Tag Archives: Adderall

Shortage of ADHD drugs

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We can't get our ADD meds and we're losing focus faster than a defective camera lens. What gives?

First, everyone (OK, doctors) convinced us that we should take meds for our ADD. So we get our prescription filled, our brains come to attention, we get things done and then ... and then ... no medication!!!!

Is it a conspiracy? Is it corporate manipulation? Is it ghosts on Halloween?

Well, it's probably not ghosts but there aren't clear reasons for the shortage of ADHD medications, especially mixed amphetamine salts (a.k.a. Adderall and its ilk) and methylphenidate (a.k.a. Ritalin).

The FDA website (http://www NULL.fda NULL.gov/Drugs/DrugSafety/DrugShortages/ucm050792 NULL.htm) reports that the Adderall shortages are caused by a variety of issues, mostly about "API" shortages. API stands for "Active Pharmaceutical Ingredient." According to Drug Store News more than 80% of the API needed to manufacture drugs in the US comes from OUTSIDE the United States! Most of the active ingredients come from Italy, China and India. So if the supply slows down abroad, our meds in the US are affected.

It is truly a global world of pharmaceuticals these days. The FDA requires that the API produced outside the US meet the same high standards for quality as those produced domestically. But ... and here's the shocking fact ... drugs produced overseas are NOT highly regulated, even for export to the US and other countries. As recently as 2008, there was a single FDA inspector assigned to China. As in one person. One.

OK, don't get me sidetracked into a discussion about the purity of drugs. This is about shortages. However, concerns about the purity of the API can delay production, too. The FDA took action against a Mexican API production facility in June 2011, which delayed manufacturing (this was not an ADHD drug API).

So...as of October 28, 2011, the FDA reported that Immediate Release Mixed Amphetamine Salts (Adderall and generics) are delayed because of API shortages (brand name Adderall), higher demand and manufacturing delays.

For Adderall ER, the picture is similar, but Shire Pharmaceuticals (who also produces Vyvanse) claims there is no shortage at the manufacturing level. There are some distribution inequities, though. So one part of the country might have a plentiful supply, while other areas may experience a shortage ... sigh.

Ritalin/methyphenidate - things are grim. As of October 11, 2011, Sandoz (which manufactures generic Ritalin) predicts "sporadic backorders" for the next couple of months. The only manufacturer who has plenty of generic Ritalin (methylphenidate) is Watson Pharmaceuticals which apparently has a lock on the market right now.

Metadate, a branded formulation of methyphenidate that comes in the CD, IR and ER variations, is at full supply from UCB Pharmaceuticals.
Metadate CD

The other formulation that is bountiful at the moment is Daytrana, a brand name formulation that is administered via a time release transdermal patch (applied to the skin). Noven is the manufacturer of Daytrana.

Bottom line is that some important meds are missing from our ADHD arsenal right now and nobody seems to be talking about it ... unless you are one of the unlucky ones who can't get a prescription filled.

What's your experience? Let us know where you live and whether you can get meds in your area. We need to help each other on this vital issue!

Neurotoxicity and meds

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Buried in the fine print of an article in Wikipedia, I found some rather disturbing information.

A number of releasing agents, notably many of those derived from amphetamine (http://en NULL.wikipedia NULL.org/wiki/Amphetamine), have been found to be neurotoxic (http://en NULL.wikipedia NULL.org/wiki/Neurotoxic) to serotonin (http://en NULL.wikipedia NULL.org/wiki/Serotonin) and/or dopamine (http://en NULL.wikipedia NULL.org/wiki/Dopamine)neurons (http://en NULL.wikipedia NULL.org/wiki/Neurons) via damage to axons (http://en NULL.wikipedia NULL.org/wiki/Axon) and dendrites (http://en NULL.wikipedia NULL.org/wiki/Dendrite), enzymes (http://en NULL.wikipedia NULL.org/wiki/Enzyme), mitochondria (http://en NULL.wikipedia NULL.org/wiki/Mitochondria), DNA (http://en NULL.wikipedia NULL.org/wiki/DNA), plasmalemmal (http://en NULL.wikipedia NULL.org/wiki/Membrane_transport_protein) and vesicular transporters (http://en NULL.wikipedia NULL.org/wiki/Vesicular_transport_protein), and the cell membrane (http://en NULL.wikipedia NULL.org/wiki/Cell_membrane), ultimately causing cell death (http://en NULL.wikipedia NULL.org/wiki/Cell_death) or apoptosis (http://en NULL.wikipedia NULL.org/wiki/Apoptosis) as a result. Examples include amphetamine, methamphetamine (http://en NULL.wikipedia NULL.org/wiki/Methamphetamine), MDMA (http://en NULL.wikipedia NULL.org/wiki/Methylenedioxymethamphetamine), fenfluramine (http://en NULL.wikipedia NULL.org/wiki/Fenfluramine), and PCA (http://en NULL.wikipedia NULL.org/wiki/Parachloroamphetamine), among others.

