Category Archives: ADHD treatment

From ADHD medication to mindfulness meditation, focus vitamins to acupuncture – they all help some ADD women some of the time. So what’s new? Effective? A waste of money? We explore them all here for ADHD women aka ADDivas!

Three weeks without Adderall

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OK, it's been three weeks since my last Adderall and I am reporting on the effects (or lack of them).

For the first few days, I found myself on autopilot, reaching for the pill case that contained my little blue "energy pills." But I steeled myself against taking them and let the ride wind down. I thought after a week, I'd evaluate my energy and focus, then decide whether to resume my meds…or not.

Well, Tracy Ware, the psychiatrist who spoke at the Meetup group (http://www NULL.meetup NULL.com/Triangle-Adult-ADHD/)two days after I stopped taking Adderall, scared the beejeezus out of me – her warnings about neurotoxicity seemed to be based in science. And I don't want fewer Dopamine receptor sites – I want MORE. Now the jury is still out on the overall effects of amphetamines, but why tempt fate?

Tracy told me privately that the Adderall would stay in my system for at least a month. A MONTH? She said that the second week would likely be worse than the first week. Hmmm .. this sounded a lot like detox, right? I didn't think of myself as an addict. Not ever. This was prescription medication. And I took only a tiny amount (max 2-3 pills a day of short acting 10 mg brand name Adderall).

But sure enough, the second week, I was draggy and had a hard time staying alert. Mostly, I was sleepy.

I found that if I got enough sleep at night (or with naps during the day), I was OK. But if I stayed up too late, got up too early or shorted my required 8 hours of sleep in some other way, I was blah. Just blah.

Couldn't get things done. Couldn't get motivated. Couldn't get going.

But here's the strange thing: I have been living in a mess in my bonus room/guest room for two years now. I am not proud of it. I am terribly embarrassed by it. But it's true.

Last week (third week off Adderall), I got the darned room cleaned up. Granted, I had motivation (my kids were coming to spend the weekend with darling little Lilly). And I had help (Erica the super organizer (http://www NULL.getalifeinc NULL.net/) came on Thursday morning and Janine the super housekeeper cleaned the rest of the house).

But I've had help before.
I've had motivation before.
But this is the first time I actually DID something about it.

Not only did we get the room cleaned, I bought a new bed, new curtains, new lamps and redecorated the room with a new duvet cover, pillows, mirrors and ceiling fan before they arrived! (Yes I had someone install the fan and hang the mirrors – is that cheating? Nope).

Point is that I am still tired/sleepy, but I seem to be getting things done anyway.
I am clearer about what I want and need done.
And I am pretty happy about it.

Is this an aberration?
Is it related to the absent Adderall?

Not a clue, have I.

But we're gonna find out.
In 10 days, I am going to go back on Adderall and monitor myself closely to see how I feel, what I accomplish and how my loved ones respond to the difference (if there is a difference).

In the meantime, I am taking more naps, trying to get to bed on time (what IS on time anyway?) and working in my garden for the first time in months.

The truth about stimulants?

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Neurotoxicity?

Permanent brain damage?

Hmm. That's not what I wanted to hear about my Adderall prescription. (http://en NULL.wikipedia NULL.org/wiki/Adderall) But stimulant medication may be causing more problems than solving them, according to Dr. Tracy Ware (http://www NULL.chapelhillpa NULL.com/providers NULL.htm), a board certified psychiatrist from Chapel Hill who was this month's guest speaker at the Adult ADHD Meetup group held at GardenSpirit. (http://gardenspirit NULL.com)

Research shows that even long term use of methylphenidate  (http://en NULL.wikipedia NULL.org/wiki/Methylphenidate) (Ritalin and its ilk) is safe but taking amphetamines (http://en NULL.wikipedia NULL.org/wiki/Amphetamine) is a quite different story. Dr. Ware showed convincing evidence that amphetamines like Adderall, Dexadrine and Vyvanse induce an artificial "hyperfocus" by increasing the availability of dopamine (neurotransmitter) in the brain.

