Stimulants Which stimulants for Narcolepsy and ADHD? Diagnosed - want info on therapeutic dose and how they feel compared to one another. No abuse posts please

[Eligiu]

Hey everyone,

I'm just waiting on the final approval after my Dexamphetamine trial for Narcolepsy (diagnosed) which got delayed due to my prior substance use history. My specialist refused to play ball with the Drugs of Dependance Unit and piss test me and check me for IV use because it's 'not his area' so he basically just chucked me in the fuck it bucket.

I emailed the DDU and they actually replied? I told them my entire drug use history and explained that my IV heroin use this year was a one off in 3 years - I put myself back on suboxone after I figured out how to use the Dark Web as I knew it'd get out of hand. I asked if my GP could prescribe with all the reports (unusual but not unheard of) seeing as the specialist refused to, or whether my Psychiatrist could once we get the second opinion for ADHD (which I need due to drug use and bipolar). They said both were fine and told me exactly how to do it.

My GP was happy to begin the process and figures he's the right person to monitor me as he's known me through my addiction and I'd tend to agree, but I still want to get the ADHD Diagnosis as it opens up more treatment options. With Narcolepsy I can only use Dexamphetamine. With ADHD I could use Ritalin or any of the others as well and my sleep specialist will still sign off that I'm fit to drive even if he isn't prescribing the stimulant.

My question is, having only tried Dexamphetamine for 2 months (and finding it really useful for my conditions, actually completely life changing) how does it compare to other prescription stimulants at a purely therapeutic dose? Are some more jittery or anxiety inducing? I like the option of being able to switch if one stops working to another one and vice versa.

I'd like to know all I can about other prescription stimulants.

I have also used Modafinil and armodafonil. They are useless to me.

I stretched a 2 months trial supply out for 4 months even with a prior meth addiction that's how unabusable prescription stimulants are to me. I can even take Dexamphetamine and sleep on a bad day. My meth tolerance remains high to this very day when I occasionally slip off the wagon for a day or so. Narcolepsy be like that.

Disinterested in reports from people taking abuse level doses. I only want information about the therapeutic dose. I kept a solid rest day/if I'm not driving I don't take it promise to myself that I will continue to do as prescribed stimulants are my only hope to keep my driver's license.

 

[Jabberwocky]

I’ve never actually met anybody using dex for narcolepsy. In fact I’ve never met anybody with narcolepsy. So I can’t comment on that.

But for ADHD I found dex to be brilliant - especially considering I was not diagnosed and did not get a script until after age 40. I don’t know what jurisdiction you are in, but here ADHD-specialist psychiatrists like mine are well aware that undiagnosed adults with ADHD very often have a history of self-medication. They see it as a symptom rather than as a reason to deny treatment. I was given my first script 3 months after I beat my first addiction to meth. There were a few more hoops but nothing major. I don’t know what happens if you relapse into a meth or other stim addiction while you are on a script for dex though and I’m too scared to ask.

Normally here you get offered a stim or non-stim treatment path and then begin by trialling the option with the best risk profile for your case in whatever option you choose. So I had the choice initially of Strattera/Atomoxetine or Ritalin/Methylphenidate. Because I had bipolar and had had manic episodes induced by SSRItype drugs I went with the stimulant option but found that Ritalin made me super jittery. It was very unpleasant. So then I tried dex and slowly worked up from 5mg 2x a day to 10 mg 3x a day over a few months. Totally changed my life and led to 5 of the best years of my life. No doubt about it.

I have never found that I developed tolerance to dex and it was never moreish at all to me. I also frequently took days off (like weekends or holidays) and never had any cravings or comedown. All that happened is I felt my ADHD symptoms coming back quickly and strongly.

 

[Eligiu]

I’ve never actually met anybody using dex for narcolepsy. In fact I’ve never met anybody with narcolepsy. So I can’t comment on that.

But for ADHD I found dex to be brilliant - especially considering I was not diagnosed and did not get a script until after age 40. I don’t know what jurisdiction you are in, but here ADHD-specialist psychiatrists like mine are well aware that undiagnosed adults with ADHD very often have a history of self-medication. They see it as a symptom rather than as a reason to deny treatment. I was given my first script 3 months after I beat my first addiction to meth. There were a few more hoops but nothing major. I don’t know what happens if you relapse into a meth or other stim addiction while you are on a script for dex though and I’m too scared to ask.

