Medication for Inattentive ADHD and depression

[Fru1tt3a]

I’m newly diagnosed at 53 with Inattentive ADHD with a previous diagnosis of Major Depressive Disorder. I was treated with methylphenidate 18mg up to 36mg. The first day was great, I felt clear headed and present. It stopped working on day 2 and I started to feel depressed again when taking the meds but in a different way , sort of not feeling like me anymore and hopeless. I stopped the meds, had a review and was put onto Elvanse 30mg. It started really well and I was happy with the results. More productive, more present, clear thinking, able to focus with only a dry mouth and loss of appetite as the side effects. On day 5, I started to feel my heart rate go up which was uncomfortable all day but I still felt ok mentally. Day 6 and my depression started to show again. Day 7 and I can’t even get out of bed. I feel hopeless and confused. I’m feeling my depression more than anything else now and wondering how I’m going to move forward. Is this a side effect that will reduce if I push through it or should I stop taking the medication. I have another review on the 15th February. Thank you reading if you got this far. I would love to hear from anyone else who has experienced this as I feel so alone right now.

[STEM_Dad]

Welcome to the forum Fru1tt3a !

Name people experience changes in the beginning when taking an ADHD medication. The brain and body have to adjust to it, so it is possible to go up and down in response

My experience is that ADHD medication doesn't make depression go away. *

Do you still experience heart racing every day on Elvanse? You should notify your doctor if it is.

I had that effect (tachycardia) every single day on Adderall, once my dosage was increased from the starter dosage. I didn't tell my doctor until the next adjustment appointment, and he was concerned. (After a month off meds, tracking my heart rate to ensure it wasn't normal for me, my doctor put me in a lower dose again. Eventually, I asked him to put me on a non-stimulant, atomoxetine, aka Strattera. Fortunately, for me it proved to be a better medication to treat my ADHD.)

