seasonalshift: Immediate adverse reaction to Adderall XR preceding onset of distressing symptoms

[seasonalshift]

Hi

 

I am presently very foggy and unsure how to go about composing this but I’ll do my best. About eight days ago (May 20) I took one dose of a 20mg adderall XR prescription I had recently been given for ADHD. If I’m remembering correctly my focus was improved and I was able to get a lot of things done without incurring much fatigue the way I normally do, but it immediately caused some pretty intense side effects, including elevated anxiety (nearly to the point of panic frankly), sexual dysfunction, appetite suppressing, GI problems, numbness/tingling in my extremities, and insomnia. I discontinued after the first dose and some of the symptoms subsided, but many didn’t and fairly quickly some new ones emerged. Presently I’m experiencing severe brain fog, anhedonia, sexual dysfunction (v low libido and genital insensitivity), difficulty w speech, heavy fatigue, dissociation (maybe depersonalization/derealization? It’s hard to tell), tremors in my hands and head and some involuntary movements, numbness/tingling in extremities (different from when on the med, less of a squeezing more like “drained”, I think I read that adderall affects blood flow), difficulty eating (also a different quality to the appetite suppressing effects of the meds), occasional insomnia, altered perception of time (everything feels much slower) and very intense depression and anxiety. I am very distressed ab these.

 

I’m a trans woman w a history of sexual abuse and medication-induced sexual dysfunction (both very distressing! tho the dysfunction was never quite persistent iirc) as well as long term dissociation due to dysphoria who has only within the last year (since I fully came out and started hormone replacement therapy) that I’ve begun to heal and enjoy being present in my body and to experience a sexuality that doesn’t feel poisonous to me, and it has been more or less heartbreaking to feel as though the like. Fruits of my progress have been taken away from me. Additionally, I’m a survivor of long-term withdrawal from other meds, most notably lamictal, and it’s very triggering to be experiencing symptoms that so closely parallel my experiences with that. I’m hoping very much I’ll experience some relief soon because I don’t feel remotely like myself. I haven’t been able to engage with any of my interests in any sustained way since the dose. I’m very afraid I’ve given myself a case of PSSD in a roundabout way, though I’m trying to stop myself from jumping to conclusions. I am going to pursue specialized treatment for PTSD w/o meds in the meantime. I would appreciate any comfort, reassurance, advice, etc 

—

(until I figure out how to pin a signature I’ll just put one here manually)

extensive history of prior psych meds usage for adhd, depression, anxiety

lamictal march-august 2018 (abrupt taper over latter four months, don’t remember dose)

abilify, three days september 2018

concerta September-October 2018

reinstated lamictal at microdose, then tapered off probably too abruptly May 2019-July 2019

Estradiol, Spironolactone, Progesterone April 2021-present 💗

Adderall XR 20mg May 20, 2022

[seasonalshift]

I’ve started to notice brain zaps over the last few hours. I’m familiar w these from previous withdrawal experiences. Not my fave! 

[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs. I'm very sorry for the various difficulties you have experienced, including the sexual abuse, dysphoria, and withdrawal and adverse effects of the drugs you took.  We are here to help, and I'm glad you found us.  We have many others here who have experienced adverse reactions to their drugs, and they can and do recover, in time.  

 

Can you please give us specific information in your signature about your drug history for all drugs you are on and have been on, especially for the past 18-24 months?  It would be especially helpful to have the details of your drugs in a concise vertical list (no symptoms), only drug names, specific dates (as best you can say for example early March if you don't recall the day) and dosages of each medication decrease or increase.  Use this format:

 

Drug name: date, dose, date, dose, date, dose…

Drug name: date, dose, date, dose, date, dose…

Etcetera

 

Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

How to List Drug History in Signature

 

Unfortunately, it sounds like you have experienced a significant adverse reaction to just one dose of Adderall.  So, while you are not in withdrawal from going off of psychiatric meds, your nervous system was not able to deal with the dose of Adderall.  The symptoms of adverse reaction are similar to those of withdrawal, so these links should apply to you.  

