ADHD meds

[tntgoodwin]

So, I just got "provisional diagnosis" of ADHD-PI, whatever that means. The person who diagnosed me said now I have to go to my primary care provider to get medication prescribed. I have to wait until January to get in to see him, but I have been trying to get all this figured out since July, so what's another few weeks?

He mentioned stimulant (Adderal, Concerta) and non-stimulant (Straterra) meds. He said if it works, the results should be noticeable very quickly.

 

Is this a normal process? This is now going to be the 4th person I am seeing about this. Which meds work better in your experience? How long did it take to see improvement after starting meds? How do you quantify improvement? Is there anything I need to know going into my appointment?

 

Thanks...

Edited December 18, 2011 by tntgoodwin

[AimeeM]

My daughter is ADD (though not hyperactive) and uses ADHD meds. She uses Vyvannse. It works BEAUTIFULLY - once we found the correct dosage. I wouldn't recommend Adderall only because there is a nationwide shortage and while you may be able to currently get them, there's not guarantee on a month to month basis (from what we've been told, as we recently went through this and that's how we ended up with Vyvannse.

 

Don't expect the first medication, or the first dosage, to be spot on. We went through several meds before finding the right one(s). To top it, they generally start with the lowest possible dose, only bringing it up as you report a mild, but not substantial change (at least, this has been our experience).

[tntgoodwin]

Yeah, I'm not hyperactive either. Are there any side effects noticed with that Med? Is it a stimulant or a non-stimulant?

[cin]

I'm on adderall. It is a stimulant, and for me, it causes me to sweat more. But everything does, so it's not a major thing for me.

 

I noticed a difference within 2 or 3 days, and I was on 10 mg. I take 20 mg most of the time, unless I"m going to be doing something where the sweating will bother me, which is on Sunday (church), but otherwise RARELY.

 

It has changed my life.

[mom2hunangirls]

I was diagnosed this year at 39. Looking back now, I was pretty classic (no hyperactivity though).

It wasnt until I was treated for a situational depression and moved past that, that my psychiatrist and I looked into ADD. My complaint was that there were lots of things I wanted to do but just couldn't seem to find a way to start and finish them. Depression was a symptom of ADD because I just couldn't accomplish anything even though I had a desire to.

Enter Adderall. I don't remember why we started there. I think I had a gut feeling that I needed a stimulant. I started on regular Adderall. Very low dose. But my body just seem to metabolize it all too quickly or something because I would come crashing down mid day with exhaustion and blankness (not a word, but....). So we tried Adderall xr. Much better. But I was then having surges of agitation. Always right before lunch. But more so it was always 4 hours after taking it. So we considered changing meds, but then decided to cut the dose in half. Worked great. Both my doc and I were surprised that that worked but it has.

I will say the rx, itself, is a pain in the neck. I'm not sure if it's my insurance or just the nature of the med...but I have to get it written for 30 days at a time, no refills. Such a pain. But worth it in the long run.

 

I describe my before meds time as walking into a very cluttered kitchen without my glasses or contacts on/in. I could tell there was a mess but it was too blury to pick one thing to start with.

On meds, I can see clearly (as if wearing my glasses) and I could pick one thing to pick up and put away and then the next thing. and I'm ok with only getting the table clean and maybe not the island.

 

Oh, and while I know regular Adderall has been near impossible to get here, so far getting the generic Adderall xr has been fine. But having a back up plan is on my agenda for my January appt.

 

Hth

Edited December 18, 2011 by mom2hunangirls
Typos

[sheryl]

So, I just got "provisional diagnosis" of ADHD-PI, whatever that means. The person who diagnosed me said now I have to go to my primary care provider to get medication prescribed. I have to wait until January to get in to see him, but I have been trying to get all this figured out since July, so what's another few weeks?

He mentioned stimulant (Adderal, Concerta) and non-stimulant (Straterra) meds. He said if it works, the results should be noticeable very quickly.

 

OK, here's the deal. Most of the adhd meds are stimulants. A stimulant is basically an "upper". An adult "may" process meds differently than ped patients, but my 12 yo dd took Aderall (xr and reg) and Focalin for stim adhd meds. They made her aggressive-like. Some of the meds come in xr (extended release) and regular doses. The xr is a bad one for many b/c the "half life" is long and it can stay in your system for nearly 18 hours (not "full strength, but tapering)....however, for the most part that meant my dd was "always UP". :glare: I pulled her from her adhd meds myself b/c of the agressive, etc issues. You should know about that and you won't know how you respond to it until you've taken it about 1 week or so. EVERYONE metabolizes these meds differently.

