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ADHD meds


I am a male in my 20's with ADHD.  

A few years ago I tried Ritalin for a period.  It worked very well for my symptoms but caused chest pain, pretty severe actually.  (10 milligrams 2-4x/dy)

I then tried Adderall.  It also caused some minor and fleeting chest discomfort--but much less than Ritalin.  However it caused my heart to really race and beat hard (at around 5 mg) in addition to insomnia.  Like Ritalin, it also worked very well for my symptoms.  

Next I tried Strattera which did not worked and only caused side effects (80 mg/dy).  

I thought perhaps I had an underlying heart condition making me so sensitive to stimulants, so I stopped all medications for nearly 2 years and was checked out by a cardiologist (2 actually).  

Both cardiologists said my heart is fine except for mitral valve prolapse (with minimal regurgitation).  My thyroid is also normal.  I even had a stress echocardiogram which was normal.  They said it would be ok to use stimulants "as tolerated".  

I've tried so hard to do without meds, using fish oils and exercise, avoiding alcohol and getting proper sleep.  However, this is simply just not cutting it and so recently I decided to try Dexedrine at a very low dose.  At 1.25-2.5 mg it was easier on my heart rate than Adderall, but still I could notice a definite, although fleeting chest discomfort (like a little bit of pain and pressure).  

I do not want to try a TCA or MAOI nor add a beta blocker to a stimulant.  

From the research I've done I think that leaves me with about 3 options.  The first is Provigil, but it is contraindicated with mitral valve prolapse.  The other 2 are Focalin and Desoxyn.  

Although Desoxyn is supposed to have the best CNS vs PNS activity, I can just imagine the song and dance I'd have to go through to get someone to prescribe it.  

So, I'm considering Focalin.  My understanding is that methylphenidate has the least peripheral actions of the stimulants and that focalin contains only the active "d" isomer whereas Ritalin is a racemic mixture of "d and l".  

My question is whether Focalin would really present an advantage over Ritalin in terms of peripheral side effects (heart primarily).  Although it's marketed under the premise that it only contains the active "d" isomer, thus allowing for half the dosage and theoretically half the side effects, I've read that the "l" isomer is actually very poorly absorbed.  

What I really liked about Ritalin was it's fast onset and short duration (no insomnia, flexibility of dosing).  Obviously I could not tolerate the chest pain.  

Getting to the point, I have 3 questions:

1. Is the L-methylphenidate isomer very peripherally acting (heart, lungs), or just "inactive"?

2.  Do you think Focalin would truly be a reasonable alternative to Ritalin for me?

3.  What are my other options?

Sorry for the long-winded post. I'm just very frustrated that I won't be able to find an effective and tolerable tx.  Thank you.
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284002 tn?1244547555
Hello there,

I am 34 and have recently been diagnosed with ADD and your comment:

"It has left my life incomplete, many goals and dreams fallen short of acomplishing, along with a depressing weight of failure that wasn't deserved even though I tried desperately"
I think Desperately is the Key word... i know the feeling.

nails it on the head form me.  That is my life.  I barely made through high school and college.  The kicker is my entire family everyone finished either Med School or some graduate school. except me.  I thought I was adopted for a while. My mom must have ADD and my dad is pretty intense too.  

Focusing is so difficult for me.  I will say the 2 times I tried cocaine I felt a clarity and profound sadness.  The hangover the next day was awful so no fear of me trying that again.

I tried Ritalin but felt it made me too anxious.

Did you try different medications to find the right one?
And what other pointers could you give a person new to this diagnosis?

Much Appreciated.


Helpful - 0
Avatar universal
Hello,
I have been an ADHD sufferer all my life. Now at age 37, it still plagues me as I wasn't put on medication in childhood.
I am a classic case of where the condition in not treated in childhood, it can most likely carry into adulthood.

It has left my life incomplete, many goals and dreams fallen short of acomplishing, along with a depressing weight of failure that wasn't deserved even though I tried desperately
to do the right things.

