Please read if you have treatment resistant depression!

Hiya all,

So I'm 30 and have struggled with depression since I was 10. Used to sit in the sand pit at school and write, "I want to die". Needless to say I have tried many many meds and most didn't work. A little over three years ago I had a psychotic break and was put on a combination that worked for that three year period. Problem was I started having hand tremors after year one. I also started slurring my speech (I didn't know that until after I stopped taking it and people started commenting on how I wasn't slurring my speech anymore). When people at work started mocking me for shaking I quit my meds cold turkey. Then about a month later (after a great month) I went back on Celexa at the request of my pdoc. Another month later she wanted me on Wellbutrin XL to give me an energy boost so I wouldn't be sleeping 13 hours a day! Well, I started the Wellbutrin XL on a Friday and by Sunday was actively suicidal. Anyhow, fast forward to the second hospital stay in 22 days. I saw the psychiatrist who is a psycho-pharmacologist. He's done research, worked for drug companies and really knows his meds. He started me on Adderall, which is approved for treatment resistant depression. Bear in mind that I'm not ADD or ADHD so instead of slowing my mind, it speeds it up.

So I just wanted to tell you all that the Adderall has helped in combination with a small dose of Lexapro and even smaller dose of Abilify. I don't think many pdoc's would think of this med for treatment resistant depression.

And I'm telling you, this crisis was scary for me because the docs (at both hospitals I was in) started talking to me of ECT!

Anyhow, let me know what you think. AND, don't stop your meds and try to get Adderall just because it works for me. It may or may not work for you, but if you're struggling and looking for something new to try for your depression, this may help.

Love and Hugs,
Tara

Boy, you've had a hell of a time.

I hadn't heard of using adderall to treat depression. I can't say I'm real suprised; after all it is a stimulant, no? I don't think it would work too well for me as I have a very difficult time "turning off". Atypical antipsychotics seem to work pretty well for me, but I can't afford any of them, so I'm stuck with the cheaper AD's.

It's wonderful that you found something that works well for you. I hope I can find something myself soon.

Congratulations on finding medication that is working well for you. That must feel great.

My understanding is that it is not uncommon to use stimulants to augment antidepressants. Both my previous and current psychiatrists use them, especially when the patient is getting some benefit from their meds but are still low on energy. I find a low dose of focalin helpful. And the nice thing is that you know pretty quickly if it's going to help.

I have had a hard time treating my depression, and my pdoc started me on Ritalin a few months ago. For those of you who do not know it is basicallly the same as Adderall. It's a stimiulant and is usuallly prescribed for ADD. I have not had a depressive episode since going on it. I really feel good!

Coco, Tara, I'm just this week put on Ritalin with much the same history, treatment resistant depression very severe.

It seems to be doing something but I'm still very depressed. Now I'm just more alert while I'm having the big debate with myself.

I'm going to send pm's to both of you. All the best.

Hi Tara,

Hearing that you are feeling a bit better makes me feel deeply happy.

Last summer when I was in a depressive episode, my pdoc considered putting me on a stimulant, but couldn't because I was tachychardic at the time and my ECG results showed abnormalities (Both turned out to be side effects of another med I was on that I've since discontinued.)

Instead we increased my Antipsychotic. And that worked, but after 4 months at the higher dose, I started experiencing extrapyramidal side effects and had to go back to a lower dose. But I've been depression free since, despite having a lot of major stressors in my life.

splitimage

im so pleased you have found something that works. after having suffered since being a small child. long may it continue!!!!!!!!

Thats so nice to have found something that works! Im goin to throw the idea out there to my pdoc next time. It would be so nice to have energy again too! My pdoc just keeps increasing antidepressant saying ill get my energy back but to no avail.

Thanks for putting that out there!

I was thought to have treatment resistant depression, was put on a lot of different stimulants and they all caused an increase of racing thoughts. Then they found out I was schizophrenic, instead. If you have a hint of a clue of schizophrenia, don't do it. It triggers psychosis because it increases dopamine, and dopamine is the chemical produced so high for schizophrenics.

Hi Vanessa, Watch how you approach your pdoc with the idea. I asked my pdoc last year, and she thought I was out of my mind. Then all of the sudden this year, when it was her idea, it was a different story. I think some docs think you may be drug seeking the stimulants. Just an FYI.

cocos421- thx for the heads up. I was kinda thinking that but he seems pretty chill, so yesterday i hinted around that to see if he would pick it up, but he shut me down....lol

Ill give it a couple more weeks and if no improvment, ill just be like....well i read on this forum it worked for a few ppl and see what he says!

