AS / ADD and anti-depressants

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I have recently been diagnosed with AS and as a result of the severe depression leading up to my diagnoses I was put on a small dose of Citalopram (5mg) which is an SSRI antidepressant.

However, I am now reviewing my medication and it's overall effect. I must say, I do not like the idea of medication, however, after reading Temple Grandin's auto-biography, and hearing how a small dose of anti-depressant transformed her life, I made the choice to experiment. And it's taken the intensity out of things, which is ok for now.

However, it has become clear to me that I have ADD as well (inattentive type) and feel that if I am to experiment with an SSRI as a means of dampening down the hypo-arousal of my nervous system, it makes sense that I should explore the posibility of a medication that takes into consideration my ADD symptoms as well.

Can anyone advise me of any medication that works well in this respect?

With kind regards

Chris

I don't have any medical qualifications - so I can only offer my own experience.

I have AS, ADHD and SpLD. I tried citalopram (affected my concentration negatively) and venlafaxine (made me dangerously ill!) and I now take fluoxetine. I find that this works really well for me and has even helped my timekeeping.

My neuro-behavioural specialist has said that people on the spectrum often get reasonably good results from fluoxetine.

There was also an article in a newspaper recently - I think it was either the Guardian or the Independent - in which a doctor said all people with autism should take fluoxetine. Personally, I don't think such sweeping statements are a good idea as all autistic people are still individuals!

But it might be worth considering and investigating further.

thanks for your response.
chris

Yea, I've been on every kind of medication, for anxiety and depression, every one just made me even worse! Now I use herbal stuff, like st johns wart, monavie, and other stuff I'm waiting on getting. I also take vitamins, which help too. If your worried that medication isn't helping, why don't you try herbal stuff, its just as affective, but doesn't always give you the horrible side affects like medication does.

_________________
Being Normal Is Vastly Overrated

Be carefull! Medications do interact. I found out most antiaxiety mediations have the oposite effect on me, this is intensified when I'm on my ADHD medicine! They tried to give me Welbutrin to help me quit smoking and I almost exploded.

I've been taking St. John's Wort for a little over 2 years now. In my opinion, works just as well as bloody Paxil, without the side-effects.

_________________
Life is a journey, let's ride

Last night I just tried the new antidepressant my doctor prescribed. I'd tried Wellbutrin which brought irrational anger, almost rage - and now this Venlafaxine HCL which is a generic version of something.

Last night I was the proud recipient of:

Night sweats
Anxiety
Panic attack
Sleeplessness
Inability to urinate
Severe nausea
and possibly diarrhea (but that might be from the excess dairy my mom's been buying for me, insisting I need it! But I suppose I could just give it away or even toss it... I just hate waste, especially when I'm lucky to have anything to eat at all!)

It could just be bad sleep deprivation, but I still feel the anxiety and near-panic over 24 hours later! I hate this terrible feeling! I will NOT take so much as a second dose of this neurological POISON!! !

Being out in the sunshine, moving my body instead of sitting at a desk, and maybe some St. John's Wort should be MUCH better for me than pills, bloody pills!

So be sure to click here for my take of all this! >>> The Drugs I Need! <<<

Hi Chris,

I just wrote a long, detailed reply, but before I could hit submit, my dog licked the keyboard and firefox closed. (I kid you not.) So here's an abridged version, yet no less serious.

a) Please take all of these comments (including mine) with a grain of salt at best. None of these people are doctors, and even if they were, they don't know your history. Ultimately, the only person who knows what's best for you is you, with the help of your doctor.

b) All medications affect each person differently. Herbal stuff may be enough for some, but others may need prescription medication--especially if their conditions are more severe.

c) Some meds (esp. SSRI's) take a while to kick in, so it's important to give them some time before deciding whether they're for you.

d) A really good site for subjective and objective info on drugs is: http://www.crazymeds.org/.

Having said all that, here's my opinion, as someone with ADD-i and AS:

I have taken Prozac (fluoxetine), Effexor (venlafaxine), and Adderall (both regular and XR). Prozac is an SSRI, Effexor is a [combined] SNRI, and Adderall is a stimulant. I won't give you my opinion of the first two, since that's not what you're asking for.

I've been on Adderall now for a couple years. There is no doubt that it helps me to focus my attention. In my opinion, it also helps me to limit those impulsive foot-in-mouth statements. However, I have always also had a tendency to hyper-focus on the things that I enjoy (i.e. aspie "obsessions"). The Adderall exacerbates that tendency. So though I may be able to focus better, I'm not necessarily focusing on the things I *should* be focusing on. Adderall also seems to exacerbate my OCD/perfectionist tendencies, which isn't good since deadlines exist.

When I asked the doc if there was any med that could help reduce my perfectionist/obsessive tendencies, he suggested the SSRI Luvox (generic fluvaxamine--not to be confused with fluoxetine, which is Prozac). Luvox (now sold in the states only as a generic) was specifically marketed for OCD symptoms, though it's still an SSRI like all the other anti-depressants, and as such, also works for depression.