It mimics the "flight or fight" response that evolved to protect us from woolly mammoths (of old) and muggers (of late). In other words, everything that is non-essential to survival either shuts down or shifts focus. Our peripheral vision narrows (to better focus on the danger), our heart rate increases (to better escape the enemy) and our focus pinpoints precisely the object in front of us.

There are obvious advantages to this hyperfocused state – we pay attention to every detail that might save our lives. But for ADHD, hyperfocus is an overresponse to force our wandering brains to PAY ATTENTION, DANG IT!

I'll share more of Dr. Ware's info in a later post but, I wanted to come clean first:  I stopped taking my Adderall. Not as a direct result of her presentation, but a few days before the Meetup gathering.

I was in a terrible place when I returned from Chicago, the ADHD Coaches Organization conference and a visit with my family in central Illinois. I don't know what happened but I felt so out of control with everything that I needed to stop and regroup.

For some reason, it made sense to me to stop taking medications that were "optional." I have taken Adderall on a regular basis for only 18 months, so that went first. My Wellbutrin, which has been my main ADHD medication for years, stayed on board.

It's been three weeks now and … oh, I think I'll make this another post. It will get waaaay too long to read …. join me in the next post: "Three Weeks without Adderall."

Does Ritalin make you smarter?

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Watch CBS News Videos Online (http://www NULL.cbsnews NULL.com)

 

Last night's broadcast of 60 Minutes (CBS) confirmed my worst nightmares: that ADHD meds will become so popular they will be treated as "brain candy" instead of as a medical necessity for people with brains like ours.

College students agreed that pill popping is rampant on campus, especially with  stimulants like Adderall and Ritalin. They take them to stay up late studying; they take them to finish papers; they take them to focus on tests.

Apparently the stimulants are prescribed for truck drivers who are on the road for hours; and even doctors who work double shifts. But hey, back in my college days, didn't we do the same thing? Except the drug of choice then was No-Doz, 200 mg of caffeine concentrated in little white pills.

I went online to see if NoDoz was still around. Yep, it's still sold and it's a lot cheaper than Adderall or Ritalin. College students said Ritalin was selling for $3-$5 per pill. A bottle of 60 NoDoz costs only $9 online. Free shipping, too..

My fear is not that college students will get hooked on Adderall. My fear is that Adderall and its ilk will become so commonplace that their legitimacy as treatment for ADHD will be diminished, dismissed or even discarded.

The non-ADHD students interviewed by Katie Couric said they could focus better, they could read fine details even about uninteresting information. That's sure not what they do for the ADHD brain. I have clients who take their ADHD meds faithfully but still can't keep their attention on the chapter or the math problem or the To Do list. The pills help us pay attention; but sometimes we veer off into worlds of focus that have nothing to do with the original task.

So, let's be clear here. Just because everybody can take stimulants and gain some focus, it doesn't mean that ADHD isn't a valid diagnosis. We're out here. We still need our meds. And even if we forget to take a few each month, we shouldn't be sharing them (and especially not selling them) to all of the rest of you out there.

I guess it makes the drug companies happy. I guess students are happy and perhaps their professors.

I'm not so happy.

Stimulating everybody’s brain?

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Recently, I heard a doctor tell a TV audience that stimulants like Ritalin and Adderall improve focus for ANYBODY, not just people with Attention Deficit Hyperactivity Disorder. His point was that a positive response to stimulant medication is not proof of an ADHD diagnosis.

Wait a minute. When I first tried stimulants they put me to sleep! It was the first thing that convinced me that I really had ADHD. I'd heard that people with ADHD have a "paradoxical response" to medication, so if I was sleepy after I took Dextrostat, I must have an ADD brain.

I later learned that I had misinterpreted that information. Stimulants don't really have an opposite effect on ADHD brains. Instead, they realign the dance of specific neurotransmitters so the neurotransmitters can hit their mark in the neuron network. I fell asleep when I took Dextrostat (100% dextroamphetamine) because it was the wrong medication for my particular brain chemistry. Adderall (a combination of four different amphetamine salts including dextroamphetamine) worked wonders for me – no midday naps, much more focus.

