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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by aazospiro on March 24, 2004, at 8:04:56
Does Ritalin make your heart race. Does it work like caffeine? Or Better? What about Ritalin LA or Concerta? Is long acting better to maintain better control? Strattera? Bupropion HCl?
Does a history of short-temperdness, slight to moderate inattentiveness especially to repetitive tasks, doing many things at once and getting flustered easily, point to AADHD?
History of numerous antidepressant trials [SSRI's actually made some symptoms worse, mood stabilizers, beta blockers, AND THEY FAILED OR ONLY GIVE PARTIAL RESPONSES TO SOME SYMPTOMS.
AND JUST BY ACCIDENT, CAFFEINE TABLETS 200 MG GAVE ACUTE SUPPRESSION OF ALL SYMPTOMS, but with a short duration of action, a headache and slight tachycardia?
Anyone here at psychobabble share these experiences. Could ADHD been the core source of this problem all along?
HELP!
Posted by Hattree on March 24, 2004, at 10:22:05
In reply to THE BEST MEDICINE FOR ADULT ADHD; HELP!, posted by aazospiro on March 24, 2004, at 8:04:56
The drug of choice depends on the person. I prefer Dexedrine or Adderall, my son does well on Ritalin. Given your history with Anti-Ds though, I wouldn't bother with Strattera or Bupropion until you've tried the Stimulants. For one thing, you'll begin to see how they affect you in about 30 minutes rather than possibly weeks. You may well find they're smoother-acting than caffeine, as well.
If you want to find out more about ADHD and whether it sounds like you (sure does to me), a really good book is "Healing ADD" by Daniel Amen. He also has a diagnostic quiz on his website, www.amenclinic.com.
Posted by aazospiro on March 24, 2004, at 11:54:51
In reply to Re: THE BEST MEDICINE FOR ADULT ADHD; HELP!, posted by Hattree on March 24, 2004, at 10:22:05
My goodness, I never knew there were so many types of ADHD. Seems I may have the combined type. Thanks very much for the tip hatree
Posted by PsychoSage on March 24, 2004, at 14:35:57
In reply to Re: THE BEST MEDICINE FOR ADULT ADHD; HELP!, posted by Hattree on March 24, 2004, at 10:22:05
well, i would hold off on excluding wellbutrin and strattera because neither affect serotonin. In fact they may be helpful with a stimulant and give a foundation of constant action instead of the sharp rise and falls of stimulants.
I would also think about your caffeine, tobacco and other substance use if there is any. When you have a sensitive brain, and you are trying to work things out with meds, you can't be self-defeating.
my hunch would say you sound like you have manic propensities. If you are comorbid which is not at all unusual then sending you flying straight to stimulants is not at all a good idea. You would need to be carefully monitored, so you don't switch on to mania. That would also mean you need balance in your regimen and you can not toss the mood stabilzers or whatever else by the wayside.
stimulants cause big time agitation and anxiety too.
provigil is a more tolerable stimulant option.
Posted by aazospiro on March 24, 2004, at 15:46:25
In reply to Re: THE BEST MEDICINE FOR ADULT ADHD; HELP!, posted by PsychoSage on March 24, 2004, at 14:35:57
>
>
> well, i would hold off on excluding wellbutrin and strattera because neither affect serotonin. In fact they may be helpful with a stimulant and give a foundation of constant action instead of the sharp rise and falls of stimulants.
>
> I would also think about your caffeine, tobacco and other substance use if there is any. When you have a sensitive brain, and you are trying to work things out with meds, you can't be self-defeating.
>
> my hunch would say you sound like you have manic propensities. If you are comorbid which is not at all unusual then sending you flying straight to stimulants is not at all a good idea. You would need to be carefully monitored, so you don't switch on to mania. That would also mean you need balance in your regimen and you can not toss the mood stabilzers or whatever else by the wayside.
>
> stimulants cause big time agitation and anxiety too.
>
> provigil is a more tolerable stimulant option.
