Archive for Medication

ADHD Medication: How To Decide

When it comes to making a decision about whether to use a medication for ADD/ADHD or not, many people struggle with this… There is so much misinformation out there, that people are worried about making the wrong decision, and whether they will be judged for it…

In this short video (taken from a presentation I did), I share with you the way to decide if you will take ADD/ADHD medication or not. And this applies whether you are dealing with child/teen ADD/ADHD, or Adult ADD/ADHD.

Please watch this short video, share your comments/thoughts below (and also forward it to friends/family who may appreciate it!).

What do you think? Do you agree with the message of this video?
Best,
Dr. Kenny

p.s. To learn a whole lot more about the safe and effective use of ADD/ADHD medication – take advantage of the special discount on the Medication Mastery Course (special ends on Monday December 5th at 11:59 pm Eastern time) [hyperlink family="Helvetica,Arial,sans-serif" size="20" color="1A12FF" textshadow="1" alignment="center" weight="bold" style="normal" lineheight="110" linkurl="http://medicationmastery.com" linkwindow="_blank"]Click Here To Take Advantage Of The Special Offer[/hyperlink]

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Long Term Stimulant Use Improves School Grades

When kids or teens are diagnosed with ADD/ADHD, doctors generally recommend medication to help to control the symptoms.The most commonly used medications include the stimulant medications – namely medicines like: Concerta, Adderall, Adderall XR, Vyvanse, Metadate CD, Ritalin LA, Methylphenidate, Dextroamphetamine, and others.

While there are many studies showing that the ADHD symptoms of inattention, hyperactivity and impulsivity improve with the medicine, and cause short term academic improvements, there has been a lack of research to show long term academic benefits.

The studies summarized here clearly document that ADHD stimulant medication helps with long term academic success.

In this research, the research team followed 5700 children from birth until 18 years old. In that group, 277 boys and 93 girls were diagnosed with ADHD. Of those with the diagnosis, some decided to use medication, and some did not. When kids took ADHD medication, they generally started in elementary school, and took it for (on average) 30 months (i.e. just under 3 years).

Of the ADHD kids who were taking medication, by 13 years old, the medication children had improved reading scores compared to the kids with ADHD who had not taken medication. Children taking medication were more likely to attend school (i.e. less absenteeism), and they were 1.8 times less likely to be held back a year at school.

The lead researcher, Dr. Barbaresi was quoted as saying: “We can’t simply focus on the symptoms of ADHD,” Barbaresi said. “We really need to be focusing on the risk for poor outcomes in school and in other aspects of the child’s life,” he said. “That’s why we have to recognize these children and make sure they get appropriate treatment.”

To read more about these studies, click here.

What do you think? Has ADHD medication helped your child (or yourself) over the long term? Please share your thoughts in the comments below.

Best,

Dr. Kenny

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ADHD Medication and Co-Existing Conditions

Virtual AD/HD Conference

 ADHD Medication and Co Existing Conditions

When it comes to ADD/ADHD, it is relatively rare that people just have the one condition. It is very common that people have 2 or even 3 conditions.

What else comes with ADD/ADHD?
It is very common for people to have the following conditions in addition to ADD/ADHD:

  • Depression
  • Anxiety
  • Behavior Disorders
  • Learning Disabilities
  • Tic disorders
  • and more…

When doctors are prescribing medication for ADD/ADHD, they may not account for the co-existing condition. Sometimes, the ADD/ADHD medication may impact on the other condition, or vice-versa – i.e. the medication for the other condition (i.e. anxiety) impacts the ADD/ADHD. It is important to understand the nature of this relationship.

This post contains the audio from an interview that I did with Jennifer Koretsky for the Virtual ADHD Conference 2010. In it, I share some facts about ADD/ADHD and co-existing conditions. And, I also encourage you to join us for the conference – where I will spend an hour teaching on this concept, and there will be a lot of other ADD/ADHD experts to help you to find answers to your biggest issues, and learn more about many aspects of this challenging condition. The Virtual ADHD Conference is on October 4, 5 and 6 2010.

