withdrawl from caffiene + cigarettes + ativan while starting adderall xr

[scrut.hut]

I am currently prescribed 600mg seroquel + 2mg benztropine + 600mg lithium + 1000mg depakote + 3mg ativan ( 1mg three times a day ) I drink large amounts of caffeine ( three to four monsters ) and cigarettes ( one pack of reds ).

The doctor is starting me on a prescription of adderall xr 20mg twice a day; In the past I have been on adderall for years on similar dosages. At the same time I am working on discontinuing the ativan. I quit the monster cold turkey at the same time. I tried to quit cigarettes cold turkey with the patch at the same time too.

I do not think quitting ativan + caffeine + ciggs all at once while starting adderall is the greatest idea. I am 4 days into this change in my meds, and starting smoking cigarettes again today.

My question is simple. Is it a bad idea to quit all of these while adjusting back to adderall, because it really doesnt seem like a good idea to me at this point. Also would anyone know which would be the best to quit first?

Im guessing quitting the caffeine cold turkey, yet continue smoking cigarettes temporarily. My doc also said take one ativan at night and one in the morning, but it seems to me that instead of taking one in the morning I should just take one as needed ( during the day to combat anxiety from withdrawls ) along side the night dose. I plan on quitting the cigarettes in a week or two, and quit the day time dose of ativan next. this would leave me with only having to withdrawl off a 1mg ativan dose at night last.

Any ideas?

 

[nAON]

It does indeed sound like a bad idea. I'd try and taper them off individually, otherwise you're gonna have the negative effects from all of them just pile up.

I'd start off just getting off the caffeine first. The ativan, if you've been using it for more than a few months, you'll have to taper down off, so you could start lowering your doses already (not by a huge amount, just go down to 2.5mg from 3mg).

Not too sure about the cigs, though I know it's often advised to keep smoking if you're both a smoker and trying to quit drugs, as it's perhaps one of the hardest addictions to break in terms of compulsiveness. Work on getting off the cigs once you've managed to taper off the ativan and quit the caffeine.

 

[NeighborhoodThreat]

This is not a good idea. Caffeine and nicotine withdrawal while starting use of amphetamines, I could see that working. Caffeine and nicotine withdrawal while also withdrawling from a benzodiazepine and starting use of an amphetamine at the same time? No, I don't see that working well at all.

A better choice would be to taper down off that lorazepam (Ativan) with a longer acting benzo like diazepam (Valium) or clonazepam (Klonopin) while you start your Adderall therapy.

 

[scrut.hut]

thank you both very much for your responses, I knew it did not sound like a good idea.

 

[Alex000]

May I ask what all of these psych meds are rx'd for and how long you've been on them? Frankly I have bigger concerns than the caffeine, nicotine, and lorazepam.

 

[scrut.hut]

sure Alex000

My diagnosis' are severe bipolar, avoidant personality disorder, and a long history of attension deficit disorder. I am actually seeking out the amen clinic very soon to bring some light into what my actual diagnosis' are...

 

[scrut.hut]

has anyone else here have experience with seroquel, or other neuroleptics, combined with mood stabilizers and adderall

 

[Alex000]

You feel you need 600 mg Seroquel, 600 mg lithium, and 1,000 mg Depakote daily to stabilize your mood properly and avoid manic episodes? Let me say, I don't think adding amphetamines to all of these meds is going to make you feel better, especially 60 mg XR divided in two doses. I think it could make you feel much worse, and possibly trigger an episode of mania or more of a mixed state situation if you truly have a severe case of Bipolar Disorder, I assume Bipolar I. Tapering off benzos certainly wouldn't help with that, nor would cutting out nicotine or caffeine. My overall advice would be to cut down esp. on the neuroleptic, the Seroquel, for daily dosing and have a PRN neuroleptic if you feel a manic episode approaching. If you aren't experiencing any negative side-effects from the lithium, and your levels are within range I don't see too much of a problem with it, it is really effective in controlling manic-depression in certain individuals. It is, however, a rather toxic drug. The Depakote seems to be the least concerning out of the three, again though not the healthiest med. Cutting down on, or cutting the Seroquel completely would really allow you to focus better, and get more done. I doubt that, or the lithium or Depakote is helping the "ADHD" symptoms. Why are you wanting to get of benzos now, just curious?

