![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 20 to 44 of 44. Go back in thread:
Posted by Katz on March 4, 2001, at 9:46:15
In reply to Re: Adult ADHD - getting stimulants prescribed (UK) » Katz, posted by Leonardo on March 4, 2001, at 9:05:32
Leonardo,
I'm sooooo happy for you! I'm thrilled that you have finally gotten the right diagnosis and are well on your way to a treatment stratery that will help. I'll be keeping my fingers crossed that all goes well.
As for me, I don't believe that I have ADHD but ADD is a possibility. I was on Ritilin approx. three years ago for 6 months. I was on 20 mg/day, never increased my dose and had amazing results. Dysthmia, Anhedonia and especially Social Phobia, all greatly improved. The med was discontinued when I was no longer able to travel 3 states away every month to obtain a prescription. My attempts to find a pdoc in my area to prescribe ritilin have been futile up until now.
A note about Dexedrine: The doc the prescribed the ritilin had me on dexedrine first. I eventually got up to 30mg/bid with absolutely no effect. I could take it, rollover and go back to sleep. I think the dex was possibly making me depressed also. But, as the saying goes, "everyone's mileage is different."
Unfortunately, my appt with the new pdoc is tomorrow and it appears it will be cancelled due to what is being hailed "the snowstorm of the century". Predictions are that it may dump 3' of snow here in New England before all is said and done. Looks like the gods are conspiring against me. Aughh! Anyway, I'm glad things worked out for one of us. Keep us posted on your progress.
Best wishes,
Kathy
> > >Leonardo,
> >
> > I'm keeping my fingers crossed and wish you the best of luck in obtaining the stims. I've been wondering how you've been doing, the last time we talked you were about to embark on two new AD trials. Since you're still trying to get stims I guess they didn't work out. BTW, I have an appointment with a pdoc on Monday (thanks to a fellow babbler) in which I will be trying to obtain some ritilin. Here's hoping we will both be successful in our endeavor.
> >
> > With prayers,
> >
> > Kathy
>
> Hi Kathy
>
> Many thanks for your thoughts, I can see that you know what its like to go through this dreadful quest of finding someone who can help you! I told my new doc it was like trying to fiond the Holy Grail. He agreed and is annoyed because it shouldn't be so hard.
>
> I was off meds altogether for about 3-4 weeks (quit selegeline), and had a very hard time coping at work, hence I haven't been posting much. I then tried the Zoloft which my SAD specialist recommended, but it was hopeless, made my head go into a real spin, worse than anxiety, just spinning racing thoughts that wouldn't settle down. My GP gave me diazepam (Valium) which calmed me down, but the zoloft obviously wasn't working for me so I quit after about 10 days.
>
> As I just replied to Shell, I got my consult with the ADHD specialist quicker than I thought (my insurance agreed to pay for this guy, I took a cancellation appointment at 24 hours notice and drove half way across the country!) He was great, I'm on the 5th day of dexamphetamine. It is early days, but very promising.
>
> I seem to remember that you didn't think you had ADHD? I found that the symptoms are not always that obvious, it took me 2 years to recognise it in myself after I recognised it in my son. Good luck with your new doc. Have you tried Ritalin before? My new doc is very stricy about the startup regime. For the dex it is a half tablet only, twice a day for 5 days, before going up to 1 tablet am, half at lunch, and half at 4pm. Then its reviewed after 2 weeks. He reckons that people who try to start up too quick can get a bad response which never settles down properly, and they have a lot of trouble later on. This may explain my variable response to the Ritalin I took. I went straight in at a full tablet, taken just occasionally. I got some very good responses, but some bad ones too, so I'm following orders from the doc this time. I think he has about 500 ADHD patients, so I take him seriously!
>
> Best wishes
> Leonardo
Posted by JahL on March 4, 2001, at 13:38:33
In reply to Re: Adult ADHD - getting stimulants prescribed (UK) » Shell, posted by Leonardo on March 4, 2001, at 8:46:54
> >I got a cancellation appointment at short notice, and saw my new ADHD specialist on Wednesday. He was great! I could have had either Ritalin or dexamphetamine, so I plumped for the dex. I had heard that it was often better for adults, though the doc thought there was no way of knowing which is best without trying them. I have to start at a low dose (2x a half tablet per day) for 5 days, and then go up. So far so good! I will try 2 tablets for the first time tomorrow.
> > I got a very strong response to the first dose, but it has been tailing off since. The first day I managed to do as much work in 5 hours as I had done in the previous week through lack of concentration. Now I feel OK-ish, but reckon I'll need a much higher dose to really tell. For the last few weeks I was really struggling at work, the odd dose of my son's Ritalin helped, but when I tried the Ritalin alternative Equasym it made me worse and very anxious. Scary.
> >So I just hoping it will turn out OK as I crank up the dose. It is certainly much more effective than any of the antidepressants I tried before.> Best wishes
> LeonardoHi Leonardo.
