Posted by ed_uk on January 14, 2005, at 14:09:49
In reply to Re: Psychostimulant Neurotoxicity » ed_uk, posted by lars1 on January 14, 2005, at 13:13:04
Hi Lar,
Thank you for your reply! Thanks for the abstracts.
>Ricaurte and McCann(1) seem to think so, too; they write, "From a clinical standpoint, when chronic use of a psychostimulant is indicated (e.g., in ADHD, narcolepsy), it would seem prudent to prescribe methylphenidate rather than amphetamine, since methylphenidate appears to lack the DA neurotoxic potential that has been well documented for amphetamine."
Here is a summary of the UK NICE guidelines...
NICE guidance (methylphenidate). NICE has recommended (October 2000) that methylphenidate should be used as part of a comprehensive treatment programme for children and adolescents with a diagnosis of severe attention deficit/hyperactivity disorder (ADHD). Treatment should be initiated by a specialist in ADHD but may be continued by general practitioners, under a shared-care arrangement. When a child receiving methylphenidate shows improvement and the condition appears stable, treatment can be suspended periodically in order to assess the need for continuation of therapy.
........Dextroamphetamine (dexamfetamine) may be suitable for patients who don't respond to methylphenidate.
>He says that Adderall works better for adults, and he won't let me even try methylphenidate. :-(
Yes, most p-babblers seem to prefer Adderall. It's strange that he won't even let you try methylphenidate though. Will you pursue the subject further?
>From what I read, the main disadvantage of methylphenidate is that it is more likely than amphetamine to cause anxiety.
Yes, and anxiety is a big preoblem for me. What about you?
>Therefore, I have to wonder how a methylphenidate + benzo combo would compare for safety and effectiveness.
For some people, a benzo might be expected to negate some of the therapeutic benefits of the methylphenidate. Others have used the combination successfully however.
>Wellbutrin, Strattera, Provigil, MAO inhibitors, etc.
Which have you tried? What did you experience?
> Is this question just hypothetical? I thought that you weren't able to get psychostimulants prescribed where you live.
There is a small possibility that if I went to a private psychiatrist, a stim might be prescribed.
>Another option would be methylphenidate + amphetamine.
If a person responded better to amphetamine than methylphenidate, perhaps it would be useful to 'rotate' the two drugs eg. Adderall on a morning then methylphenidate in the afternoon.
Best Regards,
Ed.PS. I'm about to start some new threads about stims! Please reply if poss, I'm sure you will be interested!
poster:ed_uk
thread:441645
URL: http://www.dr-bob.org/babble/20050113/msgs/442157.html