Posted by alan on September 25, 1998, at 9:55:36
In reply to Re: Psychologist or Phychiatrist? For ADD, posted by Toby on September 24, 1998, at 11:20:38
> I hope you got some relief from the side effects you were experiencing before. If so, and the Adderall was really doing some good, there is no reason for you to not have the medication. There are psychiatrists and psychologists who specialize in ADD but I don't know how you would find that out other than calling their offices. If you live near a teaching hospital, one that trains medical students and residents, the psychiatry or neurology departments would be a good place to try. They will be up to date on all the new medications, combinations of treatments, etc and will not be as skeptical of trying treatments that may be off label (i.e., not FDA approved). That psychologist (are you sure it wasn't a psychiatrist?) was correct that stimulants aren't approved in adults but that's because the company is not going to spend the money to get another FDA approval for the label when their patent doesn't have that much longer anyway. But stimulants are used all the time in adults for depression, narcolepsy, and now ADD. So try a teaching hospital if one is near to you, otherwise, just call around for a doctor that treats a lot of ADD. There are many options for treatment besides the stimulants and two of the newer ones are antidepressants: Effexor and Wellbutrin (I like Wellbutrin a little better). Also, there is Cylert (no abuse potential, once a day dosing) and some of the old antidepressants (imipramine) and some blood pressure meds that work right well: guanfacine and clonidine. One of those options may work better for you if you continue to have some of the same blunting feelings that the Adderall was causing (if I remember what you said correctly). good luck.
This may be as good a place as any to point out that clinical psychologists are not, in effect, just psychiatrists who can't prescribe, perhaps because they flunked chemistry and calculus as undergrads. (SOME are just that, of course. As some MDs couldn't hack advanced experimental methodology.) Psychologists have--or ought to have--special skills and conceptual resources which can be of special value; in cognitive-behavioral therapy, for example. Ideally, the psychologists and psychiatrists should accept a reasonable diviion of labor, and advise patients accordingly. And patients should try to determine what they need, and from whom, of course with proper profesional advice.
poster:alan
thread:664
URL: http://www.dr-bob.org/babble/19980901/msgs/686.html