Here’s the interview: ADHD Medication and Co-existing Conditions By: Dr. Kenny Handelman

Please note – in standard medical terminology – the term for this is: Comorbidity. In other words, a doctor may say: “he has ADHD and comorbid Depression”. It’s my feeling that people with ADD/ADHD have to deal with so much negativity a lot of the time, that I generally use the term: Co-existing rather than comorbid. Just my preference icon smile ADHD Medication and Co Existing Conditions

A Bribe To Consider Joining the ADHD Virtual Conference:
Is it wrong to bribe you to consider joining the ADHD Virtual Conference?
From my perspective, if you are considering joining, I want to give you a bonus – or a reason why to join today. If you feel that the conference isn’t for you, then this ‘bribe’ won’t impact you, and you won’t mind anyway, right?

To help to motivate you – especially since it is August – I’ll give a bonus to anyone who signs up before the end of August 2010. So – to qualify for the bonus, you’ll need to sign up before midnight on August 31, 2010.

What will the bonus be?
I’ve been thinking about what I can do to help you after the ADHD Virtual Conference. This conference will host a lot of great ADHD experts, and you may be inundated with information.
What you may need, after a conference like this, is the opportunity to ask questions about how to personalize the information to suit your personal situation or circumstances.
To help you with that – if you sign up from this blog (or my email list), I will host a question and answer call. I anticipate this will be a small group call, which will allow you to ask your questions of me directly. And different than many of the other question and answer calls I’ve done in the past, this one will be with an ‘open telephone line’. That will allow you to talk directly with me, and we can explore your issues in a discussion.
The date for the call will be chosen in early October. It will be one weeknight (i.e. Monday through Thursday) at 9 pm eastern time. There will only be one time and date for the call. If you can’t attend the call live, you can forward detailed question(s), which I’ll answer and you can listen to the recording. And if you attend live, I’ll chat directly with you.
The call will go for approximately 1 hour (or less or more depending on how many questions there are).
How many people will be on this call? If past experience is a measure, it will likely be a small group. This is a great opportunity for you to have a discussion with me, so that I can bring all of my experience and knowledge of ADD/ADHD to help you out in a small, personal setting.

Here’s what to do now:
If you feel like the ADHD Virtual Conference would be of benefit to you, and you’d like the opportunity to have a small group question and answer call with me (to discuss your personal questions or situation), then follow these steps:

  1. Visit the ADHD Virtual Conference website and register for it
  2. Forward your receipt email to our email support team: support@theadhddoctor.com
  3. Wait for the announcement of the special, exclusive Q and A call with Dr. Kenny Handelman. You’ll find out the date in early October 2010, and the call will be in late October 2010, on a weeknight, 9 pm Eastern time. There will only be one option available for the Q and A call, and you can attend live for an ‘open telephone’ conference call to ask your questions, or submit your questions via email to get answers and help for your specific situation.

As a disclaimer, our company receives a small referral fee for sending you to the virtual conference through our link. However, we are encouraging you to participate because we believe that you’ll get great value out of the virtual conference, if you decide to participate.

I hope you’ll join me for the ADHD Virtual Conference!

Best,

Dr. Kenny

p.s. remember – this bonus is only valid for sales which are made before August 31st, 2010 at midnight.
p.p.s. if you’ve already purchased this conference through my blog or email list, you get this bonus already :-). You just need to forward us the email receipt so that we can put you on the ‘bonus list’

Virtual AD/HD Conference

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ADHD Medication in Families

It has been known for a long time that ADD/ADHD runs in families. ADD/ADHD is very genetic. Heritability studies show that ADD/ADHD is about as genetic as height – i.e. it is in the 80-85% heritable.

A study was done that shows that it is quite common for more than one member of the family to be taking medication for ADD/ADHD.

If a child is taking ADD/ADHD medication, a parent is 9 times more likely to be taking medication for the condition as well. The researchers found that 60% of the time it was the mother vs. 40% of the time with the father.