Glad to see you're finally getting the treatment you're due. I'm amazed it was that easy. B4 I flew 2 the US to get stims, my UK pdoc referred me 2 an adult ADD clinic (in Cambridge). The letter I received from them (after *6* weeks) was accompanied by a 15 page questionare. I was told I would also be expected to undergo extensive psychometric testing & various interviews. If after all this, it was decided that I was ADD, I would be given a *single* dose of 1 med, the implication being that a non-reaction means you don't have ADD (!?!). I declined.
My US pdoc recommends test-driving as many stims as possible, to find the one that gives the best results. Why settle for good when you can have great? Something 2 think about.
Anyway, sounds like you've found a good'un-keepahold of him! Good luck with the trial,
Jah.
Posted by Leonardo on March 5, 2001, at 8:12:27
In reply to Re: Adult ADHD - getting stimulants prescribed (UK) » Leonardo, posted by Katz on March 4, 2001, at 9:46:15
Hi again Kathy!
Sorry to hear about the snow in New England, hope you managed to get to the appointment. If so how did it go, will he prescribe the stuff? We have been having some snowstorms here in Olde England too, but where I am in the south we get off pretty lightly.
I was interested to hear you say you don't think you have ADHD, but may have ADD. I don't have much of a hyperactivity component, so reckoned I have the DSM-IV category of "ADHD - primarily inattentive type". DSM-IV no longer uses the old term 'ADD' which means the same, but I now notice that most people on PB still talk about ADD rather than ADHD. I think I'll start saying ADHD/ADD to make sure I'm covered!
Anyway, it is certainly possible to have ADHD under the new criteria without ever having been hyperactive. The clincher for me was reading an adult ADD/ADHD checkilist at http://adders.org/info7.htm - give it a go! I scored a good 19 out of 20 and felt sure I was onto something. There are many other checklists around, some bring out problems with relationships and dealing with other people which might be relevant to your social phobia. I too have had low level depression always, and difficulty getting any fun out of life. ADD and depression seem to be closely linked, for me I think the ADD caused the depression because I could never get round to getting my life under control and solving my problems.
There is even an unofficial definition of 6 subtypes of ADD/ADHD including Depressive Subtype, which fits me closest I think. See:
http://user.cybrzn.com/~kenyonck/add/add_legal_public.htm
and also:
http://www.amenclinic.com/ac/addtests/default.asp
Interesting that you didn't respond to dex, but it doesn't mean that you definitely don't have ADD/ADHD. As you say, everyones different in response to meds. The book I read said that about 50% of people respond equally well to Ritalin and dex, but 50% have a markedly better response to one or the other. I hope that Ritalin works again for you this time!
I have found from my limited expereince so far a very similar response to Ritalin and dex, though the dex does seem to be smoother and gentler acting than the Ritalin as others have said. It may be worth keeping an open mind, as I have found different response to taking the same drug at different times, also some different brands of the same stuff seem to be unreliable. I found the Equasym version of Ritalin made we decidedly worse. The dex I have is Dexedrine by Medeva Pharma Ltd.
Well I took a whole 5mg dex pill this morning for the first time, I'm feeling a bit woozy and tight-headed, but it's not much compared to most AD side effects. Otherwise I'm feeling pretty good, despite work crises!
Best Wishes
Leonardo> Leonardo,
>
> I'm sooooo happy for you! I'm thrilled that you have finally gotten the right diagnosis and are well on your way to a treatment stratery that will help. I'll be keeping my fingers crossed that all goes well.
>
> As for me, I don't believe that I have ADHD but ADD is a possibility. I was on Ritilin approx. three years ago for 6 months. I was on 20 mg/day, never increased my dose and had amazing results. Dysthmia, Anhedonia and especially Social Phobia, all greatly improved. The med was discontinued when I was no longer able to travel 3 states away every month to obtain a prescription. My attempts to find a pdoc in my area to prescribe ritilin have been futile up until now.
>
> A note about Dexedrine: The doc the prescribed the ritilin had me on dexedrine first. I eventually got up to 30mg/bid with absolutely no effect. I could take it, rollover and go back to sleep. I think the dex was possibly making me depressed also. But, as the saying goes, "everyone's mileage is different."
>
> Unfortunately, my appt with the new pdoc is tomorrow and it appears it will be cancelled due to what is being hailed "the snowstorm of the century". Predictions are that it may dump 3' of snow here in New England before all is said and done. Looks like the gods are conspiring against me. Aughh! Anyway, I'm glad things worked out for one of us. Keep us posted on your progress.