Normally here you get offered a stim or non-stim treatment path and then begin by trialling the option with the best risk profile for your case in whatever option you choose. So I had the choice initially of Strattera/Atomoxetine or Ritalin/Methylphenidate. Because I had bipolar and had had manic episodes induced by SSRItype drugs I went with the stimulant option but found that Ritalin made me super jittery. It was very unpleasant. So then I tried dex and slowly worked up from 5mg 2x a day to 10 mg 3x a day over a few months. Totally changed my life and led to 5 of the best years of my life. No doubt about it.

I have never found that I developed tolerance to dex and it was never moreish at all to me. I also frequently took days off (like weekends or holidays) and never had any cravings or comedown. All that happened is I felt my ADHD symptoms coming back quickly and strongly.

Thanks for the information. Seems you and I have some similar mental health stuff going on. My Psychiatrist was initially hesitant due to my history of meth induced psychosis (high doses, not sleeping. Nothing special) but after the trial went well she really came around to it. Plus, having bipolar (70% ADHD co-morbidities rate) and autism (80% ADHD co-morbidities rate) she figures well, with that and my paradoxical meth reactions and stupidly high tolerance (even if I have a significant break I need close to 200mg to really be feeling it, yet all I do is get shit done. During this relapse I created a 30 page document that broke down into the dollar amount exactly what my NDIS funding should be for my review. I don't get horny, I don't watch porn. I just sleep the next day. I'm the most boring meth addict in the world to be frank) I clearly have ADHD and my school reports reflected that. I'd be interested in chatting to you more about this if there is a DM feature.

I don't want jittery. One of my issues with poorly medicated Narcolepsy was the unholy amount of caffeine I had to drink which skyrocketed my anxiety though the roof. 8-10 cups a day and I just shook and pissed.

To explain Narcolepsy is like... Well imagine staying up for 3 days straight without meth and trying to function. We never have restorative sleep, unless we can get Xyrem (GHB) approved which is the only drug that fixes the issue instead of masking the problem. Only available under the special access scheme and 50 people in the whole country at the whooping price of $1000-$2000 a month so I can kiss that option goodbye. It's actually the first line treatment in the US but we have our panties in a bunch because ohhh GHB so instead of letting us have a life changing medication, they just let us have ever increasing doses of amphetamines until they stop working with all the lovely side effects.

 

[Jabberwocky]

Thanks for the information. Seems you and I have some similar mental health stuff going on. My Psychiatrist was initially hesitant due to my history of meth induced psychosis (high doses, not sleeping. Nothing special) but after the trial went well she really came around to it. Plus, having bipolar (70% ADHD co-morbidities rate) and autism (80% ADHD co-morbidities rate) she figures well, with that and my paradoxical meth reactions and stupidly high tolerance (even if I have a significant break I need close to 200mg to really be feeling it, yet all I do is get shit done. During this relapse I created a 30 page document that broke down into the dollar amount exactly what my NDIS funding should be for my review. I don't get horny, I don't watch porn. I just sleep the next day. I'm the most boring meth addict in the world to be frank) I clearly have ADHD and my school reports reflected that. I'd be interested in chatting to you more about this if there is a DM feature.

I don't want jittery. One of my issues with poorly medicated Narcolepsy was the unholy amount of caffeine I had to drink which skyrocketed my anxiety though the roof. 8-10 cups a day and I just shook and pissed.

To explain Narcolepsy is like... Well imagine staying up for 3 days straight without meth and trying to function. We never have restorative sleep, unless we can get Xyrem (GHB) approved which is the only drug that fixes the issue instead of masking the problem. Only available under the special access scheme and 50 people in the whole country at the whooping price of $1000-$2000 a month so I can kiss that option goodbye. It's actually the first line treatment in the US but we have our panties in a bunch because ohhh GHB so instead of letting us have a life changing medication, they just let us have ever increasing doses of amphetamines until they stop working with all the lovely side effects.

I’m happy to chat by DM more. Look for the little envelope icon next to your name on the right hand side of the menu bar at the top of the page. But unless its really personal stuff you don’t want to share in public - it might be worth just continuing to chat here or in another public forum as the information / topic might be helpful to other people with similar issues. We probably need an Australian ADHD thread.

 

[lilbitcrazy]

I’ll try to keep this short, I used dex and found it very useful for ADHD/Narcolepsy symptoms but unfortunately, I found it too moreish and ended-up abusing it and suffering with amp induced psychosis.