The TV doctor was reacting to news that some college students swallow stimulant tablets before exams to improve their competitive edge. No word on whether the stimulants actually boosted the students' test scores, but the doctor implied that the groundswell of adult ADHD diagnoses was based more on requests for stimulants than legitimate medical testing.

This kind of pseudo-medical nonsense makes me mad. It took me a long, long time to believe that my ADHD diagnosis was accurate. Now I realized I was deeply  influenced by the skepticism of the media, the public and even the medical community about the legitimacy of ADHD. There was the pharmaceutical conspiracy theory: Big Pharma had concocted ADHD to boost their profitability. Adult ADHD was trivialized: only children could suffer from this silly little disorder so if you "still" have ADHD you must be immature. There was stigma attached to having something "wrong" with your brain: ADHD people are to be shunned or at least marginalized. No wonder I wanted nothing to do with any of it.

But here I am, broadcasting my ADHD story to anyone who stumbles across this blog. Obviously, I've come to terms with my ADHD. I know it's legit, that I am not a hypochondriac and that I certainly would never choose to take powerful medication if it wasn't necessary.

It's my responsibility – and yours, if you or someone you love has been diagnosed with ADHD – to combat the misinformation that masquerades as truth.

Do some of today's college students take stimulants before exams? You bet. Just like some college students took No-Dose when I was in college in the 1970s. And just like mega doses of caffeine, stimulants send those little neurotransmitters into hyperdrive in "normal" brains, creating frenzy instead of focus

Does it mean that adult ADHD is over-diagnosed? Nope. In fact, it is dramatically under-diagnosed; estimates show that only 10% of adults with ADHD are actually diagnosed and treated. Mark my words: in the next few years, we will see dramatic increase in the number of adults who are newly diagnosed with ADHD.

There will be a tipping point, a place at which an ADHD diagnosis carries no emotional baggage. It will merely be a condition to be treated, much like Type 1 diabetes or kidney disease. And then we can get on with the rest of our amazing and extraordinary lives.

Adderall & Vitamin C interaction

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I am working with a new psychiatrist (nothing wrong with the old one; Dr. W specializes in mid-life women with ADHD). She is running me through a trial of three new meds, none of which were on the market 15 years ago when I first tried on ADD meds  – gosh has it been that long ago?

It was a complete surprise to me to learn that stimulant medications have a distinct and negative interaction with foods that contain Vitamin C. Apparently the Vitamin C diminishes the effectiveness of the medication.*

Huh? I had NO idea this was true. I don’t know about you, but I want all the bang for my medication buck possible, so I’m gonna follow her suggestions (which she found on the package inserts of Adderall XR and Dexadrine Spansules – I need to get out my reading glasses to check that teeny tiny print more carefully).

Here’s the rule:

No foods with Vitamin C one hour before or after taking stimulants

Vitamin C big players on the food court include:

Oranges – juice or fruit
Grapefruit – juice or fruit
Strawberries
Papaya
Kiwi fruit
Mango
Cantaloupe
Lemons/lemonade
Limes/limeade

Potatoes (this is not a misprint)
Brussels sprouts
Broccoli
Kale
Cauliflower (who knew?)
Parsley
Mustard greens
Bell peppers
 

Other sneaky sources of Vitamin C

Coke/soft drinks/colas (!!!!)
Power bars
Fortified cereal
Power drinks
Granola bars
Pop Tarts
Any kind of jam or jelly made from fruits listed above

And of course…
Vitamins – multi-vitamins
Vitamin C tablets

 FYI
Dr. Wojdyska also nixes taking antibiotics in that two hour time span. And I found on the Adderall XR site that melatonin reacts with the medication, too. Insomniacs beware .. but only for that short time period.

