dexamphetamine for depression?

does anyone have any info on this? or could point me in the right direction?

my pdoc wants me to try this, to help with my energy. he keeps asking me if i've had a chance to read up on it yet and make up my mind. i'm easy to try it, but he really sounds like he won't give it to me until i've done a bit of research (bless).

so does anyone know where i can start looking? i'm at a bit of a loss because i don't think it's called the same in the states, and all the info in australia seems to be on its use in ADHD.

This would be an extremely unusual prescription for depression, & it's use is not permitted in Australia for this purpose, so we aren't quite sure how your doc is thinking.

The only way to get permits for this (& then it is ritalin , not dexamphetamine) is for ADHD.

Personally, we wouldn't touch it with a bargepole for depression & unless your doc is running a research program we can't see where he would get it, as it has been a banned drug (well hospitals only) in Australia since the early 1970s

It will not help depression, we will look for links for you, don't do it

Deliquesce,

Wow, this drug sounds powerful, almost like a narcotic street drug. EEK! It's actually like a sister to meth! I'm not sure I would take it, no wonder your doc wants you to research it first. Anyhoo, here's a place to start looking and I've copied a bit of the info for you below, so you can make your own decision.

Clinical

• Approved for the treatment of ADHD and Narcolepsy.[22]
• Treatment for depression and weight-loss may be prescribed in rare treatment-resistant cases.[23] [24]
• In all clinical treatment scenarios, the dose of dextroamphetamine should be increased gradually from/by 2.5-5 mg/day every three days-week in order to help prevent abuse by minimizing the initial euphoria and effectively estimate the minimal dose required for each individual in treatment of the relevant condition.[25]

http://en.wikipedia.org/wiki/Dextroamphetamine

http://dexedrine.net/

Love and Hugs,
Tara

thanks so much for your input, zorah and tarabug .

zorah - yeah, i think my dr might be fudging it a bit, to get me the script. he's explained that it can be used for treatment resistant depression, and that he's prepared to do whatever it takes if it might help me out a bit. sometimes when i get depressed, i'll just sleep for 14-16hrs, wake up, have dinner, go back to sleep. it's that kind of leaden paralysis that my doc thinks dex might be useful for.

i've gone through all the classes of antidepressants out there (excepting TCAs and parnate - because of the dietary restrictions), all mood stabilisers, all newer class antipsychotics. so, with the exception of ECT, i don't think there's much else out there to try. if i could just get something to help with my energy, it'd just help immensely. it scares me to think i'm just accepting this because i am desperate, though.

tarabug - thanks for those links, they're very helpful. i might hit up some medical journals and see what the story is in there. both of your responses have been helpful in making me think twice about this. so thank you .

edit: ok, the other thing i'll need to consider is that it doesn't stuff up my weight. i'm at that point where losing any more will not be good for me. also - have read that it's efficacy is decreased when used in conjunction with lithium... so there might not be any point in starting this at all.

Dextroamphetamine is a stimulant, and stimulants are very effective in helping with depression, although not usually prescribed for that purpose due to the potential for abuse. In the U.S., these stimulants are on the controlled schedule list, which means extra precautions must be taken when prescribing (no more than a 30 day supply, must see the prescriber each time for a new RX, cannot have the RX phoned in to the pharmacy, RX expires 3 days after it is signed by the doc, etc.). Stimulants like dextroamphetamine work by increasing dopamine and norephinephrine in your system. These are both neurotransmitters, and more of each can help with depression. Some anti-depressants help by raising these NTs also. For example, the AD Bupropion (Wellbutrin) also increases the levels of these two NTs, by blocking reuptake of each from the synapse back into the releasing neuron. Dextroamphetamine also blocks reuptake of these NTs but also leads to increased release into the synapse, so you get a one-two punch with this drug, instead of the more limited "one" punch of a more conventional AD such as Bupropion. So bottom line, yes, this med can help with depression.

This medication should not be prescribed to anyone for any indication (including ADHD) if the person is known to have had drug addiction/abuse problems.

There are new formulations of the drug that are not prone to abuse (and resale) because of how they are formulated, for example, Vyvanse.

I have ADHD-like symptoms and my PNP originally prescribed me Bupropion because it can help with ADHD and also helps with depression, which she thought I also had some symptoms of. This helped somewhat. To get further relief from the ADHD symptoms, she added Vyvanse to that (a dextroamphetamine), and that really helped my ADHD-like symptoms as well as depressive symptoms. I decreased the Bupropion dose and am still taking some of that as well as the Vyvanse. PNP said I could give up the Bupropion if I wanted, as the Vyvanse is probably enough to handle both my ADHD and my depression. She said amphetamines are very effective at relieving depression symptoms.

I have been taking Vyvanse for about 6 months and have experienced no bad side effects, except the first few days, when I had some insomnia. I am not addicted nor have I developed tolerance (need more of the drug to achieve the same effect). Sometimes I don't take it if I don't feel I need it or if I forget to take it until too late in the day, then I just skip it (because it would keep me awake).

Vyvanse is ingested in a chemically inactive form and slowly metabolized to the active form. There is no "buzz" or "jolt" or "high" associated with taking it. It is very smooth, gradually increasing in one's body over the day and decreasing. One dose in the AM lasts me until bedtime. If I don't take it, I don't have any bad effects like shakes or headaches or cravings. I have no history of addiction or illicit drug use and have great respect for the power of pharmaceuticals. I would not take this drug unless I had researched it thoroughly.

I really appreciate that my PNP didn't try to prescribe me an SSRI like so many doctors. I don't appear to have a lack of serotonin and so have no need for ADs like Prozac, Lexapro, Paxil, etc. I seem to do well with more dopamine in my system.

