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JTSTs2003's avatar

On 5th ADHD med - an end in sight?

Asked by JTSTs2003 (290 points ) September 27th, 2011

I’ll try to make this as short as possible but there is a lot of background info I think is important.

Inquery: I am on my 5th ADD med attempt. Not sure how many more options are out there…what if I go through all meds and nothing is right? Comments/observations/personal stories appreciated. How do you know when it’s the right one?? What happens if none of them are right? Does that mean I have the wrong diagnosis?

Symptoms: Cannot focus on task at hand, extremely forgetful/distracted, esp if schedule is messed up..it begins a confusing chain of events, losing train of thought often, hard to get back on task once interrupted, day-dreamy/gets lost in thought often, thoughts and conversation seem random to others. I have to multitask when in a lecture, meeting, on the phone or else I won’t absorb the information. Obsessive about something I can finally focus on – to the point where I don’t notice the time, don’t sleep, don’t eat, forget the world around me. I suffer at work – have a normal m-f 8–5 job in front of a computer all day.

2008 – Excedrine/Caffeine – Didn’t know what was going on, except that these two things would help. Began daily routine of large coffee in the morning that would work until 12p or so, then excedrine to help get through the rest of the work day.

2009 – Strattera – horrible. Was initially diagnosed. I was in a zombie state, lightheaded, hallucinations, nightmares, lethargy, extremely nauseated, fell asleep behind the wheel after trying for 6 weeks (gradual dosage increase). Gave up cold turkey – no withdrawal symptoms.

2010 – Phentermine 30mg/day (took only 15mg though, didn’t need full dose) to lose weight – found it helped with ADHD (later discovered it is an ADHD med, although not a very effective one so they use it for weight loss now…). The dry mouth and extreme irritability (low blood sugar?) were causing problems with life relationships so I stopped.

2011 (July) – Adipex 37.5mg – went to family dr to get help again (problems at work). 2nd evaluation. Prescribed Adipex (prescription phentermine – stronger) until I could get an appointment with the clinic specialist & a more in-depth eval. This was fine, focus could def have been better, but it was a noted improvement. Downside: felt I had to move my legs (run/walk/get blood flowing through them) to “ground” myself…I felt out of my body at times, like my consciousness was floating above my head & needed to be brought back down. Doctors still look at me like I’m crazy when I try to describe this feeling.

2011 (August) – Adderall XR – Specialist diagnosed a 3rd time as having ADD. Prescribed this. Told me legs thing was the Adipex causing anxiety, warned me that Adderall might make it worse. Had HORRIBLE anxiety on it – anger. I was screaming/freaking out on people/crying.

2011 (Sept) – Vyvanse – Psychiatrist (4th diagnosis) immediately took me off of XR (guess I had a bad reaction) to try V due to it’s reputation of not producing as much anxiety. Focus was worse than natural. Anxiety was back, but in the form of teeth clenching, causing my teeth/gums to ache, and jaw and hands shaking as if I was shivering in the evenings. (Note: He also prescribed Prozac for the anxiety, which helped during the AM, and Klonopid for the PM or as needed. Definitely helps.) No side effects when stopped cold turkey. There was no positive to this one for me.

2011 (Sept) – Concerta – Prescribed, havent started yet. (My 7yr old son is currently on it in the AM, Methylin in the PM, and is about to begin Intuniv to help with his impulsiveness. Has had great success with the 1st 2 so far the past almost 3 years, increasing dosage with his growth spurts, but it’s been waning over the past few months – he tried Daytrana patch – only worked “halfway” and he had an allergic reaction to the adhesive…for anyone out there curious about those).

Thank you!!

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14 Answers

GabrielsLamb's avatar

Psychiatric medications are Degenerative as therapies in many cases… Meaning your body will become immune and being that every product out there maxes out in dose eventually, you may have to change them throughout your life as they come out with new ones. *WHich is the reason they come out with new ones and higher doses and time release. Like Prozac, once people were left horribly dependent upon it and they were all maxing out their does, then VOILA they created the once weekly time released 90mg dose. And all was right with the world once again.

rebbel's avatar

I can only obviously speak for myself, but I knew literally within minutes that Ritalin was working, the first day I took them that day stands out in my memory as an important one…, I can remember almost all things that happened that day.
The peace….........!
Now I am thirteen years on it and to be honest I can’t really tell anymore what it does to me which in itself is a good thing too.

Buttonstc's avatar

It’s obvious that you are more sensitive than average to side effects of medications (as am I) so that makes things more difficult.

Have any of the specialists whom you’ve seen been Neurologists?

I think that for someone like you, the average GP does not have the specificity of training or experience to be the best choice for this problem. They are Generalists on a wide variety of problems (as they should be). So a Neurologist would be a more logical choice.

There are different types of holistic choices, some more controversial than others. But I’m a pragmatist. If it works for me I don’t really care who says it doesn’t or shouldn’t.

You might consider things such as Vitamin suplementation, behavioral modification, bio-feedback or other brain-focused methodology.

I had many ADD/ADHD students in my classes whose parents found success with a variety of different modalities. You just need to find the right combo for you.

Dealing with Neuro-Brain issues is a complex undertaking and pharmacology is not always the answer for everybody.

If it were me, I would begin with diet/vitamin/food additive allergies. People have tried those with success for some.