 

Video on Recovery from Psych Drugs

 

Windows and Waves Pattern of Stabilization

 

 

Here is a link with checklists of common symptoms: 

 

Dr Joseph Glenmullen Withdrawal Symptom Checklists

 

 

Here are some techniques to cope with symptoms: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

Stability is really important.  Please read the link about stability:

 

Keep It Simple, Slow, and Stable

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

Magnesium

Omega 3 Fish Oil

 

This link will explain more about recovery from an adverse reaction:  

 

Immediate Adverse Reaction

 

Please hang in there, and give this lots of time and patience.  Using some non drug coping strategies can help a lot - it won't get rid of the symptoms, but it will help you get through them more smoothly.  Please keep in touch and let us know how you are doing.  

[seasonalshift]

Hi

 

Thank you so much for this reply. I will add my drug history signature as soon as I can gather enough spoons. I hate to seize on like. Catastrophic notions but there are a few points I would like some clarity on. The first is like. How apt would it be to think of what I’m going through as an “adverse reaction” given that I am not certain that I ever *fully* recovered from my lamictal withdrawal/PAWS (which began in mid 2018, and was maybe exacerbated by brief periods of psych med usage thru mid 2019, also I have been dealing w chronic stress ever since, tho I have experienced significant and lasting symptom abatement from that WD esp coinciding w my time on gender affirming hrt)? Am I experiencing an adverse reaction to one dose of Adderall XR, or am I prolonging a preexisting case of PAWS? Does the distinction matter that much? Does this affect my timeline for recovery? 
 

The second question is. What is going on with my sexual function? I am experiencing genital anesthesia and a more or less totalizing incapacity to become aroused. Have I given myself a case of a kind of adderall/withdrawal induced PSSD? Fwiw I’m also experiencing very significant depersonalization/derealization, I feel confident saying at this point. I am also a lifelong sexual trauma survivor fwiw. Sorry if this is like confused. My sexual function has been very very important for my healing so far as it’s given me the capacity to understand myself as myself (ie a lesbian) rather than the closeted, dysphoric, dissociated wreck I was coerced into living as for most of my life prior. Hand in hand with that frankly is the dp/dr. Not being able to see myself as a woman because I can’t see myself as *anything* while depersonalized (and similarly, my incapacity to see myself in relation to others, irl or in fiction, while derealized) has destabilized my sense of my identity pretty significantly. Idk I would very much like to experience relief from these symptoms particularly. 
 

Lastly, I have several major surgeries lined up for roughly the next year or more. These are gender affirming surgeries intended to provide relief from debilitating physiological and social dysphoria (which bear down on my overall well-being). The importance of these surgeries for trans people like myself can’t really be overstated, but I would like to have as much information as possible about what kind of effect I might be able to expect like having these procedures done during my recovery (I mean presumably. the first one is in October, and I’d obviously be thrilled if I was more or less over this **** by then) might have. They are major reconstructive surgeries that would each require 2-4 hours of work under general anesthesia. Under normal conditions, they are followed by months of painful recovery of the kind that afaik is typically managed with heavy painkillers. There will be at least three procedures, potentially several more. Additionally, I need to undergo at least five more sessions of electrolysis hair removal to prepare for one of them. These sessions are painful and physically taxing, and are performed under local anesthesia (the administration of which via injection is what’s painful, for the most part, excruciatingly so). In the past I have been exhausted for several weeks following each session. I actually have another one of these sessions coming up in about a week. I would like to get some sense of how these would interface with my recovery as well. I would prefer not to put any of these off if possible. Though I don’t think I have enough information to weigh the risks of exacerbating my recovery by way of the physiological/chemical distress of these procedures vs. the risks of continuing to live both w dysphoria of the kind I’m presently dealing with as well as the minority stress that comes with being a visibly trans woman (not to mention the depressive effect the disappointment at having to put off these procedures might induce). Any insight wrt this would be appreciated!