It really pisses me off that there are arrogantly ignorant individuals who are trying to impose their seriously lacking opinions of the medical facts that has been learned about ADD/ADHD in just the past 15 years. Especially with modern medical scanning devices, have learned to map the different brain centers, and how they work in relationship with each
other under various stimuli or situations. To you IGNORANT OPPRESSORS, SHUT the F**K UP!!! You don't know what its like, no idea, to have, and grow up with ADHD. Being labeled weird, shunned, not allowed to fit in with your peers, academics are yet another terrible struggle as ADHD people need more one on one time to learn and perfect subjects like mathmatics, or large volumes of information. Fact is with class overcrowding nationwide, teachers only on the average can spend only 3-5 minutes of quality time a day with each student in thier classes.

I finally had to go on disability in 1999, also beginning a 5 year up-hill battle to finally get my ADHD issue addressed, and medically treated. I just kept getting "passed" around no "Medical/Mental Professional" wanting to deal with the reality of that I had extensively researched why I was labeled "HYPER" as a kid, and learned of many others getting proper medical treatment for thier condition.

In late spring of 2002 I sent via e-mail a 7 page letter of complaint to NIMH about how I was being treated/misdiagnosed/neglected where I lived. Many Doctor's names were mentioned, as well as my whole life story living with ADHD. That shook a few cages in the local medical community. I did it before they knew I was going do something so socially acceptably drastic in trying to get help: Notify the national mental officials whom ALL practicianers in every state have to ultimately answer to. Also it brought about an investigation on who/why were these individuals dressed up as DEA or ATF who were conducting "Raids" for a brief time on several doctor's offices during thier patient/business hours. Terrifying/Manhandling patients, and treating everyone in the office like criminals being detained in a crack house raid. They would threaten the Doctor that they were above the law, and they would revoke the Doctor's license if He/She kept prescibing ADHD Stimulant medications for ADHD people. After my little stir-up letter to NIMH, these "Raids" all suddenly stopped. But many Doctor's were frightened to help ADHD people for quite some time in the years that followed.

By November of 2004 after further psychiatric tests, changing of Doctors, and year on Wellbutrin(Did nothing!), Straterra(What a Joke!), I have been finally prescribed Adderall XR. A great victory won for me after a lifelong of ADHD suffering.
my Doctor tells me to take 40mg of Adderall in the morning
along with 1mg of Clonazepam, and 100mg of Zoloft. Almost exact
to what I suggested in my letter to NIMH. Well IT'S WORKING GREAT! I have been on this regiment for over 2 years now, and have had no bad side-effects. I can eat during the day medicated, but most of all GONE! is the scatterbrainess, mind going in all directions at once yet going nowhere like a car stuck in the mud. GONE! Is the impulsiveness "off the wall" quirps, spaz-outs, etc. Adderall has replaced it all with calmness, thinking before acting, great focus and attention
span, concentration at optimal performance, less fidgetiness
while sitting for long periods, and I able to study/learn/retain significant amounts of complex technical information. It makes it to main memory now where it didn't before.

I am contemplating returning to college for another degree. I still have to put many parts of myself together as my life was also filled with Mental/Physical/Sexual abuses. I am glad to know relief from ADHD for the first time in my life. It angers me why I wasn't on this medication in childhood. I was the victim of a well meaning handicapped Mother, and my Grandparents who raised me for her. Thier ignorance in saying No on ADHD medications that my school's Principals, Counselors, and Teachers were pleading with them for years to put me on, set the road for inevitable disasterous hardships I would endure.

My family is mostly passed away now, and I had to persevere alone in getting help to control my ADHD. Stick with stimulants for treating ADHD. They have been tried and proven for decades
in treating the condition.

Thank you for you time in reading this testimony.
Helpful - 0
Avatar universal
Your "brain chaining" is exactly what happens to me.  

Over the last couple of weeks I have gone 'cold turkey' off my 75mg Efexor + 2 Ritalin in the morning which was not planned but once I started I continued to see if I could find the real me.

I was diagnosed AADHD with moderate depression 3 years ago and I know I have a disorganised house with paperwork everywhere and lots of jobs started but never completed.  I go off on my "brain tangents" I call them and get a good idea and then another good idea so there are lots of balls in the air so to speak.  My answer I thought for this behaviour is that I am afraid that if I complete a job then there may not be something else for me to do so there are lots of jobs for me to do, cannot get bored this way.  My husband reckons this "excuse" is wearing a bit thin now and that I am more intelligent than this to allow this to happen.