A few months back I began adding 20mg of Memantine to my daily 300mg xl dose of Bupropion, I found the combination worked well - calming and mildly stimulating, with around 8 hrs. or so of effectiveness. (I wrote a short report on Memantine and Bupropion here, if you’d like to read more ?)

However, I needed a longer active duration, so I added 25mg of Atomoxetine to the cocktail and now I have a 12 – 14 hour window of steady state effectiveness, I’m 1 week into trailing this but so far its good and allows me to up be and around, alert, calm and fully functioning with a smooth wind-down at bedtime. Just some food for thought since you enquired about alternatives.

 

[Eligiu]

I’m happy to chat by DM more. Look for the little envelope icon next to your name on the right hand side of the menu bar at the top of the page. But unless its really personal stuff you don’t want to share in public - it might be worth just continuing to chat here or in another public forum as the information / topic might be helpful to other people with similar issues. We probably need an Australian ADHD thread.

That's a solid point. Actually I saw a post today on my Facebook about how in Australia they're finally considering approving Ritalin XR for people diagnosed as adults. I haven't finished my diagnosis process for ADD like I mentioned - psych has checked my school reports and has agreed symptoms present between at least 12-18 from my middle school reports, but there wasn't much to see in the years earlier than that. I'm a trans man, so I don't fall into the 'hyperactive' type as in assigned female at birth people, the inattentive type is far more common. And my school reports were basically 'excellent student, would be better if he paid more attention' or 'there have been a frightening amount of times Matthew has been disinclined to work much at all this semester despite his excellent grades. If he hopes to not fall behind next year he will have to improve his attitude in class.' When I asked my parents for the reports they were pretty dubious - they said I wouldn't find anything 'ADHD' in there but tbh I think they only looked at my grades. Funnily enough after my mum googled adult ADHD in assigned female at birth people she recognised all the symptoms of the inattentive type in herself, and now wants to get diagnosed too to see if she can get some help and has actually agreed to be present for the family interview that is necessary for my diagnosis which is great, because my brother probably wouldn't have been that useful. He's getting assessed for Autism now that I got a diagnosis - the whole family reckons they're neurodivergent since the psychologist stuck a fancy 'level 3 autism' label on my forehead. My dad says 'he always identified as being autistic' and he probably is, but he's also just a massive jerk.

When I got to university I fucking fell apart. No one to chase me around for assignments, or homework, or give me stuff I lost. None of the lecturers cared about a random guy in their class who seemed a bit distracted. I tried my friends Ritalin in 2017 and it did nothing at all, which was when I started to first suspect ADHD, and brought it up with my (new at the time but current now) psychiatrist but obviously due to my then current meth addiction she was reluctant to dig into that. After being given the Dexamphetamine trial for Narcolepsy after trying modafinil and armodafinil at the highest doses, it was absolutely life changing. I finally felt like what I imagine feeling normal feels like. My psychiatrist asked how it was (because she did have her concerns) and I was like 'I feel amazing. I read a book this week - I haven't read a book in 5 years for leisure. I wasn't getting distracted every 5 seconds or feeling like I was about to fall asleep.' Then she asked me to described how it made me feel and I was like "surprisingly less anxious - I was worried it being a stimulant it would be worse, but my anxiety has decreased compared to on modafinil. And my brain doesn't feel cluttered anymore. I feel like when I wake up in the morning and take one, I can think of a list of 5-6 things I need to do that day, and start one immediately and not just feel overwhelmed by the list and not know where to start, then I can work through them sequentially. I was able to do chores, and keep my desks clean. I did laundry on time. I could do my dishes and remember when to pick up my medication. I wasn't losing things all the time, I even cleaned my car (which to me is an impossible task). It was mundane, but the difference was night and day. I could complete boring paperwork, and other distasteful tasks.' She was thoughtful for a bit then said what I described sounded exactly like what someone with ADHD would say when starting a stimulant, which like I said, I've sort of known for a while.

