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Really Struggling With Fog- Focus: Is This Adderall Or 2 Little/wrong Med? Help Pls

Adderrall focus-task completion prob Xyrem

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#1 Misseddx

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Posted 18 October 2013 - 01:22 PM

Hi all, I haven't written in months- extreme time constraints, but periodically read. This group and your feedback on your N experiences is truly helpful -pls keep posting!

I have 3 ?s related to a very bad (worsened) inability to focus & it is worse since taking Adderall; my/more details are below if u have time to read.

1) Does Adderrall ever make one UNable to focus and complete tasks?
I'm now only taking 30-40 mg daily- started this med 4 mo ago. Though I noticed I could "think" better upon starting it, my focus & task completion ability is consistently much worse on it. However, this could be an outcome of a concurring stressor in my life & general Narc (N) too.

2) Does xylem help your brain fog & ability to focus? (I'm taking 3 mg melatonin & 3mg Lunesta nightly, still seem to work, c below for more info)

3) Any tips on improving this problem? (Meds, non meds, etc). I'm including exercise, good sleep regimen, seeing a counselor once mo @ high stress situation, eating right things to watch blood sugar levels, etc. however, I've not been best w all of these & trying to be better.

My- more Details if u have time:

Problem:
I'm really struggling daily with a inability to focus and complete even basic tasks without distraction and going on to something else b4 I finished the 1st thing. It is also taking me way too long to finish basic things. (Eg, walk in room doing 1 thing and starting something else; same with work issues, cleaning up kitchen, paying bills, etc). Upon reading this post, I'm aware that it is 2 long 2... This focus prob is very different than before & has lasted several *months*; it's also different than the daily extreme exhaustion and "brain fog" (both separate and combined) and resulting inability to function from them (years of experience w this).
Overall, I am experiencing really bad "mental bouncing" from thing to thing and it's extending into everything I do. I'm in my mid-40s, & never dx or had ADD or ADHD, tho in hindsight always did have minor focus probs periodically. But this *level* of focus-problem is new/extreme over the last few months.
I was dx w N w-out Cat in 3/13 (polysom. & MSLT- go into REM sleep w naps), & likely had N for 10-20 yrs b4 dx; I think I've had/have lots of assoc med problems resulting from sleep deprivation, but that's another topic...

My meds:
1. currently take 30 mg adderrall XR in AM and periodic 10 mg in afternoons. I know long term adderrall use can cause confusion, but I have only been taking it for 4-5 months.
-- I had to increase initial June dose from 10 mg to 30 to be effective. I'm uncertain if this is a tolerance effect and I need to incr the dose now; since the "bouncing thoughts & actions" is much worse & been worse all summer & before, I'm seeking feedback before agreeing to increase dose (I know to only increase/change under Dr. Rx and direction). The pharmacist thought adderall unlikely to cause this focus prob, but unsure in my situation... I typically get the weird, rare or unusual side effects from many meds. So want to ask others in addition to calling the Dr. Next.
-- My current energy on 30 -40 daily mg adderrall is good, not perfect, but not like unmedicated (difficulty functioning), so I've been hesitant to incr dose given the long term tolerance effect and Nuv not an option 4 me.
-- adderrall does cause me incr talkativeness (do watch 4 this now) & have the circulatory issues- extremely cold -painful hands & feet (in 80-90 deg weather), literally like ice. Dr. saw & said blood flow ok but to watch.
-- Can't take nuvigil. tried nuvigil twice - worked really gr8 for energy, but both times caused very severe rash (esp back) that developed after 2-3 wks. Dr. Let me try a 2nd time bec couldn't rule out another allergy cause & so effective. I did notice continued brain fog on nuvigil & *improved* thinking (less fog) when starting adderall; but this extreme focus prob is worse last few months & not improving.

2. Other Daily Meds:
Also taking all these 4 at least 2+ Yrs, so no changes--
A- 20 mg celexa (for 10+ yrs)- without it- anxiety, with it, fine unless life 2 stressful; B- synthroid (hypothyroid-levels checked in June-good); C-*need* to take 3mg melatonin to become sleepy (take 45 min b4 bed--highly effective, not placebo effect); D- also 3 mg Lunesta nightly since May. Re lunesta: Prior to N dx, took lunesta 3-4 times/wk for yrs as only way to have good functioning next day (chose nights to take it). Sleep dr recommend take nightly since it worked 4 me & not 2 change 2 many meds at once; still seems to work to allow me to stay asleep & wake up refreshed.

