Can Stimulants be a Destabilizing Influence?
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Q:  Can Stimulants be a Destabilizing Influence?

I was diagnosed with ADHD about a year before I was hospitalized for bipolar. After trying Zyprexa, Depakote, Tegretol, now I am on Lithium.  I feel fully stabilized yet my ADHD symptoms are still present, this is cripling my ability to work or be productive at college. Ideally I would like to go on Adderall.  I would like your opinion on the combination of Lithium and Adderall.  Thanks so much

Dear John -- 
I have quite a few patients who've been through what you're describing who've done quite well when a stimulant was added, without evidence of the stimulant "destabilizing" things (i.e. counteracting what the lithium is supposed to be doing).  Whether stimulants can be a destabilizing influence has not really been studied systematically, to my knowledge; there are mixed opinions about how much risk they pose in your situation, and no research data I know of to go on.  

Dr. Phelps

Published June, 2003


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