Since being diagnosed my disorganisation etc has got worse - I never used to be like this which is very interesting.  That is why my husband believes the meds have not been good for me.

I have been off the meds now for 2 weeks and I think nearly over the terrible withdrawals.  Maybe my motivation will come back and I can get on with completing all the jobs that I have started.

ADD does exist and my son was diagnosed with it first 3 years ago and then it was my turn.  He has suffered severe anxiety for years and depression and the meds have helped him a lot.

Good to get your feedback when you have time.  Cheers, Lionness
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Avatar universal
Hello all, I was perusing this thread, being recently diagnosed with ADHD, and I was trying to get an idea of how to get the best treatment. My doctor does not want to give me any stimulant, well he will as a "last resort" but wants to start me on Strattera. I took it for about a week but couldn't keep my eyes open long enough to know if it was working,plus the littany of side effects it lists are extremely off-putting. I'm already on Wellbutrin but only 150 mg and it's SR, so it lasts about six hours I believe.. I quit Lexapro b/c it actually made my anxiety worse and I gained weight. I would rather take a low level dose of stimulant than this Strattera stuff which the doc says has fewer side effects than a stimulant. Is there truth to that? As far as I know Strattera is new and not well studied due to it's newness. I have been taking my husbands ADD meds but taking only a fraction of what he takes and it has really helped me when coupled with the Wellbutrin. I know it's not the best idea to take a medication not prescribed to you but I am not abusing it. I only take a 4 hour acting dose in the am and I take about 6 mg. My doc is convinced that a stimulant will give me more anxiety and it's been the opposite so far. Do I tell him I already know the stimulant is working for me? Or will that make him think I'm abusing it? I know I don't want to take Strattera..it seems far more powerful to me than the stimulant.Any insights would be welcome. As far as the guy who thinks this disorder is poppycock..well gathering a few reputable looking quotes is not convincing at all. Especially when he seemed not to be the most literate fellow. He probably could benefit from some ADD meds.. :)
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Avatar universal
I just had to comment again on the slew of posts that is intended to inform everyone that ADD is not a biochemical disorder. Is it out of concern that you took the time to illuminate all of us about the folly of ADD or was it more a sanctimonious diatribe designed to make us feel like idiots? It does exist, there's certainly grey areas, there's certainly reason to evaluate it carefully and to be careful with the treatment for it. But it does exist..as does depression,anxiety,manic depression etc and so forth. It may not be as prevalent as some think or perhaps it is more prevalent. Who really knows? Not me, not many of us I would think. And perhaps in another era that valued creativity and diversity in ideas and wasn't so fixated on the bottom line, we would have productive enjoyable lives and not worry that we have a hard time concentrating on things, are forgetful, daydreamy. If we weren't bombarded with so much information and forced to juggle so many tasks, we might not notice this as a "disorder",but it is, in fact, a disorder, whether it's a societal malady or the result of malfunctioning brain chemistry. The two often inform each other. Comorbidity can include our society, don't you think? There's another disorder emerging, superiority affliction disorder, or SAD.. why not be more empathetic and careful with your proselytizing?
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Avatar universal
I don't know if you(DontTakeDrugs)will come back to this forum but I would like to say to you that it is not cool to state all of that info without telling YOUR story. If you are not ADD then you have no platform in which to speak. If you are ADD then you have a lot to learn about this dis-EASE. If you are a professional then you are not acting like a professional and not helping any of us with your "copied" information from some journal that you yourself, obviously, have not participated in the studies. If I were you and you are fortunate enough NOT to suffer from ADD or a related mental problem then count your blessings and live your life to the fullest while you can. I have missed more than my share because of this disease/disorder. I hope that you or anyone else that shares your viewpoint will take what I say into consideration.  

