Mental Health New ADD dx, looking for best treatment plan

[Siccsmack]

I'm an opiate addict, I've been on suboxone for 2.5 yrs. Im down to 4mg twice/day. I have chronic low energy and no motivation. Recently began seeing a psychiatrist and she's certain I have ADD. She thinks 450mg Wellbutrin might be enough to fix my motivation issues, but I've always felt like my energy level is the issue.

I was taking methadone (from the street) for 2 years before that. It's crazy to me how different methadone and suboxone feel. On the methadone, I had so much energy all day, from 20mg. I was able to start and maintain a diet, I performed better at work, I felt alive. I got off it because there weren't any clinics in my area and I didn't think continuing to get it illegally was safe... I got on suboxone and never looked back. The suboxone is different, I have a bit of energy an hour after I take it but it quickly fades into a dull, lazy haze. Um functional, but unmotivated and sometimes lack the energy to even do the basics like shower or make dinner.

My new doc thinks the methadone acted on my dopamine the same way Wellbutrin would. My wife is on subs/Wellbutrin (for depression) but she doesn't seem to have any more motivation or energy.

I think I need a stimulant. Vyvanse seems like it would be perfect, maybe paired with a lower dose of Wellbutrin. Does anyone have experience with this drug combination?

My goal would be to accelerate my sub taper over the next year and jump off at 1/2 MG. Right now, I don't have any motivation to do that. I'm a bit skeptical that adding a stimulant to the mix could be a good thing, but looking back over the last 20 years, u can really see how it could have helped me stay focused and stay in school. I've just always lacked energy and motivation...

Thanks!

 

[CSM25]

I am not sure if it will help you in the way you want it to, but I did have some pretty good success with Dexadrine. I was stuck in a university program I hated at a school that
was not willing to help its students (constant administrative issues, difficulty to get in required courses, and staff that don't want you to succeed), and I was really depressed.
I got diagnosed with ADHD late, and Dexedrine helped me tremendously. It wasn't perfect but I had the success I needed. If I woke up early say at 6 am and took it, and then slept again til 6.30 or 7 I could get up and do all the things I needed to do without being overwhelmed with my failures, or the impending threat of failures. It was motivating. I am not sure how it interacts with suboxone and such. Vyvanse is the prodrug of dextroamphetamine, lisdexamphetamine as you probably already know.

Dexedrine gave me the energy that was manageable. The other ones didn't help me so much, but YMMV. Besides I have an additional comorbidity.
Adderall (brand name) was very motivating but I quit that very shortly after starting. That was even more of a "kickstart" for me. But I could not tolerate some side fx.

 

[CoastTwoCoast]

I'm bipolar with ADD and you have to be careful with stimulants. It can trigger paranoia because of being bipolar. So if you notice more paranoid thoughts, it's probably a good idea to stop it or you could spiral down into the psych ward.

Anywho, I was on Vyvanse and that spiraled me into the psych ward with paranoia I wouldn't wish on my worst enemy.

So now after a long break, I asked my doctor what other stimulant I could try because being scatterbrained is annoying. She started me on Ritalin, 10 mg twice a day. I love it! I have focus and energy. I can concentrate.

I'm also prescribed klonopin too.