Has Elvanse affected your sleep? If you are sleeping less, then that might be affecting your mood, too.

~~~

*I have not had a diagnosis of Major Depressive Disorder. I was diagnosed with depression last year, after being on ADHD medication for two years, which my doctor labeled in his notes as "episodic depression". (It was triggered by big changes in my life.) I had to be treated with a depression medication for months to help get out of it; my ADHD medication wasn't fully effective until the depression lifted. (I'm prone to anxiety, and they affects how well my ADHD meds work, too.)

[Fru1tt3a in reply to STEM_Dad]

Hi. Thank you for your reply. My heart and blood pressure have come down now and it’s not racing anymore, although I have informed my medication provider of this. The meds worked so well up until day 5 when I experienced the rising heart rate, but it seems since then my depression and adhd symptoms are fully back leaving me hopeless again. If it’s just a period of adjustment then I’m of course willing to push through. I guess I’m hoping that this is a normal response to early use of Elvanse really.

[STEM_Dad in reply to Fru1tt3a]

Since you've had a good response from is so far, then you can probably expect it to help again.

I think that for a lot of people, the body will have a big response to stimulants at first, then have an overcorrection, then eventually stabilize.

The more experienced the doctor is with managing ADHD and depression, the more likely that together you will find the right dosage for you.

I recommend that you keep a daily journal of your experience on the medication. Track the ups and downs, the side effects, and anything unexpected. Try not to be anxious about anything...try to separate your observations from your feelings (but feel free to journal about both).

[Fru1tt3a in reply to STEM_Dad]

Thank you. I have been jotting down my symptoms, feelings, blood pressure and heart rate since I started Elvanse. I’ve got a meds review next week, by which time I’m hoping things will be more settled. Thank you for your reply

[Nto84]

First of all I want to say that I feel for you very much. Being one step away from your cure and have to stop abruptly is really tough. I didn't experience something exactly like this myself but I have some thoughts that might be relevant.

First of all, I have the 12 year old ADHD daughter, and this autumn she started taking methylphenidate. At the same time she went to the local school (we are refugees in a foreign country) and had some problems due to the language barrier. She started feeling depressed and overwhelmed because of that, she was hysterical every single day and I consulted our child psychiatrist. She said that in case of the depression she will need to stop the treatment with methylphenidate and first treat the depression. So maybe this is it.

I have some good news though, which are now based on my own experience. I also had the depression and I was treated with good old Prozac (fluoxetine). At some point I noticed that it really affected my ADHD symptoms in a good way. My mind was laser sharp. I became curious and searched for the information about the connection of fluoxetine and ADHD, and I found the research which stated that fluoxetine was as well used as the sideway stimulant med for us.

So my point is that maybe firstly you need to address the depression, and find a really good evidence-based ADHD aware psychiatrist who helps you with the right treatment. Also maybe Strattera will be a better option for you, you need to discuss it with your doctor.

Just don't lose your hope, finding the right treatment may be a bit tricky but I'm pretty sure it exists. Supportive hugs, if I can.

[Fru1tt3a in reply to Nto84]

Thank you so much for your reply. You have given me hope and I will definitely be discussing this at my review next week. I was researching yesterday, and I came across a dr that said if you have both depression and adhd, they have to be treated simultaneously, as more dopamine lowers serotonin and vice versa. This would make sense as I’ve got a diagnosis of major depressive disorder. Thank you for your kind words and I hope you’re all so good xx

[trillium42]

Yes, if you are not on meds for depression, that could be why. My teen has been on both an antidepressant and a stimulant at the same time and it has helped.

[Jozlynn]

Hi Fru1tt3a!

I too am a late diagnosed ADHDer (I was 50) and I also suffer from depression. I have to be on both meds- Vyvanse for ADHD and Pristiq for depression. I even have a small dose of Abilify added on to help with the depression. I thought being on the Vyvanse, and the way it helped me FINALLY function better, would help to solve the depression - but not all depression is situational and apparently mine isn't, as I too struggled with having it show back up after being so excited about what the Vyvanse was doing for me.

What I did find was that the anti-depressant I was on previously did not work well in conjunction with the Vyvanse. The psychiatrist had to adjust those meds and put me on something new that has worked well.

As long as you're totally open with your med provider about the depression, hopefully they'll be able to find a good combination that works for you. Just don't give up on the ADHD meds. Once my depression was back under control, I once again could see the benefits of the Vyvanse.

One thing to be aware of though - you'll feel the benefits of the ADHD meds much more intensely in the beginning (first week, for me), but then your brain kind of adjusts and it stops feeling SO much different - you just find that you're able to function better than you were before the meds. It's a little disappointing, to be honest, because that initial feeling of "OMG, I can FUNCTION like the rest of the world" is a bit of an emotional rush, then it settles down to where you don't really "feel" anything when you take it.

That being said, having had to go without my Vyvanse for almost 2 months at one point due to the med shortage, I can promise you that it's working even when you don't really feel anything anymore. The difference on and off meds is pretty significant for me, personally. Without them, my motivation bottoms out, my ability to stay on task disappears, and I can't prioritize to save my life. It feels VERY reminiscent of depression, to be honest. But on my meds, I'm able to function in a corp environment (that is definitely NOT conducive to ADHD), prioritize things in the business I've started, respond to emails that I would otherwise avoid, etc. There is without a doubt a difference, and I'm forever grateful for the ADHD meds.

Wishing you ALL the best!

[Fru1tt3a in reply to Jozlynn]

Thank you for your reply. It’s now day 7 and I feel better than I did on day 5 and 6 which is hopeful. I felt so bad on those days, I was even considering not taking my meds today but I’m glad I did. I got hold of my medication provider and they said depression can be an early side effect and to carry on if I can. I’ve got a meeting with them next week. Thank you again and I’m glad you found a combination that works for you. Depression can be so devastating to your life.

[Charlylea in reply to Jozlynn]

Exact same feeling for me when I found out at 48! Did you try Addreall? I was on 20 mg and then had 70 hours of neurofeedback and friends were saying I looked shaky so down to 10m but now I am not focusing well at all. PS. Also, getting my business back and could use some advice. It/s been a year and still no way to book my services. I have researched every tool out there for the backend and can't make a decision and figure out how to put all my ideas for services a site and market it. . Did you find any grants to help you out, andOccupational Therapists. Unfortunately, I got let go from ICBC last January for having a minor ADHD meltdown over not believing I needed an accommodation. So, my name has been smeared and my EI is out in a month!!!