Note:  To this Forum, Sorry for the 3 posts in a row but true to an ADD'er I am impatient for conversation and I hate to wait for input. LOL Thanks
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Avatar universal
I was officially diagnosed with Adult ADD last spring and started on Adderall XR. I take a fairly high dose, 80mg a day.  I also take Provigil and and two meds for Bipolar, Lamictal and Wellbutrin. I was diagnosed Bipolar over 6 years ago but still struggled quite a bit, even though medicated to treat this illness.  When I started being treated for The ADD it was kind of like a missing link or puzzle piece in my treatment had been found. You cannot tell me that it does not exsist.  That is absurd! This diagnosis was the answer to so many abnormalities in behaviors and thought. I have had to make adjustments in my therapy, such as the addition of provigil. Before I was in treatment I could not see what my falts were.
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Avatar universal
I would like to ADD that I started Adderall XL almost a year ago and it is still working for me. I agree that you must make corrections on your own, such as organizational changes and new ways of doing things but before the treatment, this was impossible for me to follow through with. Just like most people with ADD I had many plans, usually all at once, but could never implement them to completion. When I was working I ended up with mounds of paper work just because I couldn't make a decision as to what to do with it. My house was a mess because I would start thinking about rearanging things or I would spend too much time on the details that it looked like I never got anything done by the end of the day. Sometimes that would be morning because I would get started late at night when ideas raced through my head at such a pace that I couldn't apease them until I got up and started the project. I call it, "Brain Chaining" because one thought leads to another which leads to another which leads to another and so on. I am sure that true Adult ADD individuals can relate. Even with medication it is still like that at times but at least I have clear thoughts most of the time and decision making becomes easier. One more thing I would like to say that I have not read about too much are relationships. I used to drive my husband crazy. He would explain something to me and I would not see it. I just could not comprehend what he was talking about or I would argue my view until he would just say "conversation is over" and just walk out. Even then I would not be able to stop my mouth long enough to think about what he was saying, let alone what I thought was so important. We have gotten to the point that when I am like this we hardly can talk about anything. Not even "what do you want for dinner?". It has been like this for years and years. I would say all the way back to my youth. I won't go into that at this posting but there is a lot more that proves I am ADD and the medication has changed my life and probably saved my marriage and maybe even my life. Anyone want to talk about addictions and compulsive behavior prior to medication and how that changed?
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Avatar universal
I have a son who had a brain mass removed and is also educated under the Autism Spectrum category.  I am also a special education professional.  Children who spend their lives having to use sticker charts, behavior programs, and other positive programs for every single thing (Yes, they are great for many things but not if you have to do it forever, all the time)... feel different and less than the kids who get things for just being themselves.  The stress of failure with these programs can be intense.  
When my son was 4 he could not sit to eat, listen to a story, or even be hugged.  He was one of the youngest patients the hospital had put on Ritalin, and believe me I was scared.  He listened to "Brown Bear" that very day!  It opened his world.  Is it such a stretch to think that a child with obvious damage shown on an MRI (rt. frontal/temporal lobe and global effects) is so different from kids where we dont have the technology to see the damage as well?  We know early intervention works for every issue but in this area we hold off treatment due to the stigma people who are underinformed and who do not have to watch their children suffer being punished and cry and not have friends because they want to be good but just can't stop themselves endure daily.  You can label it whatever you want.  But if the ADHD label brings relief and strategies and understanding to people, then we need to consider it (in a careful, systematic way of course).  No one can deny another's experience.  These days there actually are neurological tests that support ADHD diagnoses.  Symptoms and careful, loving team work, being an advocate for yourself or your child are what is most important.  Nothing can be accomplished by hurting eachother.  Of course there are people who are misdiagnosed with adhd when they should not be.  However, there are many more who have suffered with no help and have been thought to be lazy, underachievers when the appropriate support would have made a huge difference.  I have seen it time and time again.
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Avatar universal
I have a seven year old son who just started on Focalin, and for all of you who don't believe ADHD doesn't exist, tell that to the child who was on the verge of being put in Special Ed., and is now at the top of his class, in 2 weeks!!!  The pill that my son takes every morning is a necessary medication, NOT a drug!!  If you don't want to take them, fine, but how dare you tell me that this condition doesn't exist!!!!  Live with it, and then tell me there's no such thing!
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Avatar universal
Yeah I bet that my boyfriend and his son wish that there was no such thing as adhd either. What a load of **** that person was saying, any ways i found that children with adhd also have food allergies to. I do not have my step son on any meds at this time with control things with food and what his body needs that has seen to help a lot. We also have communication sessions to. It is hard to have two people diagnosed with the same problem but I handle it. It helps that my back ground has years of experience with mental health and other disabilities, but also I still have all my problems to manage. Go with what your heart feels to be the best path for you. Also know that you have the right to not take the medication that the doctor want to give. You should be allowed to do your own research
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Avatar universal


The name is dontakedrugs not "meds" and that is because there is no such thing as ADD medication.You cannot medicate to rectify a biochemical disorder that doesnt exist.

