[Guest]

I'm a 50 year old male who has been struggling with depression and occasional panic attacks for many years. I also suffer from narcolepsy, which ws diagnosed at a sleep clinic five years ago. I have been treated in the past with Prozac, but have experienced little improvement. I recently began seeing a new psychiatrist who, after interviewing me and conducting a few tests, diagnosed me as suffering from a genetically-based, severe depression coupled with mild adult attention deficit disorder. He prescribed a rapidly increasing dosage schedule of Effexor plus 20 to 40 mg of adderall.

This psychiatrist is a very prominent member of his profession, so I am not questioning his expertise (certainly not at this point). I must admit that I'm a little apprehensive about the rapid increase in medication levels he has prescribed. I was also somewhat surprised by his dx of adult ADD Is this a common condition? His reasoning in reaching the diagnosis made sense, but it seems a little puzzling that anyone could complete graduate degrees, including a law degree, and become a fairly successful academic with such a disorder.

Is the recommended course of drug therapy consistent with what you might prescribe, given the diagnoses?

Sign me "A Little Apprehensive."

[Guest]

It is certainly possible to achieve a lot and have ADD. My suspicion is that Winston Churchill and Theodore Roosevelt had variants. We look for a chronic and pervasive style that goes back to childhood. Forgetfulness, inattention, starting projects and not finishing them are the sort of things we look for. On the other hand, the disorder is controverial in adults who were not diagnosed as a child. It has to be present as a child.

In terms of approach, Effexor and Adderall do make sense. There are different styles. I usually try and start one medication at a time, but many other psychiatrists feel comfortable starting both. You could ask him if it's OK to start one at a time if you are apprehensive. His approach is certainly not all that controverial or out of the ordinary.
[quote] I'm a 50 year old male who has been struggling with depression and occasional panic attacks for many years. I also suffer from narcolepsy, which ws diagnosed at a sleep clinic five years ago... [/quote]

[Guest]

Thank you very much for your reply.

I did, indeed, have the problem of forgetfulness of a certain type--e.g., where I placed objects, why I came into a room, but not about facts amd figures, which made it easy for me to skate through school with high grades and particularly high stabdardized test scores. That makes the ADD dx seem plausible. On the other hand, I could concentrate on things that interested me for extended periods, and almost always produced what was regarded as accurate and concise work.

Back to medications: one additional question. Would the addition of Wellbutrin to the Effexor and Adderall be logical (and safe), given that the doctor believes that I suffer from a deficiency in both serotonin and dopamine?

Again, I appreciate your help.

"A Little Apprehensive"
[quote] It is certainly possible to achieve a lot and have ADD. My suspicion is that Winston Churchill and Theodore Roosevelt had variants... [/quote]