 

Two weeks ago she was prescibed a "non-stim adhd" med called Intuniv. It's relatively new. It has been a huge blessing here. It's non-stimulating so she doesn't have the rage/withdrawal of the stim adhd med, but it still helps her to focus.

 

I would think you may want to seriously consider a non-stim med first. Give it 2-3 weeks and see if you and your family notice a difference.

 

Is this a normal process? This is now going to be the 4th person I am seeing about this. Which meds work better in your experience? How long did it take to see improvement after starting meds? How do you quantify improvement? Good question. Well, if you are more focused, more relaxed, processing improvement and so on. I quickly learned that math was a "marker" for my dd. She was not doing well in math. Intuniv has helped her jump back into math with A's! I could care less if she's an A student, but my point is she is processing the information much better, retaining concepts, improved memory and application, etc and the swing from struggling to working quickly and well is such a drastic and obvious difference!!! Is there anything I need to know going into my appointment? Side effects of meds. Cost. Brand or generic.

 

Thanks...

 

Keep us posted.

PS....adding: Look for Asta on the s.n. board. She is the go-to woman for these questions. HTH!!!

[elise1mds]

We've run through several meds with DS. Of course, all kids are different and YMMV, but Vyvanse works the best for him. The biggest problem we have with it is that it does suppress his appetite quite a bit, so right now we're actually taking a break from the Vyvanse and using Intuniv instead. It's not quite as good at controlling his symptoms, BUT he is putting weight back on. We'll see how it all pans out. Before we started Vyvanse, we tried Strattera and Focalin XR. The Strattera wasn't bad, but it didn't continue to provide control after a couple of months, so we discontinued it rather than continually upping the dose. Focalin worked beautifully, but when it wore off about 5 p.m., he would rage like nothing I'd ever seen (until DD came along, but that's another post). The Vyvanse has a noticeable wearing off period, but he doesn't rage; he simply loses impulse control.

 

For a while we tried not medicating, but in the end he wasn't able to focus enough to learn, so we had to restart them. We tried things like caffeine, supplements, etc., but none of them really worked like a true stimulant medication. If you do use a non-stimulant first, you'll have to wait longer to see the effects than if you use a stimulant. It takes several weeks to work up to the proper dosage and get the non-stimulant into the system.

 

Best of luck in your search for what works!

[Heather in Neverland]

My dh and ds are ADHD. We have not had good luck with medicine in general. While the meds have helped with attention issues, the side effects have been horrible.

 

For my dh, the meds caused him to be angry and caused ED (he said he would rather have attention issues any day of the week :tongue_smilie:). Apparently ED is a common side effect for men.

 

For my ds, the meds made him angry and moody and exacerbated his motor tics.

 

They have tried concerta and adderall and strattera. All of them caused weight loss due to no appetite and insomnia.

 

So they are not on any meds. I hope they work better for you.

[MamaSheep]

From what I gather the "best" medicine depends on the individual person. My dd is thriving with Adderall, but it was a disaster for my friend's son, who is now doing well on another stimulant. With dd I noticed a big difference the first time she swallowed a pill.

[tntgoodwin]

At this point in my life both ED and appetite suppression would probably be blessings in disguise, lol!

[angel marie]

yes, this pretty much is the routine. if the person who diagnosed is a psychologist, they can't prescribed so you have to go to an m.d.

if i were you, i'd do research on the internet on the different types of adhd meds. some are short acting. some of time-released. the non-stimulant ones unfortunately have not had alot of success. different meds and dosages work differently for different people so it is really hard to tell you which one is best. i used to be a school nurse and the students were on it all. there are some crazy sites on the internet with crazy info that has not had the proper testing to back up the data. be careful not to go on these sites.

the process can take a little while to get the medication and dosing right. you will be looking for the symptoms that you are trying to help be better controlled, and will be reporting this info to the doc. remember that dosing is everything. a little tweek in dosing can make a huge difference in it helping your child. try to be patient. i've read that meds help 85% of kids with adhd in partnership with other modifications /counseling do help. best of luck to you.

 

angel R.N.

[AimeeM]

Yeah, I'm not hyperactive either. Are there any side effects noticed with that Med? Is it a stimulant or a non-stimulant?

Stimulant. The only side effect is that of most other stimulants - a loss of appetite. We've had to teach Autumn to eat to sustain and, unfortunately, sometimes ignore her body's cues. If left to her own devices, she simply doesn't eat. Other that that, the med works GREAT.

