Coming off SSRIs and people's experience of Xaggitin XL

[Nurseadhd]

I am on 36mg of Xaggitin XL. I don't take it until lunch time because it wears off after about 8 hours and that's no use to me in the afternoon/early evening. I use coffee to get me through the morning. I have a med review tomorrow so hopefully I can get some advice/answers regarding what's best going forward. I have been on SSRIs since my teens (over 25 years) and I believe this was partially due to misdiagnosis but also overlap of symptoms so now I'm wondering if I should even be on the ssri. Has anyone xeperience of coming off ssri after commencing adhd meds?

[Gettingittogether]

I'm sure there are a range of experiences, but depression and ADHD do go together without the depression being "caused" by the ADHD. It's called "comorbidity"--where you see one condition, you see the other. Just share your thoughts with your provider. I take an antidepressant and an ADHD medication.

If you decide to go off the antidepressant, do so very slowly and gradually, like over a period of a year--titrate downward. Otherwise, lots of people are having seriously disorienting, painful side effects from coming off antidepressants too fast without giving the brain and all its biology a chance to adjust.

Are you happy otherwise with the Xaggitin. I took Concerta, same med, with methylphenidate, also long acting. I went up to 54mg I think with concerta.

[Nurseadhd in reply to Gettingittogether]

Thanks for replying. If I'm honest I know that I have depression as I've had 3 debilitating episodes and the ssri meds along with CBT and counselling pulled me out of it, thankfully. I think I'm still in denial about my diagnosis. I've spent so long being the way I am I worry about becoming dependent on another medication. I have difficulty assessing my behaviour when I take Xaggitin XL but I have noticed that when they wear off my mind begins to race or if I don't take them a day I feel overwhelm and I'm more reactive to situations rather than being mindful and processing first. I am due to take on a huge challenge in my career, both academically and professionally so I'm best continuing with both meds and seeing how I am after a further period of time.

You said you took Concerta, do you mind me asking which adhd med you are on now?

Thanks again for your response

😀

[Gettingittogether in reply to Nurseadhd]

I'm on short-term or immediate release Ritalin. Concerta and your med are long-term release. I now take short term release. But I've tried others: Vyvanse and Adderall XR. It's just that Ritalin (methylphenidate) just seems to work the best for me.

If you're going to take on a tougher job with more responsibilities and so on, I highly recommend you add therapy to your mix.

[Hominid711]

Dear Nurse,

Hi again <3 <3

I've also suffered a number of horrendous disabling major depressive episodes starting with the first that I can recall at twenty and lasting about 7-8 months since I didn't know what was going on never mind treatment existed. There were shorter, less disabling anhedonic low motivation episodes prior. They may have been primary or secondary to the General Anxiety Disorder I am currently diagnosed with (not sure about the completely accurate diagnosis here but by now it's an academic question and not of much relevance). The depression I became aware of before realising the abnormality of anxiety, probably because it caused the greater shock and ceasing of functioning on more levels and noone would force me to get up - I was by then a med student and no longer living at home - whereas the anxiety was at most a subconscious state, somehow feeling on edge with a sense of dread all the time which my brain must have interpreted as a part of the "I"/my personality. It was there as an undercurrent, escalations easily triggered, noticed, but still not realised as abnormal, an illness. With the benefit of hindsight the depression creeping up on me may therefore have been secondary to the performance anxiety which came with primary school, until which time I remember having a mostly joyful, hyperactive "tomboy" childhood, my father whose undeclared favourite I was encouraging my boisterous nature, buying me my beloved bright blue dungarees with that large football sticker, teaching me cycling without support wheels, jumping off the 3m board into the deep pool, monkeying around with me, and with running and cycling as fast as I could down any hill, minor and not so minor accidents included.

My nature was - and is - so different and this/these mood disorder/s, again, primary or secondary to ADHD has/have robbed me of so many months if not years of my life that I am not interested in trying less meds ever again.

I used to be on Citalopram 40mg daily for years and since my diagnosis of ADHD and start of treatment 8 months ago I have been on the combination of Elvanse/Vyvanse 70mg - works for 13-14h - and the SNRI Venlafaxine 300mg daily which apparently is a bit better than an SSRI in ADHD with mood disorder. I wanted to go on the maximum dose of each to ensure I got the full benefit so titrated both up fairly speedily. I don't have any significant side effects. I feel myself and very much contented.

I'd probably be ok had I continued the SSRI Citalopram 40mg daily which because of the lack of motivation and the problem with procrastinating I had intended to have switched to Venlafaxine before I learned that I have ADHD. My psychiatrist who prescribed the stimulant was happy to go along with it.

Anyway, the current combination works very well for me.

I wouldn't come off the antidepressant. Why rock the boat? I myself will stay on the meds as long as I'm not taken off and ideally til the end of my life if by then this will be made feasible by further research.

Don't worry so much about dependence. At the dose it works best for you you are not very likely to become dependent on the stimulant. And SSRI/SNRIs don't have a dependence potential.

Hope this helps.

A fellow clinician

[Nurseadhd in reply to Hominid711]

Hello again 😊

I have similar experience with the anxiety and depression and it is difficult to know if adhd was what triggered these. I made a few attempts in my life to come off SSRIs and within months I was unwell so I do believe they are necessary for me to cope and function.

My consultant wanted to try me on a different adhd med but said that there had been studies showing interaction with it and the Sertraline I take so he prescribed Xaggitin XL. I haven't taken it in a few days and feel OK but I've also been on days off from work so who knows!

I just feel that the timing of beginning adhd meds isn't great due to having to take on a new challenge.

Thanks for your reply, it's really helpful to hear your story