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Suggest Treatment For Resistant Depression

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Posted on Thu, 19 Feb 2015
Question: I am impressed with your credentials! Ok, here we go. I have resistant depression and the only drug that has really worked for me is adderall. It;s been 2 years now, and I battle mightily to keep my tolerance down.
I am prescribed sixty but am trying to keep it 45mg.
I tried NMDA products memamtine for three weeks and but may gave me a headache, and sometimes I wonder if I am coming off of it given the huge half life. I quit two weeks ago.

I noticed that the common thread was the idea of blocking calcium into the cell so I went to my family doctor and gave me 40mg , once a day of verapamil which helps block the hardening of the cell and I suppose allows it to process whatever Adderall does with noranephrine, dopa etc. and Gabatein?
Sooo, I assumed that the best time to use verapamil and keep tolerance down would be to take it 30 minutes before my dose of 20-25 adderall at 6 pm. I felt virtually nothing and in fact a little depressed although I think I feel some anti-anxiety from the Verapamil.
Question: If i take my two doses of Adderall say at 2 pm and 6 pm when should I take verapamil, before, during, or sometime near midnite? I imagine I could get the ok to take two 40 mg verapamil if I neded it.
My goal is to get all that is possible from my adderall all the while finding the best time to decrease or maintain tolerance, based on it's tolerance. I use magnesium faithfully and try to keep an alkaline base. I realize that I can take some verapamil if I were to get too wound on adderral.

Thx in advance, XXXXXXX XXXXXXX

a
Thank you , XXXXXXX XXXXXXX
doctor
Answered by Dr. Ravi Soni (52 minutes later)
Brief Answer:
Adderall should be started from morning

Detailed Answer:
Hi, thanks for writing through HCM.

I have read your query and understood that you are suffering from resistant depression and taking adderall for last 2 years with significant improvement.
Now you are going to start verapamil which is a calcium channel blocker used as an antihypertensive to help your anxiety.

Verapamil has shown some improvement in patients with mania and hypomania. It is commonly used to treat mania in a pregnant woman because other drugs have teratogenic effects while verapamil has less effects on foetus. It effectiveness in anxiety and depression is not scientifically studied.

Whatever you are talking about verapamil and adderall interaction is not scientifically proven. Taking verapamil will not allow any other benefit. It may decrease your anxiety because it is a antihypertensive.

Another thing if you want to take benefit of your adderall dosage of 40-45 mg, then you can take the first dose around 12 PM and second dose around 5 PM. BY doing this it can have maximum effects, in addition it won't interfere with your sleep.

For decreasing anxiety verapamil can be taken at any time, if you have significant worsening of your symptoms of anxiety and depression in the morning then taking it in the morning would be wise otherwise I usually give these drugs in the evening just before or after dinner. Verapamil has half life of 5 to 12 hours so take according to the symptoms during the daytime as well.

Hope I have answered your query. If you have further query then I shall be happy to help.

Wish you good health.
Regards,
Dr Ravi Soni

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

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
Dr.
Dr. Ravi Soni

Psychiatrist

Practicing since :2010

Answered : 538 Questions

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Suggest Treatment For Resistant Depression

Brief Answer: Adderall should be started from morning Detailed Answer: Hi, thanks for writing through HCM. I have read your query and understood that you are suffering from resistant depression and taking adderall for last 2 years with significant improvement. Now you are going to start verapamil which is a calcium channel blocker used as an antihypertensive to help your anxiety. Verapamil has shown some improvement in patients with mania and hypomania. It is commonly used to treat mania in a pregnant woman because other drugs have teratogenic effects while verapamil has less effects on foetus. It effectiveness in anxiety and depression is not scientifically studied. Whatever you are talking about verapamil and adderall interaction is not scientifically proven. Taking verapamil will not allow any other benefit. It may decrease your anxiety because it is a antihypertensive. Another thing if you want to take benefit of your adderall dosage of 40-45 mg, then you can take the first dose around 12 PM and second dose around 5 PM. BY doing this it can have maximum effects, in addition it won't interfere with your sleep. For decreasing anxiety verapamil can be taken at any time, if you have significant worsening of your symptoms of anxiety and depression in the morning then taking it in the morning would be wise otherwise I usually give these drugs in the evening just before or after dinner. Verapamil has half life of 5 to 12 hours so take according to the symptoms during the daytime as well. Hope I have answered your query. If you have further query then I shall be happy to help. Wish you good health. Regards, Dr Ravi Soni