>
> Best wishes,
>
> Kathy
>
Posted by Leonardo on March 5, 2001, at 8:27:29
In reply to Re: Adult ADHD - getting stimulants prescribed (UK » Leonardo, posted by JahL on March 4, 2001, at 13:38:33
Hi Jah
Well finding out how to get the appointment was not that easy! As you may recall my previos Pdoc was trying everything else first, and I'm not sure that he would have prescribed stims in the end anyway. My GP refused to prescibe without a specialist diagnosis, not surprising I guess. I found the NHS waiting list at the Maudesley hospital in London was 14 months! There is a London clinic called Integrated Neurocare (Dr G Hosking), which charges £775 for a comprehensive diagnosis, but my insurance wouldn't pay. So eventually I found the Bristol Priority Clinic (Dr P Cosgrove) who charges £250 for a diagnosis in a 1.5 hour consultation, and no problem with prescibing stims if diagnosed. Follow ups are by phone.
I had the choice of Ritalin or dex, I'm trying dex, but I think I can switch if it doesn't pan out. He is trying to get Adderall imported, but hasn't got it yet. He is keen on starting at a low dose and working up gradually, and also knows that a 'good' response is not necessarily the best achievable. I think he prefers to exhaust the possibilities of the first trial by upping the dose as far as possible before switching though.
What did you try, did you find a winner? Do you think you have ADD/ADHD or something else?
> Hi Leonardo.
>
> Glad to see you're finally getting the treatment you're due. I'm amazed it was that easy. B4 I flew 2 the US to get stims, my UK pdoc referred me 2 an adult ADD clinic (in Cambridge). The letter I received from them (after *6* weeks) was accompanied by a 15 page questionare. I was told I would also be expected to undergo extensive psychometric testing & various interviews. If after all this, it was decided that I was ADD, I would be given a *single* dose of 1 med, the implication being that a non-reaction means you don't have ADD (!?!). I declined.
>
> My US pdoc recommends test-driving as many stims as possible, to find the one that gives the best results. Why settle for good when you can have great? Something 2 think about.
>
> Anyway, sounds like you've found a good'un-keepahold of him! Good luck with the trial,
>
> Jah.
Posted by Katz on March 5, 2001, at 11:18:14
In reply to Re: Adult ADHD/ADD - getting stimulants prescribed » Katz, posted by Leonardo on March 5, 2001, at 8:12:27
Hi Leonardo,
Thanks for all the info. I took the test and scored 13 out of the twenty. Seems to still leave me up in the air about the right diagnosis. The crux of the problem (as I see it) which is hindering a diagnosis of ADD is that I don't have *disorganizational* problems even though I do *tune out* and have many other ADD symptoms. The medical establishment seems firmly entrenched in the belief that ADD/ADHD *must* be accompanied by "an inability to get organized" and a propensity toward *multi-tasking*, as their main criteria for an ADD/ADHD diagnosis. Since I have neither one, an ADD diagnosis is automatically thrown out. I believe it's time for the "experts" to reevaluate the current ADD criteria. I truly believe that I am ADD w/o the current gold standard components. In any event, it is theorized that ADD/ADHD may be caused by hypoactivity in the frontal lobe region of the brain. I believe whatever label is put on my condition, it is also probably caused by the same inactivity of the frontal lobe and that is why I had such a robust reaction to the ritilin. I know for a fact that my brain needs to be stimulated and not sedated! The fact that we have to struggle in vain to get a stim is ludicrous! While addiction is cause for some concern, this simple little pill has far less serious side effects than any of the tradtional AD's on the market.
My appt with the pdoc was cancelled and rescheduled for next week. I'll let you know what happens.
Best wishes,
Kathy
Hi again Kathy!
>
> Sorry to hear about the snow in New England, hope you managed to get to the appointment. If so how did it go, will he prescribe the stuff? We have been having some snowstorms here in Olde England too, but where I am in the south we get off pretty lightly.
>
> I was interested to hear you say you don't think you have ADHD, but may have ADD. I don't have much of a hyperactivity component, so reckoned I have the DSM-IV category of "ADHD - primarily inattentive type". DSM-IV no longer uses the old term 'ADD' which means the same, but I now notice that most people on PB still talk about ADD rather than ADHD. I think I'll start saying ADHD/ADD to make sure I'm covered!
>
> Anyway, it is certainly possible to have ADHD under the new criteria without ever having been hyperactive. The clincher for me was reading an adult ADD/ADHD checkilist at http://adders.org/info7.htm - give it a go! I scored a good 19 out of 20 and felt sure I was onto something. There are many other checklists around, some bring out problems with relationships and dealing with other people which might be relevant to your social phobia. I too have had low level depression always, and difficulty getting any fun out of life. ADD and depression seem to be closely linked, for me I think the ADD caused the depression because I could never get round to getting my life under control and solving my problems.
>
> There is even an unofficial definition of 6 subtypes of ADD/ADHD including Depressive Subtype, which fits me closest I think. See:
>
> http://user.cybrzn.com/~kenyonck/add/add_legal_public.htm
>
> and also:
>
> http://www.amenclinic.com/ac/addtests/default.asp
>
> Interesting that you didn't respond to dex, but it doesn't mean that you definitely don't have ADD/ADHD. As you say, everyones different in response to meds. The book I read said that about 50% of people respond equally well to Ritalin and dex, but 50% have a markedly better response to one or the other. I hope that Ritalin works again for you this time!