In my clinical experience working with kids and teens, often times when a parent gets a diagnosis of ADHD and starts treatment (often including medication) this can have a dramatic impact on the outcome for the child or teen. This relates to the fact that a lot of the parenting approaches which work for ADD/ADHD kids and teens involve the parents introducing structure in the parenting. If the mother or father have ADD/ADHD, they may struggle to establish the needed structure. When they receive treatment, things can improve significantly.

Do you have more than one family member taking ADD/ADHD medication? What’s your experience?

Best,

Dr. Kenny

http://www.theglobeandmail.com/servlet/story/RTGAM.20060928.wadhd0927/BNStory/specialScienceandHealth/home

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ADHD Medication in the Summer?

For many years – doctors suggested that people only take ADD/ADHD medication for school days. So, doctors suggested that people stop their stimulant medicine on weekends and holidays (including Christmas breaks, summer breaks, etc.).

In the past 10-15 years, there has been more of a recognition that ADD/ADHD impacts many more areas of people’s lives than just academics. ADD/ADHD impacts social areas, psychological areas, emotional areas, etc. As such, doctors now recommend taking stimulant medicine all week long, and during the summer breaks as well.

I’d like to get your perspective. Does your child or teen take a ‘medication holiday’ during the summer holiday?

Please vote on this poll here, and share any comments in the blog post below.

[poll id="4"]

Best,

Dr. Kenny

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Vyvanse in Canadian Pharmacies

February 14, 2010

Vyvanse was launched in Canada officially on February 1st, 2010. Even though it was officially launched, there have been some issues with the ability of pharmacies to get Vyvanse on their shelves.

As of February 12, 2010 – the following pharmacies have access to Vyvanse (i.e. if they don’t actually have it in their pharmacy, they can order it from their wholesalers and have it in within 24 hours)

  • Shoppers Drug Mart
  • Jean Coutu
  • Main Drug Mart
  • People’s Drug Mart
  • Pharmasave
  • Total Health Pharmacies
  • Wal Mart Pharmacies

I’ve been informed that by Wednesday February 17th, 2010, 80% of pharmacies will have access to Vyvanse from their wholesaler.

And by Friday February 19th, 2010, 100% of pharmacies will have access to Vyvanse from their wholesaler.

So, if your doctor gives you a prescription for Vyvanse (and you’re in Canada), you can go to one of the pharmacies above (which already have Vyvanse), or ask your doctor if it’s OK to wait until your particular pharmacy can get the medication in.

To be clear – there is nothing wrong with the Vyvanse supply or medication. The reason for the delay has to do with the paperwork and regulatory aspects which the wholesalers have to complete to be able to store and ship a stimulant medicine. This will be resolved quickly (and hopefully easily for you!).

Best,

Dr. Kenny

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Adderall: Dosing and Duration

Mention the phrase “attention deficit hyperactive disorder” and most people immediately associate it with the drug Ritalin. The two words seem to go and and hand with the other.

It might surprise you to know though that in the U.S. Adderall is actually the most commonly prescribed medication for this health disorder. Adderall and its sister medication Adderall XR share nearly 25 percent of the medication market. That means that for every four people taking some type of prescription drug — one of those people is taking a form of Adderall.

Different from several other attention deficit drugs on the market, Adderall is not a single chemical or drug, but a powerful bend of a combination of stimulants. Specifically Adderall is composed of amphetamine and dextroamphetamine.

The medical community believes this prescription drug works through the restoration of the balance of neurotransmitters in the brain, namely dopamine and norepinephrine.

ADD/ADHD isn’t the only health disorder that Adderall benefits, though it’s certainly one of the biggest. This medication is also administered to those individuals who suffer from narcolepsy. This is a condition in which a person suddenly and randomly just falls asleep regardless of the time of day or the activity he is pursuing.

Having said this, Adderall should be not used to treat tiredness or for those who don’t have an actual, diagnosed sleep disorder.

