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Mental Health

Treatment of PTSD with Adderall

10/09/2007

Question:

Hello,

6 years ago I was attacked by a dog at the animal ER where I was the head ER vet tech/hospital mananger. One month after the accident I was diagnosed with R.S.D(Reflex Sympathetic Dystrophy) afer the crushing wounds on my left arm/hand.

I was treated with 63 nerve blocks to help with physical therapy, which at one point was 5 days a week.My husband was in 9/11. I was 8 blocks up and saw it all happen. Six years later, I have continued with care for severe P.T.S.D., panic attacks and night terrors. Also, I ambeing treated for deep depression. I have been seeing a P.T.S.D. Dr. for 4 years. I drive an hour to see him every week, as well as spend 1 hour on the phone keeping thing`s somewhat together. Today I have ~ 65% use of my arm. Very hard work. It became my job!! The following meds are what I take.

R.S.D., Neurontin 800mg 3x/d Elavil 75mg 1x/pm

Mental Health, Lexapro 40mg/1x/am Atavan 1mg/am,noon,afternoon 1.5mg/1x/bedtime Clonidine .2mg/am,pm

Supplements, All the B vits MSM (I ride, used to anyway. Even that has gone:( )

C, E, and Cal/with D

I have been on these drug amounts, without change, for ~ 1 year. I try to not take my afternoon dose of Atavan if I can. I do not like the short term memory loss. I also like to try to get through some of my attacks on my own. I am down to maybe 2 to 3 panick attacks a week. I also have the added strange trigger of lightning storms.They trigger P.T.S.D. episodes and some partial missing time events. I do not have any previous problems with cracks of lightning prior to the attack.

I`ve been more depressed over the last 6 to 8 months than any prior time in the last 6 years. We, my husband and I have also had the horrible blows of his father being terminal with cancer. My oldest brother is also terminal and not doing well. I continue to be on workers comp, as well as SSI. My previous doctor for my meds left the practice 3 months ago. We had talked about my more severe moods, but wanted to make sure it wasn`t brought on by other stressors other than the accident. This lead me to my appointment with a new doctor this morning. He wants to try me on 5 mg ER Adderall in the morning. His thought is that it will hopefully jazz me up enough to not be so tired, crashed, living in my cave( as I call my bed ridden days). After being online and knowing a little about the drug myself, I`m questiong this use before I start. My P.h.D. Dr., for my P.T.S.D., etc., has an avocation with the use of meds with the disorders I priviously mentioned. I have my phone visit with him in the morning and will talk with him as well. I feel I can give his name due to the fact that he gives talks, etc., all over the country. Dr Dan Egli. He is wonderful. We did so much Ivivo work with the animal hosp. I have such a list of thing`s we`re working on, but I am a failed patient for now when it comes to the building itself. I`ve made it to the front door. I know this is a good thing, but it is not a closed file. I can`t go in any Vets offices. I have horses and I tried my Equine Vets Equine hosp thinking it might be different, they weren't.That`s too much to read, but there it is. My life for the past 6 years.

What are your thoughts??

Answer:

Treatments like Adderall or even Provigil have been used historically to reverse some of the symptoms of depression or possibly reverse concurrent medication side effects that overlap with symptoms of depression. It certainly is possible that the current regimen is contributing with some of these symptoms (energy/sedation). Adjusting the dose of some of these treatments might help without the need for adjunctive Adderall. If not possible, than a careful use of adjunctive medication (5mg of Adderall or possibly Provigil) might be of some help but must be monitored carefully given the current regimen.

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Response by:

Nicholas A Votolato, RPh BCPP Nicholas A Votolato, RPh BCPP
Assistant Professor of Pharmacy
College of Pharmacy
Assistant Professor of Psychiatry, Emeritus
College of Medicine
The Ohio State University