I am aware of the fact that stimulants can cause anxiety and agitation.. Thats actually what SURPRISED me about the caffeine. Because although I drank about 9+ cups a day of that stuff I never achieved the calm I had. Intially it felt like an moderate buzz, which last for about 15-30 minutes and then it was like total calm, minimal agitation sometimes none. My mind slowed to a controllable speed, but my cognition wasnt impaired. However, the strange thing is that even though mentally i was about 90% better, my heart raced alittle and my hands tremored a bit. I actually fell asleep about 4hrs after 200 mg of caffeine!This is weird!
Posted by francesco on March 24, 2004, at 18:13:04
In reply to THE BEST MEDICINE FOR ADULT ADHD; HELP!, posted by aazospiro on March 24, 2004, at 8:04:56
> Does Ritalin make your heart race. Does it work like caffeine? Or Better? What about Ritalin LA or Concerta? Is long acting better to maintain better control? Strattera? Bupropion HCl?
Dr. Amen says that caffeine is useful in the short term for ADHD even if harmful in the long term.
Ritalin may have some side-effect (insomnia, weight loss and blood pressure problems) but it's usually well tolerated.
The main problems with Ritalin are
1. not everyone affected by ADHD responds to it while can respond to different stimulants (Adderall, Dexedrine, Pemoline)
2. its effect lasts for only 3,5 hours (on average).
Strattera and Bupropion may work for someone but they are usually considered second-line treatements.
Other options are noradrenergic TCAs (Imipramine and Desipramine). They can be effective at lower doses than those used for depression and their effect last for the whole day.> Does a history of short-temperdness, slight to moderate inattentiveness especially to repetitive tasks, doing many things at once and getting flustered easily, point to AADHD?
Yes
> History of numerous antidepressant trials [SSRI's actually made some symptoms worse, mood stabilizers, beta blockers, AND THEY FAILED OR ONLY GIVE PARTIAL RESPONSES TO SOME SYMPTOMS.A mixed strategy may help. The best thing should be finding a doctor who's experienced with ADHD and willful to consider the different options and combos. Reading Dr. Amen's books is usually a good starting point to trying to detect which med can help before you try them.
Good Luck
Francesco
Posted by aazospiro on March 24, 2004, at 19:12:46
In reply to Re: THE BEST MEDICINE FOR ADULT ADHD; HELP! » aazospiro, posted by francesco on March 24, 2004, at 18:13:04
Interesting how Dr. Amen mentioned diet and how too much carbs can exacerbate some symptoms. It was soooo true in my case. And it was always worse after lunch. Hard to going in hte morning and extremely lethargic after lunch from about 12:30 pm - around 3-4 pm.
Posted by Securitas on March 26, 2004, at 5:27:05
In reply to THE BEST MEDICINE FOR ADULT ADHD; HELP!, posted by aazospiro on March 24, 2004, at 8:04:56
Look at:
http://www.medscape.com/pages/editorial/resourcecenters/public/adhd/rc-adhd.ov
Posted by francesco on March 26, 2004, at 7:08:33
In reply to Re: THE BEST MEDICINE FOR ADULT ADHD; HELP!diet?? » francesco, posted by aazospiro on March 24, 2004, at 19:12:46
> Interesting how Dr. Amen mentioned diet and how too much carbs can exacerbate some symptoms. It was soooo true in my case. And it was always worse after lunch. Hard to going in hte morning and extremely lethargic after lunch from about 12:30 pm - around 3-4 pm.
It's the same for me. But I'm not avoinding carbs, for me it's quite difficult since I live in Italy and, you know, pasta and pizza is not just a cultural sthereotype ;-)
Amen insists a lot on the diet, I don't know how much his wievs are shared though.I want to add there was an ADHD fellow on this board who's doing great on pemoline now. I had good results with a tryciclic (Anafranil) that has both NE and SE reuptake properties. Every ADHD is different and my suggestions are to find a psychiatrist that knows how to treat this disturb ... psychostimulants are not necessarily the only key to your peace of mind.
This is the end of the thread.
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