So when the other prescriber chucked a shit fit because he refused to urine test me and check me for IV drug use saying 'he isn't DASSA' (Drug and Alcohol Services SA who I get ORT from) despite the legislation being perfectly clear that someone on ORT needs to have urine testing done and be monitored both at the clinic they get ORT and at the clinic they are being prescribed stimulants, he thought they were just being dicks and put me in the too hard basket despite me having warned him of this. Thankfully my GP was super understanding, and thought that he was actually better positioned to monitor for me drug use as he treated me during the worst year of my addiction and would definitely pick up on me regularly using again by how I look. He submitted the reports, tested my urine, checked me for IV use, and sent everything off. He just phoned me today saying it's finally all been approved, and I need to do monthly ongoing urine testing as well as pick the prescription up twice a week, at least initially while they work their way up to trusting me.
I'm perfectly happy to play their games to get the medication I need. They actually thanked me for the email correspondence I had with them and explaining my drug addiction in extreme depth (like pointing out that the incident of IV heroin use that was flagged on their system was a once off in 3 years. I told them I'm also getting tested for ADHD and asked whether my psychiatrist could prescribe if we follow all those rules (secondary diagnosis etc for history of substance misuse) or whether my GP could with the correct paperwork. They said either and actually gave me all the forms necessary. I think they could tell I'm not trying to abuse it and just got screwed by the other doctor. I'm not misusing it by abusing it or diverting it, and I need it to keep my license (the Narcolepsy doctor at least agreed to say I was fit to drive for another year because I had 2 weeks worth of Dexamphetamine left when I went to see him when my initial application was refused because they needed more information, but he said if I'd come in two weeks later I would have been 'unmedicated' so he would have had to take my license. I needed to get this (or stimulants from my psychiatrist) sorted before September this year to keep my license and therefore my job. This is the last medication I can take for Narcolepsy - the only other medications that work are SSRI's, which are off limits because of Bipolar and my psychiatrist won't let me take any of them because all of them in particular are notorious for triggering mania, and my Bipolar was originally triggered by SSRI's so it's a no go. If the Dexamphetamine stops working, that's it for me with this diagnosis, I'm done. Ubers for the rest of my life, until the government approves Xyrem, but that doesn't look like it's happening anytime soon. So I'm absolutely desperate to keep this medication, and keep my tolerance as low as I can, even if that means getting the ADHD diagnosis, and switching between stimulants if necessary as I can still be ticked off to drive with Ritalin or Adderal, even if the sleep specailist isn't the prescriber.

I’ll try to keep this short, I used dex and found it very useful for ADHD/Narcolepsy symptoms but unfortunately, I found it too moreish and ended-up abusing it and suffering with amp induced psychosis.

A few months back I began adding 20mg of Memantine to my daily 300mg xl dose of Bupropion, I found the combination worked well - calming and mildly stimulating, with around 8 hrs. or so of effectiveness. (I wrote a short report on Memantine and Bupropion here, if you’d like to read more ?)

However, I needed a longer active duration, so I added 25mg of Atomoxetine to the cocktail and now I have a 12 – 14 hour window of steady state effectiveness, I’m 1 week into trailing this but so far its good and allows me to up be and around, alert, calm and fully functioning with a smooth wind-down at bedtime. Just some food for thought since you enquired about alternatives.

Wow it's crazy how some people find it abusable and some don't. An ex friend of mine (who I recently fell out with because he kept pressuring me to sell my remaining Dexamphetamine and future supply to him by diverting it after he initially pressured me into giving him 6 pills and I stupidly agreed to 'test if he had ADHD' - he literally asked me the day I got my prescription. I told my GP (who put my Dexamphetamine authority in) that I'd diverted it, but that I wasn't friends with this guy anymore because he reacted so aggressively when I told him I just felt uncomfortable that he did it because I don't like being treated like a dealer, and I'm also already on incredibly thin ice with the DDU. If I get caught I'm toast. When I told him the initial application didn't go through he was like 'wow you really screwed me' (even though I was the one potentially losing his license) and when I told him I was being put on a staggered supply he was like 'damn now I have to find a real dealer?' And I just let it slide at the time, but then he kept asking about the modafinil too. It wasn't subtle at all. But he really liked Dex and the thing was, our agreement wasn't 'I'll give you some and if you get high I'll continue to give you some' it was 'You didn't respond to Ritalin so let's see if you respond to this and if not maybe you should get a referral to get checked for ADHD' but he I suppose thought it was the former and tried to push me into it.

Are the things you suggested supplements? I'm on some serious psychiatric medication (Lurasidone, Valproate) so I can't stick things in my body without being absolutely certain there won't be any interactions with what I currently take. I know that seems stupid when I still take illegal drugs, but supplements can really fuck with psychiatric medications and I don't wanna experience seratonin syndrome or something.