>
> I have found from my limited expereince so far a very similar response to Ritalin and dex, though the dex does seem to be smoother and gentler acting than the Ritalin as others have said. It may be worth keeping an open mind, as I have found different response to taking the same drug at different times, also some different brands of the same stuff seem to be unreliable. I found the Equasym version of Ritalin made we decidedly worse. The dex I have is Dexedrine by Medeva Pharma Ltd.
>
> Well I took a whole 5mg dex pill this morning for the first time, I'm feeling a bit woozy and tight-headed, but it's not much compared to most AD side effects. Otherwise I'm feeling pretty good, despite work crises!
>
> Best Wishes
> Leonardo
>
>
>
> > Leonardo,
> >
> > I'm sooooo happy for you! I'm thrilled that you have finally gotten the right diagnosis and are well on your way to a treatment stratery that will help. I'll be keeping my fingers crossed that all goes well.
> >
> > As for me, I don't believe that I have ADHD but ADD is a possibility. I was on Ritilin approx. three years ago for 6 months. I was on 20 mg/day, never increased my dose and had amazing results. Dysthmia, Anhedonia and especially Social Phobia, all greatly improved. The med was discontinued when I was no longer able to travel 3 states away every month to obtain a prescription. My attempts to find a pdoc in my area to prescribe ritilin have been futile up until now.
> >
> > A note about Dexedrine: The doc the prescribed the ritilin had me on dexedrine first. I eventually got up to 30mg/bid with absolutely no effect. I could take it, rollover and go back to sleep. I think the dex was possibly making me depressed also. But, as the saying goes, "everyone's mileage is different."
> >
> > Unfortunately, my appt with the new pdoc is tomorrow and it appears it will be cancelled due to what is being hailed "the snowstorm of the century". Predictions are that it may dump 3' of snow here in New England before all is said and done. Looks like the gods are conspiring against me. Aughh! Anyway, I'm glad things worked out for one of us. Keep us posted on your progress.
> >
> > Best wishes,
> >
> > Kathy
> >
Posted by Shell on March 5, 2001, at 12:54:08
In reply to Re: Adult ADHD/ADD - getting stimulants prescribed » Katz, posted by Leonardo on March 5, 2001, at 8:12:27
That's fantastic! I'm so glad you FINALLY found someone who can help you. It's just a shame it took so long to do so. Someone less determined to find a solution would have given up long ago and as for the unfortunate person with ADHD who didn't even know to look for a diagnosis....
It's not quite that difficult in the US, but from what I've read here, it is more difficult than I'd realized. I had no problem at all being diagnosed and medication prescribed at my first appointment with my regular family doctor. I wish it could be that simple for everyone.
So how is it going with the Dexedrine? I have a cousin who prefers it to the Ritalin because of the smoothness you described. I am taking Concerta (54 mg in combination with 300 mg Wellbutrin) and I really can't compare it to any of the others since it is the only medication I have tried. I noticed that the first few weeks the effect was much more noticeable, now it is very subtle. I wonder if that is normal?
I am really glad you finally received the diagnosis and treatment you needed. Can your records now be transferred to someone closer to home or do you need to continue your cross-country treks for treatment? I don't know what your laws are, but here we must pick up the written prescription in person every month; I hope that's not the case for you.
Keep me updated!
Shell
Posted by sorcha on May 2, 2001, at 20:24:31
In reply to Re: Adult ADHD/ADD - getting stimulants prescribed » Leonardo, posted by Shell on March 5, 2001, at 12:54:08
Sorry to barge in on a dead (last post two months ago) coversation like this but I thought I'd try and revive it as I'm interested in more information.
I've encountered many of the same problems you speak about regarding diagnosis and prescriptions and am feeling very frustrated right now.My younger brother was diagnosed at 13 as ADHD. My father tried Ritalin for a while when they were thinking of it for my brother and found it worked fantastically for him. My brother never did get it and was expelled from school at 15.
Personally I never had much problems with school although I never did homework (from the age of about 6), was always disorganized and inattentive and never 'fulfilled my potential'.
I have been trying to get my bachelor's degree for the past 10 years or so, have switched majors several times, can't hand in anything on time (if ever), never study for exams more than a few hours before when I feel extremely pressured and have great difficulty writing papers. I have also switched 5 jobs in the past 6 years and am currently unemployed (as of January - the last company I worked for folded).There is no doubt in my mind that I am ADD (I am willing to forego the H) particularly since I recognize all the symptoms I see in my brother and my father in myself. There is no doubt in my parents minds that I am ADD either.
The medical establishment here (in Israel), on the other hand, does seem to have doubts. It is very difficult for my to find someone who will diagnose me, let alone get a prescription for something that might help.
I have gone to a psychologist, who claims it's not her responsibility and suggested I go to a private facility specializing in learning disorders. They won't see me since they only diagnoze children. My appointment with a neurologist yielded little result as he said he can diagnoze me but it won't be recognized by my medicare for prescription matters. The psychiatrist I saw sent me back to the psychologist saying he will have no problems prescribing ritalin when I come back with a psychologist's diagnosis.
