Suspected ADHD & SSRI’s

[iHeartTomJones]

On a long waiting list to get a adhd diagnosis(another 2 years) Private is an option, but no shared care with be offered afterwards ie with prescriptions and I can’t afford to foot this bill. Had a pre assessment via telephone and it’s looking very likely it’s adhd.

I am on my 7th ssri which is strongly looking like a failure like the rest has been. One of those has been a SNRI. Apparently people with ADHD don’t tolerate SSRI medication.

has anyone any experience of this and could kindly offer some of their advice to help? I’m not sure what to do next.

I have a confirmed diagnosis of ADHD and I take fluoxetine (20mg daily) which is a SSRI and it works really well for me.

@HundredMilesAnHour Thats really reassured me. Thank you.

@jacelynorlando i have already flagged this up. No further forward. Gp telling me it shouldn’t affect SSRI’s being effective. The pre assessor saying potential ADHD does be affected by them. I don’t bloody know anymore……

@iHeartTomJones are the SSRIs you've tried for treating your depression or for treating your ADHD? Do you suffer from depression or is it a case of ADHD burnout etc being mistaken for depression?

Just fyi, my fluoxetine and my ADHD meds (Concerta XL) are both prescribed for me by the same psychiatrist as he's treating me for both conditions.

It has been shown that fluoxetine and tricyclic antidepressants can be safely combined with stimulants. No unusual side effects were observed in any of these studies. Source:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2990565/#:~:text=Desipramine%2C%20however%2C%20was%20found%20to,in%20terms%20of%20ADHD%20symptoms.&text=It%20has%20been%20shown%20that,in%20any%20of%20these%20studies.

Your depression might well be down to ADHD, so antidepressants do not solve the underlying problem. ADHD is a real disability and stimulants are life-changing. Why do you say that shared care is not an option?

@HundredMilesAnHour i have severe anxiety. I find anti d’s are making me worse and I am constantly crying. This is on going as years but getting considerably worse. Possible adhd has only been suspected as year. I am exhausted and my head just needs a rest.

@londonsquirrel I am in n.ireland where shared care isn’t an option. It’s all very frustrating

@iHeartTomJones How old are you? Just wondering if it might also be peri-menopause related? I became very anxious and cried at the drop of a hat and it turned out to be peri and HRT made it disappear (and if I miss my HRT, it all comes back).

@HundredMilesAnHour i am 36. I’m not sure as I’ve been like this for years. My concern is that I’m taking anti d after anti d to help me but instead they are making me worse.

I'm sorry to hear that. Could you ask to be referred to a psychiatrist? Trying 7 different anti-depressants and all of them making your anxiety sounds like you need more specialist help.

Has anything else changed as it seems unusual that 7 different meds would all make you worse?

I've had various SSRIs over the years and even with ADHD, none of them have made me worse. The side effects might have been horrible/too much but they never made my mood worse. Your case sounds very concerning so no wonder you've had enough.

@HundredMilesAnHour i am on a waiting list to see a psychologist. Another long wait. Doctor seems happy to try another anti depressant after this also. I’m at my wits end.

Has anyone tried solely an anti depressant and found relief from suspected ADHD?
I just want so desperately to try a stimulant to see if it helps me. But I can’t.

I take sertraline for anxiety and have a diagnosis of combined type adhd (very hyperactive) - I don’t take adhd meds as my lifestyle suits my wiring and I don’t feel the need (certainly would if I had to work in an office environment, or was studying, though). My anxiety wasn’t about anything in particular, but I was in a constant state of high alert due to noticing everything all the time - the sertraline has helped with this (I still notice everything, but it doesn’t set off alarm bells like it used to).

@iHeartTomJones Can you ask your GP to refer you to a psychiatrist? (May be yet another waiting list but worth a try). They have much more specialist knowledge in meds for mental health and it sounds like you need that level of expertise rather than your GP just trying you on med after med.

I can recommend a private psychiatrist (he's in Oxford but also works over Zoom) but he's expensive, and the meds also mean private prescriptions too.