If you have tried many meds with no success (treatment resistant depression), then I think giving a stimulant a try is worth it, unless you are addiction-prone or have some other medical problem that isn't compatible with stimulant use (such as heart trouble).

I would not be scared of this. It could really help. If it doesn't, then you can just stop taking it. Keep in close touch with your doc when first starting it, just to make sure you are doing OK. It does not generally cause weight gain, but can lower appetite in some people and lead to weight loss. If you are already underweight, keep a watchful eye if you start this med.

BTW, I am also in psychotherapy, and this is helpful with depression too.

Good luck!

Vyvanse:
http://en.wikipedia.org/wiki/Vyvanse

I have been on Dexedrine (Dextroamphetamine) for over a year. My pdoc started me on it because of my severe treatment resistant depression. It is a last hope medication for some people.

After being on it for a bit, my pdoc realized that part of my problems were because of ADD. The Dexedrine slows my brain down so I am able to stay focused on one thought or one task. It helped with my depression because I was able to get caught up at work and started feeling better about myself.

Yes, it is a last resort but it has worked out well for me.

oh god, sunrise. thank you so much for typing all of that out for me. it's just in my language, i could understand that. thank you so, so, so much.

also, thank you both sunrise & depressme for sharing your experience with it. it helps to know that it's been helpful to at least a few people - and like it's been pointed out earlier, if it doesn't work for me, i can just stop.

i know i'm not the worst-case-depressive out there, but certainly i haven't come across anyone else in my circle of life (small as it may be) that has been on so many ADs/pharmy combinations and not had it work for them. so it's reassuring that there are other people who have tried this before me, because if anything, i feel a bit alone in this.

i will do a heap of reading over the weekend so i can give informed consent on monday when i see pdoc next.

Good luck, deliquesce. I am glad to see you taking the informed consent so seriously. I think a better informed patient leads to better success in treatment in all areas of medicine. I will be curious to hear back after you talk to pdoc and wonder whether he will suggest Vyvanse since it is engineered to reduce the abuse potential. Vyvanse is fairly new and so, at least in the U.S., is not yet available in generics, so it's kind of pricy. I don't know how the patent and generics thing works in Australia. Vyvanse costs me $35/month with insurance. Without insurance, it would cost about $150! In contrast, generic Wellbutrin (Bupropion) costs me $5/month.

Agreeing with some of the other posters...

I have bipolar II with depression/somnolence/lethargy that has been extremely difficult to treat. For my particular situation, Vyvanse is a fantastic drug. It gets me functional and coherent.

It's true that people with drug dependence issues should be wary of the stimulants as they can be addictive. Personally, I have been taking Vyvanse a long time, and I don't experience withdrawal if I don't take it. I just have a recurrence of the original symptoms I take it for, no worse than before.

The only thing I don't like about stimulants is that they really seem to burn up your energy while they're working, then leave you exhausted once they've worn off. Extended-release formulations such as Vyvanse and Adderall XR can help offset that problem.

Good luck!

thanks guys. i'll report back and let you know which version my pdocs prescribes - i dont think he'll give me vyvanse - i'm not even sure it's available yet in australia (we tend to be a few years behind you guys).

Hi there,

I've been on & off dex for 17 years (doctor started me on them at the ripe old age of 12)

To answer your questions - yes and no. It certainly makes you feel happier, motivated and generally enthusiastic, but what goes up must come down & when you come down from dex, it hurts (for me anyway).

I was a happy, social child but quickly transformed into a total mess by my teens. I have life together now, though still struggle from time to time. Dex keep me trim and happy for short periods - also help me with studies and motivation at work. So, little difficult to completely boot, but getting there.

The most balanced I've ever been was during my mid 20's, 4 years of my life where I completely stopped taking meds and started jogging. Try it! Jogging combined with a healthy, fresh diet will make the world of difference - mentally and physically.

Good luck, A

Hello!
I can give you a lot of information regarding the use of dextroamphetamine for those with depression.

Dexedrine (dextroamphetamine) comes in an IR (immediate release) forum or an XR (extended released) form. The IR pills only last 2-4 hours while the XR capsules last anywhere from 4-8 hours. It is also a generic.

Stimulants - in this case an amphetamine - have been used for decades for those with depression and are used now for people who have certain types of depression including treatment-resistant depression, melancholic depression or just a very dysphoric stubborn depression where the person has severe fatigue and very low motivation. They can help augment antidepressants very well - especially SSRIs that cause emotional flattening and fatigue. Many psychiatrists commonly use stimulants in combination with other antidepressants and for many it's a life saver.

How do amphetamines work in the brain? Well, they "make" the neurons release norepinephrine and dopamine - two activating neurotransmitters. They also block re-uptake of these as well (although somewhat weakly). So basically the synapse between your neurons is occupied with more of these stimulating neurotransmitters which then activate more sites on the adjacent neuron. You might have heard on TV or from another source about people who are addicted to certain drugs experiencing a "crash" after the drug wears off. Well, this also happens with prescription stimulants like dextroamphetamine. Why? Because of how it works: it forces your brain to release its storage of NE (norepinephrine) and DE (dopamine) and in doing so the brain has to make more to keep up - supply & demand - and it doesn't always catch up. So, many people feel a crash as their last dose wears off - feeling very tired, mood is kind of "blah" etc. However, the intensity of the crash depends on how much you're taking and if it's the IR or XR version - the XR version being the better option because it slowly releases the med into your body and doesn't drop off sharply like the IR form does.

Side Effects: insomnia, appetite loss, weight loss, nervousness, diarrhea and rapid heart beat.

Cost: If your insurance won't cover it- which many do not unless you are diagnosed with ADD/ADHD or Narcolepsy, you can count on paying around $20-40/mo for 60 pills.

I hope this has helped some. If you have any other specific questions please feel free to ask!

Jerry