell myself it's wearing off in 2 hours need to be ready, and acutally doing that made the crash or the let down not as bad. But a suggestion is take your vyvanse during hte day, save the stablziers when it wears off, now im just a poster, ... so this is just street advice, not medical advice - i would take mood stabilizers after the dexamphetamine wore off, it made me less irrtible and less moody. Trileptal defiantly decrease vyvanse, but you could get adjusted to it, that you could learn to tolerate it with vyvanse. That's all, these are more thoughts rather than suggestion, and definitely not medical advice.
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