I have combined ADHD - I pretty much maxed the scores for both types. At the time of assessment though I had a full psychiatric assessment on top of this. I was perimenopausal and have had bouts of anxiety and depression for years and panic disorder. I had also made pretty impulsive decisions linked to this that landed my in hospital on a pscyh ward. ADHD brings a whole host of co morbidities and I had no knowledge of ADHD at the time but am now ridiculously clued up on it thanks to the hours of research I've done over the years since I was diagnosed. I have pretty much all of the co morbidities.
What I would say is that a diagnosis can help you understand yourself better. It is worth looking and researching all the ADHD traits and seeing if you really believe you have it. If you do, then access all the ADHD support forums and organisations and research all the recommended methods /tips of ways to support yourself. I say this because you can start helping yourself now. Medicaiton might not suit you once diagnosed and if that is the case you will be in no better position from the diagnosis than you are now. With or without ADHD meds you need to learn skills/tools to help yourself manage your emotional regulation. Read the books, listen to the podcasts, follow the people on social media, go on the websites etc. Do the therapy, or workbooks etc. What is also worth considering is whether you have ADHD or in fact another condition. There are so many overlaps in symptoms and it is easily misdiagnosed. ADHD and PTSD/cPTSD, OCD, and bi polar disorder have lots and lots of overlap in their behavioural and symptomatic features. Look into this. Are you taking any medications for your anxiety? Are you undergoing therapy for it? Are you looking into somatic as well as talking therapies to help with this? Medication wise, I took Sertraline to begin with. I've tried Paroxetine, Duoloxetine, Pregabalin, Quetiapine, all sorts. So far Vortioxetine is the one I do best with - its not the most common of anti depressants and more likely to be prescribed by a psychiatrist than a GP as a a result to start with. However, Fluoxetine is also recommended for people with ADHD. I didn't opt for that because I have a terrible memory and can forget to take them, so I needed anti depressants with a longer half life as a result. I take HRT and I also take stimulant medication for my ADHD. It is helpful to a degree but certainly not life changing. I don't 'take the ADHD meds on weekends and some days I forget. They help me feel less overwhelm and can help with focus but for me they aren't a wonder drug that solves everything. And given the impact and stress they can have on your heart/liver/kidneys etc at some point in my life I will be advised to stop taking them. I hope some of this helps? Good luck on your journey of figuring it all out. For me, the best thing that has helpedme so far is recognising what I need to do to keep me in check. They are as follows: Get outside every morning, exercise regularly both cardio, strength and also yoga (yoga to me is movement meditation, it makes me focus on my breath and I find vinyasa sufficiently hard that I don't think about anything else for the hour), I go to therapy every week, I go on a lot of walks with my friend and we talk a lot. I avoid places that make me overly stressed, I'm learning to say no, I'm learning to stop, pause, observe what's going on with me rather than immediately reacting when stressed. I try and ensure I'm not on my own when I feel vulnerable. I write a lot. I take photographs all the time of the glimmers in my day to remind me of the good things I've seen grow or change or that have brought me comfort in some way -it can be watching plants emerge, beautiful trees on a walk, frost on leaves, an amazing hot chocolate, my cosy slippers, my dog sleeping next to me etc. I listen and only follow people that help me feel good on social media. I listen to experts and therapists and follow nutritrionists and wellness experts. I listen to podcasts that make me laugh. I don't listen to the news I don't follow people that make me feel bad about myself. I dont' want things that will trigger me. I try and remember to take a step back when I'm overwhelmed and recognise why. Have I said yes to everything? Am I trying to people please to the extent I have lost any sense of myself? Am I over thinking? Have I taken on too much? Have I set too high a standards and goals? Where is the pressure coming from? Is it real and genuine or perceived? I've blethered on and on in true ADHD style! Sorry! Yikes.

@iHeartTomJones I know it can be annoying they treat you as an experiment, trying one antidepressant after another. And it can also be very terrifying to try something new after so many have not worked. I know the feeling, I am kind of in the same boat: SSRIs and SNRIs both give me bad sleep side effects, after a while on them I don't feel refreshed no matter how long I sleep. My psychiatrist suggests tring another SSRI, but I am just scared. I have a friend though who tried 6 antidepressants before he found something working for him. I admire his perseverance...
So... Even though it might seem like trial and error process, it can end well with appropriate specialists involved.
As for depression - my partner was diagnosis with ADHD and he tried ads before with various degree of success (all of them stopped working at some point). He is on ADHD medication now and says he does not experience depression since taking stimulants.