ADHD meds

[windbeat]

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.

[Lady Axxiom]

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

[dontakedrugs]

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-

[BigBodyBenz2k3]

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 ***.

[LaudieLane]

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.

[Mpbosnia]

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.

[momnurse]

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.