It's like catch22
He did, however, prescribe an antidepressant (parotexine) after a 10 minute conversation. I do not believe I am depressed and I do believe I could benefit greatly from Ritalin but have no idea what to do anymore.Any suggestions?
Posted by Bill L on May 3, 2001, at 8:57:09
In reply to Re: Adult ADHD/ADD - getting stimulants prescribed, posted by sorcha on May 2, 2001, at 20:24:31
Sorcha- maybe you could call or write a letter to the psychologist and tell him or her that the psychiatrist said that he will give you Ritalin but needs the psychologist's diagnosis. Ask the psychologist to therefore write the diagnosis on a piece of paper and mail it either to you, or directly to the psychiatrist. Good luck!
> Sorry to barge in on a dead (last post two months ago) coversation like this but I thought I'd try and revive it as I'm interested in more information.
> I've encountered many of the same problems you speak about regarding diagnosis and prescriptions and am feeling very frustrated right now.
>
> My younger brother was diagnosed at 13 as ADHD. My father tried Ritalin for a while when they were thinking of it for my brother and found it worked fantastically for him. My brother never did get it and was expelled from school at 15.
>
> Personally I never had much problems with school although I never did homework (from the age of about 6), was always disorganized and inattentive and never 'fulfilled my potential'.
> I have been trying to get my bachelor's degree for the past 10 years or so, have switched majors several times, can't hand in anything on time (if ever), never study for exams more than a few hours before when I feel extremely pressured and have great difficulty writing papers. I have also switched 5 jobs in the past 6 years and am currently unemployed (as of January - the last company I worked for folded).
>
> There is no doubt in my mind that I am ADD (I am willing to forego the H) particularly since I recognize all the symptoms I see in my brother and my father in myself. There is no doubt in my parents minds that I am ADD either.
>
> The medical establishment here (in Israel), on the other hand, does seem to have doubts. It is very difficult for my to find someone who will diagnose me, let alone get a prescription for something that might help.
> I have gone to a psychologist, who claims it's not her responsibility and suggested I go to a private facility specializing in learning disorders. They won't see me since they only diagnoze children. My appointment with a neurologist yielded little result as he said he can diagnoze me but it won't be recognized by my medicare for prescription matters. The psychiatrist I saw sent me back to the psychologist saying he will have no problems prescribing ritalin when I come back with a psychologist's diagnosis.
> It's like catch22
> He did, however, prescribe an antidepressant (parotexine) after a 10 minute conversation. I do not believe I am depressed and I do believe I could benefit greatly from Ritalin but have no idea what to do anymore.
>
> Any suggestions?
Posted by Carl Nolan on May 10, 2001, at 7:10:08
In reply to Re: Adult ADHD/ADD - getting stimulants (UK) » JahL, posted by Leonardo on March 5, 2001, at 8:27:29
Hello all!
I have for the first time bagan reading about ADD after suspecting for some time that I am affected by it. The psychiatrist that my GP referred me to has no doubt that I was probably diagnosed with something compatible to ADD as a child, whatever that means. I live in London and at my local hospitals, The Royal London and St Bartholomew's, the adult mental health department has no experience of diagnosing adults. In order to establish if there is a depressive component, I have been prescribed Venlaxafine (Efexor). The medicine is ineffective and causes side effects also, nor am I depressed. Please can somebody tell me more about the Maudesley. A friend of mine told me that there is a unit there, but I thought perhaps they saw a poster on the wall or something. I have been told that if I find a specialist I can be referred. At 27 I am despairing. I have had many jobs, no idea what to do next, am easily distracted, thoroughly disorganised, know the score? Something that I have noticed, not once have I read anything, from anyone talking about ADD, about the dangers of ADD. Does anyone not cross roads without realising? Do you know if a response to Ritalin would be treated as part of a diagnostic aid? I am going to try and acquire some. Are there any ADD groups meeting here in London? Will write more soon.
Posted by katz on May 10, 2001, at 9:00:09
In reply to Re: Adult ADHD/ADD - getting stimulants (UK), posted by Carl Nolan on May 10, 2001, at 7:10:08
Hi Carl,
Leonardo would be the one with the information you are looking for. Unfortunately he has not been posting lately. He finally succeeded in getting an ADHD diagnosis and subsequent treatment after a very long & difficult struggle with the medical community in England. Hopefully, he will get these posts in his email and respond to your questions. Leonardo, if you're reading this, please let us all know how you're doing.
Good luck,
Kathy
> Hello all!