 

Overall, as of rn I’m feeling more or less optimistic. I’ve survived prolonged withdrawal under more hostile conditions before and frankly equally horrifying **** besides. I’ve gotten used to taking a long (like decade-plus long) view wrt my healing, and while it’s frustrating not to be able to participate in my healing and my transition with the kind of enthusiasm and joy I enjoyed prior to this reaction, I am still hopeful that in the long run, with the support of my friends and family, I’ll become something like the extraordinary woman I think I could be. 

[seasonalshift]

Btw if it’s worth noting, I’m not currently employed or expected to be employed anytime soon afaik. I have adequate financial support and a lot of free time to devote to resting and recovering. 

[Ariel]

Hi @seasonalshift

Welcome to SA. 

I am sorry for your distress. 

 

Have you seen this link getofflex sent you? How to Summarize Your Drug History in Your Signature

 

16 hours ago, getofflex said:

Can you please give us specific information in your signature about your drug history for all drugs you are on and have been on, especially for the past 18-24 months?  It would be especially helpful to have the details of your drugs in a concise vertical list (no symptoms), only drug names, specific dates (as best you can say for example early March if you don't recall the day) and dosages of each medication decrease or increase.  Use this format:

 

Drug name: date, dose, date, dose, date, dose…

Drug name: date, dose, date, dose, date, dose…

Etcetera

 

Setting this up will help you get the guidance you seek (if indeed there are answers to your questions -- sometimes we are left with a whole lot of questions and very few answers). 

 

[seasonalshift]

I will add a drug history in my signature as soon as possible. I am probably going to need to wait until my roommate is available to help me with that but I do have a partial history in my first post that accounts for a lot of the stuff I’ve been on especially recently. I’ve been on over a dozen different psych meds since I was about like eight in several classes (including SSRIs, SNRIs, stimulants, antipsychotics, antiepileptics, etc) and a bunch of supplements and a handful of other substances besides. Mostly just supplements for the last few years tho, and not much at all for the last year other than daily calcium/magnesium, multivitamin, vitamin d3, and a once weekly vitamin d2 (all of which I’ve been on for prob less than six months, at a guess, tho I’ll double check before adding to my signature). And my hormone replacement meds. And then the one dose of adderall. 

[getofflex]

58 minutes ago, seasonalshift said:

I will add my drug history signature as soon as I can gather enough spoons. I

I went ahead and copied into your signature box for you.  Please update it with more info if there is more.  I was composing my response here while you posted this, so we were posting at the same time.  

 

58 minutes ago, seasonalshift said:

How apt would it be to think of what I’m going through as an “adverse reaction” given that I am not certain that I ever *fully* recovered from my lamictal withdrawal/PAWS (which began in mid 2018, and was maybe exacerbated by brief periods of psych med usage thru mid 2019, also I have been dealing w chronic stress ever since, tho I have experienced significant and lasting symptom abatement from that WD esp coinciding w my time on gender affirming hrt)? Am I experiencing an adverse reaction to one dose of Adderall XR, or am I prolonging a preexisting case of PAWS? Does the distinction matter that much? Does this affect my timeline for recovery? 

It is a distinct possibility that your nervous system has been sensitized by your previous psych med history and withdrawals, and therefore it contributed to this adverse reaction.  The more we go on and off psych meds, the more likely it is that our nervous system will become kindled, or sensitized.  

 

Kindling

 

Yes, it could affect your timeline of recovery.  Recovery is complex, and unpredictable.  This thread will go into all the variables that affect the length of recovery from psych meds, and facets of it. 

 

How Long is Withdrawal Going to Take, Factors Affecting Withdrawal

 

58 minutes ago, seasonalshift said:

The second question is. What is going on with my sexual function? I am experiencing genital anesthesia and a more or less totalizing incapacity to become aroused. Have I given myself a case of a kind of adderall/withdrawal induced PSSD?