Adderall is taken by mouth upon arising in the morning — or at a time in the morning specifically directed by your physician. If more than one dose is prescribed than you’ll more than likely be instructed to take them about four to six hours apart. That’s the approximate duration of this prescription drug.

This means that you — or your child — will need to take this pill at least two times and probably three times a day. And be careful about a “before bedtime” dose. If you or your child should take these less than six hours before bedtime, sleeping problems may arise.

Be sure to take this medication exactly as prescribed. Your doctor has tailored your dosage to meet your specific medical condition and to your responses to previous therapy. At the outset of using Adderall, you may find that your physician is “fiddling” with your prescription. It may seem like fiddling to you, he’s actually making all the necessary adjustments — fine tuning your dosage you might say — that hopefully will give you precisely the correct amount for your daily needs.

Dr. Kenny

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Methylin: Liquid and Chewable ADHD Medicine

Your doctor has just handed you a prescription for the attention deficit disorder (ADD/ADHD) medication methylin. You’ve just received a different form of methylphenidate. In other words, you’ve just received a prescription that has the same chemical compound as Ritalin with one major difference. The medicine you’re about to take to your pharmacy comes in two forms: liquid or chewable.

Parents of children who can’t swallow pills are tremendously thankful for these forms of the stimulant. Ironically, this same medication that you use to treat your child’s ADHD or attention deficit hyperactivity disorder is the very same one used in adults to treat narcolepsy. This is the disease where people fall asleep for seemingly no reason.

Methylin, in most cases, should be taken two to three times daily. For the most part, your child will probably be administered a dosage of anywhere from 10 mg to potentially 60 mg per day. This will be divided into two and possibly three dosages. Your last dose, by the way, shouldn’t be taken after 6 p.m., because it can interfere with sleep.

If your child is taking the chewable variety of the medicine encourage her to drink an entire, full glass of water after chewing the medication. Ensuring that the medication is downed with at least eight ounces of water helps to prevent any possible choking.

Many parents, when giving their children liquid medications — especially over-the-counter — depend on the household “teaspoon” as a measurement. Try not to do this. As tempting as this may be, if you’re administering the liquid form of Methylin, use a regular “dosing spoon” for a more accurate delivery.

You may want to instead even use a regular measuring cup or even an oral syringe for measurement.

It doesn’t matter whether you take the medication with your meal or not. However, it is important that you follow your doctor’s instructions — and the directions on the label — when using methylin. Otherwise, you may not get the best results from it.

Of course the exact doses of Methylin will vary depending on a number of factors, not the least of which of them is the age of the person the medication is prescribed for. Your child’s dose may also vary depending upon if she’s already tried several other alternatives for treating her ADD/ADHD. And of course, the last variable in dosing amounts will hinge on any other prescription medications she may be currently receiving.

Yes, every prescription medication (and over-the-counter ones too!) come with some type of side effects. Those of Methylin include nervousness, insomnia, loss of appetite, nausea, dizziness, headache, drowsiness, stomach pain and weight loss.

Has methylin been helpful for you? Please share your comments and experiences below.

Best,
Dr. Kenny

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Generic Adderall XR – New Formulations

Adderall XR went generic in the US in April 2009. I wrote an initial blog post about it here: Generic Adderall XR. You can also review the nature of generic medicines in an article here: Are Generics The Same?.

While my initial thoughts were that the generic Adderall XR was very similar to the trade brand (made by Shire), the comments on my blog post made it clear that many people are finding that the generic version of Adderall XR just doesn’t work as well as it is supposed to.

As DS writes:

“After the first week, I really felt a difference, but tried to put it out of my mind. My shoulder and rib cage is sore, I don’t sleep and I am snapping at people all day, all night. This is not the same drug mixture/compound. It cannot possibly be. I feel tired from the lack of sleep, moody/agressive/weepy (not me!), sore (for no apparent reason) and just plain out of sorts.

Has anyone had any luck figuring out why some of us are feeling this hell-ish effect from the generic version?

