Medicines for ADD ADHD
Like everything else, this is going to be harder and take more time than I thought.
To repeat – everyone is unique. What works for one won’t for another. You need trial and error to find the right medicine at the right dose on the right schedule that works for you. For some, these medicines work a miracle, for some, they are helpful, and for others, no.
The Stimulants:
Methylphenidate – Ritalin (plain, long-acting, sustained-release, in a skin patch), Concerta, Daytrana, Focalin, Focalin XR, Methylin, Medadate CD/ER. Most common possible side effects are stomach upset, anxiety, loss of appetite; these can usually be managed and minimized if they do occur. Safe, but use carefully with heart problems or high blood pressure. Not very addictive but are being abused/misused by college students. Probably not helpful unless you have ADD ADHD. Very expensive brand-name, but generic is available for some. An advantage is you can take them when you want and leave them off when you want.
Amphetamines – Adderall, Adderall XR, Dexedrine, Vyvanse (less abusable)- Probably not more effective than methylphenidate, although they will be for some people. Probably more addictive and more abused. Side effects, probably about the same. Again, use or not when you want to.
From Oren Mason MD based on newly published research:
- We are beginning to understand the causes of ADHD. ADHD is a condition that involves abnormal brain function.
- Specifically, normal folk have capabilities in their brains that ADHD folk don’t. So far, the reverse hasn’t been seen.
- Stimulant medications restore (at least some) normalcy to brain function. They are not–as they are sometimes described–giving ‘speed’ to normal brains. They bring normal brain function to people who were born without it.
- These findings have been so consistent across multiple studies, that they can be considered “scientifically proven”.
Notes:
I have no experience with the amphetamines. Medicines are not The Answer for most people. I recommend medicines, strategies (often with coaching) and therapy (to deal with the underlying shame, low self-esteem, depression, etc.). You need a careful evaluation to rule out other possible causes of the symptoms and comorbid conditions which are frequent. I don’t think these medicines calm us down. I think they basically help us focus and then we can calm down. I haven’t been able to clarify the actions of stimulating release of norepinephrine and dopamine from the neurons versus blocking their reuptake, or both. I get conflicting stories.
Happy Valentine’s Day!
Doug
Bonus links:
Lots more, especially about Ritalin:
I am hoping to get some clarifying comments, as well as any questions you may have.
My brain functions more normally with medicine.
ADDadultstrategies 
Doug,
As for the role of dopamine and the other neurotransmitters there is an “Inverted U-Shape Dopamine Action” that describes the performance of working memory and cognitive control. This means tool little or too much dopamine will cause impairment and may be the source of your conflicting stories. Look for information on D1 and D2 dopamine receptors.
LikeLiked by 1 person
boz- thank you. That is new information for me, and I’m trying to get this stuff straight. I know that both the Ritalin and Adderall cause release of dopamine and norepinephrine, but do you know if they both also block the reuptake?
Thank you for commenting.
Doug
LikeLike
Doug,
Think of dopamine as the energy comptroller of the brain. Where it gets received D1 or D2 receptors is going to determine behavior flexibility. One end of the balance is perseverance and the other is distraction. If an ADHD patient has too much stimulant medication they become distactable again.
That’s what I gleaned from some recent research findings. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3901300/#B4
David
LikeLike
Living with my ADD before I knew that I had it was quite the wild ride. The diagnoses were many, the solutions were few. Medication for the wrong problems did not help, and, in fact, made things even worse. But the day did come when I knew what was wrong. I went to my psychiatrist and told him what I thought. He was a new doctor to me, so this was going to be interesting, to say the least…
We spoke, I actually gave him my report cards from the elementary grades. I told my new doctor that I did not want to take medications that were not going to make things better. He agreed that doing so would be pointless. He did, however, schedule some testing, along with some lab work. When I saw him next, it was to take my computer-based tests. I was just finishing up when he stuck his head through the door and said, “Hi! We need to talk”. that was on my 50th birthday.
Therapy was started and I learned so much! My collection of tools has changed somewhat over the years, but the tools really help. My favorite is my personal planner. No medications have been tried at all for my ADD. Aside from other health issues, I just did not want them. Could they help me even more? Perhaps, but I liked my life then and I love my life now that I have learned so much about how to help myself.
Dianne in the desert
LikeLiked by 1 person
Dianne- great story! many do fine without medicine, i dont know if it would make your life any better, or if it might some but not be worth the trouble. Your’re happy where you are so thats the point – if it ain’t broke, dont fix it.
thank you for commenting
doug
LikeLike
Vicki – sounds like a good therapist. But also, maybe you could pick one very specific problem to work on, with a strategy. Success in that will make your life better and help with the feelings you are working on in therapy. Maybe ask you therapist about this?
LikeLike
I am now taking Vyvanse. I first misread your article, thought you said it is less “useable” as I’ve run into issues with dissolving it in water, how much water, wait, I already put water in there. Oh, I don’t know, if there’s a mistake to be made, I will make it.
But I wondered what you mean by less abuseable. Is it because it is slow release? Or the type of slow release? Not that I want to abuse it. I don’t at all like that edgy feeling if I have too much, which I’ve accidently done.
So I have 2 strategies for preparing the Vyvanse. I now have a large mouth (specimen cup) with measurements so I can mark the water fill line forever and it’s easier to pour in the capsule contents.
And I recognize that I need to prepare this, say at 6 pm after dinner, rather than when I’m rushing to bed, and am more inclined to make mistakes..
LikeLiked by 1 person
Vicki- good for you! Great strategy and problem-solving, using dinner as an anchor to fix the medicine before you are rushed.