[tntgoodwin]

yes, this pretty much is the routine. if the person who diagnosed is a psychologist, they can't prescribed so you have to go to an m.d.

if i were you, i'd do research on the internet on the different types of adhd meds. some are short acting. some of time-released. the non-stimulant ones unfortunately have not had alot of success. different meds and dosages work differently for different people so it is really hard to tell you which one is best. i used to be a school nurse and the students were on it all. there are some crazy sites on the internet with crazy info that has not had the proper testing to back up the data. be careful not to go on these sites.

the process can take a little while to get the medication and dosing right. you will be looking for the symptoms that you are trying to help be better controlled, and will be reporting this info to the doc. remember that dosing is everything. a little tweek in dosing can make a huge difference in it helping your child. try to be patient. i've read that meds help 85% of kids with adhd in partnership with other modifications /counseling do help. best of luck to you.

 

angel R.N.

 

Well, it's for me, not one of my dds. What websites are good?

 

And thanks everybody, this is really helpful.

[sheryl]

Thanks to Elise I remember one more hint.

 

My dd's neurologist suggested "fish oil" for her symtoms to help with focus, etc. I bought one brand of "high grade" fish oil, but a very learned woman at the local health food store told me to buy "Nordic Naturals 3-6-9 Complete" (liquid). My dd is 12 + yo and 85 lbs...I give her 1.5 teaspoons each day. This is also "high grade/excellent brand" and so worth it. Runs about $50 for 1 month. This may take a few weeks to notice a difference. I would HIGHLY recommend it. Give it a fair try for a month and see what you and your family think.

[LG Gone Wild]

tntgoodwin

 

I might be right behind you...

 

 

:bigear:

[angel marie]

Thanks to Elise I remember one more hint.

 

My dd's neurologist suggested "fish oil" for her symtoms to help with focus, etc. I bought one brand of "high grade" fish oil, but a very learned woman at the local health food store told me to buy "Nordic Naturals 3-6-9 Complete" (liquid). My dd is 12 + yo and 85 lbs...I give her 1.5 teaspoons each day. This is also "high grade/excellent brand" and so worth it. Runs about $50 for 1 month. This may take a few weeks to notice a difference. I would HIGHLY recommend it. Give it a fair try for a month and see what you and your family think.

 

yep, notable studies have been done on this and it did make a difference in the test groups. it was published in one of the journals, but i can't remember which one. i think the pediatric journal.

[sheryl]

http://helpguide.org/mental/adhd_medications.htm

 

Note the side effects. Now, this is NOT to say that everyone will experience a bad effect, but it is NOT uncommone either.

 

I truly believe the rule of thumb here is to be careful on a stimulant med. The way I think is to try the LEAST invasive first which would be your fish oil and non-stim med....there are 2 I know of Intuniv and Strattera. (Angel, are there more than 2?). IF the non-stims don't work, THEN move the stims at a LOW dose and NOT an xr.

[tntgoodwin]

tntgoodwin

 

I might be right behind you...

 

 

:bigear:

 

*turns around quickly

[angel marie]

Well, it's for me, not one of my dds. What websites are good?

 

And thanks everybody, this is really helpful.

 

i would search around for a list of adhd meds and go to the drug websites. you will see that they are all very similiar, but the drug companies play around with the salts in the drugs to make them different. the mayo clinic may have some stuff. search adhd in adults. look for sites that come from legit sources. if you find yourself on one of those radical sites just click yourself off of them. they will only stress you out if you read it.

the meds will hyperfocus you. take after eating. you may experience a little stomach ache at first, but will subside after a week or two. it may decrease your appetite. some people get headaches. some of my teens say it affects them socially--more of a flat affect.

it could affect your sleep (lack of). the biggest thing about that is you have to see how long the med works and not take it too late in the day so you can be tired at night. you also need to make sure you drink a bunch of water to flush it out of your kidneys by the end of the day---and when it is out of your system---it's out. there is no residual.

if the adverse effects get too out of hand, then the doc will make a change in medication or dosage or both. doc will also make adjust meds if it isn't working for you.

some of the adhd meds have generics. some are the same, but are under different brand names. i have found that some of the generics don't work as well as the brand names. there are different schools of thought on generics vs brand drugs. your insurance (as you probably know) isn't going to want to pay for the brand names.

also, some of the meds that have come out that are not stimulants are being marketed for adhd that were previously marketed for other things like depression. the drug companies found that it wasn't helping the original reason why they made it , but found that it helped other things. it's a last ditch effort to make some money off the drug. unfortunately the non-stimulant meds are working, but some people swear they are when used with adhd meds that weren't working alone.

hope all of this helps. you'll get the hang of it and will be a pro on it in no time. :)

angel

[tntgoodwin]

I guess I should see which meds Tricare covers.