 

[lilbitcrazy]

Are the things you suggested supplements? I'm on some serious psychiatric medication (Lurasidone, Valproate) so I can't stick things in my body without being absolutely certain there won't be any interactions with what I currently take. I know that seems stupid when I still take illegal drugs, but supplements can really fuck with psychiatric medications and I don't wanna experience seratonin syndrome or something.

No they aren't supplements. Bupropion and Atomoxetine are often used for the treatment of ADHD, with Bupropion also used in some cases for the treatment of depression in Bipolar Disorder. Memantine in this scenario might be considered as a mood stabilizer given its NMDA antagonism and has also been explored in the treatment of Bipolar Disorder.

 

[arrall]

Dexamphetamine

Dex IR is probably your best bet for ADHD. I've been prescriped Bupropion, Adderall XR, Dexedrine IR and SR, and Vyvanse. Dexedrine IR is the only one that reliably works for me. Adderall XR works but not quite as well and has far worse anxiety + physiological side effects. Same with Dexedrine SR weirdly enough, screws up my appetite and gives me bad anxiety but IR Dex doesn't do either.

I've also tried a friend's Concerta (extended release Ritalin) in high school when I was having trouble getting medication from my GP because my ADHD diagnosis was from when I was very young (~6 years old) and had always been brushed off and ignored. Frankly, the Ritalin-based meds are less effective for a lot of people (but more effective for some) and seem to have more side effects. They didn't really do jack shit for me. They're just prescribed more often because they are supposedly less addictive and work better for certain people (My aunt was telling me that my cousin who's ~8 years old reacts far better to the Ritalin-based meds than Vyvanse, but was on the Vyvanse because he couldn't swallow pills).

No they aren't supplements. Bupropion and Atomoxetine are often used for the treatment of ADHD, with Bupropion also used in some cases for the treatment of depression in Bipolar Disorder. Memantine in this scenario might be considered as a mood stabilizer given its NMDA antagonism and has also been explored in the treatment of Bipolar Disorder.

Bupropion isn't approved for ADHD in most places, because quite frankly it's pretty ineffective. It's a decent antidepressant, but I've been off it for about a month and it definitely worsened my Bipolar for the 2 years I was on it. I haven't personally tried Atomoxetine, but I've heard the side effect profile is pretty bad and I don't know anyone who tried it and didn't dislike it.

Memantine is not approved anywhere for ADHD or Bipolar to my knowledge. I've personally tried it once and it was ... weird. Just made me look + feel out of it for a few days and my muscles were a bit tightened up as well. I plan on doing a longer trial with a lower dosage (I took somewhere between 60 and 100mg) at some point. I think the main justification for OP taking it would be that it could likely reset his high stimulant tolerance from the meth use and any meth-related neurological damage he may still have. On the flip side, self-medicating is a dangerous path to go down and - outside of moderate-dose MDMA or psychedelic use with a tripsitter/therapist (or close friend who can play therapist), - not something I like recommending to people.

 

[Eligiu]

Dex IR is probably your best bet for ADHD. I've been prescriped Bupropion, Adderall XR, Dexedrine IR and SR, and Vyvanse. Dexedrine IR is the only one that reliably works for me. Adderall XR works but not quite as well and has far worse anxiety + physiological side effects. Same with Dexedrine SR weirdly enough, screws up my appetite and gives me bad anxiety but IR Dex doesn't do either.

I've also tried a friend's Concerta (extended release Ritalin) in high school when I was having trouble getting medication from my GP because my ADHD diagnosis was from when I was very young (~6 years old) and had always been brushed off and ignored. Frankly, the Ritalin-based meds are less effective for a lot of people (but more effective for some) and seem to have more side effects. They didn't really do jack shit for me. They're just prescribed more often because they are supposedly less addictive and work better for certain people (My aunt was telling me that my cousin who's ~8 years old reacts far better to the Ritalin-based meds than Vyvanse, but was on the Vyvanse because he couldn't swallow pills).


Bupropion isn't approved for ADHD in most places, because quite frankly it's pretty ineffective. It's a decent antidepressant, but I've been off it for about a month and it definitely worsened my Bipolar for the 2 years I was on it. I haven't personally tried Atomoxetine, but I've heard the side effect profile is pretty bad and I don't know anyone who tried it and didn't dislike it.