You could very well be experiencing PSSD.  This not an uncommon symptom for people going through an adverse reaction to psych meds, and withdrawal. PSSD does tend to gradually resolve itself, but it takes a lot of time.  Here is our thread about PSSD.

 

 PSSD

 

58 minutes ago, seasonalshift said:

Lastly, I have several major surgeries lined up for roughly the next year or more. These are gender affirming surgeries intended to provide relief from debilitating physiological and social dysphoria (which bear down on my overall well-being). The importance of these surgeries for trans people like myself can’t really be overstated, but I would like to have as much information as possible about what kind of effect I might be able to expect like having these procedures done during my recovery (I mean presumably. the first one is in October, and I’d obviously be thrilled if I was more or less over this **** by then) might have. They are major reconstructive surgeries that would each require 2-4 hours of work under general anesthesia. Under normal conditions, they are followed by months of painful recovery of the kind that afaik is typically managed with heavy painkillers.

I believe that anesthesia, and the pain killers, since they affect the nervous system, may very well have a worsening effect on your symptoms from your adverse reaction to Adderall.  Hopefully you've had a chance to read the links I posted in my first response to you.  From those, you can see that the brain is incredibly complex, so it really needs stability to heal from the adverse reaction.  When the brain receives any chemicals (drugs) that are psychoactive, such as pain killers are, this puts you at risk of going into further nervous system chaos and instability.  I'm sorry, I realize this puts you between a rock and a hard place, but I want you to be fully knowledgable about the possibilities, so you can make informed choices.  Here is a link that explains what is going on in our brains when we are recovering from withdrawal and adverse reaction.  It's long, but it will help you understand why these things take so long, and just how complex recovery is for our nervous systems.  

 

What is Happening in Your Brain? (Explains why recovery takes so long)

 

35 minutes ago, seasonalshift said:

Btw if it’s worth noting, I’m not currently employed or expected to be employed anytime soon afaik. I have adequate financial support and a lot of free time to devote to resting and recovering.

I'm very glad to hear this. Please let us know how you are doing, and keep it touch.  

Edited May 30, 2022 by getofflex

[seasonalshift]

Thank you for this response, too. I wish it had contained better news obv! But I appreciate your being straightforward. 

[seasonalshift]

Adding that I hyperfixatedly scrolled thru the PSSD forum the other night and frankly it scared the **** out of me. I am trying to soothe myself w notions that most of the people posting in that thread were people who had not yet recovered and were thusly despairing but yeah it rly did a number on me. Altostrata’s posts in that thread were reassuring to read tho. 

[getofflex]

I’m sorry to hear that the thread was upsetting. That’s understandable. Please remember though that the people who do well tend not to post in the forum and the people who don’t do so well post more so the results are skewed that way. And yes you’re right a lot of them are in early recovery and hadn’t yet recovered.  

[seasonalshift]

Totally totally. And yeah realistically I am more worried ab the prospect of going through another years long prolonged withdrawal + PSSD this time rather than like. Permanent debilitation. But again yeah I think I’ve survived worse and with less support. Thank u again for ur forebearance. 

[Ariel]

@seasonalshift

Would it be helpful to read some success stories about members who have healed from PSSD?

Sometimes reading success stories gives me hope and encourages me to keep going.

 

I did a search for PSSD success stories in the recovery forum: 

https://www.survivingantidepressants.org/search/?&q=PSSD&type=forums_topic&quick=1&nodes=28&search_and_or=and&sortby=relevancy

[seasonalshift]

Thank u Ariel. It is helpful to read ab success stories (at least in the abstract, too close attention paid can be triggering or otherwise lead to my hyperfixating and catastrophizing). I think I was under the impression from the discourse I had encountered about PSSD that it was, necessarily, a permanent condition. Reading about cases where ppl have recovered and receiving assurance like getofflex’s that it “tends to resolve over time” has helped me adjust my perspective wrt that lol. 
 

