Meds Experiences Thread!!

My sibling tried a new ADHD med (atomoxetine) yesterday, and ended up face-down on their keyboard at 4 AM, mumbling to people in Discord about unicycles made of centipedes, a train of thought that was eventually derailed when they couldn't remember what part of a leg dogs were.

I don't think they'll be trying it again.

 

So it turns out that abruptly stopping your ADHD meds is a Bad Idea (who would have guessed!) and also that there's a specific bad reason to do that with Concerta and its relatives called "concerta crash" wherein it can cause depression and anxiety.

I mean, I knew that it'd make me tired and miserable. But - it is, it turns out, likely making my depression worse. And possibly making my executive dysfunction worse.

Symptoms of Concerta Crash: fatigue, irritability, difficulty focusing, difficulty sleeping, nightmares, depression, anxiety, headaches.

tl;dr: I'm a dumbass who brought this on myself by not actually looking up what would happen if I don't consistently take my ADHD meds when they started getting low. Mom's looking for the contact info for a clinic that'll take out-of-province patients without extra cost, so that we can get new prescriptions and everything else I need.

 

so far Duloxetine with a bit of risperidone has been helping the personality disorder/c-ptsd/anxiety/major depression hellbrain. the duloextine in a small dose wasn't enough and wasn't fixing the episodes of hysterical downs that'd keep hitting me. the risperidone, a low dose at night, reigned those into a different kind of control. up to 80mg of duloxtine was helping a lot as well. i just got bumped up to 100mg and start that the day after tomorrow, on doctors recommendation because of self harm urges continuing and because of physical stress from my daily situation.

i think that might finally be the sweet spot. no hysterical grade breakdowns but very very far from numb. in enough control of myself that i can feel something and feel bad thoughts and feelings, and.. actually be calm enough to sort through them and calm myself down before things get bad. It's not the high grade "Everything is awful forever!!!!!" screaming terror upset stuff, it's a tolerable level of stuff even if it's bad stuff. i honestly haven't felt this good mentally in years, and i'm looking forward to the higher dose easing into the sweet spot i need to make those episodes stop entirely.

side effects of these so far are... nothing really? i didn't notice any new issues. maybe a little bit of sleepiness at night from the risperidone, but it could be from another med i'm on at night. i WILL say tho that if you miss the risperidone be prepared to feel like the inside of your brain is chalkboard textured and slightly vibrating till u take it. duloxetine is fine if you're a bit late, and i've missed it once with no side effects. no zaps or anything, no overwhelming side effects. net good gain.

 

Update after over a year on Effexor-ER: it's pretty great! My various mucous membranes are a little dry, but other than that there are very little in the way of side effects, and I don't feel like shit unless my environment is so shitty that that's obviously Why, and even then, it's just normal shitty, and not so much depression shitty.

I have had some spells of reduced executive function, and also anxiety. I think part of that has to do with having my family as housemates being Not Great For Me. I sleep pretty well, except for pollen issues. The only weird thing is a really extended multi-night dream setting, but that could just be random.

 

so i take hydroxyzine pamoate (the capsule version) for sleep and as a PRN for anxiety attacks and this medication has had a shortage since AT LEAST JANUARY and my local pharmacy isn't gonna have any availalbe until July

while it does work, just be weary if any of you are being prescribed it currently (whether it be new or refills). i'm getting frustrated having to take obscene amounts of melatonin to be able to get to sleep within 3 hours and to get at least 5 hours of sleep every night

 

an update: my partner and I were able to find a pharmacy that has a 10 day supply, but it isn’t working for some odd reason so I’m worried that I was given the wrong medication

 

I started melatonin recently after I saw a random internet person say that if you have ADHD sleep patterns, you need to take it around sundown, not 30 minutes before bed as per package directions, and it seems like this actually worked (unlike previous times I've tried taking melatonin). I've managed to more or less knock my sleep cycle about an hour and a half earlier. The downside is it keeps giving me weird super-vivid dreams and most of my dreams suck.

 

Winner for the fact that it helps you sleep better, but witnessed for the shitty dreams!

 

I don’t know how much you’re taking, but often the doses on supplements are very, very large. (I’m not aware of any harmful effect associated with this that wouldn’t be solved by just not taking it in the future if it happens.) It can be possible to find much smaller doses if you really look, though you may have to investigate Walmart or some other superstore rather than the usual drugstores. I can’t find 100 mcg anymore, but I can find 300 mcg. If the dreams continue to plague you, maybe a smaller dose would be worth trying?