(If you think taking an antacid like TUMS will allow you to eat citrus, you’re right, but note that *taking antacids INCREASES the effect of Adderall. Be careful out there….)

Thanks, Dr. W – you’re the best.

And now you know the rest of the label…

Hugs

Linda

*From the FDA site re: interactions with Adderall XR
Drug Interactions:
Acidifying agents -Gastrointestinal acidifying agents (guanethidine, reserpine, glutamic acid HCl, ascorbic acid, etc.) lower absorption of amphetamines.
Urinary acidifying agents -These agents (ammonium chloride, sodium acid phosphate, etc.) increase the concentration of the ionized species of the  amphetamine molecule, thereby increasing urinary excretion. Both groups of agents lower blood levels and efficacy of amphetamines.
Alkalinizing agents -Gastrointestinal alkalinizing agents (sodium bicarbonate, etc.) increase absorption of amphetamines. Co-administration of ADDERALL XR® and gastrointestinal alkalinizing agents, such as antacids, should be avoided. Urinary alkalinizing agents (acetazolamide, some thiazides) increase the concentration of the non-ionized species of the amphetamine molecule, thereby decreasing urinary excretion. Both groups of agents increase blood levels and therefore potentiate the actions of amphetamines.




 

 

Wellbutrin generic – bad news?

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I’ve always worried that generic drugs aren’t quite as good as the brand name version and now there’s mounting evidence to prove it.

Wellbutrin XL 300 (Budeprion XL) works just fine for depression and many ADHD symptoms. But when some patients are switched to the generic formulation, they reported frightening symptoms: fast onset of severe depression and serious suicidal thoughts.

In a recent article published by the People’s Pharmacy (http://peoplespharmacy NULL.com/)a woman reported no problems with the original Wellbutrin XL 300 but said that she had "the worst case of depression" she could remember when her pharmacy substituted the generic equivalent. It should be noted that the difference has not been reported in the 150 XL formulation at this point.

Apparently the generic version releases the medication at a different rate than the original, thus creating quite different response rates and effectiveness.

This news scares me – because a lot of ADDivas take Wellbutrin, including me – and there is the potential for serious repercussions. Suicide is not to be taken lightly, especially when antidepressants are supposed to ward off those thoughts and actions.

Equally important, however, is that many ADD women and men have already experienced differences in generic medications vs. brand name drugs that treat ADHD. I cannot take generic Adderall, for instance. Other people cannot take the brand name version. Ditto for any of the other drugs on the market today.

There are two ways to look at this issue, in my opinion.

1) We need to make SURE that we are receiving the exact drugs prescribed for us with NO substitutions by the pharmacy or insurance company (this may take some lobbying by you or your doctor).

2) If generics really do release their active ingredients at different rates than the original drug, it gives us even MORE options to play with to treat our ADHD symptoms.

After all, drug companies are making a fortune by adjusting the release time of ordinary drugs like old fashioned Ritalin, slapping their brand on the bottle and charging 10 times the price of generics. I know folks who can’t take the brand name drug but have good results with the generic. It works both ways. But the bottom line is the same: we all react differently to medication release schedules, to the type of drug prescribed, to the interval we take the drug, etc.

OK, now the disclaimer: this is NOT something to play with on your own. Obviously there can be serious consequences. Drugs are not a smorgasbord from which we can pick and choose. Work with your doctor to find the best combination for you.

But if you are switched to a generic and suddenly notice your symptoms change, call the pharmacy AND the doctor immediately. You deserve to take the meds that work best for you,
brand name OR generic.

Read the full report at Consumer Lab. (http://www NULL.consumerlab NULL.com/)

Neurons, anyone?

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It’s 6:15 am in California and I’m sitting at the pumpkin-colored Formica breakfast bar that separates the living room from the kitchen in my tiny retreat cottage. The cottage is actually a one-bedroom trailer anchored into the rocky north San Diego County hills.

I booked it to accommodate my return appointment at the Hallowell West Clinic. I am determined, at last, to stand toe-to-toe with my Attention Deficit Disorder.

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