I hate to say the obvious but it’s a lot of trial and error. But try to find a good Neurologist who is at least open to consider alternatives to only pharmeceutical solutions.

Good luck with that one.

GabrielsLamb's avatar

@Buttonstc Great answer!

“If it were me, I would begin with diet/vitamin/food additive allergies. People have tried those with success for some.”

I agree, and exercise helps as well executed with the point being to exhaust the body to subdue the brain.

Afos22's avatar

Have you tried medical marijuana?

keobooks's avatar

You may want to try a sleep study. I found out recently that much of my ADHD symptoms were actually severe sleep deprivation. I thought I was sleeping soundly, but it turned out that I was waking several times a minute during the night for about a second at a time.

I still need the medication—but a different one—Nuvigil. I take a MUCH lower dose than I needed before. Fixing the sleep apnea cured 60 – 70 percent of the symptoms.

Buttonstc's avatar

@Afos22

That’s an interesting suggestion. Do you know of any studies indicating effectiveness for this specifically?

Even if a particular state allows MM, they are all over the place for which conditions/illnesses are allowed. There is no uniformity on that. If one’s particular condition is not on whatever their particular list is, they’re as out of luck as if they lived in a state where it’s not legal.

Obviously things like Cancer, Aids, chronic pain are a sure thing. But I’ve done some research into this and don’t recall seeing ADHD mentioned.

Plus, doesn’t pot tend to make someone’s mind fuzzier rather than focused on tasks?

Not sure about that, but so I’ve heard :)

Nullo's avatar

You might consider finding a really good coping strategy and dropping the meds entirely. I was diagnosed with ADD back before it was lumped in with ADHD – I’ve been prescribed about half of the stuff on your list, and while still in school ended up settling with coffee and chewing gum in the mornings, and a Ritalin before exams in left-brain classes.

I’ve gotten a lot of mileage out of instrumental music (and foreign pop music) – give that freewheeling attention something to latch on to that won’t distract you. Mozart and Daft Punk might be your new best friends. Doodling, fidgeting, taking notes, and spinning in my chair help me think or else pay attention, but some of those would be awkward in an office environment.

keobooks's avatar

I don’t think MM would be good at all for ADHD, personally. It’s usually treated with a stimulant and MM does not have a stimulating effect at all. Some of the very common side effects of MM are short term memory loss, lack of motivation or drive and poor executive functioning—three things that ADHD meds specifically help patients combat.So basically, marijuana would be doing everything possible to make the ADHD worse.

I was trying to hold my tongue because it’s a peeve of mine. I am pro marijuana legalization and believe it has many beneficial medical, . But I can’t stand it when some of the more enthusiastic people who think it cures every ailment known to man and has no detrimental side effects.

MM is one of the worst choices for ADHD in my opinion.

Afos22's avatar

@Buttonstc Yes, marijuana can make someone’s mind fuzzy if they ingest a great amount of it. However, it can be used to aid concentration and focus. Marijuana is also a well known cure of sleeping problems as well as lack of appetite, which the @JTSTs2003 is also suffering from. You could look those ones up easily if you do not believe me. I do have some links that support Medical Marijuana being used to treat ADD. Here is an article and here is a video I could not easily find any long term studies, but i’m sure they will be available soon enough or at least found with longer than 5 minutes of searching.

dabbler's avatar

@Buttonstc “Plus, doesn’t pot tend to make someone’s mind fuzzier rather than focused on tasks?” Depends on the mind.

I’ve had Ritilin explained to be a depressant, for ordinary nervous systems it causes reduced funtionality. It the apt subject, whose mind is going way too fast to engage with reality normally, ritalin can bring it into range. I am not a doctor nor have I ever taken ritalin but the mechanism surprised me. Some people who are normally traumatized into a stupor because inside things are rocketing about at an unmanageable pace get downshifted into a space where they can cope.

Some say medical marijuana has that kind of beneficial pacing effect on some people.
Some will say it depends also on what you are attempting to focus. And sometimes whether you are attempting to focus.

JTSTs2003's avatar

Note on the marijuana thing: I’ve known a few people who smoke instead of taking meds. Maybe it calms them for a while…but since you can’t really take “smoking breaks” at work, they still suffer at work. They seemed severe enough to have benefitted from the right cocktail of regular meds. Just my opinion…

@Buttonstc: I havent been to a neurologist yet. Until this suggestion I didnt even know they existed. After doing some research, I’ll have to see if my insurance covers it – otherwise…I’ll live haha.

@keobooks: That’s a really good suggestion. I remember reading a lot about sleep deprivation mirroring adhd symptoms…when I get sick of the meds, that will be my next stop (again, not sure insurance will cover it).

As for the diet and exercise changes: ohhh yes I know I SHOULD, but I definitely do not have the discipline to sit & pre-plan my meals to exclude the processed/chemically enhanced foods…Too bad they don’t make an ADD diet like they do for jenny craig – where you can order it straight to your home ;P

Afos22's avatar

@JTSTs2003 It can come in pill form or eaten in cookie, or something similar. Smoking is definitely not the only way to take it.

Buttonstc's avatar

Regarding insurance covering for aNeurologist, in most HMOs I believe that your primary physician must make a referral for that since it is a specialty.

But with all the difficulties you’ve had tolerating these meds there’s a clear cut need.

As a matter of fact, I’m a bit surprised that your primary hasn’t yet suggested this yet since ADD/ADHD is at its core a brain/CNS problem.

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