People can definitely get nightmares from disruption of their sleep cycle. Drugs that wear off during sleep can absolutely do this. I don’t know if melatonin is likely to wear off during sleep. I know light destroys it, but I don’t know if there are other metabolic systems that would cause it to exit your system while you’re still asleep? If this were to be a problem, and you don’t get nightmares if you manage to take it at bedtime to your knowledge, maybe taking part of the dose at sundown and the rest before bed could help prevent it from leaving too soon or suddenly, if that’s even a thing melatonin does?

Anyway, I’m glad you’re able to sleep.

 

I grabbed the smallest dose they had at the drugstore, which was 300 mcg. Might try cutting the pills in half at some point.

I definitely figured I should go for the low end, because I also had a vitamin supplement to buy while I was there, and one of the less extreme brands had 200x the minimum DV in one pill and wanted you to take two daily.

 

Yeah. That’s a really good idea. I’m unsure about how absorption is (pretty bad I understand) but the 100-300 mcg doses are way more in line with what you’d actually expect in the human body according to my psychiatrist. If you’re already getting effects and side effects, it’s probably an effective dose. Literally.

Unless there’s a score mark down the pill, it’s not guaranteed to be homogeneous. I’m frankly not sure if supplements abide by the score mark rule anyway, but in a prescription drug that means you can break the pill into pieces and be getting the expected fraction of the drug. Sometimes there’s no helping it even if it isn’t homogeneous, and you just have to make do. Such is life.

If you decided you wanted to pursue this but the supplements were making your life too hard and you have access to a doctor, there is a prescription drug that might be worth a try. Rozerem is a sleep aid that’s a very similar molecule to melatonin and acts on some of the receptors. I think it may be more selective. The biggest benefit is that, since it’s a prescription drug, it’s required to meet standards for prescription drugs, including reliable doses that aren’t weirdly huge.

 

I'm not too worried about it; my main concern is trying to kick my internal clock a bit earlier because I can get a little SAD-y in the winter and I don't like walking home from work in the dark, and the dreams are mostly a weird annoyance. I just brought it to this thread because it seemed like a potentially useful bit of weird anecdata.

 

Anyone ever taken suvorexant before? My new doc is prescribing me a 10 day sample and I was wondering if anyone else has taken it (for insomnia)

Edit: I was also wondering if anyone had any negative/positive/notable experiences on suvorexant

 

I was just showing up to discuss suvorexant/Belsomra! So I know two other people who have tried it for idiopathic hypersomnia I think? Which overlaps with what the average person would call insomnia a surprising amount. It didn’t work well for either of them. Made them both feel weird and bad.

For me it’s been amazing. Unfortunately the FDA did something extremely boneheaded with it. 20 mg is apparently the smallest dose where it shows a significant difference from placebo. It’s also I think the lowest dose they have trial data for with side effects and stuff? (This is all second hand information so I hope I’m remembering correctly.) That’s fucked up because a fair number of medications have a higher incidence of side effects at low and high doses compared to medium doses. But the FDA decided that 20 mg should be the highest dose and that 10 mg and 5 mg doses should also be available. Apparently this means it’s possible they’re causing patients to be prescribed ineffective doses that nonetheless have unusually bad side effects, but we just don’t know.

It didn’t really work for me until I misunderstood my doctor’s instructions and took two 20 mg pills when one was okay but not really sufficient. Suddenly I realized for the first time in my life that people wanted to go to bed when they were tired because they got drowsy. It was amazing. But 40 mg is twice the maximum FDA-dictated dose. That doesn’t mean a doctor can’t prescribe it. They darn well can, but getting insurance to pay for this very expensive medication is pretty much impossible at that dose.

Fast forward a few years, past a variety of trials of different med combos to try to make 20 mg of Belsomra work. I got fed up. My doctor did some research and discovered the FDA fuckery. We managed to cobble together manufacturer coupon deals (absolutely look for coupons on their site if you take this med!!!), partial insurance coverage, and individual pharmacy deals to at least afford for me to try a 40 mg dose.

I’m gonna post my phone’s attempts to record my sleep since August. The numbers are totally wrong. I do not get this little sleep per night by any means. Any given night might be really incorrect. But try to ignore that and look at the pattern.

