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ADD and Pituitary Prolactinoma

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I am currently on 150 mg of Zoloft and 100 mg of Lamictal daily. (I should mention that I have a pituitary prolactinoma.) I am also finishing up the last of an antibiotic to get rid of a couple of periodontal abcesses. I have 1 day left of the antibiotics. I am so worried about my future with teaching and kids/ family if I can't get my rampant disorganization and sporadic structure and inattentiveness under control. Except for my ADD, I am told that I am a wonderful teacher. I just have significant trouble paying attention, prioritizing/ sequencing tasks, and organizing. I want to benefit my students so they can have the best teacher available. Can you help me?

Oh. Also for further information, I did not do so well on Adderall in the past because I quickly build a tolerance threshold. It works wonderfully at first. Believe me, I cleaned out and organized my classroom and apartment in two or three days with a clear focus, but it ended up causing problems with my mood and heart palpitations because I was having to take more to acheive the same effect over a 2-4 month period of time.

I just really need some help for my ADD!!

Other relevant information: I am a 32 year-old female, about 5'10" or 5'11," and about 185 pounds.

Category: Psychiatrist

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Hello,

Thanks for choosing DoctorSpring for posting your query.

I have gone through your question in detail and I can understand what you are going through.

Your two main problems that you are suffering are
1) Depression
2) Adult ADHD

Zoloft 150mg and Lamectal 100mg are good drugs in good dosage for resistant depression but it seems your depression is not getting better with these medications. There is an undeniable feeling of hopelessness in your write up and that suggests that you certainly need to change the antidepressant. Further the another cause to switch the antidepressant in your case is that you have a co-morbid ADHD along with depression and hence Bupropion would be a better option in such cases as it helps both in depression as well as in ADHD.

Also along with the medications you should also take up cognitive behavioral therapy.

This therapy is taken by either a psychologist or a psychiatrist in which the therapist identifies impaired cognition (Thoughts) and try to correct them. They are 15-20 min weekly session and there should be around 8-10 sessions to help you with your illness.

If adderal has not suited you then that doesn't mean you should leave all the hopes. Methylphenidate is also a stimulant and has good efficacy in adult ADHD and should be a good choice for you.

Also try as much as possible the organizing tools such as a maintaining a dairy or using various smart apps on your smart phone.

Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.

Wish you good health,
Kind regards
Dr. Srikanth Reddy M.D.


Patient replied :

Hi Dr. Reddy,
Could the Bupropion work well in conjunction with the Zoloft and Lamictal? Could it give it a boost? Would you be able to give me an online prescription?

Thank you so much,
Sarah


Hello,
Thanks for the follow-up query.

Yes Bupropion can boost the effect of Zoloft and Lamictal as far as depression is considered as it acts as an antidepressant in the different way. As Doctor Spring is an online forum, legally we are not supposed to prescribe medications without physically examining you. Such regulation are primarily meant for the safety of the patients as well as the Doctor. Further any prescription given in E-mail will not be honored by the pharmacy in your country. Sincere apologies for the same.

Regards


Dr. Srikanth Reddy
Category: Sexologist
Experience: 
Doctor of Medicine (MD), Psychiatry Residency Program,2001 – 2012
M.B.B.S,Mahatma Gandhi Institute Of Medical Sciences, Sevagram

Certificate Course in sex Therapy and Counselling, Sexology and Counselling, A
Sexology,Medikon Sexual Sciences, Mumbai

Training in Advanced Neurology at a leading corporate hospital (CARE hospital) in Hyderabad

Child Psychiatry Training in National Institute of Mental Health and Neuro-Sciences, Bangalore

Sex Therapy and Counsellingat MEDIKON Sexual Sciences, Mumbai.
Dr. Srikanth Reddy and 4 other Medical Specialists are ready to help you

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