Today is day 4 of Adderall XR, 20 mg in AM. I was also started on 20 mg of Prozac to help w anxiety. I have taken the equivalent dose of Adderall regular release in the past, and NEVER felt like this!! My heart is racing and it feels as iff it's skipping one or two beats a minute. I can't believe this is going to take another 5 hrs to wear off!
Is there something different in the XR that is not in regular Adderall, or could it be the combination of the XR w/ the Prozac (it's only day 4 of this, too, so it's hardly therapeutic yet). Has anyone else ever experienced this when switching from reg to XR??
I'm quite frankly a little scared right now, so if anyone has had a similar experience, please let me know! Oh, yeah, I'm also at work right now so I don't have time to search through the old messages to see if this has already been addressed. I'm very sorry if this is an old subject!!
Thanks!
WW
Just to let all of you know- I went back to my doc yesterday and it seems as if the reaction I had was a result of the combined stimulant effect of the adderall (XR or otherwise) with the prozac starting at the same time. Seems as though he mistakenly wrote for 20 mg XR when he meant to write for 10mg XR (his notes said he prescribed 10 mg but I have the bottle and the pharmacy has the script that say 20mg). I have been off the prozac since saturday (only took three days of it) and finally today I was able to take the adderall with no bad effects.
The take home lesson for me is to never, ever start more than one new med at a time! I'm just glad that I'm young and healthy enough to have avoided serious consequences, because there were a few times I really thought I might have a heart attack. It makes me wonder about the cases of "sudden death" of kids taking the XR- like what else they were taking that would have generally been considered safe to combine w/ the adderall. I wonder how many of them weren't really all that "sudden" but resulted from the kid not knowing or being able to communicate how they were feeling on their meds.
Anyway- thanks to those of you who responded to help me. Leigh and Smallmom- I hope things with your children go well!
Wonder Woman,WonderWoman,
Oh my gosh, how frightening! I'm glad you're okay.
WonderWoman:
I'm so glad you got everything straightened out. I know doctors are human and can make mistakes, but it's scary!
Our pediatrician has drilled the one change at a time rule into my head. Whenever we introduce a new med or new discipline technique or even a new food, we make one change at a time. If something goes right, you know what made the difference. And if something goes wrong, you know what to blame. Good sound advice.
The only difference is that XR is extended release. Wonder Woman, I MAY be able to help. Not sure. My son, who is nine, was on regular Adderall for a long time. The doctor decided to finally treat him for his anxiety with Prozac. At the SAME time, my son was switched to the XR version of Adderall (same dose). The teachers reported "extreme hyperactivity." One said, "This is not the same boy." The doctor (a psychiatrist who specializes in ADHD) AND a therapist we see BOTH said that his reaction was to the Prozac. It's unusual, but it does seem to happen. I wouldn't rule out a reaction to Adderall XR, but given how similar your history is to my son's, I felt compelled to tell you what our doctor said. I'd definitely call the doctor, though, just to make sure.Thanks, Leigh,
I kind of decided the same thing, since I know that I have never reacted like that to Adderall in the past. I stopped taking the prozac and have noticed a distinct difference over the past two days. I've also decided that I don't really like the Adderall XR form very much. I imagined that it would be smoother and more subtle than the regular, but instead I'm finding that there are two very intense "release phases" , and the drop off as it wears off has given me a headache every day since day 2.
I'm definitely going to call my doctor tomorrow and see about changing meds. If youdon't mind my asking, what did you end up doing about the prozac? Were you able to find another med that worked or did you take it out of the equation altogether?
Thanks! WW
Just wanted you to know . . .
My 12-year-old son (dx with ADHD and anxiety) has taken and stopped various stimulants over the last two years, including Concerta (facial tics), Strattera (migraines) and Adderall (worse facial tics). He is now on Focalin, and doing a lot better (when he agrees to take it, but that's another story).
He took Prozac for one day two weeks ago and had a rage reaction -- throwing books, sliding a 500-piece puzzle to the floor, breaking a window. My husband had to take him outside to the driveway until he calmed down. This is not a violent child. Needless to say, he will never take Prozac again as long as I'm around.
Hope that helps!
I've always been prescribed the maximum dosages for as long as i can remember, starting with ritalin, then ritalin sr, then adderall, then adderall xr, then concerta (54mg) with a 5mg dose of focalin. I prefer to take the concerta only when necessary and instead rely on the focalin, which does the job with minimal problems. The XR gave me some bad rebounds, which is why I don't recommend it, though it works differently for different people.