I wish I could get more trans perspectives on this tho. Like I have been on track to get SRS within the next year or so and I have no idea how that interfaces w this stuff, other than notions that the process could affect my recovery trajectory by way of the attendant neurological stress. And frankly the sexual dysfunction stuff is making me extra conscious of parts of my body that I’d prefer not to be, more or less 24/7 as of rn. 

[seasonalshift]

I think I could use some more assurance that things are going to get better for me given enough time? 

[getofflex]

Hello, I can understand that you are feeling anxious and uncertain about recovery.  This sentiment is shared by many here.  I know someone gave you PSSD recovery success stories.  Here are links that can be very helpful.  Part of the way we recover is to try to change our thinking and attitudes towards recovery.  Our brains have tremendous healing powers.   This is referred to as neuroplasticity.  These symptoms are very compelling, and they trick us into believing that we will be like this permanently, but that is not so.  These links will go into it more: 

 

Steps for Managing WD Symptoms

 

Healing from antidepressants. How to speed up the recovery process

 

Neuroplasticity 

 

Norman Doidge - The Dark Side of Neuroplasticity 

 

Emotional Spirals

 

 

Acknowledge Accept Float

 

"Change the channel" -- dealing with cognitive symptoms

 

 

Edited May 31, 2022 by getofflex

[Ninabird]

@seasonalshift

welcome to SAD. I’m so sorry you are going through a tough time right now. I am not going through PSSD but I am going through WD. You are in very good hands here. 
Getofflex mentions something that I have been working on and that is changing the way we see recovery. It’s so hard when you are not feeling well, I know but it does help. 
Im here if you ever need support. 
 

Thinking positive thoughts for you. 
ninabird. 

[seasonalshift]

I’m sorry I haven’t responded sooner! On top of withdrawal I think i also have chronic fatigue and I’m in recovery from a concussion too and it can be like. Impossible to gather the spoons to do stuff sometimes. I can’t say much more than this for same reasons but thank you for these responses 

[Ariel]

@seasonalshift

So sorry to hear about the concussion on top of everything else. Oof. Hugs to your brain! 

Just be really gentle and kind with yourself. Practice patience, acceptance, self-compassion as best you can. 

Time will take care of the rest, and you will heal. 

Love and white light to you 

[seasonalshift]

I do have a question about kindling. Do we know if will it ever resolve? Like long-term (say decade plus etc) does it resolve to the point where one could tolerate substances similarly to how one could pre-sensitization? I’m not planning on trying stimulants again anytime soon but the difference the adderall made in terms of my executive function was pretty appreciable, even as it obviously came with pretty intolerable side effects and neurological destabilization etc and I’d love to know if it would ever be safe for me to try again. This would also obviously be useful to know for other reasons. 

[seasonalshift]

Also. I took a low dose of omega-3 along w some vitamin e a couple hours ago and have had a pretty intense like. Overstimulation type reaction to it. Kind of a similar head rush and anxiety to when u took the stimulant. Tho not as intense yet I don’t think. Kinda upset about this! Could maybe use some reassurance that I haven’t like. Immediately set myself back in a consequential way. 

[getofflex]

4 hours ago, seasonalshift said:

I do have a question about kindling. Do we know if will it ever resolve? Like long-term (say decade plus etc) does it resolve to the point where one could tolerate substances similarly to how one could pre-sensitization?

I do believe that our withdrawal symptoms resolve eventually.  Now whether or not our nervous systems go back precisely to our predrug state, I don't know. I imagine eventually, we could tolerate substances we couldn't tolerate during WD. 

 

 

2 hours ago, seasonalshift said:

Also. I took a low dose of omega-3 along w some vitamin e a couple hours ago and have had a pretty intense like.

Since you took 2 things at once, we don't know for sure what caused this.  We suggest only trying a low dose of one supplement at a time.  

 

2 hours ago, seasonalshift said:

Could maybe use some reassurance that I haven’t like. Immediately set myself back in a consequential way. 

