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Have Crohns Disease, Depression And ADHD. Take Colazal, Clonzepam, Zoloft And Adderall. Suggest?

Posted on Thu, 8 Aug 2013

Question: I have chrons depression and adhd. most stemming from the chrons. I cannot find a doctor that can help me with all things. so I have to go to two different specialists with no insurance and the medication is soooooo expensive...I take colazal, clonzepam zoloft and adderall. I may get on my husbands health insurance soon but they said that I have a pre-existing condition and may have to wait a year....what to do?

Answered by Dr. Preeti Parakh (2 hours later)

Hi XXXXX

You have mentioned three problems - Crohn's disease, ADHD and major depressive disorder. You are currently on Colazal for Crohn's disease, Adderall for ADHD and Zoloft and clonazepam for major depressive disorder. You are finding the medicines expensive.

Before I advise you, can you please let me know the following:
1) Which of the three was diagnosed first and what came later?
2) Before you were put on Adderall, were any safer and cheaper alternatives tried? How has Adderall benefited you?
3) What other medications have you tried for depression? Are you still depressed?
4) Are you dependent on any substances?

Best wishes.

Dr Preeti Parakh

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Preeti Parakh (13 hours later)

I thought I paid for an internist? Is it always assummed that one has addictions if they take adderall or clonzapam..I am acctually more "dependent" on the zoloft because it changed my whole life and my families. the adderall and the zolfoft work well together for some reason. The dr put me on adderall after I was diagnosed with chrons. The adderall helps with the lack of dopamine and the zoloft helps with the serotonin. If there is one without the other its not good. chrons seems to suck every nutrient you have including messing with you mentally. Depression was diagnosed first....I know my body so well that I "knew" something was wrong. when they put me on every antidepressent there was and nothing worked than they checked further. after no answers shortly after my sister almost died in the hospital with chrons. The doctors assumed the stress of that incident sparked something inwardly and I started bleeding. Low and behold I went to the doctor and they did a colonscopy and I have it as well. They found out the depression was from the chrons that had not manifested yet and the adhd is something I have had all my life. However, I went off of it when I was 25 for 10 years while trying to get pregnant. When I was diagnosed in 2010 with chrons they put me back on it because they could tell by my symptoms that it either resurfaced or never went away...I just chose not to take it.

Now I am trying to find an internest in this small po dunk town I live in so maybe there can be some sort of answers. I do have an appointment with an immuologist so we shall see how that goes...
XXXXXXX

Answered by Dr. Preeti Parakh (38 minutes later)

Hi XXXXXXX

Thanks for writing back.

Considering your problem of expenses and having to see two specialists, this is what I feel. You cannot do without consulting two different specialists, one for your Crohn's disease and the other, a psychiatrist for ADHD and depression. But it is definitely possible to reduce the expenses on your medications.

Treatment for Crohn's takes precedence over your mental health problems which have already improved; so continue with Colazal, if it is working for you. From the details you have given, it appears that you were diagnosed with depression in 2010 and Zoloft helped you overcome it. Zoloft and other such medications used to treat depression are usually gradually tapered off nine to twelve months after one becomes well. One doesn't become "dependent" on Zoloft.

Clonazepam is given for even shorter intervals than Zoloft and can also be tapered off gradually. Hence, you can discuss with your psychiatrist if Zoloft and clonazepam can be tapered off gradually, thus reducing your expenses.

Regarding Adderall, you can try getting the generic version, which is far cheaper. Also discuss with your doctor regarding cheaper alternatives like generic versions of bupropion (Wellbutrin) or atomoxetine (strattera) which work very well in ADHD.

Bupropion is especially suitable for you as in addition to treating ADHD, it also has antidepressant action, acts on dopamine, and is easier on the gastrointestinal system than zoloft. If you are a smoker, it also helps you quit by reducing your craving for nicotine. It has no dependence potential.

Hope this helps. Best wishes.

Dr Preeti Parakh

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Preeti Parakh (1 hour later)

Thanks for your advice...I have been on wellbutrin for a year and it caused extreme restlessness. I dont smoke. I also tried straterra and it was hideous and for sure not cheaper... My goal is not to change whats already working. My goal is to possibly find some assistance with the meds that are already working...thanks for your time...but i really would like to speak to someone that i requested next time...

Thank you, XXXXXXX

Answered by Dr. Preeti Parakh (5 hours later)

Hi XXXXXXX

Thanks. Hope you are able to find generic versions of the medicines you are taking and save up on the expenses.

Best wishes.

Dr Preeti Parakh

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Prasad