>
> I have for the first time bagan reading about ADD after suspecting for some time that I am affected by it. The psychiatrist that my GP referred me to has no doubt that I was probably diagnosed with something compatible to ADD as a child, whatever that means. I live in London and at my local hospitals, The Royal London and St Bartholomew's, the adult mental health department has no experience of diagnosing adults. In order to establish if there is a depressive component, I have been prescribed Venlaxafine (Efexor). The medicine is ineffective and causes side effects also, nor am I depressed. Please can somebody tell me more about the Maudesley. A friend of mine told me that there is a unit there, but I thought perhaps they saw a poster on the wall or something. I have been told that if I find a specialist I can be referred. At 27 I am despairing. I have had many jobs, no idea what to do next, am easily distracted, thoroughly disorganised, know the score? Something that I have noticed, not once have I read anything, from anyone talking about ADD, about the dangers of ADD. Does anyone not cross roads without realising? Do you know if a response to Ritalin would be treated as part of a diagnostic aid? I am going to try and acquire some. Are there any ADD groups meeting here in London? Will write more soon.
Posted by Noa on May 10, 2001, at 10:44:42
In reply to Re: Adult ADHD/ADD - getting stimulants (UK) » Carl Nolan, posted by katz on May 10, 2001, at 9:00:09
I am not sure using venlafaxine to DIAGNOSE a depressive component is such a great strategy. To me, a med trial is to see if the med is effective for you, not to establish a diagnosis. Afterall, a lot of these meds are used cross-diagnoses.
Posted by JahL on May 13, 2001, at 22:51:35
In reply to Re: Adult ADHD/ADD - getting stimulants (UK), posted by Carl Nolan on May 10, 2001, at 7:10:08
Hi Carl.
I'm UK also. Don't think a great deal of the Maudsley.
I recently got an appt for ADD @ ADDENBROOKE'S NHS TRUST (Adult ADHD Clinic)
HILLS RD,
CAMBS,
CB2 2QQ.They have a specialist Adult ADHD Clinic. The psychatrist destined to treat me has written 3 times; I am impressed by his persistence; it makes a refreshing change!
I couldn't suffer the NHS waiting lists (not *too* long) & hopped on a plane to the US where I was offered 4 different stims. You'll most likely only be offered Ritalin & then only if you satisfy their dx criteria by way of filling out reams of questionaires.
Don't be disheartened tho'-definitely worth asking yr GP for a referral. Go private if you can afford it. Good luck.
J.
(just ask if you need any more details)
Posted by Carl on May 30, 2001, at 9:22:40
In reply to Re: Adult ADHD/ADD -this might help... » Carl Nolan, posted by JahL on May 13, 2001, at 22:51:35
Jah, hello there!
Thank you for your reply and the Cambridge address. It will, most likely be my last resort though. I am unsure at the moment. Then again I have only just begun the trek on this railway track of a journey, and I mean the one my mind has to make. Should not be that difficult, my mind takes more directions than the London Underground map. I guess it is all the red tape, or rather red lights, that I think make getting an ADD diagnosis problematic.
So what happened at the Addenbrooke NHS Trust? I hope you don't mind me asking. Did you manage to keep your appointment?
You say thet you could not suffer the NHS waiting list any longer. How long is that? Are you north or south of England?
What of the Maudesely (sp?) then? What was the dissapointment there?
I am unable to go private. Costs you see. I might have to make provisions to do so later on in the game, I might end up having to. I am studying at the moment, yet again, and difficult as it can be psychologicaly I am going to have to sit most of the year again. For me though, being such a laid back never mind do it tommorrow type of person I don't think it will bother me to much.
Jah, have you any idea of the cost involved in getting a private consultation, treatment, and repeat prescriptions? More interesting is your visit to the States. Where did you go exactly, and how did you get on? East coast is obviously cheaper to travel to. Did you have any problems with the medical establishment or the medicines. Also, how did you obtain your diagnosis? Was it through your US trip or is an American diagnosis not recognised here?
The latest I have heard is that there is a unit at Kings COllege London, you the hospital medical school? Well I am told that are doing research into ADD. In particular they are researching possible links between ADD and Dyslexia.
I am trying not to be disheartened at the moment. Anxiety, I feel is becoming an issue. Probably this is because of the long and drawn out process that I am going to have to endure. Another thing that is of great concern to me is the fact I might never be diagnosed at all. Is this a fear you had at times? I am absolutely certain that Attention Deficit is my problem, right back to the age of birth so my mum tells me.
Please would you explain what you mean about dx. The 'reams of questionaires also'. I have recently been referred for a psychotherapy appointment. The waiting list is approximately fourteen months. However, they are not going to send me date until I return a fifteen page questionaire. No problem, I'll do it tonight when I've done my census form!
I apologise for the delay in replying. All the above I wrote a couple of weeks ago. I've just added to it today. I have been hospitalised for Epilepsy. Another problem. Can you believe that they are trying to put ADD down to Epilepsy. I suppose you can. I know different. After all my fits are quite infrequent. Anyway, I'll not go into the realms of that now. I have given you enough to read about. Never before have I written something so questioning. Forgive me.
Carl.