What this says essentially is that amphetamines can damage neurons and cause cell death. But the piperidine compounds aren’t as  toxic – that’s Ritalin, Concerta and Daytrana:

In contrast, piperazine (http://en NULL.wikipedia NULL.org/wiki/Piperazine), aminoindane (http://en NULL.wikipedia NULL.org/wiki/Indane), and oxazoline (http://en NULL.wikipedia NULL.org/wiki/Oxazoline) releasing agents, as well as those from various other chemical families (http://en NULL.wikipedia NULL.org/wiki/Chemical_family), are considered to be either fully nontoxic (http://en NULL.wikipedia NULL.org/wiki/Toxicity), or significantly less toxic (http://en NULL.wikipedia NULL.org/wiki/Toxicity) in comparison.

Methylphenidate belongs to the piperidine (http://en NULL.wikipedia NULL.org/wiki/Piperidine) class of compounds and increases the levels of dopamine (http://en NULL.wikipedia NULL.org/wiki/Dopamine) and norepinephrine (http://en NULL.wikipedia NULL.org/wiki/Norepinephrine) in the brain through reuptake inhibition (http://en NULL.wikipedia NULL.org/wiki/Reuptake_inhibitor) of the monoamine transporters (http://en NULL.wikipedia NULL.org/wiki/Monoamine_transporter). It also increases the release of dopamine and norepinephrine. MPH possesses structural similarities to amphetamine (http://en NULL.wikipedia NULL.org/wiki/Amphetamine), and, though it is less potent, its pharmacological effects are even more closely related to those of cocaine (http://en NULL.wikipedia NULL.org/wiki/Cocaine).[1] (http://en NULL.wikipedia NULL.org/wiki/Methylphenidate#cite_note-0)[2] (http://en NULL.wikipedia NULL.org/wiki/Methylphenidate#cite_note-1)[3] (http://en NULL.wikipedia NULL.org/wiki/Methylphenidate#cite_note-2)

I’ve written here previously about Dr. Tracy Ware’s assertion that amphetamines aren’t such a good choice for our ADD brains, even if they do help our focus and concentration. And that Ritalin (methyphenadate) isn’t quite so bad. This article supports her opinion.

Darn it. Just when we found something that would at least wake up our brains a little, allow us to focus, the ultimate effect is negative. I sure don’t want cell death in my neurons. I think it’s back to caffeine for me. But in small doses so my heart doesn’t go pitty-pat in ways it shouldn’t.  (sigh)  Don’t you wish this was easier?

YOUR truth about stimulants

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Should you stop taking your Adderall or Vyvanse or Dexadrine now that you've heard Dr. Tracy Ware's presentation (http://store NULL.lindaroggli NULL.com/product_p/d-the%20truth%20about%20stimulants NULL.htm) about the potential dangers of amphetamines? Maybe yes. Maybe no.

I just got off the phone with a woman (let's call her "Maggie") who recently started taking Vyvanse with great success. No side effects and improved attention, etc. After she listened to Tracy's presentation, she was unnerved by the possibility of brain damage with amphetamines so she switched medications (to a second tier ADHD drug). Maggie's been in a downward spiral ever since. Missed appointments, foggy brain, battered self esteem. Nothing we aspire to, right?

