I'm currently taking Cymbalta for generalized anxiety, fibromyalgia pain and ADHD. While I've only been taking it for three weeks I can tell a marked improvement in all three. Thank you for this thorough breakdown of it's effects and treatment uses, very helpful.

@dr.johnkruse6708

Күн бұрын

You're welcome, and I hope that it continues to help you.

thank you, very interesting

, thank you dr. john I wonder why parkinson disease meds like sinement or stalevo usually not use in treatment of ADHD?

@dr.johnkruse6708

Ай бұрын

I agree, these dopamine boosting agents would seem like logical options. There has not been a lot of research on these drugs, and what l little there is did not show large enough benefits to encourage further research. Here is more on amantadine, one of the mainstays of Parkinson's treatment. kzread.info/dash/bejne/oHqLwdySYamXoMo.html

Have you gotten much better results with cymbalta over strattera? The reallly scary thing about seritonin reuptake inhibitors is how hard they are to get off of them, and if if duloxotine is that much stronger Ron serotonin than it would seem that duloxotine would have a bigger withdrawl effect. Does the benefits overweight the risks over strattera?

@dr.johnkruse6708

Ай бұрын

The vast majority of people I have worked with tolerate Cymbalta with minimal problems, and all of them have been able to stop, with a gradual (two month or more) withdrawal, without any lingering problems. More on antidepressant withdrawal is here kzread.info/dash/bejne/qoKWpdGYqbLNlZs.html In contrast, almost everyone I have worked with has had trouble starting or continuing on Strattera. If you look at the comments on this video kzread.info/dash/bejne/kax4tciqh6iZc7A.html it seems that while some people have had good success with Strattera, it is more common to have a miserable experience. In my clinical experience Cymbalta's benefit/risk ratio for treating ADHD is much better than Strattera's.

Is amantadine anticholinergic? I have been taking it for ADHD. It has a very subtle effect, I noticed I can focus better while reading and my mind doesn't wander after every couple of lines. But I heard that it's anticholinergic and I think maybe I am a little dumber on it. Does Duloxetine help with the motivational aspects of ADHD? Task initiation, productivity, executive function?

@dr.johnkruse6708

Ай бұрын

Amantadine appears to have some anticholinergic side effects in humans, but in animal studies the molecule doesn't seem to bind to acetylcholine receptors. I've had some patients report improvement from duloxetine with motivation, task initiation, and productive

Heard this one already,good one.Can you do one on Venlafaxine?

@dr.johnkruse6708

Ай бұрын

Everything I would want to say about venlafaxine (Effexor) is in this video on Cymbalta. When venalafaxine was the only SNRI available, it made sense to use it. It really doesn't anymore for most individuals, since it is so relatively weak on the norepinephrine reuptake transporter. Even though there are more studies on venlafaxine for ADHD than there are for duloxetine, I think any direct head to head study of the two would be a hands down winner for duloxetine.

Dr John, thanks so much for your videos, you're helping our ADHD community with useful information and suport. Let me ask you: my dilema is between Vyvanse 50mg and 70mg, the 50mg gives great internal concentration, I can read, it calms my brain and no rarely I feel sleepy, while the 70mg wakes me up, gives me some extra energy but I cant read for long time, its like I'm little hyper. Since I'm inattentive ADHD, maybe CDS/SCT, which dosage seems correct to you? In my country there are only 30, 50 and 70mg Vyvanse dosages.

@plymix8389

Ай бұрын

Hey, I’m not the doctor but i can offer my advice since im in a similar dilemma. My max dose of effective vyvanse is 40mg but I take 20mg since 40mg makes my impulsive. I’ll explain my thoughts to you. Basically, your body has only a certain ammount of dopamine it can actually regulate, too much dopamine above that ammount without any other drug to increase regulation such as Guanfacine and you will become impulsive. Even though 40mg feels so much nicer of an amp for me, I have come to enjoy the peace of not being impulsive at my 20mg I take. Same as you I feel very sleepy usually? But the 20mg takes care of that but I kinda do feel like I want a little more. But yeah, It gets better overtime and once you start beliving in it, you will love it more. That extra amp for a trade off in impulsiveness is not worth it bro. There is 30mg of Vyvanse. You can try 30mg x2 for a total of 60mg a day aswell if you can afford the extra pills. Edit: another option you can try it’s taking the low dose of Guanfacine extended release. 1mg is the lowest. Take that and 70mg of vyvanse. It should be able to weaken the 70mg down a bit. The issue is that it might overweakn it to feel like 50mg. But yeah just giving you another option. (I actually take 1mg 2x daily with my 20mg 1x daily of vyvanse and it works amazingly)

@dr.johnkruse6708

Ай бұрын

Vyvanse capsules can be opened to get intermediate doses, so that might be an option, if you're "open to it". My general advice is always to get by with a lower dose than a higher one, if possible, just to reduce the likelihood of any long term problems.

thank you so much for sharing your knowledge with these videos! i have 2 quick questions, if you don't mind: do you think duloxetine is more effective for treating adhd than bupropion? and, do you have an opinion on combination treatment with a non stimulant + amphetamine? i am sometimes taking low dose ritalin in the evening, after my dextroamphetamine during the day. it seems to calm me in a way the amphetamine doesn't, and helps me to just relax before bed. i would be interested in adding a non stimulant to the amphetamine, in hopes that it could add a similar calmness like ritalin does for me, and to provide some additional stability in between the d-amp doses.

@dr.johnkruse6708

Ай бұрын

I've seen both buproprion and duloxetine work well for ADHD, but I have not been able to pinpoint any patient characteristics that identify who will respond better to one than the other - except if there is substantial co-occuring anxiety I would very likely try duloxetine first. I have worked with many individuals who have had good results from a combination of either duloxetine and stimulants or bupropion and stimulants, and usually it allows them to take a lower dose of stimulant than they otherwise might have.

@carltonlassiter7724

Ай бұрын

​@@dr.johnkruse6708 thank you for the reply, much appreciated!

@angeloselarja

13 күн бұрын

​@dr.johnkruse6708 would combining duloxetine with bupropion be a good idea?

@dr.johnkruse6708

9 күн бұрын

@@angeloselarja I've seen it help some individuals, and others where it either didn't add value, or contributed to anxiety and over arousal. If it is an option you pursue, I would start with a low dose, and see what your personal results are, good or bad.