If you read above you should note   "There is no evidence of any etiology of disease in this condition"ADD drugs are poison.


You think i should think before i post?Well ill leave you with some more food for thought -





Thursday, January 5, 2006  





Reported risks spur new study of ADHD drugs
By Andrew Bridges

The Associated Press

WASHINGTON
Helpful - 0
Avatar universal
stop slobberring on the fatty.
You are just confusing all of us ADD sorts playing around out here in fairy land.

Think before you roll out the bloviators rug and inflict all of that rotton stench of decaying, discarded refuse on us all.

retch!
my words fail me.
Begone!

Lady AXXIOM
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Avatar universal

There is no such thing *** ADHD "medication" the term is "poison".



If you find drugs prescribed for ADHD provide you with relief then im glad but maybe also try ;

cough medicine,alcohol,aromatherapy or standing on your head.All of these other options have as much scientific basis for trying but they arent known to cause brain shrinkage like ritalin is.



    ADHD doesnt exist-

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Avatar universal
ADHD does friggin exist? I've dealt with it for 26 years. I've totaled countless cars due to distraction..Loose things on a everyday basis. Suspended almost expelled from military school.I was the worst behaved kid ever on Dexedrine since 3. I've struggled in  college in one of the toughest majors there is. I punched a cop broke his jaw ended up with a felony 4 almost prision, Wanna talk about compusive? I've done everything from tell teachers to fu** off to emptying clips at cop cars a few almost got mortally wounded on ocasion. But yet  I have a genious IQ and have never been caught in any crime I've committed. Hell I even shot 2 U.S. marshalls. Why I hate cops, Fbi,Dea,Ati. So i unleash what I can't in class or in public on law enforcement personal. Nobody knows who i am so whatever.But ADHD doen't exist my ***.
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Avatar universal
First, I would like to mention that drugs for add/adhd are not a cure all.  Most, like myself, will find over time they will see both improvements as well as drawbacks.  Personally, I have found the medication has helped me focus on tasks that otherwise would have been impossible to start as well as following through with them all the way to the end.  I also am slowly learning how to follow systems to keep my life in order.  However, even after more than a few years of medication, I still manage to go through just about 5-8 cellphones a year and 3-4 credit cards it by no means will ever conquor all my absentmindedness.  And if you suffered from insomnia before, ha, look forward of endless nights of mindless internet surfing.  It seems as though when the adderall wears off my brain soars to even greater levels of stimulation.  However, this doesn't bother me at all because these are my finest hours when my imagination runs rampent and my creativity is at its highest. The physical consequences I have encounter: poor circulation, flushed face, stiff jaw (somewhat clenched), loss of appetite, red/hot hands as adderall wears off...
Mental consequences: Increased addiction (ciggerettes, caffeine), increased anxiety when not on drug, agitation with extremely hyper people, losing sight of the "big picture" and often times spending too much time hyper-focusing on the little tasks...I miss alot of my old flaws... So I don't take my medication on the weekends or when I find I don't need it, it isn't ME, it just helps me along my journey that would too often venture off the road and crash if I didn't.

Anyone who has ADD knows how hard it is to function in a society that condones all the things we somehow do best.  I completely lack self-control.  Not only has this gotten me in trouble with school (kicked out of class, suspended, poor performance, low self confidence, bad reputation, arrested, etc) but most importantly it has caused so much damage to relationships with the people I love and care about.  
I just want to stress how important it is to remember that taking medication is just part of the solution.  There are some really great books out now that do a wonderful job of explaining that ADD is a WONDERFUL thing if you learn how to take control of your life and find a balance of solutions that works for you.