- Sleepless (and crabby) in Seattle

The original generic Adderall XR was produced by the pharmaceutical company Teva.

Now, two more pharmaceutical companies will be joining the production of Adderall XR:

  1. Impax Pharmaceuticals will begin to ship its own version of Adderall XR at the end of 2009/early 2010. You can read more about this here.
  2. Sandoz Pharmaceuticals just settled a law suit with Shire (the original makers of Adderall XR) to allow them to make a generic version of Adderall XR as well. It is not clear when their production and distribution will begin. You can read about this here.

Why Are These Generics Coming?

When a pharmaceutical company creates a new medicine, they get a patent for a certain number of years. They spend hundreds of millions of dollars to get their drug to market, and then they have a number of years to profit from their medicine, before it goes ‘generic’ and other pharmaceutical companies start to manufacture the medicine (and they sell it for less).

Even when a medicine is within its patent, the generic pharmaceutical companies start law suits to challenge the patents – i.e. to see if they can start to market the drug earlier, and increase their profits. It seems that the companies that are now manufacturing and selling generic Adderall XR have pursued the legal process to challenge Shire’s patent, and they are now in the position to start to manufacture and profit from this medicine.

What does this mean to you?

Well, although I initially thought that the generic Adderall XR wouldn’t cause problems for people – there are 94 comments on my original blog post which essentially prove me wrong – i.e. many people are struggling with the generic form of the medicine.

Here is where it gets complicated.

If you used to be on the Shire Adderall XR, and then the Teva generic comes out – your pharmacy or insurance gives you the ‘cheaper’ version. Let’s say it doesn’t work as well for you, but because of the finances, or your insurance’s policy, you work with your doctor, adjust the dose and make it work.

Now, your pharmacy, or insurance company may make a deal with Impax – to get their new version of generic Adderall XR. Now, the formulation is slightly different again. Translation – you may have a different response or reaction to the new version of the generic than you did to the first one. You’ll need to go to your doctor, advocate at your insurance, and see if you can get on the medicine which works best for you.

Of course, if you can afford it – you can always ask your doctor for a prescription for Adderall XR – No Substitution (this means that your doctor is insisting that you get the original adderall xr only). The thing is that your insurance can refuse to pay for it, even if your doctor is that specific.

This can be complicated for you, or your child if you take Adderall XR. Best to monitor your symptoms, and work with your doctor to find the best solution for you.

Please share your thoughts and comments below. Your input is tremendously helpful to thousands of other people who come to this blog and learn from your experience.

All the best,

Dr. Kenny

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Nascar and ADHD

Nascar driver Jeremy Mayfield has shared that he has ADHD, and takes the medication Adderall for it.

This disclosure has come in a ’roundabout’ way. This relates to the reports that Mr. Mayfield was suspended from driving due to finding amphetamines in his urine during a random urine drug screen. Mr. Mayfield has explained that he takes Adderall medication for ADHD, as well as Claritin D. This issue is before the courts. You can read the news updates here.

While Mr. Mayfield is going through a rough time right now, I am happy to hear that he has openly disclosed his diagnosis of ADHD. This can lead to advocacy and support for the many kids diagnosed with ADD or ADHD each year.

I do wonder how many of the Nascar drivers have ADD or ADHD?

Although there is research which shows that people with untreated ADHD are at risk of more accidents while driving, my clinical experience in ADHD suggests that people with ADHD often excel at ‘extreme sports’. Whereas driving to the store at 40 miles per hour may be boring, driving on a Nascar track at speeds in excess of 200 mph can be exciting and can command one’s attention. And as Mr. Mayfield explains – he is taking an ADHD medication while driving.

I do hope that things work out well for Mr. Mayfield, and that he uses this situation as a springboard for advocacy for ADD/ADHD. I hope that he can be a role model for the thousands of boys (And girls!) diagnosed with ADD and ADHD each year.

What are your thoughts and experiences? Please share them below.

Best,

Dr. Kenny

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