Q. What is the effective treatment for ADHD?

Hello doctor,

I was diagnosed with social anxiety four years back and then depression the following year, and ADHD for two years. I have a question regarding ADHD medication. I have tried several ADHD medications, including Concerta, Ritalin, Dexedrine, and Vyvanse. I have noticed that it usually works in the first few days, then suddenly stops working. The same thing happens to me on antidepressants as I have tried many of them, and some helped in the first few days but then stopped working. So the efficacy is not consistent, which happens to me a lot. I am confused about this. I have also noticed that I am struggling with mood swings occasionally. Does that mean I need a mood stabilizer?

Kindly help.

Thank you.

Hello doctor,

Thank you for your response.

I have never tried to take ADHD medications with antidepressants simultaneously. I only tried each in a different period of time. I do not take any drugs or drink alcohol at all. I do not take any other medication for another condition. I am currently struggling with anxiety and ADHD symptoms, and a few years back, I was diagnosed with depression, but I later realized that the cause of my depression was because of Inderal, as I used to take it every day for four years, and when I stopped it, the depression symptoms decreased dramatically, and now I am only using Inderal occasionally for anxiety, and I noticed that every time I use it I get depressed. Do antipsychotics work with stimulants? Do you mean that my ADHD medication would not work with me because my symptoms are resistant to medication, or do you mean I need to add antipsychotics alongside stimulants for them to work correctly? Also, how can I address the anxiety symptoms? Do antipsychotics help with anxiety, or do I need to take antidepressants with antipsychotics?

Thank you.

Hello doctor,

I have tried the tablet Sertraline for about two weeks, I noticed a significant benefit in the first three to four days, and then it disappeared. I also noticed in the second week a zombie feeling which I think is called emotional blunting, which is why I stopped the medication so does emotional blunting means the medication is not working due to the increase of serotonin? Also, I have a few questions, why can I not take stimulants with the therapy you suggest? Does the Sertraline with Olanzapine only help with ADHD without needing stimulants?

Please answer.

Thank you.

Hello doctor,

Thnak you for your reply.

I just want to mention that when I used Sertraline, I have noticed that my ADHD symptoms increased, especially the lack of concentration, so does taking Olanzapine with it remove that? I have read that Escitalopram is a better choice compared to Sertraline. I also want to mention that one of my friends was also diagnosed with depression, and his psychiatrist prescribed him Lurasidone alongside Escitalopram. Does this combination helps with ADHD symptoms? Is it better than the combination of Sertraline and Olanzapine?

Please give your suggestions.

Thank you.

Hi doctor,

Thank you for your advice.

I went to my psychiatrist (this is the first time with this psychiatrist), and he told me that my main issue is social anxiety and I need to treat it first and then consider ADHD medications again. He explained that I do not have depression but rather social anxiety, which is why most of my medications did not work. I am not sure about this explanation, but he prescribed me Paroxetine CR, and I am currently on day three of those medications. I started the medications with 12.5 mg yesterday and increased it to 25 mg today. I have noticed a great mood, decreased anxiety, and racing thoughts with a decreased need for sleep and fidgeting. Are these symptoms normal, or does that mean I might have bipolar disorder type 2? I read online that antidepressants might induce bipolar disorder, and I am worried that I might have undiagnosed bipolar disorder type 2. I also want to ask you about Paroxetine withdrawal symptoms. Is it terrible and challenging to stop it? Because I have read that it has the worst withdrawal symptoms compared to other SSRI medications, and I am worried about that. Also, I have attached a document of my past experiences with all medications. Hopefully, it will help explain my past issues.

Please give your suggestions.

Hi doctor,

Thank you for your response.

Does that mean my ADHD increased due to the intake of the tablet Paroxetine rather than the possibility of having bipolar disorder? Because I read that taking SSRI might diminish dopamine release, which is why ADHD got worse right? If so, does that mean I need to add stimulants or mood stabilizers in the future after I complete the entire course of the Paroxetine tablet? Please give your suggestions.

Hi doctor,

Thank you for the reply.

My brother was diagnosed with GAD and tried Pristiq for three months, from 50 mg to 150 mg. However, the tablet did not help. Then he tried Cipralex for two months, from 10 mg to 20 mg. He felt better initially, but now it made him feel worse. What is the best option for his current condition?

Hi doctor,

Thank you for the reply.

My brother’s symptoms are loss of control, fear, the anxiety of recurrence and fear of going out or taking a shower, confusion, and shortness of breath. Before taking Vyvanse, his symptoms were in control. He is currently on Xanax and Cipralex, which helped him reduce some of the symptoms, such as taking a shower and going out. Does that mean taking another medication from the same SSRI group will be similar? Because my brother tried Ciprolax, and Sertraline is an SSRI as well.

Hi doctor,

Thank you for the reply.

My brother took Escitalopram 20 mg for eight weeks, and his psychiatrist increased the dosage to 25 mg. During the first four days, things were better; he increased the dose to 30 mg. Also, in the first two days, he was good, but the symptoms of a panic attack, shortness of breath, and fear of losing control came back. Should he keep taking it or decrease the dose or stop taking it? When he was taking 20 mg, he felt better in a day, which is why his psychiatrist increased it to 25 mg. Then, he increased it to 30 mg.

Hi doctor,

Thank you for your prompt reply.

I hope you are well. I am currently on Paroxetine CR 37.5 mg, and it has really helped me, changing my life by reducing my social anxiety and irritability and providing me with a sustained mood throughout the day. However, I am still struggling with ADHD symptoms, and I suggested Wellbutrin to my doctor as I mentioned my hesitation about stimulants. Now, I am on day two of Wellbutrin, and I have been feeling a bit anxious and nervous with no significant benefits so far. I am considering switching to Adderall or Dexedrine, but I have come across information on the internet about potential enzyme interactions between Paroxetine and these medications. They mention that enzyme blockage might build up over time, potentially worsening anxiety, increasing irritability, and reducing efficacy for both medications. Additionally, I found an interaction mentioned on the online website between Wellbutrin and Paroxetine. I am quite confused and concerned about these interactions and not sure what to do. I really do not want to change Paroxetine since it has been so helpful, but I still need assistance with my ADHD symptoms. If you have any recommendations, I would greatly appreciate it.