[cin]

 

They have tried concerta and adderall and strattera. All of them caused weight loss due to no appetite and insomnia.

 

 

 

This side effect NEVER happens for me. :glare:

[angel marie]

http://helpguide.org/mental/adhd_medications.htm

 

Note the side effects. Now, this is NOT to say that everyone will experience a bad effect, but it is NOT uncommone either.

 

I truly believe the rule of thumb here is to be careful on a stimulant med. The way I think is to try the LEAST invasive first which would be your fish oil and non-stim med....there are 2 I know of Intuniv and Strattera. (Angel, are there more than 2?). IF the non-stims don't work, THEN move the stims at a LOW dose and NOT an xr.

 

i am not sure of all the names now. i haven't been a school nurse for a little over a year, so some new ones may have surfaced. i do know that the non-stimulant ones that have been marketed are antidepressants, mood stablizers (like abilify), and bp meds like guanfacine (intuniv) and clonidine (kapvay) that have shown some help with adhd/alone, but mostly in combo with stimulant medications--and some of this is recommended only for kids and teens.

 

it will just depend on the doc prescribing on which course will be taken. the doc may not be willing to wait around for the fish oil to work. if the adult needs the med all day, the doc may jump right to the long acting. i'm with you though, the least amt of med to do job is the best.

 

angel

 

angel

Edited December 18, 2011 by angel marie

[Carrie12345]

ADD meds are so far from an exact science.

When giving them a go, keep in mind that they are NOT weight-based or age-based dosages, so don't go comparing dosages with other people. The only way to find the right dose is to do some careful and supervised experimenting.

 

I've personally only used Adderall. It caused extreme weight loss, which was great at first, but not so great long-term. I did my best to eat breakfast before taking a pill. I'm not a big breakfast person to begin with, but I found that I had to force myself or I'd often forget to eat ANYTHING before dinner. My body just didn't send hunger signals.

 

I was on a 3x/day prescription, but found the 3rd dose would keep me up all night, so I only did 2x/day and never past 4pm. At one point, I even scaled the afternoon dose back to 1/2 a pill. It scared me away from time-released versions.

 

Dry mouth was a big factor for me. Also, hyperfocusing has always been one of my issues. Adderall pushed it into overdrive. That was still better than before, but definitely came with its own drawbacks.

 

It's also said that acidic foods and beverages mess with the absorption rate. I'm not big on juices, but I stuck to my coffee anyway. :tongue_smilie:

 

I found http://www.addforums.com helpful.

 

I did not have a perfect experience with Adderall, but it certainly had its benefits. I'm seriously considering going back on after the holidays.

[NotSoObvious]

For what it's worth, our pediatrician prescribed Concerta to our daughter, and said he wouldn't prescribe Vyvanse unless Concerta didn't work. He mentioned something about how Vyvanse is absorbed in the body and that it was harder on the...liver? I think. Maybe something to ask your doctor about.

 

Concerta worked wonderfully for us. Beautifully. Changed her life. We didn't have any of the negative side effects because my dd already had a tendency to overeat. This helped her control her appetite. The first two weeks felt like she was the Energizer bunny, but by week 3, that had tapered off. She always took Melatonin at night to sleep.

 

She hasn't been on for about two months now, just because I'd rather not medicate her, if possible. She's doing well. If I had to put her back in school though, I'd immediately put her back on the meds. That's awful to say, but she wouldn't survive any other way!

[tntgoodwin]

Most of the people I have talked to prefer either Adderal or Concerta...

[EKS]

With the stimulant medications, you will see improvement immediately if the dose is correct.

[Laurie4b]

So, I just got "provisional diagnosis" of ADHD-PI, whatever that means. The person who diagnosed me said now I have to go to my primary care provider to get medication prescribed. I have to wait until January to get in to see him, but I have been trying to get all this figured out since July, so what's another few weeks?

He mentioned stimulant (Adderal, Concerta) and non-stimulant (Straterra) meds. He said if it works, the results should be noticeable very quickly.

 

Is this a normal process? This is now going to be the 4th person I am seeing about this. Which meds work better in your experience? How long did it take to see improvement after starting meds? How do you quantify improvement? Is there anything I need to know going into my appointment?