Memantine is not approved anywhere for ADHD or Bipolar to my knowledge. I've personally tried it once and it was ... weird. Just made me look + feel out of it for a few days and my muscles were a bit tightened up as well. I plan on doing a longer trial with a lower dosage (I took somewhere between 60 and 100mg) at some point. I think the main justification for OP taking it would be that it could likely reset his high stimulant tolerance from the meth use and any meth-related neurological damage he may still have. On the flip side, self-medicating is a dangerous path to go down and - outside of moderate-dose MDMA or psychedelic use with a tripsitter/therapist (or close friend who can play therapist), - not something I like recommending to people.

I have heard of Bupropion but I don't think it's widely aviailable in australia. A medication I'd like to try for my anxiety is Buspar, but actually I found Dexamphetamine helped my anxiety by significantly reducing my coffee intake. Something to be thankful for. I'm super excited to go back on this medication and function properly again, I never felt more normal and like I could just be organised for once and do stuff. It made ny whole life make sense finding out im Autistic and have ADHD this past 12 months. Everything fell into place - like why I have 3 friends from uni who all had GPAs above 6 and i was no less smart than them, but I couldn't get mine above just over 5. I felt so stupid compared to them and I wasn't - I just could not focus the same way they could. Imagine what I could have done medicated. Wow.

 

[lilbitcrazy]

I have heard of Bupropion but I don't think it's widely aviailable in australia.

It's prescribed as Zyban here in Australia and is used to treat nicotine addiction, I got a private script for it @ 300mg XL after I had some good outcomes using it. Atomoxetine also worked well in the therapeutic range (80mg I think) but the s/e's were a bit daunting, the good thing is that Atomoxetine can be stopped without wind-down so I've added a low dose to my current regime and so far so good

 

[lilbitcrazy]

@arrall

think the main justification for OP taking it would be that it could likely reset his high stimulant tolerance from the meth

Just for clarity, OP asked initially about other stimulating medications -

My question is, having only tried Dexamphetamine for 2 months (and finding it really useful for my conditions, actually completely life changing) how does it compare to other prescription stimulants at a purely therapeutic dose?

I was addressing this question, OP didn't mention approved medications but I'll keep that in mind for any future correspondence.

Regarding Memantine these studies might be of some interest to you?

1. Add-on memantine to mood stabilizer works
2. A 10-Week Memantine Treatment in Bipolar Depression
3. Memantine: New prospective in bipolar disorder treatment

 

[arrall]

@arrall

Just for clarity, OP asked initially about other stimulating medications -


I was addressing this question, OP didn't mention approved medications but I'll keep that in mind for any future correspondence.

Regarding Memantine these studies might be of some interest to you?

1. Add-on memantine to mood stabilizer works
2. A 10-Week Memantine Treatment in Bipolar Depression
3. Memantine: New prospective in bipolar disorder treatment

My point was that Memantine doesn't really do anything for ADHD and evidence (such as what you linked) for treating bipolar disorder is quite weak.

I will look into those studies, thank you for sharing.

I saw that you did a trial of memantine on yourself that seemed to go well. You may be onto something combining it with the Wellbutrin. Axsome Therapeutics' combo of Wellbutrin + DXM is currently pending approval for depression and they're also studying it for dementia.

Have you noticed any improvements in your mood/work/cognition long-term since your post?

Also, I believe you said that you're still taking this with both bupropion and Strattera? If you are combining the latter two, please exercise extreme caution as combining two NRIs together is quite risky. Do you have a psych prescribing them both to you, is the Strattera from an old script, or are you obtaining one/both through another route?

 

[lilbitcrazy]

Have you noticed any improvements in your mood/work/cognition long-term since your post?

Yes, my mood is stable and my cognition is negatively impacted temporarily after dosing Memantine 10mg twice daily, however its only minor and recovers after an hour or so, then it’s almost over-compensating and my recall and soft skills are enhanced. I have noticed I enjoy interacting in more challenging situations as I have the resources to hand and can trust and rely on my memory, stability and communication skills which of course brings positive reinforcement.