Wonder Woman,
We stopped Prozac after about four weeks. I should have stopped it sooner, but was encouraged to continue until the four-week-med-checkup. It was a tough four weeks for my son's teachers, I can tell you that. At home, he was hyper as well. Anyway, what I may not have mentioned ( I know I mentioned this in another post somewhere) is that there is a questions as to whether or not my son is bipolar. It has not been diagnosed, but the fact that he has had a heck of a hard time on stimulants AND reacted to Prozac with extreme hyperactivity is a red flag for us. I'm not happy at all to know that. And I'm not convinced it's bipolar after a year of research and finding out from various parents in my circle of friends that "bipolar" has been the latest thing to diagnose kids with. Still, it could be what we're dealing with. Anyway, so my son is now on Depakote (a mood stabilizer) along with the Adderall XR. It can take over a month to see a difference, and I've yet to notice a thing (we're starting week four).
Small Mom , that must have been FRIGHTENING! By the way, I'd be curious to know if the Focalin causes facial tics because I was told it's in the same family as Concerta and Ritalin. That's why the psychiatrist my son sees said it wouldn't be a good option and would very likely cause tics, too.
Leigh:
I can't tell you how shaken I was by my son's reaction to Prozac. And my son was so spooked that he is reluctant at this point to try any new medication. We are taking a medication vacation and will go to a new doctor in July to see if we can find the right combination of meds for his ADHD and anxiety. Right now he is taking nothing for anxiety. In addition to Prozac, he tried Celexa, which made him so tired and apathetic that he couldn't get any homework done. Our current psychiatrist has suggested Wellbutrin, but we think we'll wait for the new doctor before we try anything else.
In terms of facial tics, my son started getting a mouth grimace about a year and half after beginning Concerta, which we were told is unusual, but it was right after the dose was raised from 27 mg to 36 mg. When my son stopped taking Concerta in February, the tics decreased but did not totally disappear (you do have to watch pretty carefully for them, however). When he tried Adderall in April, the tics were so bad that kids at school were asking my son what was wrong with his face. (In good humor, he told them he had chapped lips!) Again, the tics decreased significantly when the Adderall was stopped. In my son's case, Focalin does not significantly affect his facial tics. He has been taking Focalin sporadically over the last few months (with an increase two weeks ago from 2.5 mg to 5 mg twice a day -- refuses to go to the school nurse for a midday dose), and we see a mild tic with or without medication but no increase in tic activity while on Focalin. In fact, we went to see his neurologist Friday for migraine management, and she said she thought Focalin was a good choice for someone with tics. She said she uses it with all her patients who have Tourette's (while my son doesn't have a dx of Tourette's, he certainly has the tics). My understanding is that Focalin is a refined version of Ritalin that is supposed to cause fewer side effects. So you may want to ask your psychiatrist again, or get a second opinion about Focalin. It might be worth a shot. BTW, long-acting Focalin is supposed to be available sometime this summer.
Good luck with your son. I'm sorry you're having such a difficult time figuring out his dx and finding the right combo of meds. That must be incredibly hard for all of you.
SmallMom38502.6867824074Thanks, Smallmom , I may ask about Focalin again if we have to make yet another change. My son's tics were things like eye-blinking and a very loud snorting noise and throat clearing sounds. He's had 13 changes/9 various meds since age five. I get sick just thinking about it.
This is a great web site. I love how it's set up and how easy it is to get "messages" via e-mail.
Leigh:
Just wondering . . . Does your son still have the tics off stimulants? Or do they totally disappear?
It is hard to try all these meds -- since February my son has tried 4 stimulants and 2 antidepressants, with no real success. (Focalin is the best, but it doesn't last long enough.) Hence, the new doctor in July. I have to believe there is a combination of meds that will make him feel better than he does right now (hating school and not doing any homework).
SmallMom,
The ones that caused major tics, I did see them continue even at nighttime when the meds had worn off. That wasn't good at all. Once we stopped those all together, the tics vanished completely. Adderall was the ONLY one that gave just minor tics (which, by the way, wore off after a short while on the medicine). I now give the meds on weekends and during the summer as well. I know, though, that whenever the dosage has to be increased, the minor tics will start up again for a few days and then go away.
By the way, you mentioned homework. It has ALWAYS been a nightmare for us with the exception of a rare day here and there. It results in tantrums, and it frightens me sometimes to see my son just sit there and pull his hair, break his pencil and scream, "I don't know how to do this!" I'm talking about work he absolutely knows how to do. Part of the problem was his meds would wear off by the time he was home. He switched to the XR version in mid May, but I won't know how it affects homework until school starts up again. Anyway, the school came to our rescue this year. After a couple of SST meetings (and, I guess, showing them how exhausted I was by issues at home), the assistant principal and school psychologist instructed my son's teachers to lessen his homework load by half. He was to do only the even numbers or the odd numbers in his workbooks. That made a HUGE, HUGE difference. I was so surprised the assistant principal came up with this idea. I never would have imagined that. My son has an IEP for 4th grade now, which starts up August 10th. It was a long road to get things set up, and I'm just praying the "plan" helps my son. First grade was a challenge. Second grade was a nine-month-long nightmare I would like to forget (very much a teacher issue), and third grade was tough and full of struggles (but the teacher was AWESOME).
Leigh_GA_6638503.3039814815