Vyvanse- “Lisdexamfetamine itself is inactive and acts as a prodrug to dextroamphetamine upon cleavage of the lysine portion of the molecule.” Because it has to be cut by an enzyme to work, which takes time, it is slower to be available to the brain and less able to give a rush, and therefore less abusable.
sounds like you’re making good progress in the process of getting the dose and timing adjusted just right for you. we need to learn how to use our medicines.
Thank you for commenting.
Doug
LikeLike
Well, adding my input for anyone to see: I’m on Methyilphenidate for a month, the dosage has been slowly increased by the doctor since the beginning and it was prescribed mostly so I deal better with people around me – like most ADD/ADHD adults, I don’t have what people call a thick skin; which, as I’m told, is caused by my ADD. After a month, it hasn’t worked magic. I think knowing what I have and getting valuable tips on how to deal from other fellow ADD-patients here has worked about as much as the medicine. But I do notice that, while I’m still bitchy about strangers, I have it easier when it comes to dealing with people I’m forced to deal with it in everyday life, especially at work. I don’t have the thickest skin, but I’m now more able to say to myself “Let it go!” and focus on the next task for the time being – something that was unthinkable most days BM (Before Meds). Looking forward to reading more, Doug!
LikeLiked by 1 person
Ram – “able to say to myself “Let it go!” and focus on the next task “!
wow! what kind of magic were you looking for? 🙂
that’s great.
Hope you’re working on strategies for using the signal to avoid the blowups?
Thank you for commenting.
Doug
LikeLike
Doung, I guess I was looking for the kind of magic that makes me not burn myself in the oven three times a day – even if it’s too light to make a blister, it hurts like hell and leaves a mark for a few months. My forearms look like you wouldn’t believe it and none of my colleagues has the same problem. They’re baffled at how my arms look and I usually get “You just have to concentrate”. Hah. Wise guys…. But yes, being able to force myself into focusing on occasion is good, but not infallible. I think I’d only consider it a miracle if it was infallible, but I might be expecting too much, judging from your comment. 😉 And yes, I’m thinking of strategies to work on the blowups, but whenever I think of answering the other post, I’m outside of the house and it’s hell to find certain stuff on my Smartphone.
LikeLiked by 1 person
RAM – well, the medicine helps us focus, but it doesn’t solve all our problems, does it?
“You just have to concentrate.” – Sounds a lot like “you just have to try harder”, pretty useless advice for us ADDer’s.
problem solving – other than trying harder to concentrate better – like trying to roll a big boulder uphill with your arms tied behind your back and your legs tied together for us –
are there any other things that might help? I don’t know the situation, but I wonder about abestos sleeves or protective ointment or some other way to get things into the oven or trading off that part of the job with somebody else or something you can come up with since you do know the situation.
glad you’re working on the strategies.
I am cell phone challenged – currently trying to figure out how to use my password to get onto LinkedIn??
Thanks for communicating. Best wishes
Doug
LikeLike
Thanks for the tips, Doug, although I do have to I say, they sadly don’t apply. I don’t think anything with asbestos is allowed in Germany, let alone asbestos sleeves. Longsleeves alone would help, but my brain implodes from the heat alone when I think of it – same reason why I can’t trade-off: that’s what I was trained to do on the new job, who they needed on Sundays. That means, at least 4 hours straight opening and closing oven doors, pushing stuff in and out. Telling the bosses about ADD… whew… my new boss told me today: “You’ve been doing something mistakes on Sundays, and I don’t know why, but it can’t go on.” Like that. Doesn’t wait for an explanation, doesn’t care. And he’s not alone. It’s a b*tch of a job. Whoever said being a pastry-chef was a creative job is a liar. It’s strict and there’s no wiggle room – unless you’re extremely fabulous, which I’m not. I’m working on switching professions, but it will take time. Still, can’t let my head hang. Well, more than half-an-hour a day or so. You have to allow stuff to really sink in before you can do anyhing about it, that’s what I say 😉 Thanks for the tips. I’m going to try and find out a pattern on when I burn myself and what strategy can I use. Thank god I only do the oven on sundays…
LikeLiked by 1 person
RAM – I think you caught on, those were not tips or suggestions, but examples. You’re exactly on the right track -“I’m going to try and find out a pattern on when I burn myself and what strategy can I use. ” my theory is that every problem has a solution. If we recognize it’s a problem and then think about it, and one of our ADD ADHD “gifts” is thinking outside the box
thank you for commenting
Doug
LikeLiked by 1 person
I like the quote “(medications) bring normal brain function to those born without it” I was recently diagnosed late in life, as you were, and it is a developing concept to me that, as this says, I was born without normal brain function. I have lived my life with this, and thought for so long it was more or less ‘normal’, although a little bit different.
I am having psychotherapy to deal with the emotions and issues of ADHD, in addition to medication. The therapy gives me some hope that a productive new normal may be achievable. And gives me a place to validate all the pain and shame. I could not move forward without it.
Thank you, Doug, for addressing the meds and treatments. I applaud your small bites. It’s most difficult to be concise like you are doing. Great job!
LikeLiked by 2 people
vicki – I do find it difficult to be concise, but that is one of my goals. Good for you for being in the therapy – it’s hard work, and takes guts, but can be very helpful. And hope you are picking up strategies.
Thank you for commenting.
done
LikeLike
I have your book, among other resources, for help with strategies as I am ready. Early on, my therapist says to focus most on accepting the ADHD and grieving my losses. Thank you for the support.
LikeLike