What is ADHD ADD

Attention-deficit hyperactivity disorder (ADHD) is a neurologic syndrome that exhibits symptoms such as hyperactivity, forgetfulness, mood shifts, poor impulse control, and distrac...

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Treatment of Adult AD/HD
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The bulk of the available data on the treatment of AD/HD are derived from studies in children. Here is a summary of the pharmacotherapy that has been found to be effective in Adults with AD/HD
1) Stimulants (Adderall, ritalin) are the most commonly used meds in adults with AD/HD but the response rate varies from 25-78% in the limited number of studies and concerns about effects on heart rate and BP make them more difficult to use in adults
2) an Atypical stimulant Modafinil (Provigil) has been found to be as effective as Ritalin in studies and does not have effects on HR and BP.
3) Antidepressants : Tricyclic antidepressants (desipramine, imipramine) and Buproprion (Wellbutrin) have also been found to be as effective as stimulants in Adult AD/HD
4) Strattera is a NON stimulant FDA approved for adult AD/HD based on studies which found it to be more effective than placebo for Adult AD/HD
Dr O.
Posted on 10/09/06, 12:10 am
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Reply #1 - 10/12/06  10:07pm
" Thats a great question
I think its a little of both
When they study adults with ADHD they find many missed (undiagnosed) mood disorders/psychiatric conditions (bipolar, anxiety d/o, depression) AS WELL as medical conditions (hyperthyroidism, etc)that cause distraction and concentration difficulties....thats why one of the MAIN criteria for adults is that SYMPTOMS WERE PRESENT EARLY ON IN CHILDHOOD.
I also think the meds just dont work very well even in the best designed studies...having said that..i do have some patients who have done well on strattera and provigil..i really dislike the stimulants in adults and have had some bad outcomes with those.Thanks for the thoughtful question.
Dr O. "
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Reply #2 - 10/20/06  9:28pm
" My husband takes Strattera and Trileptal.I understand the Strattera, but not why he is on the Trileptal. He doesn't have epilipsy. I worry about him being on the wrong medication. What is the Trileptal for? "
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Reply #3 - 10/20/06  11:51pm
" Hey Heather
You are right to be curious about the Trileptal..so am I
It is an antiepileptic drug and also has Off label indications for Bipolar disorder and Neuropathy (chronic pain)
Im not sure why your husband is on it unless whomever is treating him thinks he might be bipolar.
Dr O. "
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Reply #4 - 10/21/06  10:08pm
" My husband isn't bipolar. That I know for sure. The p-doc that he first went to put him on this medication and he hasn't had it change. We were both seeing the same doc at that time. This doc had me over medicated so bad that I couldn't function. I ended up changing docs. The next p-doc I went to was very upset at what this other doc had me on. My husband isn't seeing this doc anymore but our primary care doc. He is going to have to see the primary care doc soon and I want to see if there could be some changes made. I know that you don't know his case history but is there some questions we should ask the doc that might be helpful. Also he was told that he had three types of ADHD. Is there such a thing? "
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Reply #5 - 10/22/06  2:39pm
" Hey Heather!
First...if he has had NO response on trileptal...there is no reason to take it.
then you can ask
1) what is the indication for trileptal?
2) is it approved for this use?
3) is there any evidence to suggest it works?
4) what other meds can we try since this doesnt seem to be doing anything for him?
ive never heard of 3 types of AD/HD...
Dr O. "
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Reply #6 - 11/12/06  1:43am
" I know this doesn't really apply to treatment, unless maybe you consider self-treatment by education.
I had a Personality Theory class a while back, instructed by a clinical psychiatrist. He recommended a book to me. Some parts of it have been really helpful.
Driven to Distraction: Recognizing and Coping with ADD. It's by Edward M. Hallowell, MD, and John J. Ratey, MD>
I have to go back and read some of it once in a while, to see what I've missed (duh!). "
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Reply #7 - 11/21/06  8:20pm
" Heather I have to say that yes there are different degrees of ADHD but i cant understand the breakdowns you listed. Ive adhd all my life Im now 29 and have son with it as well. I have to say that I can relate to all those symptoms. Im very innatentive,daydream, cannot focus, lose interest quickly, get bord easily, cannot sit still, impulsive, and as for the defiant disorder,Im sorry but if youve been dealing with this as long as I have yes, your going to start getting pissed. Everyone I come in contact with either doesnt beleive in adhd or thinks Im unintelligent. I think differently than others, I think alot faster than others, thats all. In this world, Its easy to start getting angry at people for treating you like some kind of moron. If you ask me, doctors dont even know that half of it. You wont know unless you have it. You'll never know how much this defines you and impacts your life unless you deal with it everyday. "
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Reply #8 - 12/12/06  7:52pm
" I am taking Focalin on top of Straterra for my ADD. It does help quite a bit.

Uther "
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Reply #9 - 12/28/06  12:46am
" Hi,

I'm new here. I was diagnosed with Adult ADD at age 35 (last year) My current physician has tried two different meds. Neither have worked, and he is unwilling to try anything else. I'm thinking of switching physicians. I live in PA. Does anyone have any suggestions? Know of a good doctor? I would really aprreciate any help I could get. My neice and nephew both have ADD. Ritalin works for my nephew while only adderall works for my neice. It took trial and error for both of them before they found the meds that worked for them, but they both see pediatricians (their ages are 13 and 16).
Thank you in advance for any suggestions. If you would like to email me my email address is gibgirl70@aol.com.

Thank you!

Tara "
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Reply #10 - 12/30/06  11:38pm
" I certainly had no ADHD symptoms as a child, but my ADHD came from a head injury at the age of 18. Because of that, anybody can look at my CAT-scan and MRI and clearly see what's wrong with my brain!! I went through a full outpatient head injury program and nobody ever even mentioned the possibility of ADHD once. It took 18 years to be diagnosed, all the while having *every* ADHD symptom. On the one hand, it makes it easy to tell when a medication is working-- it just reminds me of the time when my brain used to work correctly! On the other hand, few people even know that ADHD from a head injury is possible. The issue of this type of adult ADHD needs *much* more attention than it is getting. It will be a tremendous public health issue in the near future with the huge number of soldiers coming back from Iraq who survived head injuries (a larger number than in any previous military action of any kind.) The time has come to treat it seriously. "
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