no idea about the meds.

but i wanted to tell you, regarding hypothyroidism, i have it too. my thyroid is almost just scar tissue. docs can barely feel it anymore (Hashimoto's). When I added Cytomel to my Synthroid, my depression lifted so much!!!! I'll never go without it again! (and my levels were normal too, but my doc agreed to add Cytomel). Watch it though, if you have high blood pressure.

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I'm prescribed Wellbutrin SR 150mgs 2x daily Adderall XR 15mgs 2x daily Celexa 40mgs 1x daily

The Celexa seems to work best in the first two weeks of starting it or doubling the dose. Then there's a significant drop off. I only seem to notice the Adderall when its wearing off because I notice myself becoming exhausted. The Wellbutrin seems to mildly calm me a little. I'm nearing the point of giving up on the Adderall because I feel it makes me unnecessarily fatigued & I am already battling with enough bouts of excessive sleep. For example; I went to sleep around 9-10 pm sunday night, woke for nearly 2 hours the next evening, went back to sleep and woke up at noon on tuesday. This has been happening for years now. My psych seems to think nothing of it. I have concerns.

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Speaking as a doctor who treats ADHD, and as the mother of a son with ADHD, one can develop a tolerance to stimulant medications over time. This is why it is important to follow up with your medication monitoring appointments in order to inform your prescribing doctor what is working, what is not working, etc.

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Hello, and thank you. ^_^

Just in your opinion, what is MOST likely to happen if I mention during my appointment that it's been losing effectiveness? Is it likely a physician would raise the dosage, or even switch medications entirely? (Having tried generic methylphenidate already, I was switched when it wasn't helping. But when Adderall XR works, it works very well.)

Since he didn't seem to believe tolerance was an issue, is it really that inadvisable for me to try to take a 'break' from it myself, to lower the tolerance? How long WOULD such a drug holiday have to last, generally? I understand everyone metabolizes differently, but there must be a range...)

I understand it's best to let your doctor know what is going on, and I intend to, on my next visit. Still, if there is a way to manage this on my own, I'd like to at least give that a go.

Sorry if it seems like I am leaping all over you with questions, but....

...Well, I guess I am. ^_^ Sorry.

Thanks again!

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I have had the same symptoms with similar meds. 40mg Lexapro 450mg Wellbutrin sr 120mg Strattera. I started having trouble getting out of bed, exhausted, 3 cups of coffee, and foggy headed, slower paced getting ready took 2 hours, exhausted i would have to lay down for a nap 2 hours later, could not do my job panic attacks, anxiety, you name it i had it. When i read about the side effects from going off these drugs i realized i was having drug withdrawl symptoms while taking the meds. dr changed meds to 20mg Lexapro 450 Wellbutrin srand 60 Strattera. within 4 days my foggy head was less, i could get out of bed, and had more energy. Oh and my husband said i stopped twitching my whole body, also no more brain shocks. Now i needhelp with executive brain function. always late, can't finish a project, clutter,clutter, clutter. Your Dr was like my old one, for 4yrs i asked to be tested for ADD, no you don't have it, just a hectic life like everyone else. God blessed me one day with a new dr got tested in a few days i was on meds.

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I was on wellbutrin sr and adderal also. It was a great combo till I had a seizure at the lake with my family and the in-laws. I scared the heck out of everyone. I was lucky that I wasn't in the water at the time. I only take wellbutrin sr now, as it works better than the adderal. I had never had a seizure before and I have never had one since. And yes, I took ritilin for a while too, before the wellbutrin, and it just quit working after a month or so.

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I started out very sensitive to Ritalin. Very little got me a huge benefit, a little more got me side-effects. I now take normal amounts of Concerta. I still notice that I develop a tolerance through out the year. I work at a school district, so my stress and work levels cycle. I try to use little or none over the summer, and I find that this resets my tolerance for the most part. This time of year is tough... organization demands, stress, deadlines, staff morale problems, and the Concerta doesn't help as much as it did in September.

http://askdreric-schoolpsychologist.blogspot.com/

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I have had MAJOR isues with building up a tolerance, although some docs just don't seem to believe that's possible. I took ritalin in increasing doses for over a year (got up to 35mg every 3 hours, at which point my doc almost had a heart attack on my behalf) until it just quit working. Extended release formulations don't seem to do much at all for me, Adderall didn't do so well... Vyvanse was off to a great start but then quit working by the end of the summer. By then my doc was running out of ideas, and we tried Nuvigil, which worked BRILLIANTLY the first time I took it. Miraculously well. And diddly squat ever after. Dextroamphetamine has been of limited help.

At this point, I've given up. I re-introduced diet soda into my diet in an effort to control it, but alas, I can't drink as much as I used to, so it's not doing much. And, AFAIK, my insurance won't cover alternative therapies. But maybe, if I can find a doc on my new insurance who won't just write me a prescription and send me on my way, I can find something that will help.

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