I don't believe that you set yourself back in any significant way.  I imagine in a day or two this will resolve itself.  

[seasonalshift]

Gotcha gotcha thank you for these 

[seasonalshift]

Checking in again. 
 

I’ve been doing a bit better for most of the time since i last posted. Have been able to get back into a lot of my old habits despite emotional blunting making it a harder to enjoy them/engage w them as much more than distractions (which are nice to have, anyway). But rn I’m experiencing a pretty severe flare up of WD symptoms that has coincided w my like. Hyperfixating on withdrawal and pssd forums again (something I’ve managed to avoid doing for pretty much all of the last week and a half or so) which has been triggering even as it’s also maybe been useful? Having a very hard time thinking rn brain fog and like stress activation and inattentiveness are rly intense atm. My inclination is to chalk this up to a reaction to an acupuncture session (my first) I had yesterday. I made sure to emphasize to the acupuncturist that I wanted a calming treatment and she agreed that’s what I needed but even so I feel very agitated, sorta similarly to how I felt after taking those supplements a bit ago (or the adderall before that, tho this isn’t so intense). Fwiw I also recently went out of state for a surgery consultation and am probably still a bit exhausted from that. I definitely experienced a mood crash and some symptom flare ups during and the day after the trip. Speaking of surgery tho, weighing how/when/whether to proceed with my upcoming surgeries has been very very stressful. I am so ******* desperate for relief from my dysphoria (and other attendant problems having to do w being visibly transfem) but the flare ups I’ve been experiencing lately (on top of my more-recent baseline, which maybe has just been a window anyway, being pretty awful too) and some of the upsetting stories I’ve read about people in this forum having bad reactions following even minor procedures w minimal drugs given has me very very worried about my future. Idk I’m losing my train of thought. 

[seasonalshift]

Obviously I’m inclined to pessimism atm bc of the symptoms I’m experiencing but like during the less-distressing days I feel like I’m getting by in part by repressing my anxieties wrt surgery and now they’re hitting me harder or something like that

[seasonalshift]

I’ve been experiencing such extremes of panic and exhaustion that I’ve been unable to bathe without assistance and hyperventilating without being able to focus enough to regulate my breathing to try to calm down. Also want to note w my whole experience so far there’s some kind of combined PSSD/dysphoria/anxiety effect that is just ******* agonizing, moreso for how scared I am to do everything I need to do to get bottom surgery anytime soon (ie like in the next year). Idk. One is supposed to reduce external stressors as much as possible during recovery but dealing with genital dysphoria (combined with sexual dysfunction) is like a continuously running stress generator and for ppl like me surgery is the only way to resolve at least the former. 

[seasonalshift]

I think dysphoria and spaciness may have been masking some pelvic pain tbh. I’m not sure how long it’s been there precisely or if whatever I’m dealing w today is causing it to flare up or something but in the last hour I’ve noticed some pretty intense aching pain in and around my perineum and scrotum. Since the adderall reaction I’ve definitely been more prone to sitting w my legs crossed pretty tightly in a way that could be aggravating. It’s very intense rn to the point where I don’t think I could comfortably wear anything other than loose pants/skirts/underwear. I definitely experienced an averseness to tight bottoms earlier on post-adderall but at the time I chalked it up to combined dysphoria/anxiety wrt genital sensitivity. Which is still a factor now but also like. It is now clear to me that something down there *hurts*, pretty badly. If it persists I might get evaluated for pelvic floor dysfunction and pudendal neuralgia. 

[getofflex]

18 hours ago, seasonalshift said:

I’ve been doing a bit better for most of the time since i last posted.

That's good to know.  

 

However, it sounds like you are also going through a lot of stress, with the acupuncture, and the other stress factors.  Because our nervous systems are destabilized by WD, often we react to things differently, and even paradoxically, than most people would. 

18 hours ago, seasonalshift said:

Speaking of surgery tho, weighing how/when/whether to proceed with my upcoming surgeries has been very very stressful.