Other FYI--
1. Have had extreme stress, esp since early June -unfortunately ~ same time as starting adderrall.
(short term -6 + mo situation, but involved coming into very chaotic situation & high ongoing emotion). Luckily I have a supportive spouse and other support.
2. Get Daily to weekly headaches-migraines for years; working on this systematically with neurologist for last 8 yrs. Track meds and off them long enough to see that the focus prob/fog is not from med (thought it was from the Triptan). Massage & PT help best, but no cure, migraine med side effect usually better than migraine, but not always...

Couple times this week I have recently noticed that I felt more clear in the AM before taking Adderrall, then muddled in the day. (usually set alarm to take stimulant then 2nd alarm 30-60 min later 2 wake up, so didn't know this). Tho this could be my life "style"/stress right now... But I need to be able to function and am losing days, weeks, & months of functioning.

Any tips on improving this problem (med or non med) would b appreciated. I've learned 1st hand that keeping a "strict sleep regimen" is paramount (use to dismiss- but really true), & stress makes it all worse! I'm at the point of keeping detailed excel lists with dates, etc (like project management) to prioritize (& I really do have too much going on now- doesn't help).

Sorry so long. Thought details may help w your feedback. Again, any input is appreciated. And, Thx to the folks who keep this site going!!!

#2 Ferret

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Posted 18 October 2013 - 08:57 PM

Customized for you and the meds you're currently taking...
http://www.drugs.com...0-1621,1463-869

Check out the combination of Celexa and Lunesta (which you started taking regularly in May)

Using citalopram (Celexa) together with eszopiclone (Lunesta) may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment.

 

 

and the combo of Celexa and Adderrall XR
Please bring these interactions to your Doctor's attention ASAP.



#3 Misseddx

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Posted 20 October 2013 - 02:01 PM

Thx Ferret 4 your prompt feedback. I will follow up ASAP w doc. Also thx 4 taking the time to read my lengthily (2wordy) details, as you pinpoint on what I agree is likely compounded bad med interactions and probable cause w & beyond the adderrall. I run the same type of med checks b4 taking any new med & raised both results w my Dr in May and June b4 changing meds. At these times tho, I could think fairly well (well, not so poorly...) and he thought ok to try. As the brain fog progressed in late summer (when adderrall incr), I blamed it on the extreme stressful situation. Alas, the key problem of not being able to think clearly is just that: u can't process-reason clearly! So I didn't even reconsider all meds, just thought I was majorly stressed out. The last couple weeks I have removed myself from the stress situation & and was alarmed to see how far reaching the focus prob is. Thx again!

#4 Ferret

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Posted 20 October 2013 - 08:33 PM

You're more than welcome. Your post was not "wordy", it was "detailed" which was most helpful in trying to pinpoint a problem.

Sometimes it takes a while for these drug interactions to rear their ugly heads. It depends on the individual, their metabolism and dosage.

Likewise, it takes a while for a medication to reach its full potential to help an individual. Don't write something off because it's not a "magic bullet" that has immediate effect. Patience.

Best of luck for the future!



#5 Misseddx

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Posted 21 October 2013 - 01:21 PM

Thanks Ferret. left message w sleep doc @ his suggestion for change. My sleep doc & neurologist (latter for migraines) both previously suggested I try xylem instead of lunesta if no significant improvement in EDS as my "next step."

Ferret or others, Any thoughts @ trying xylem w my meds & combos? (I know I can rev more on this site if easier). (My meds of 20 mg celexa; 30 mg adderrall XR+ 10 mg few days/wk; 50ug synthroid; 3 mg of melatonin; aleve, plus Frova -Triptan 4 migraines, wh always makes fatigue/thinking very bad if I take on top of this.). Considering xyrem, it's just a really bad timing in my life to have any more extreme side effects (4 the next month) that make me unable to function, tho I'm not getting anywhere fast w this extreme "fog- thinking" (focus) problem & think something needs to change. Stop lunesta & nothing else? Without both a sleep med nightly & stimi, I'm exhausted all day...tried march -mid may. Trazadone also has same (serotin) warnings, so not keen on trying that either. No celexa (wh is the main probable drug interaction) & very anxious, tho open to try to titration off that (say that now til my anxiety returns...); could ask doc @ short term Xanax use again. Know u all can relate to this juggle of picking what the worst symptom is to treat.