Spoiler

Even if it’s pretty wonky at telling when I go to bed (and to a lesser extent when I wake up), it’s definitely not totally off base. The thing that changed was 40 mg of Belsomra. It fucking works. It’s not a miracle but it feels like one.

Belsomra is an orexin antagonist. Orexin is a neurotransmitter that promotes appetite and wakefulness. An antagonist suppresses wakefulness. (I haven’t noticed any particular appetite effects; it may be targeted, dunno.) Sleepiness and wakefulness aren’t two sides of the same coin, they’re competing states. If I’m not at all inclined to be sleepy, Belsomra can’t make me sleepy. It can only prevent excessive wakefulness from overpowering sleepiness.

Most sleep meds attempt to promote sleepiness and do nothing about wakefulness. The best one for you really depends on what your specific problem is, I’d imagine. My problem is apparently a fucked orexin system.

Thanks, Belsomra.

 

@Verily the message was a tad long to quote on mobile, but I'd like to give you my biggest thanks and appreciation for your super detailed reply about Belsomra! reading about your experiences on the medication was super helpful, and the intricate details you put into your reply as well as the history of Belsomra and the FDA were also super super appreciated!! if this forum had the equivalent of a reddit gold I'd definitely give it to you now

I've now taken 4 doses of it total (15mg) and honestly? it's the fastest I've ever fallen asleep. first two doses I slept 5 and 6 hours but the next two doses had me sleep 7 hours to the minute I took the med the night before. though the first night I slept like a rock.

after my 5-year-old combo of 50mg hydroxyzine pamoate + ever increasing melatonin stopped working in July, I was worried about what I could possibly do to actually sleep. this seems to have done the trick for me.

edit: changed some wording up. jet lag's hitting harder than expected

 

Has anyone else just had citalopram (Cylexa) shit the bed on them when taking it for anxiety

 

citalopram made my anxiety way, way worse. i only stayed on it for... less than 6 months, maybe more like 4... but it was really bad.

 

dr wrote me a scrip for Atomoxetine today. after a year of begging for adhd help, and him finally relenting after saying the magic words "i'm getting in trouble at work because of my performance; directly tied to my inability to focus". he has wanted me to do neurology testing to make sure i have adhd before giving up the addictive stimulants which is perfectly fine tbh

however it's stupidly expensive even with my insurance and idk if i can afford it long term if it might not help much. does anyone have experience with Atomoxetine personally?

 

I gotta be honest, I've been on 60mg of atomoxetine for nearly a year now and it's done...possibly nothing? I thought maybe it was one of those meds that took a while to kick in, so I kept taking it, but now that I'm this far in I have no idea what I'm taking it for. But then it's like, I've been taking it for so long that I don't remember what I was like before I started, so maybe I was even worse at concentrating before. I mean, I do get some work done. But it's still such a struggle to make myself start working, and I haven't yet figured out how to defeat my greatest foe, procrastinapping.

I took a stimulant for the first time in years recently (not even a prescription stimulant, just a little caffeine) and it was amazing how big of a difference it made. I really felt motivated to do things, and not just lay around spacing out. It's a shame that I can't stay in that mode for long without it bubbling over into paralyzing anxiety. :'/

 

the stimulants aren't addictive though?? I mean maybe in much higher quantities than what you get prescribed for ADHD, but I've been on and off of both concerta and adderall for years and never had anything like withdrawal. you build up a mild tolerance I guess, but like. nothing even close to actual addiction. the only reason ADHD stimulants are restricted substances is because people like to sell them.

when it comes to nonstimulants, the only one I've been on was strattera and it helped a little but the nausea side effect was bad enough I eventually went back to the stimulants.

oh yeah also I'm curious what kind of neurology testing he wants to do. I only ever got a quiz assessment thing - similar to the self-diagnosis ones you can find online but standardized, and then the psych went over it with me to clarify anything he wanted to know. has your doc given you anything similar? is he a psych, or a general practitioner? if he's not an actual psychiatrist, it may be worth asking for a referral - just make sure you don't get referred to someone who primarily deals with ADHD in children, because they aren't always good at diagnosing adults ime.

edit: the first result when you google "neurology testing for adhd" is an article about diagnosing adhd which says that neurology testing isn't necessary for diagnosis, it can just help rule out other possibilities. it's just one article, but still.