Yes, I very much understand that.  I've been dealing with a stressful situation myself, and oscillating back and forth about it, and yes, that is very challenging.  The traveling can also be very stimulating to a destabilized CNS. 

 

11 hours ago, seasonalshift said:

I think dysphoria and spaciness may have been masking some pelvic pain tbh. I’m not sure how long it’s been there precisely or if whatever I’m dealing w today is causing it to flare up or something but in the last hour I’ve noticed some pretty intense aching pain in and around my perineum and scrotum.

I'm sorry to hear about this issue as well.  It's good that you are considering having it checked out. 

 

Be very gentle with yourself, and perhaps try to limit exposure to any information online that may increase anxiety or be triggering.  Here are some things that may help: 

 

Easing your way into meditation for a stressed-out nervous system

 

Withdrawal causing intrusive or repetitive thoughts, rumination, and increased panic?

Health anxiety, hypochondria, and obsession with symptoms 

 

Relaxation exercises, guided meditations, calming videos, sleep hypnosis

 

"Forest bathing" reduces cortisol, aids mood, immune system

 

Music for self-care: calms hyperalertness, anxiety, aids relaxation and sleep

 

Music Therapy / Music for Wellness and Healing

 

Mindfulness and Acceptance
 
Good links for anxiety/worry

 

 

 

 

[Altostrata]

Hello, @seasonalshift

 

If I understand your history correctly, It appears you may have had many psychiatric drug switches prior to going off lamotrigine in August 2018, which triggered withdrawal symptoms attributed to lamotrigine. You then tried several other drugs (to counter withdrawal symptoms?), reinstated "microdose" lamotrigine (what dosage?) and then tapered off that by July 2019, again experiencing drug withdrawal symptoms.

 

When you tried Adderal, another stimulant, in May 2022, were you still experiencing withdrawal syndrome from your prior drug use?

 

What we see here is that when people have a history of going on and off drugs and switching drugs (which often causes withdrawal symptoms that may go unrecognized, their nervous systems become more and more sensitive to other psychoactive drugs, until they start experiencing outsized adverse reactions from "normal" dosages and more severe withdrawal as they go off more drugs.

 

In addition, while going through psychiatric drug chaos 2018-2022, you initiated other powerful psychoactive drugs in April 2021 , the steroids estradiol, spironolactone, and progesterone. 

 

You may have gotten sensitized by psychiatric drug mishaps over the years and be suffering protracted withdrawal syndrome or the after-effects of adverse reaction to Adderall or other of your drugs. However, you may also be experiencing adverse effects of the steroids you are taking. We cannot tell the symptoms of drug adverse effects apart, they all take place in the same nervous system.

 

We will not be able to distinguish adverse effect caused by your psychiatric drug history from those caused by your steroid regimen. At any rate, we do not have easy answers that we could recommend to you to deal with psychiatric drug-related adverse effects. 

 

Given you are actively taking estradiol, spironolactone, and progesterone, your situation is too complex for peer support. With your treating physician, you will need to explore the possibility that any of your symptoms are from your current drug regimen and perhaps adjust your current dosing.

[seasonalshift]

Noted noted. The lamictal microdoses I took in 2019 started at 0.5mg/day, down from which if I’m remembering correctly i tapered in a few increments down to 0.25mg/day before halting suddenly. As far as I could tell I was not experiencing outsized adverse reactions to my hormone replacement therapy regimen (I experienced common adverse effects of spironolactone comparable to what many of my trans woman friends have described) before the wave brought on by my recent adderall exposure. Certainly in my case the adverse effects were heavily outweighed by the positive ones. Frankly it’s difficult to overstate the positive difference hrt has made for me. But given my more-dysregulated state since my adderall exposure I will talk to my physician about whether some of my current symptoms could be attributable to certain of my hrt meds and whether I should adjust my dosing. Many of my prolonged withdrawal symptoms had abated significantly by the time I tried adderall in May 2022 but others hadn’t gone away, tho my sense of how attributable my symptoms could have been to withdrawal was confounded by my ADHD, PTSD, dysphoria, and a couple of concussions sustained over the last couple years. 

