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.

[mynewme]

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.

[mynewme]

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?

[spedmom]

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.

[autismmom]

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!

[joss26]

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

[dontakedrugs]

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