Posted by Sulpicia on May 30, 2001, at 23:46:07
In reply to Re: Adult ADHD/ADD -this might help..., posted by Carl on May 30, 2001, at 9:22:40
> Hi--
forgive me for barging in. You mention UCL, ADD and dyslexia:
might this have been Oxford instead [people rolling in their graves
no doubt :)]?
Have a look at these links:
http://www.dyslexic.org.uk/abstracts.htm#AJR-FAMetabhttp://www.dyslexic.org.uk/images/ajr_doc_efa.pdf
I don't know if you'll find them of any use but they appear
to have had some success using essential fatty acid supplements.
No prescription needed, essentialy harmless, and who knows?
Perhaps something to try while you figure out how to get a proper
diagnosis and treatment?
I have ADD myself and I certainly feel for you -- and I'm a grad student.
I *believe* that were it not for diagnosis and treatment [w/adderall],
I would have performed dreadfully on my comprehensive examinations...
Best of luck.
S.
Posted by Carl on May 31, 2001, at 8:29:00
In reply to Re: Adult ADHD/ADD -this might help..., posted by Sulpicia on May 30, 2001, at 23:46:07
Thanks Sulpicia for the links.
I will check them out sometime. For the moment I have a lot of emails to reply to. Dyslexia itself is not a problem I have. Perhaps I sounded as if it was.
It wasn't UCL I mentioned but Kings College Hospital, part of St Thomas's and Guys. Oxford does sound like a good bet, however. I shall look into it.
Thank you again for the links. Are you new to this thread? If you return can you let me know if there are any decent English websites.
Regards
Carl.
Posted by XYZ on August 21, 2003, at 5:58:51
In reply to Re: Adult ADHD/ADD - getting stimulants (UK) » JahL, posted by Leonardo on March 5, 2001, at 8:27:29
Hello everyone. It seems that this thread has died a death, which is a pity. First of all thanks to all -Leonardo especially - for giving me the low-down on Dr Cosgrove and the Bristol Priority Clinic. I've just been diagnosed with the hyperactive form of ADHD and been put on Dex. Despite only taking 2.5mg twice a day at first and now 5/2.5./2.5 I'm amazed at the improvement. At the moment I do feel a definite crash when the level in my system drops, but I suppose I have to work out dosing over time.
I'd like to know what other people have found it like and how it compares to Ritalin. I am also interested to know if there's a "theory of gravity" involed - i.e. must what goes up come down. I know Paul Erdos (the Hungarian mathematician) took benzedrine for the last 25 years of his life and was the most prolific (and one of the most talented) mathematicians of last century. He stopped for a month and apparently couldn't work, so it does seem to have long term potential.
Back again soon
XYZ
Posted by Meghan on August 21, 2003, at 11:22:46
In reply to Adult ADHD. Stimulant experiences wanted. (UK), posted by XYZ on August 21, 2003, at 5:58:51
Hi, I wanted to tell you that I have tried just about every type of stimulant for Adult ADHD. I have been on Ritalin, Concerta, Adderall, Medadate. I do not recomend Medadate since it made me have stomach issues and I was constatly running to the bathroom. I prefer Concerta 54 miligrams because it is time released and so I only have to take it once a day and it lasts for 12 hours. Good luck. :-)
Posted by Aeryn on August 22, 2003, at 17:56:25
In reply to Re: Adult ADHD. Stimulant experiences wanted. (UK), posted by Meghan on August 21, 2003, at 11:22:46
My husband has adhd and takes stimulants although he will soon switch to strattera (non-stimulant ADHD med). I actually know a lot of folks in the same boat who have made the switch to strattera and say it is much better than stimulants in every way. You might think about trying it if you can get it in the UK.
Otherwise, you will notice, perhaps, as he did that different stimulants produce different results. Adderall takes away "interest" for him but smoothes out his personality, Ritalin gives him good focus and good interest (not ADD over interest or lack of it), but the rebound is hell. No rebound with Concerta (long acting ritalin) but it did nothing for his temper. He now takes adderall and concerta. Good combo, but not fabulous so the switch to strattera is being investigated.
Best, Aeryn
Posted by Zenclearer on August 22, 2003, at 18:10:14
In reply to Re: Adult ADHD. Stimulant experiences wanted. (UK), posted by Aeryn on August 22, 2003, at 17:56:25
Is it? Most of the adults anecdotally report --from what I've seen online -- that Strattera is not better than stims.
Votes from ADDers????
Posted by Viridis on August 23, 2003, at 16:39:33
In reply to Strattera really better than stims for ADD?, posted by Zenclearer on August 22, 2003, at 18:10:14
I find Strattera plus Adderall very helpful, and it's pretty common to combine Strattera with stimulants. For me, the two seem to have complementary effects.
Posted by Zenclearer on August 23, 2003, at 20:46:02
In reply to Re: Strattera really better than stims for ADD? » Zenclearer, posted by Viridis on August 23, 2003, at 16:39:33
Glad it works well for you!
Any added side effects? Water/urinary retention from the Strattera? Any dry skin probs? Any change in weight?