Well just realized I got a little off topic...as to answer your question:

It can take quite a while for which ever stimulant you are taking to work effectively because finding the right dosage can be extremely difficult.  If after a week you feeel absolutley no improvement or worse (too much medication), you want to call your doctor and let them know.  Be patient.

Also if you haven't yet read Delivered from Distraction, it is expectional.
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Avatar universal
I recently started adderall.  I am 41 years old and have been hyper my whole life.  I obsess and hardly ever finish a project I start.  I have distroyed a lot of relationships due to my obsession to run over peoples words. I find it hard to stay focused while someone is talking. I can forget a major task as easy as walking out of a room.  I dont want to believe I am ADD.  I dont like taking this medicine.  I have been taking it for 1 week.  I have never taking any meds until now.  I am on zoloff and adderall.  My feet are cold and my hands are sweaty.  I went to the hospital because my left foot went blue.  I did not know the meds caused this till now. The hospital diagnoised me with phelbitis.  But its not its the result of adderall.  I wonder why the dr didnt put two and two together.  Anyway, I wanted to know if anyone out there knows when  I will stop climbing the walls.  I was told it would take one week for it to calm me if I was ADD.  Its not working.  Although I am staying up all hours of the night doing different tasks.  Please help with some info.
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Avatar universal
My daughter, 11 years old, is ADD. Not hyper. She was failing in school. We tried Adderall and within a year her scores were at level, up 2 grade levels. She doesn't care to take it, but has helped her so much to consentrate. She make A honor society this year in 6th grade, she was so excited, she was livid. This has also helped her anxiety of not being accepted due to her poor grades.
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Avatar universal
I tried 60 mg of Ritalin for 8 months and am now on Adderall, 20 mgs. twice a day.  I think the Adderall will need to be upped when I see my doctor again.  I recently got off Effexor, which was the worst withdrawal I've ever experienced.  I had no problem switching from Ritalin to Adderall. Does anyone have any Adderall withdrawal knowledge?
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Avatar universal
i have had adhd all my life but did not start taking medication for it till 2000. it has changed my whole life. no more obsessing, i can pay attention, i can sit still...it is wonderful. i wish i could have taken these meds when i was a young child..i wouldn't have made so many bad choices. there IS such a thing as adhd.
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Avatar universal
Is there a fish oil available that is easy for a child to consume and are there guidelines for dosage on a child?  I, too, have heard of this from a friend who is extremely knowledgeable about alternative and homeopathic medicine.  Any info is appreciated.
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Avatar universal
Thought this was interesting...
  
Children on fish oil capsules showed improvements in attention, behaviour and vocabulary.  

If your child has attention deficit hyperactivity disorder or ADD, the solution may be as simple as giving your child fish oils.

An Australian study suggests daily dose of fish oil helps calm children with attention deficit hyperactivity disorder.

Children in the study were given a commercially available dietary supplement containing a combination of fish oil and evening primrose oil, in a ratio of four to one. They were given just under a gram of fish oil a day.

The results showed that children on the active fish oil capsules, rich in omega-3 fatty acids, had improvements in attention, behaviour and vocabulary. They were able to concentrate better, they were calmer, less impulsive.

The reason why fish oils are important is possibly because 60 per cent of our brain is composed of fats, the most important being omega-3 fatty acids, such as those found in fish oil, and omega-6, like those in evening primrose oil. And as many people are deficient in the omega-3 fatty acids, it can cause several problems.

There's a growing body of research that's finding evidence of links between omega-3 deficiency and mental health problems like depression and schizophrenia. And research is also suggesting that some children with developmental problems, including dyslexia, can benefit from taking omega-3 supplements.

The fish oil conducted in this study had higher concentrations of EPA and DPA. Researchers are starting to think that perhaps EPA is the important one of the two. So when you
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Avatar universal
yea, i got 14 yrs old daughter who has a.d.h.d. since age 7 yrs. she had been on different mediciens changed since 7 yrs. Right now, she dont take a.d.h.d. medicine anymore. just  medicne called Ablify to take at bedtime everynight to help her to think clear. doing well. wait til she gets older , it gets better or worse? who knows? . it is very hard thing on adhd medicines or not on people.
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Avatar universal
RFK
Ditto.
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