Antidepressants vs stimulants

Antidepressants vs stimulants

Antidepressants and stimulants seem to be equally effective for adults with attention-deficit hyperactivity disorder (ADHD). Recent controlled studies suggest that desipramine (an antidepressant) may be as effective as methylphenidate (a stimulant) for improving symptoms of adult ADHD

My doctor took me off of my antidepressant a few months ago because I’m taking Vyvanse, a stimulant, now. He doesn’t like me being on an antidepressant and thinks I look like I’m doing well without it. I know that what I “look like” has nothing to do with how I actually feel. I’ve been told that I’m great at hiding my feelings and always having a smile on my face even though I’m really miserable. This is the first time not taking an antidepressant in about 20 years. Even with the Vyvanse, I still have problems with low self confidence, spiraling negative thoughts, and now crying once in a while. What’s so wrong with being on an antidepressant? I’m looking for a new doctor and thinking about asking for an antidepressant that focuses on dopamine. I’ve read at additudemag.com that dopamine is important for people with ADD. Does anyone have advice about people with ADD and antidepressants? I don’t want to make things harder on myself if an antidepressant could be helpful.

Hi. I was diagnosed with ADD as an adult few years ago. Once I got diagnosed with ADD that was the missing piece and the root cause for what I was experiencing. My psychiatrist had me on an anti-depressant and Vyvanse. I also had been seeing a therapist to work on the same things you mentioned. My mood began to improve with the therapy so my psychiatrist began titrating me off the anti-depressant while on Vyvanse. We checked-in before stopping the anti-depressant. I was also hesitant stopping the anti-depressant too but so far, so good. It’s been about 3+ years since I’ve stopped. I have since switched to Conserta only because Vyvanse made me grind my teeth.

I can only speak for myself but I think it was beneficial to have both medication management and talking therapy. I have a new psychiatrist after moving to Boston from NY City 2 years ago. He recommended an adult ADHD/ADD cognitive behavioral therapy (CBT) program which is short-term and skills-based to help with organization but also to manage mood and negative thoughts. There’s currently a waitlist for the adult program. So I found a private therapist trained in CBT and familiar with ADHD. He’s aware of my psychiatrist to coordinate care if needed.

It hasn’t been easy. Not sure if your doctor specializes in ADHD/ADD and when you were diagnosed. I’m also a therapist. Medication and therapy differs on a case by case basis since many people with ADHD/ADD are also dealing with anxiety, depression, or other psychiatric or health problems. For me I had to shop around and talked to others with ADHD/ADD and with ADHD experts. My psychiatrist was good in NYC and knowledgeable enough. So the work I did with my doctor and therapist focused more on mood-related problems. My new psychiatrist in Boston is an ADHD/ADD expert which has made such a difference so now I’m focusing on tackling the ADD behaviors that can lead to the mood problems.

If you think the doctor isn’t listening to you then it makes sense to look for someone else who can and who you can talk to openly about your concerns and what you’re feeling. I realize there may not be many specialists out there depending on where you live. So when looking at a new doctor or therapist, ask how familiar they are with ADHD/ADD. Unfortunately, many providers don’t think ADHD/ADD are real. And keep asking questions to see if there are other options if you’re not ok with what the doctor recommends. A responsive doctor will take a patient’s concerns into consideration and should be giving you clear explanations for their recommendations.

Good luck!

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