 

Thanks...

 

 

Read up on Cogmed first and see if you'd like to give that a try before meds. http://www.cogmed.com/ Check out the research link. The research is published in peer-reviewed journals. It's one of the very few non-medication interventions that has a number of double-blind studies by universities in Europe and the US backing it up.

 

It is a computer based program to increase working memory, which causes a huge portion of the trouble in ADD or ADHD. It is comprised of 25 one hour sessions--5 days per week for 5 weeks in a row, then if desired, a maintenance schedule of I think three 20 min sessions per week. It is pricey when you first look at it--but if you considered those as therapy sessions, it wouldn't be pricey at all. The very best results are gained by teens, but adults also have significant improvement.

[tntgoodwin]

Actually, they said my working memory was very good...:confused:

[Laurie4b]

Actually, they said my working memory was very good...:confused:

 

Very unusual for an ADHD diagnosis.

[tntgoodwin]

I thought so as well. If I remember correctly, I could hold one thing at a time in my memory, but I was easily distracted or something like that.

[NotSoObvious]

I thought so as well. If I remember correctly, I could hold one thing at a time in my memory, but I was easily distracted or something like that.

 

Yes! A really good example of this is my daughter doing long multiplication. She'll multiply, then go to add, and somewhere along the way she forgets what the answer to the multiplication problem just was. It takes her longer to do everything. It took her a loooong time to learn to add and subtract for this exact reason.

[Laurie4b]

I thought so as well. If I remember correctly, I could hold one thing at a time in my memory, but I was easily distracted or something like that.

 

Well, see, you ought to be able to keep more than one thing in your working memory. One theory right now is that poor working memory causes the distractibility, rather than the other way around. So that if someone with normal working memory momentarily gets distracted by the kids in the next room, she can keep the train of thought she was on prior to the distraction in her working memory and so get right back on task, whereas someone with poor working memory gets distracted and there is nothing left to go back to in the working memory (the distracting event took up the allotted space) so the person wanders off task.

 

Additionally, people with ADHD often cannot tune things into the background so they hear more, see more extraneous stuff and therefore have more chances to be distracted than others. Perhaps that's what they were telling you.

 

Good for you if yours is intact, but it's just not very common to have good working memory with ADHD. I would check back with them and see if you are remembering correctly.

[AngieW in Texas]

My oldest was originally diagnosed with ADD-inattentive at 11yo. We tried several medications at that time, but she had horrible side-effects and got absolutely NO benefit from them, so we stopped trying after the 4th med.

 

At 17.5yo she told me that she wanted to try medication again because she didn't feel safe driving due to her lack of focus. This time she was diagnosed ADHD-combined type and Asperger's (much more accurate diagnosis, although I still think that's not all). She's actually taking ordinary Ritalin. She started off at 5mg, but has worked up to 20mg. It definitely helps with her focus, but she has a hard time remembering to take it. She hasn't had any side effects.

 

I agree with the others to stay away from the long-acting variety.

[tntgoodwin]

Has anyone had issues with Concerta causing them to overheat quickly?

[rafiki]

.

[Geo]

TNTGOODWIN....Overheating, or just "sweating-because-you-got-up-and-walked-across-the-room"? I ask, because that is a symptom of some ADHD meds. Straterra is awful about that symptom.

Edited February 17, 2012 by Geo

[tntgoodwin]

Well, it mostly occurs when I am working out or running. I will get about 1 lap around a track and just burst into sweat, heart pounding, flushed skin, etc. This wasn't a problem before Concerta, that I know of. Also some days just walking to my car can cause it.

Edited February 17, 2012 by tntgoodwin

[Geo]

Well, it mostly occurs when I am working out or running. I will get about 1 lap around a track and just burst into sweat, heart pounding, flushed skin, etc. This wasn't a problem before Concerta, that I know of. Also some days just walking to my car can cause it.

 

Sounds like the meds. You could google "Concerta" "perspiration" and see if you can get a confirmation on that side effect. It may disappear after a while...or not. Stinks, doesn't it?

[tntgoodwin]

Yes, especially since my career requires me to meet certain physical standards. :glare:

[Ellesmere]

It's always good to talk with others who have BTDT. I'd also encourage you to find a pharmacist that you like and trust if you haven't already. :)

[tntgoodwin]

Actually, a couple of my best friends are pharmacists. :001_smile: Unfortunately we no longer live near them.:(

Edited February 17, 2012 by tntgoodwin