Have to say I'm quite leery of xyrem based on some of the posts I've read here @ side effects, tho am open minded to trying & hopeful that maybe it could work like it does 4 some. Substituting xyrem instead of lunesta still doesn't look "ideal" in terms of my drug interaction profile (eg, drugs.com or webmd) either w the celexa. Thinking @ asking doc if I should try extended titration schedule again to wean off celexa bec of interaction concerns, tho I typically have significant anxiety w-out it (tried as long as 2 mo). Pharmacist says celexa prob has least side effects based on my meds other than trying Zoloft. However, I'm luckily not depressed, just get terrible anxiety without celexa in the past, so maybe it's worth a try. (When put on celexa initially 4 situational depression & anxiety; luckily depression went away). I do know that the Frova -Triptan- is a bad mix per med checker- way 2 much serotonin impact, so I've been going without the Triptan last 10 days 2 c if thinking improves since focus so bad. It does, but not enough. Migraine issues not fun, tho incr message trigger point therapy to weekly helping neck probs & assoc migraines & no drug side effects. (Tho costly $$)

Ok, my whine time (wh I will try not to do)- I'm sooo tired of this systematic approach & time spent (10+ years w my migraine, severe neck pain/ probs, and EDS issues) to find that "new right" thing that helps, until the tolerance effect kicks in, & it no longer works. (med, food, fitness, stress reduction, sleep -- track & change only 1 thing for 2-6 wks based on what it is). I know to only change 1 thing at a time, but gosh, this is getting old & pardon the pun, but really tiring. I've been down many roads where the tx-med side effect or withdrawal effect from discontinuing wasn't worth it (many meds worse than migraines 4 me). I was hoping my migraines would magically disappear w initial tx of narcolepsy; they r as debilitating or more than the EDS & likely related, wh is why I know I need to try to improve my sleep quality (Normal but disrupted sleep: I wake up many times all night, tho I don't remember most). I know I need to b patient, and will be; my migraines are a tad better, but still a ways to go to improve daily-weekly life. EDS manageable w stimis, but I'm very scared @ what happens when they stop working too. I'm very very fortunate-- I have a wonderful hubby & son & just want to enjoy them. I'd also like to be able to "focus" & think to function! (My poor patient hubby... Wh I do not for 1 sec take for granted). Oh well, we take the good days w the bad, eh?, and hope for more good ones overall. Thx 4 "listening."

#6 Ferret

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Posted 22 October 2013 - 09:15 PM

I really think that you should work this out with your Doctor. I'm not passing the buck but he/she knows you a lot better and all any of us can do is point out interactions...and I totally missed the migraine medication that you are taking.
I do know that antidepressants are regularly prescribed with stimulants for Narcoleptics with Cataplexy. Basically an upper and a downer...the downer is supposed to decrease cataplexy and the upper to keep you awake. What I don't know is WHICH antidepressants work with WHICH stimulants. The only choice available in '86 was a combo of Ritalin and Tofranil...that's it...no other choices...and it didn't work for me.
Antidepressants are horrible to get off and your body is VERY used to the Celexa.
So, is there a point in time, that you can go back to...like May?...before the increase in Lunesta and the addition of Adderall? What were you feeling? Good, bad or ugly? Something triggered your need for a change and that's the point that I think you may want to start at with your Doctor. That's just imho and I sure as hell aren't walking in your shoes.
Best of luck.

#7 Misseddx

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Posted 24 October 2013 - 08:54 AM

Thx Ferret. I completely agree @ dr best to work they it- I did call dr. office this past mon. & my appt is this afternoon. But I *really* appreciate u taking the time to think thru this; it helps, since I have had situational stress & attributed symptoms solely to that & just pushed thru. Thx again & have a good one!

#8 steaks

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Posted 25 October 2013 - 11:11 PM

To get the most out of any stimulant, you need to be well nourished.  For example, I get a lot, and I mean a lot more out of Nuvigil if I am well hydrated.  I stay steady drinking 12 ounces of wheatgrass/barleygrass/kamut grass with plenty of pure water.  It works soooo much better.

 

The stimulant is the accelerator of the car, the nutrients are the gas, and your body is the car..







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