I didn't start taking that, however, because I don't want to take an SSRI at this time. But because stimulants exacerbate obsessiveness, I asked the doc whether there was a non-stimulant ADD med. He suggested Strattera. I have been taking it for only a week now, and in the meantime have cut my Adderall dose in half. Strattera is an NRI (Norepinephrine Reuptake Inhibitor). Norepinephrine is also one of the three neurotransmitters (including seratonin) that is thought to affect mood (the other is dopamine).

It's too early to tell whether the Strattera is helping, though I did manage to clean my house on Tuesday for the first time in many months. (They say stimulants will have that effect, too, but that wore off pretty quickly with me.) That may mean nothing. I also got out of bed before my alarm the other day, which rarely, if ever happens. Again, it could mean nothing. Or it could just be a temporary effect from the med switch. And despite titrating off the Adderall, I haven't noticed a *decrease* in attention while on the low dose of Strattera.

Now, when the doc had first prescribed Effexor for depression (almost 2 years ago; not on it anymore), he said that it can also help with ADD symptoms. This makes sense, since it's an SNRI (seratonine AND norepinephrine reuptake inhibitor). Personally, however, I didn't notice that much of a difference in my attention, and I took a stimulant at the same time anyway. It MAY be enough for you, though.

Wellbutrin affects norepinephrine and dopamine reuptake, but not seratonin. I have never tried it, but it might also be good for ADD symptoms, in addition to depression. Read crazymeds.org though, because in this case, it does interact with Strattera.

Ha, this ended up being pretty long anyway. Hope it was helpful. If you've got more questions, feel free to pm me.

Dani

Medication is a double edged sword, IMO. Since the age of six and my (possibly defunct) ADD diagnosis I've been on medication. In the course of ten years I had been put on about fifty to sixty different prescriptions. I've been taken to the emergency room for EKGs at the age of eight, and I've gone through other horrible reactions.

Currently I'm on medication for anxiety and depression, but in light of learning about Aspergers I'm not sure if these are co-morbid or just part of the AS ball of wax. I'd like to get off my meds, as I feel I'd be alot less tired and would lose some undesirable side effects like burning after being in the sun less then twenty minutes and such. But it has helped me get to where I am now.

I've seen medication turn people's lives around, including my father's. Because of Prozac he's become a much better father and husband. So, it has benefits and it has losses. I guess you have to decide whether it's worth the potential side effects.

Before considering taking St John's Wort, you should probably know that it interacts with other drugs like mad, partly because it's a mild monoamine oxidase inhibitor, but more because of its P450 cytochrome activity. Your doctor will probably tell you that you should not take it if you are taking:
• anticonvulsants (carbamazepine, phenobarbitone, phenytoin)
• cyclosporine
• digoxin
• HIV protease inhibitors (indinavir, nelfinavir, ritonavir, saquinavir)
• HIV non-nucleoside reverse transcriptase inhibitors (efavirenz, nevirapine)
• oral contraceptives
• selective serotonin reuptake inhibitors (SSRIs) (citalopram, fluoxetine,
fluvoxamine, paroxetine, sertraline)
• theophylline
• triptans (sumatriptan, naratriptan, rizatriptan, zolmitriptan)
• warfarin
• prilosec
• gleevec
• amitryptaline
• others, this isn't an exhaustive list

You should also not take it for 5 days before any surgery, as it interacts with some anesthetics.

I'm on Adderall for ADD. I just got dxed with ADD back in February, so I'm new to the meds angle as well.

So here's what I have to say. If I could only take one kind of medication for the rest of my life, excluding all others, I would take the Adderall. It's completely turned my life around. I love it. I love being awake. I love being focused. I love being able to focus. I love the attentiveness and the ability to concentrate that has come as a result of taking it. It's awesome.

And that's what I have to say about that.

I was on Effexor for nearly a year but had to quit because it was really screwing me up. I went on Zoloft after that and it has been the perfect drug for me. I can focus and I don't have the anxiety/depression that I had before. It's help me do much better with both work and school, so it has definitely been well worth it. Every now and then I will think I don't need it anymore and will taper off until I'm not taking it anymore, but then I will slip into a deep depression and will not want to do ANYTHING. I don't know, I'd like to live my life without dependency on a drug but I really don't like the person I become when I stop taking it.

Criss, that is a TINY dose you're on. Do you have to cut your pills into 4 pieces? I take it you're on it for autism, not full-blown depression.

I'm on 40 mg of citalopram and that does'nt even touch the sides, so 5mg is a fairly small dose.

Hi Ana, nice to have contact with you once more. yes, I cut the 20mg tablet into four little pieces with a razor blade (u get a really satisfying clean cut)

I have only been on it for 2 months, since my diagnosis & I have ceased to be depressed, but continue to take it as a means of experimentation with re quality of life with re dampening down the hypo arousal of my nervous system.

being a 41 year old man, and being told I had a form of autism was a great relief, however, I was deeply depressed leading up to my diagnosis and the result of this cloud of unknowing being dramatically lifted was in itself overwhelming, as all of a sudden I was consciously experiencing 'my autism' for the first time.

I am now reviewing the meds.

how are you doing?

Cx