Again, I severely advise against the amphetamines, like super-severely. I do not think they will help, I think they will be very detrimental to your mental health and condition. I understand "ADHD" symptoms can be troubling, but this won't solve it with all the other meds you're on, seriously. You are jacking your neurochemicals up! In addition to my advice on staying away from amphetamines, and cutting down on some of your other meds, I suggest starting or increasing your frequency and duration of psychotherapy. I know mania is awful, but the depression cannot be ignored because it is sometimes interrupted by manic episodes. An anti-depressant could be of help, but first you have to stabilize on a better med regimen.

 

[scrut.hut]

What if i tapered down to 200mg of seroquel, or at the minimum a PRN neuroleptic, while continuing depakote. The doctor might continue my ativan PRN. Would then adderall still be not a good idea? Would it be more reasonable to have no neuroleptics? I really cannot continue any schooling without treating my adhd somehow. Any ideas?

 

[Alex000]

What if i tapered down to 200mg of seroquel, or at the minimum a PRN neuroleptic, while continuing depakote. The doctor might continue my ativan PRN. Would then adderall still be not a good idea? Would it be more reasonable to have no neuroleptics? I really cannot continue any schooling without treating my adhd somehow. Any ideas?

Frankly, any amphetamines for you, someone who suffers from a "severe" case of Bipolar Disorder, could very easily trigger a manic episode. If you do choose to take amphetamines, I would suggest a lower daily dose of neuroleptics or no neuroleptics on a regular basis, and then you could take a neuroleptic + lorazepam for the amphetamine comedown. Your doctor rx'd a fucking high dose of amps for someone with no tolerance, and taking 30 mg Adderall XR 2 x daily will get you tweaked, not in a good way. Maybe like 15 mg Dexedrine Spansule once in the morning if you really need amphetamines. That would be smoother and more pleasant, and the dose is not too high. I don't advise prolonged daily use of amphetamines to anyone, though, as they are very neurotoxic.

There are non-amphetamine drugs which have proven to be efficacious in the treatment of "ADHD", even non-stimulants. One drug that comes to mind is Strattera, which is an NRI. Wellbutrin (regular or SR or XL) is another option, which acts on both norepinephrine and dopamine, however, this can be somewhat stimulating. Tricyclic anti-depressants could be really good for you esp. because of your depression and mania. They are toxic, and they do have a good deal of side-effects, but have anti-depressant properties as well as some properties which are rather like the properties of neuroleptics. They are not as dangerous, generally, as neuroleptics, though. Tricyclics can be really sedating, but that usually wears off some, and can prove to be stimulating. They are about as efficacious as SSRI's for depression.

Whatever you decide to take or not take, I do advise to taper down on the neuroleptics, seriously, it concerns me. 600 mg Seroquel is not unheard of at all, but it is a very high dose. I wouldn't really promote lithium like I said for reasons of potential risk and toxicity, but it can really helpful in manic-depression (Bipolar). Depakote is just another mood stabilizer and concerns me the least. Neuroleptics are great PRN's for those who need them, like those who suffer from manic episodes. A decent dose of a neuroleptic + a decent dose of a benzodiazepine, and you should abort the mania successfully, however, you might want to follow up with some dosing afterwards. I don't think neuroleptics are healthy drugs, but they can be GREAT for some people when they need them as I said.

Also, I absolutely advise more psychotherapy and personal therapeutic activities like art etc. These will help. Your "ADHD" and depression could very well be one, and your mania is well your mania, and you have avoidant personality disorder. I would try to focus on your symptoms with drug therpay and other types of therapy. Diagnoses and labels are overrated x 1,000,000.

 

[gman7104]

im not a doctor, but combining adderall and all those drugs seems like an idiotic thing. Seroquel does the opposite of adderall, first of all.