Regarding taking 2 NRIs together, thank you for the warning - duly noted, saying that, the addition of Memantine changes the characteristics of Bupropion making it more of a DRI and less of an NRI due to the metabolizer inhibition, to what degree I don’t know? But the combination petered-out after about 8 hours or so hence the addition of Atomoxetine. Previously Bupropion on its own would last around 12 hours so I reasoned that it was due to the lessening effect of the NRI component? Frankly, it works well and I have researched thoroughly combining Bupropion with Atomoxetine in the past, the interplay between each increases the concentration of the other and I found it useful for a time.

 

[arrall]

Yes, my mood is stable and my cognition is negatively impacted temporarily after dosing Memantine 10mg twice daily, however its only minor and recovers after an hour or so, then it’s almost over-compensating and my recall and soft skills are enhanced. I have noticed I enjoy interacting in more challenging situations as I have the resources to hand and can trust and rely on my memory, stability and communication skills which of course brings positive reinforcement.

A bit odd that the dip only lasts an hour. Memantine doesn't even kick in that fast. Are you sure that it isn't placebo or due to another factor? I personally have the tendency to attribute any sort of 'off' feeling to drugs when looking for effects.

Previously Bupropion on its own would last around 12 hours so I reasoned that it was due to the lessening effect of the NRI component?

Bupropion (and without metabolic inhibition, its metabolites) should be accumulating in your system and lasting a lot longer than that. Are you taking IR/SR instead of XL? XL's effect time is about 24hrs and I found that I never noticed any sort of dip like with SR. It was also far better for my mood since SR seemed to trigger both hypomania and depression for me.

 

[Eligiu]

Ya'll talking some serious drug combination shit right here and I'm just here waiting for my Dexy script to be approved so that I can start hitting the chemist up twice a week for my twice weekly sustenance. I love the way that Dex makes me feel, but not the same as I feel when I take Klonopin. If I take 5 Klonopin, I want 50 more. THAT is moreish to me, taking Dexies 2-3 times a day is not.

 

[lilbitcrazy]

Bupropion (and without metabolic inhibition, its metabolites) should be accumulating in your system and lasting a lot longer than that. Are you taking IR/SR instead of XL? XL's effect time is about 24hrs and I found that I never noticed any sort of dip like with SR. It was also far better for my mood since SR seemed to trigger both hypomania and depression for me.

300mg XL, I initially tried 150mg SR (Zyban) and it worked well for about 4 hours or so then effects would diminish, I tried a generic version that made me irritable and edgy, like a mixed state hypomania as you describe but without the depression.

Prior to taking Memantime, Bupropion 300mg XL would definitely last longer and felt slightly more stimulating - it's most likely the Memantine NMDA antagonism that's at play?

 

[lilbitcrazy]

Ya'll talking some serious drug combination shit right here and I'm just here waiting for my Dexy script to be approved so that I can start hitting the chemist up twice a week for my twice weekly sustenance. I love the way that Dex makes me feel, but not the same as I feel when I take Klonopin. If I take 5 Klonopin, I want 50 more. THAT is moreish to me, taking Dexies 2-3 times a day is not.

d-amp was great, no question about it but it left me crashing and desiring more. Do you take both Klonopin and Valproate?

 

[Eligiu]

d-amp was great, no question about it but it left me crashing and desiring more. Do you take both Klonopin and Valproate?

No more Klonopin for me, I blacklisted myself. Shit is way too dangerous for me, I took 100 pills in a day once in Jan while on Suboxone and fucked myself for a whole week but was still driving. Literally the only drug where my morals go out the window and I drive under the influence so I'm making sure I have no access ever.

Currently I'm on

Valproate 500am 500pm
Lurasidone 120pm
Melatonin 6pm

Some other hormonal medications for my transition like testosterone and progesterone, and occasionally I'll use some propranolol to stop physical anxiety symptoms. And once my Dex prescription is sorted now that the authority has been approved I'll be back on that.

I don't find the crash particularly moreish because I actually use the crash to force a prescription nap (sleep specialist tells us to do that with narcolepsy) so it actually works in my favour. My general dosing is 5mg at 9am, 2.5/5mg (depending on if I'm driving or working or just going to an appointment or bumming around at home) at 1pm, having a nap at around 4-5pm for an hour, then either I'll skip the last dose or have 2.5mg at 6pm and be asleep by 10pm.

 

[Jabberwocky]

It’s probably worth mentioning that a combination therapy involving Bupropion and Naltrexone together has shown promising results in the treatment of methamphetamine addiction. It seems quite hard to get prescribed though.