Posted by Shell on January 24, 2001, at 11:46:15
In reply to Prescriptions for ADHD stimulants, Ritalin etc » Shell, posted by Leonardo on January 24, 2001, at 5:42:05
> My situation is that I am being treated for depression (including seasonal affective disorder), but the possibility that I have ADHD too is a new one I've only recently started discussing with my psychiatrist. The drugs Ritalin and Dexedrine can be prescribed in the UK, haven't checked about Adderall and Concerta yet. According to the British National Formulary, Ritalin is only prescribed for childhood ADHD, similar for Dexedrine. They are specifically excluded for treating depression. So it looks like you need an ADHD diagnosis to get the prescription. Unfortunately, ADHD isn't officially recognised in adults yet in the UK, so adults getting stimulants prescribed is more difficult. I need to do more research to see if any adults in the UK are getting stimulants offically for ADHD, I don't know yet.Hmm...sounds pretty complicated. I wonder what happens with ADHD children. Is their medication terminated on their 18th birthday? I would be surprised were there not more than a few who discontinued medication upon reaching adulthood and noticed a decrease in functioning. Do you think these patients are ever allowed to resume the medication, despite being adults? If so, that would set a precedent for adults being prescribed stimulants for ADHD.
> I think my Pdoc may eventually let me try stimulants, but only if he is convinced that my concentration/attention/memeory problems can't be explained just by the depression. I will need to try some different antidepressants and show that I can be free of depression, but still have ADHD symptoms..... Unfortunately, this process will take several months at least, as I have not yet found a really successful cure for my depression. A quick trial of Ritalin etc would give me a good idea of whether I really do have ADHD or not, though of course my Pdoc can't support this.
I'm not convinced that you should have to get the depression under control and then demonstrate that you still have ADHD symptoms. If your doctor isn't convinced that concentration/memory/attention problems are not caused by the depression, even if all your other depression symptoms disappear, he could still argue that those problems are simply remnants of the depression unrelieved by the medication (rather than caused by ADHD). Were that the case, would he still be willing to prescribe a stimulant to augment the antidepressant(s)?
It's not clear to me whether you feel you do have ADHD (since you have only recently began to discuss the possibility) or if you feel that the addition of a stimulant will help alleviate your depression. There are a number of online screening tests that could give you a good idea if ADHD is a possibility. I'm not sure if your doctor mentioned it, but one way to distinguish ADHD symptoms from depression symptoms is by comparing their time of onset. If your attention/concentration problems are due to depression, they would have started when the depression did. If they are due to ADHD, they would have always been there, even when you didn't have depression. One of the things that must exist in order to have an ADHD diagnosis (according to the DSM-IV - do they use that in the UK?) is that the symptoms were present before age 7 or 8. Unless you were a depressed child, I would think that if you had those problems for as long as you can remember, that would point to ADHD rather than depression as the causative factor.
For what it is worth, I can tell you that I was initially treated for depression. My doctor sent me to a psychologist for therapy in addition to the medication she was prescribing (Effexor and Wellbutrin). At the first session, the psychologist diagnosed ADHD-inattentive type and we started Concerta (which is just an extended release version of Ritalin). My attention problems did improve dramatically the first day, but the real surprise was that the depression seemed to respond to it as well. That could be coincidence however, since I added the Wellbutrin only a month or so before and it may have been that the Wellbutrin effects were just beginning to be noticable around the same time. I'm not asking too many questions, since the combination works for both the ADHD and the depression (dropped the Effexor, it didn't seem to help).
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> I have ordered drugs from 2 online pharmacies successfully so far, but they were recommended by people who had already used them. So I was hoping to get a recommendation from here!
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> LeonardoHas your doctor indicated that he would prescribe a stimulant if you could prove that your symptoms improve when you take one (probably not, but thought I'd ask)? I have read that most people, even those without ADHD or depression seem to have some degree of improved concentration with stimulants, so I'm not sure that the fact that you respond favorably to them would convince him that you have ADHD (were that what you intended).
I'm sorry I can't be more helpful. I have no medical or psychological training, so my opinions are just my opinions..I could very well be way off base. I've just been there and done that. Perhaps it would help to bring the results of a self-administered ADHD test to his attention at your next appointment.
Shell
PS - I have heard that doctors in the UK feel that ADHD is overdiagnosed in the US (and it may well be). I read something recently that suggests an explanation of why the incidence of ADHD may actually be higher in US than in the UK. The assertion was that the type of people who would be willing to leave an established society to start over in an unknown country would be more likely to have a higher incidence of ADHD (due to the ADHD personality being both less resistant to change and more novelty seeking). They then explain that these were the type of people to immigrate to the US in large numbers and since ADHD has a genetic component, it would follow that this country started with a higher level of ADHD type genes in the gene pool, which is continued through their offspring.
poster:Shell
thread:52294
URL: http://www.dr-bob.org/babble/20010122/msgs/52411.html