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Please help me figure out my schizoid+add med problem

  • Thread starter Thread starter helpwpsychoadd
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helpwpsychoadd

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So im on:

abilify 5mg
wellbutrin sr 100mg
zoloft 50mg
dexedrine 15mg

1st - zoloft/sertraline + dexedrine/dextroamphetamine = worked fine together for adhd but i still got psychotic and depression wasnt totally resolved

2nd - zoloft + wellbutrin/bupropion + abilify/aripiprizole + dexedrine = depression and psychosis are gone, but now adhd is in full effect because dexedrine is completely ineffective

No, it has to be either and/or both wellbutrin and abilify that have made dexedrine useless.

abilify is a partial da agonist/antagonist and wellbutrin is an NDRI. considering dexedrine is an agonist and DRI, what do you think is causing the interference?

is it the DA antagonism of the abilify affecting the DA release/reuptake from dexedrine? is it the DRI of wellbutrin blocking the release of the DA transporter?

ive read abilify attenuates d-amp and meth, and wellbutrin and zoloft can also either potentiate or attenuate d-amp effects? nothing exists for methylphenidate....

So WHAT DO YOU THINK IS ATTENUATING THE DEXEDRINE HERE?!!! maybe both abilify and wellbutrin?

like i said, with zoloft dexedrine worked fine, but adding these two new ones at the same time has rendered my adhd intolerable.

im going to see my doctor about this, but its driving me crazy and i want a psychopharmcological reason for this....i mean dexedrine has NOOOOOOO effect whatsoever.

!!!ALSO, what do you think would be the effect of wellbutrin+abilify+zoloft on focalin/dexmethylphenidate, since its just a DRI? would that be a good alternative to dexedrine?

MOD please ask in ADD/advanced drug discussion
 
Have you looked to see what the cyp450 implications of this combination are? I think everything you are taking is 2d6 active but I don't remember inhibitor, substrate, or inducer. I'd check into that. My guess is that the DA partial agonism of the abilify would account for the attenuation of the dexedrine.

Per OP request I'll send to ADD. Anon-------------------------->ADD
 
Depending on how long you have been on the dexedrine, this could, in part, be tolerance (basic, I know, figured I would ask).

Your doctor should know quite a bit about pharmacology. Have you relayed your concerns?
 
Tolerance cant be an issue. Like many others, ive maintained the same effect from the same dose for years. not only that, i took 25mg to check if it would make a difference, and nothing at all.

i am going to talk to my dr about this as i mentioned, but she does not like to discuss pharmacology all that much, she shrugs it off for hte most part and just says "try this"

i asked in ADD because i wanted to know what you guys thought it was (tolerance definitely excluded). i also dont think the enzyme substrates are doing it.

first i thought it might be receptor affinity, but i dont think so. my guess is abilify is maybe lowering the released dopamine in the synaptic cleft from dexedrine, the wellbutrin is maybe blocking DAT reverse transportation of the dexedrine OR its affinity and DRI effect is stronger?

ALSO the second question, what would happen with focalin/dexmethylphenidate with these meds (considering the dexedrine isnt working)
 
I would think that both bupropion and aripiprazole could attenuate your response to the dexedrine. For your purpose though, I'd consider taking the buproprion out of the mix before aripiprazole, though. With the risk of psychosis quite high you don't want to be quitting the aripiprazole without deep consideration.
 
bupropion decreases the ammount of dopamine released but it also has tolerance lowering effect. aripiprazole most likely is the culprit

ask your doctor about other antipsychotics. quetiapine most likely will work with your other meds (if you take it before you go sleep)
 
(OP posting)

Thanks for the responses. Seroquel/quietapine isnt an optino for me, though. And the wellbutrin was the buckshot that topped off my schizoid issue. like zoloft takes care of the anxiety and depression a bit, abilify takes care of anxiety psychosis and depression a bit, and then the wellbutrin just knocked the depression outta the park, almost instnatly. for my main issue (schizo/bipolar) the zoloft+wellbutrin+abilify has not only been the best combo cuz ive tried a few, but its also the least toxic metabolically which makes me ok with takin meds i otherwise wouldnt. adhd is bad, but not as bad as psychotic disorder

however, i think attenuation is coming from both dopaminergic agents, not to mention sertraline also has DRI. so maybe its the combo of all three DA competition in the antidepressant/antipsychotics that the dexedrine cant release DA.

but what do you think would happen if i substitute FOCALIN for dexedrine? its a DRI, like the others except its affinitey and occupancy is stronger. do you think there would still be no effect? ive been on focalin before, and i prefer dexedrine, but if focalin will actually work, id switch...so what do you think would happen with focalin?

can anyone help figure this out with me, im still waitin for the dr to call me back since yesterday
 
Dude its the abilify..... it has been shown to completely attenuate d-amphetamines effect and is used to block the drugs effects in stimulant addicts.

Your doctor is a fcking retard.
 
I fully agree. Said course of treatment is nonsensical........Do not assume your physician always knows best......especially in the realm of psychiatry......

And no, patients never argue with me concerning the anesthetic agents I choose, but then again, they rarely get such a chance....and its entirely different arena....

Can you elaborate on said psychosis, degree and past Dx in specificity....?
 
(op posting)

schizoaffective

amphetamines are totally ineffective, and it must be as everyone agreed. its like taking an ssri with an 5-htp releaser like e. the DAT must not be able to reverse, but that doesnt mean their reuptake cant still be inhibited so....................

would focalin, a DRI, still work??????????????
 
Not exactly nonsensical. amphetamine may raise DA levels, and aripiprazole may antagonist some DA receptors, but not all.

I still don't think it's a brilliant cocktail, but it's not entirely moronic.
 
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