Tara, I have read your entry and it reads like I wrote it myself. I am currently on Celexa & Wellbutrin and have been for a while. I have tried just about everything available over several years, including ECT, and I feel just as bad as ever. A few years back, I was prescribed Ritalin and it did elevate my mood, but I was taking five a day and it raised my blood pressure among other things. I took the Ritalin with various AD's over at least a 10 year period, but it was taking a toll on me for sure. I am printing your entry and I will take it with me when I vist a new Psyc in a week or so. Thank you for sharing your experience. You may have helped many others that have read your post. Take care of yourself.
All the best,
Jerry

Hi, Glad you found a solution that works for you
I've been on several antidepressants with no effect, and like you, the one I'm on now which appears to be working somewhat, is causing tremors... I've done a lot of research online and heard about ADHD meds/stimulants - and while this to me seems like a great idea as I'd have more energy and could also lose weight, I doubt they'd be suitable for me as I have anxiety and panic attacks... Anxiety and depression are a bad mix as for depression they want to speed you up and for anxiety they want to slow you down - what then?! I've recently been prescribed beta blockers, so i'm hoping that they, with my antidepressant, will have the desired results. I too fear that I'll get to the point where they'll be talking about ECT...

just an FYI, I was gonna wait a few sessions to ask for stimulant, but yesterday when i went, based on my symptoms, he suggested Adderral. I couldnt believe it!
So....we'll see how this goes-esp w/ my depressed state im currently in!

My pdoc put me on Dexedrine for depression and ADD. It works great. And I say that after being on every med under the sun. None of the meds or med combos works as great as the Dexedrine.

That's good. I hope it works out for you. Funny how our doctors change their minds like that. I think mine just forgets a lot of what I tell her. I want an increase in Ritalin, but I'll let her make the call. That's what I did last time. Instead of asking for it, and getting turned down, I told her how I was feeling and she said OK, we'll increase Ritalin. I think they like to call the shots to feel important or something.

How do you know if you really have treatment resistant depression? I mean, I assume you've tried several meds and nothing helps? Are you also in therapy? Exercise? Work?

I see a T once a week and a pdoc. I'm currently on 200mg zoloft, 60mg buspar & 600mg lithium and I don't feel like it helps at all. My concern is weight gain. I refuse to keep messing with meds and potentially gain weight. My T has asked if I've ever tried abilify or cymalta, but again the weight gain. When I first started seeing my pdoc I wasn't sleeping and he gave me ambien. Now I'm in a depressive state and he immediately thought bipolar, which is why I went to him because my T thought I could be bp2.
He asks me if I exercise and I do. I run, just did my first 5k and have another coming up. Then he asks if I'm running too much, or if I'm training for a marathon. Nope. I just crash! My T thinks it could be treatment resistant depression. I've been mostly on meds for 10yrs. Only off during pregnancies and a couple months after each baby. Pdoc doesn't say much just wants me to keep trying to find something that works.

What symptoms did you have that lead your pdoc to prescribe adderell/ritalin?

My pdoc says i have tx resistant bipolar depression because pretty much ive tried all ssri's, and pristiq, and many others to no effect. This has been over a course of 10 yrs.

He now is trying an MAOI antidepressant, but still no improvment as of yet (im on highest dose od 12mg emsam patch)

He sees my depression is rapidly going downhill and is now talking about ECT but wanted to try a atimulant first.

He did give me adderral but unfort. It was WAY too high of a dose and i pretty much felt like i was strung out. I did notice a more positive attitude tho but way too chatty and too much restlessness as the dose was too high for me.

1 thing my pdoc said: 1st time he gave it to me i was to call on 3 hrs to check in on my mood on it. He knew i was having si ideations and wanted the adderral to lift my mood, not give me the enegy to go out and do something stupid.

Hopefully this info can be somewhat of help to you

Good Luck

Another thing I have seen mentioned though I can't remember where is the magnetic treatment. Yesterday my doc hinted at using it before ECT. He also described a new med which is a partial serotonin re-uptake inhibitor which seems to be more effective for some individuals who don't respond well on the normal meds. these may be worth looking into for some of us.

I am on Viibryd, which is a new antidepressant, don't know if it's the one your doc was talking about or not. It was FDA approved in January and released mid-june. I have been on it since then and was thinking it wasn't really working, but then ended up off of it for a few days, and ended up figuring out that it's working, at least somewhat

Yes, I have a close friend who has had a lot of success with TMS (for resistant depression). I hope the get it sorted out with the insurance companies soon.

Since 2006, when a young substitute pdoc tried augmenting my treatment with Ritalin, it seems to be becoming a more common practice. It turned around my depression. I've had changes since then - after losing insurance and thus losing my meds in 2008, quitting them cold-turkey only to end up in crisis before the year was over, I looked back on the time I was on Ritalin with Seroquel and Cymbalta and recognized mild manic symptoms. My meds were changed to Concerta, Celexa and Wellbutrin, which never really felt like it was doing as much as it could, and after a semi-crisis two months ago the dosages were increased and Abilify added, which feels more effective. Now I feel like my depression isn't chemical but caused by isolation and stressors. One of which being it appears I've lost Medicaid and this med combination costs almost $1200/month, which is more than I make...

I also have had a real struggle with treatment resistant depression. I've been on a slew of antidepressants and other class drugs since a young age with not great results. On a few occasions my pdoc has thrown stimulants into the mix I had tried several including adderal, vivance, concerta and dexedrine. With some benefit from the vivance, but not great, and quite a mood elevation from the dexedrine-but tachycardia so I had to go off it. Now just a couple days ago I tried Focalin XR in addition to my usual high dose Lexapro, with really good results. My mood went from waaaay low to, well, pretty darn good . I'm dealing with some issues though (insomnia, no appetite, possibly metabolizing it oddly) so my pdoc has suggested I fiddle with the dosing using Focalin IR tablets. But right now I'm actually getting hopeful for the first time in almost two years!