So why didn't she immediately stop the new meds and go back to Vyvanse? I suspect she called me for a reality check on whether I believed amphetamines really killed off brain cells. And I do. I told Maggie that many medications have potentially serious consequences: high blood pressure medication can cause sexual problems (http://www NULL.mayoclinic NULL.com/health/high-blood-pressure-and-sex/HI00091) for men. The FDA reported today that taking a malaria drug could cause severe kidney damage (http://drugstorenews NULL.com/story NULL.aspx?id=146043&menuid=335)and heart failure. There are unintended consequences to almost every choice we make.

But also I told her that returning to Vyvanse sounded like a good idea. I'm not a medical doctor so my opinion is worth about what you pay for it – $0. But it makes eminent sense to me to stick with something that works versus flailing around trying to save your brain cells. And yes, I DO understand that salvaging brain cells is an important goal, but the jury is still out on whether those cells will regenerate or not. There is a LOT we don't know yet about the brain and how it repairs itself.

Even more important, there is a quality of life issue here.  We ADD women have been through a lot of stuff (OK, sh**t) in our lives. Finding a medication that actually works to bolster our time management, organization, sense of well being, is a godsend.

We shouldn't stop exercising because we might pull a hamstring or sprain an ankle. And we shouldn't stop taking our amphetamine medication because someone told us there is potential for cell death. For heavens sake do NOT stop taking medication without telling your doctor! Those consequences could be even more dire than continuing the meds!

Anyway, Dr. Ware doesn't shun amphetamines; she prescribes them for her patients who need them. That includes those of us who don't see much improvement with Ritalin-family meds (like Tracy's own husband!).

The fact that I stopped taking my Adderall was more about looking at the factors that were causing me to feel out of control and a bit crazed. Sure there is a lot going on in my life. There is ALWAYS a lot going on in my life. And changing one thing at a time, to see the effects, is the way I can narrow down the cause of the problem, and then find my way back to a solution.

I don't know about you, but I want to feel alive every day. I want to feel good about myself and productive. I want to feel proud of myself and I'd like the people I love to be proud of me, too. It's not too much to ask of an ADD life. I know. I've lived it. And I'm going back there.

That means I will probably go back to Adderall. Not sure yet. Working on it. But if I do return to amphetamine medication, it will be MY truth about stimulants. Not Tracy's. Not Maggie's (Vyvanse is awful for me, BTW). Not Susan's or Ellen's or Mary's. Mine.

You need to find YOUR truth about stimulant medication. Yes. No. Maybe. Sometimes. Alternatives. Rotating. It's all part of the mix. If there is one thing I have learned about ADHD it's that it is literally a different experience for everyone. Personalized treatment..that's where we're headed, according to another psychiatrist who visited our Meetup group last night.

Work with your doctor, monitor your symptoms, get reaction from your loved ones. Find your OWN truth and then, make peace with it. None of us are gonna get out of this alive. Something, somewhere, sometime when we least expect it and probably don't want it, will cause our bodies to shut down and we'll bid farewell to the mortal coil.

So how do you want to live your life in the meantime? At my retreats I always read a poem by Mary Oliver (http://www NULL.loc NULL.gov/poetry/180/133 NULL.html)that ends with this line: "Tell me, what is you plan to do with your one wild and precious life?"

You alone have the answer. For all of it.

Depression delights

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Maybe it was my husband’s near-fatal heart condition (http://lindaroggli NULL.blogspot NULL.com/2007/03/nailing-down-cloud NULL.html ) three years ago. Maybe it was the cease-and-desist order for GardenSpirit (my dream come true retreat house) (http://gardenspirit NULL.com) last year, which is forcing me to jump through extremely bureaucratic hoops (can you spell R-E-D T-A-P-E?). Maybe it was my parents moving into assisted living this week with virtually no notice. Maybe it was the failed project to redirect water away from my front yard that culminated in an ugly gash 4 feet wide and 200 feet long. Maybe was my dear Sheltie painfully hobbling toward an inevitable end. Maybe.
 