[Altostrata]

2 hours ago, seasonalshift said:

Many of my prolonged withdrawal symptoms had abated significantly by the time I tried adderall in May 2022 but others hadn’t gone away

 

However, you may also have had changes in your steroid regimen at the same time.

 

2 hours ago, seasonalshift said:

how attributable my symptoms could have been to withdrawal was confounded by my ADHD, PTSD, dysphoria, and a couple of concussions sustained over the last couple years. 

 

Definitely a few confounders there.

 

At any rate, if you had an adverse reaction to Adderall, all we could do is tell you to take care of yourself to minimize symptoms while they gradually fade over time. We cannot address the adverse effects you may be getting from your current drug regimen.

[seasonalshift]

That makes total sense. I am suffering from very heavy brain fog and fatigue (on top of ADHD symptoms that I can’t medicate!) so it’s probably going to take a while for me to investigate things wrt my hrt regimen (I’m also taking a few supplements that haven’t been listed in my signature yet for similar impairment reasons — those are iirc magnesium, calcium, a multivitamin, and a vitamin d3, all prescribed before the adderall setback). I don’t mean to sound like a broken record but the notion that I might have to put off my gender affirming surgeries to avoid another setback like this (and I am very confident that the adderall has been the trigger for this recent cascade, it was essentially an overnight thing after I took it) is so dreadful that I can only cope with it by dissociating. I mean I’m maybe using some faulty reasoning there insofar as my dissociative symptoms probably have as much to do w a first-order WD response as w that but like. I really can’t imagine surviving putting these off for longer than like a year at most (my first is currently scheduled for this October), with several months breaks between. But obviously I am terrified to put my body thru the stress of intense reconstructive surgery, anesthesia, recovery, etc, three times while in protracted withdrawal, even if I can probably find ways to minimize drugs used. I’ve done a lot of reading on this forum about surgeries and it seems like many users have been alright w minor procedures involving general anesthesia w propofol and   certain non-opiate painkillers (i feel like most of these cases have involved people being put under for less than half an hour?) but I don’t really have a sense of how well ppl tolerate longer/more intense procedures. I’m sorry if this comes across kinda directionless. I’m in the middle of a rly bad symptoms flare up today and having a hard time thinking straight. I think I just need some perspective on this that doesn’t lead me to worst case scenario type conclusions. 

[Altostrata]

Personally, I would not have multiple elective surgeries while suffering from a severe adverse drug reaction. Surgery itself will require additional drugs, all with their own potential adverse effects, plus iatrogenic risks of hospitalization, such as nosocomial infections. Up to you if you want to compound your problems by adding risks associated with surgery.

[seasonalshift]

That sounds reasonable ://. I’m aware no one can give me a precise timeline wrt recovery, but is there any way to know when I’m like. Recovered *enough* for it to be worth risking getting surgery? Gender affirming surgeries are hard to talk about in this context bc they are necessary, life-saving procedures for many trans people, but the factors that determine *when* it would be necessary for any individual trans person are so situation-specific that it can’t reasonably be argued that I am on a specific deadline, but I know that I can’t put them off indefinitely and expect to live comfortably enough to manage. Frankly the hope of being able to access these surgeries soon is one of the biggest reasons I’ve managed to stay alive as long and heal as much as I have after being put through a life-ruining situation by an abuser. There is a certain point at which the distress associated with gender dysphoria outweighs the distress of some extent of PAWS symptoms, and I would be willing to endure some amount of setback for the sake of relieving the former, but I would obviously like to minimize the risk of the latter. 

[Altostrata]

I cannot advise you on this, sorry. You must assess your own tolerance for risk.

[seasonalshift]

That makes sense. Thank you for your responses.