No sleeping problems? Generally, Adderall would make me rather irritable on rebound, so now I take dex. The cognitive effects are great, but I have terrible fatigue sometimes, and other times, I still feel foggy on the dex.
Posted by utopizen on August 23, 2003, at 22:42:56
In reply to Re: Strattera really better than stims for ADD? » Viridis, posted by Zenclearer on August 23, 2003, at 20:46:02
> Glad it works well for you!
>
> Any added side effects? Water/urinary retention from the Strattera? Any dry skin probs? Any change in weight?
>
> No sleeping problems? Generally, Adderall would make me rather irritable on rebound, so now I take dex. The cognitive effects are great, but I have terrible fatigue sometimes, and other times, I still feel foggy on the dex.
>You don't have to resort your hope on Straterra.
If you're not seeing full control over your ADD, assuming Cognitive Behavioral Therapy has been tried, and you've tried the various stims, I doubt a non-stim is going to be *better*. Maybe it'll have some synergy when added to an existing stim, but I really doubt it would be *better.*
I get urinary retention on the stims, but I'm not about to ask my doc for an alpha blocker over it. It's certainly not worth switching to Straterra... knowing my ADD is rather severe, having had a neuropsychological evaluation over it at MGH-Boston (best researchers of ADD disorders, have an entire child psychopharmacology dept.)
I take Desoxyn. You should ask about it. It tends to have the fewest side effects of the stims. Adderall sometimes gave me social lability (sudden, unexplainable expression of extreme emotion, in my case sadness, occassionally as I talked). Didn't happen often, but not something I liked. It also was boring. I don't know, some like it.
Only think I don't like about stims- it makes me talk too much, about boring things, and write long things.
I also have Idiopathic Hypersomnia, so Desoxyn is great for that. Adderall not as much. I tried Provigil for my fatigue, 500 mg(!), that was a joke. So I'm not very optimistic Straterra would help, I went through the SSRI hope routine for 2 years for my social anxiety until switching to Klonopin.
What is it about drug makers coming out with products far more expensive than ones made decades ago, and yet far less effective?
Never forget to appreciate the potency of an older drug. Lithium (50'S). Klonopin (1975). Xanax. Desoxyn (1944). Adderall (in 70's, "Obetrol"). Ritalin. Dexedrine. Barbituates. Meprobamate. Nardil. The list goes on.
Side effects have been marginally reduced with newer meds. But who cares about side effects when the drug's the only one that works? It costs more, does less. There will never be anything more potent than an amphetamine, something so safe yet effective at so many things. Except Desoxyn, but it's still a kind of amphetamine...
Posted by zeugma on August 24, 2003, at 13:02:47
In reply to Re: Strattera really better than stims for ADD?, posted by utopizen on August 23, 2003, at 22:42:56
Strattera will only replace stims as first-line tereatment for uncomplicated ADHD when and if conclusive evidence surfaces that that Strattera is either better than or equal to stims in efficacy, and has fewer side effects in the bargain. At least, I fervently hope that will be the case. I realize fully that the stims are not the most 'politically correct' drugs, and this could create a bias in favor of Strattera. Something of the same kind seems to have happened with the SSRI's with respect to the benzodiazapines, which likewise are less ;politically correct' drugs. (In the bargain, the SSRI's displaced existing treatments for depression, the TCA's and MAOI's, due to the mislabeling of these drugs as 'antidepressants.') A read through some outstanding books by David Healy, "The Antidepressant Era" and "The Creation of Psychopharmacology", will provide illustrations of how historically this process has worked. The term 'pharmacological Calvinism' was coined by the eminent researcher Gerald Klerman to describe why this happens. I'll give a quote from one of Healy's books ("The Antidepressant Era") that sums up this part of his argument:
"[pharmacological Calvinism] refers to a belief system in which drug use is held to be bad and even dangerous if it makes you feel good. A drug that makes you feel good either is somehow morally wrong or is going to be paid for with dependence, liver damage, chromosomal change, or some other form of secular theological retribution. Following up this lead, an NIMH study in the 1970's found that many lay people viewed nervous problems as a sign of moral weakness and the use of something like tranquilizers for such difficulties as further evidence of weakness."
Posted by zeugma on August 24, 2003, at 13:05:54
In reply to Re: Strattera really better than stims for ADD?, posted by utopizen on August 23, 2003, at 22:42:56
While it's too soon to say whether Strat will eclipse stims for uncomplicated ADHD (see my above post), I do think that for ADHD'ers with comorbid major depression, Strattera, with or without a stimulant, will prove far superior to the the combination of SSRI plus stimulant.
Posted by J. Backer on November 3, 2004, at 9:41:05
In reply to Re: Strattera really better than stims for ADD?, posted by utopizen on August 23, 2003, at 22:42:56
strattera cant even remotly touch my ADD-I like dexdrine does. Strattera also gave me side effects -Axiety -sedation.
peace -j
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.