Or maybe, under a constant attack of stress, my brain reverted to its genetic predisposition. Depression.
 
Ugh. I really hate that word. And it seems to have descended on me despite my best efforts to 1) ignore it 2) pretend I was far too ‘healthy’ to fall victim to it and 3) work like a madwoman to outrun it. But thanks to my new psychiatrist, I am starting to view depression in a different light.
 
“It is really unfortunate that we use the word ‘depression’ because it sounds like you are sad. That’s not what depression is,” Dr. Ware (http://www NULL.chapelhillpa NULL.com/providers NULL.htm) told me yesterday. “It’s more like the frontal lobe of the brain goes dark.”
 
Frontal lobe? Hey, isn’t that an ADHD issue? Isn’t that all about executive function and planning and impulse control? Hmmm, could they possibly be related? Well yes. And no.
 
Depression isn’t ADHD. I was pretty angry when I found out I had ADHD because depression and ADHD in women are often confused. Even after I learned that ADHD often has a sidecar disorder along for the ride (like depression, bipolar, obsessive-compulsive), I was mad at all those doctors who had misdiagnosed me. I decided I’d probably never been depressed at all. It had been the ADHD all along, right?
 
Uh, probably not. Dr. Ware reminded me that signs of depression include lack of concentration, distractibility, trouble with focus. Huh. Sounds a lot like my good friends Inattention and Distraction, who pop up in a diagnosis of ADHD.
 
I suspect that for me, depression and ADHD take turns at the helm. One is in the driver’s seat while the other rides in the sidecar, then they switch places. Since it has been years since I was really depressed, I blithely decided that it would never return. Ever. WRONG.
 
Many of you wondered why I chose to stop taking my Adderall, especially when it had served me so well in the past. What I now realize is that the Adderall was keeping me afloat, squishing that depression into a corner so I could get something DONE (my favorite four letter word, remember?).
 
It was actually a miracle/stroke of genius/blessing that I stopped taking my Adderall because it peeled back the covers to reveal a more basic issue that I probably wouldn't have noticed otherwise. When Dr. Ware told me that  depression actually causes cell death in the brain (which is repairable, thank goodness) I suddenly understood why I’ve been struggling with even basic tasks (but embarrassed to admit it).
 
I have lots more to say about this but I know the ADD brain prefers short, sweet articles, so I’ll stop here for today. Stay tuned …
 
Oh, and my treatment plan includes being consistent with my antidepressant, fish oil, exercise and folic acid….tantalized???? Come back tomorrow for more….
 
(But first, tell me about your experience with depression…were you ever diagnosed with depression before your ADHD diagnosis? After? Talk to me!)

Mood changes

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Is it just me or is the world more moody these days?

Oh yeah. It's me.

I don't know what's going on with me and have been reluctant to share it with you since I try hard to stay upbeat. But darn it, I just can't seem to get it together right now. I forget things. I snap at people I love. I overreact.

I suppose you could point to my Adderall "vacation" as the cause, but it was happening even before that. In fact, that was one of the reasons I actually TOOK a vacation from stimulants (helped along by new information from Tracy Ware).

I just don't feel like "me" right now. Everything seems to bring out the worst in me. I am not happy with this person I have reverted to (yes there was a dark time that I was this person almost all the time – yuck).

In between, I managed to turn a big corner: I was in touch with my own wisdom. I could trust my intuition (and did). And now it's like a delicious dream from which I have awakened. I want to go back to sleep again. I want the "good Linda" back again (sigh).

Well, what's the lesson here? That life isn't all a bowl of cherries? That I don't have it all "together?" That it's pretty normal to ebb and flow with moods and wisdom and intuition and the rest of it? Probably.

What I do know is that it will return – that elusive sense of well being. I know it. I've tasted it, lived it, steeped in it. And I will again. But right now, I just wanna crawl into a little ball and cry. I might just do it. Tears are cathartic for me.

Oh, wait, I have to go to a birthday party in 10 minutes!. Maybe the storm can wait a bit,,, Pictures from the Big Birthday coming up next.

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.

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.

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.