Who Needs ADHD Medication?

Let’s face it – medication treatment for ADD and ADHD is controversial.
It is often a really big decision about whether to start a medication or not.
One of the first questions is this:
Who even needs to take these medicines?
Another way to think about this is:
What is the rational for ADHD medication treatment?

I’ve created a free video for you to learn more about this.
You can see it here: ADHD Medication Mastery.

And when you click through to that site – you’ll be given the opportunity to sign up for free ADHD Medication updates. You’ll get more videos with useful tips to help you and the people that you love.

Click through to see the video now (while it’s still fresh in your mind).

Best,

Dr. Kenny

p.s. I’ll be giving you many free videos and lessons on ADHD Medication Treatment in the coming weeks – so make sure to take advantage of it!

Technorati Tags: ,

Claim Your Free ADHD eBook
Signup For Dr. Kenny's weekly ADHD eNewsletter and get a free eBook:
PBOOK001shrunkendown225CroppedTransparent Who Needs ADHD Medication?
ribbon blue Who Needs ADHD Medication?
lock Who Needs ADHD Medication?
We hate spam just as much as you

Comments

  1. I posted a link to this video on my Website, as well as on add.about.com. I appreciate Dr. Handelman’s balanced approach to ADHD treatments. Moreover, he backs up his assertions with facts.

    Don

  2. I see that your Who Needs Medication for ADHD? video is still using the old results from the NIMH Multimodal Treatment Study (i.e. 2001 vs. 2007) which suggest that those treated with medication do better than those treated using other methods (psychosocial), whereas the newer data show that there is no difference in outcomes between treatment types in the long-run and that, children still taking medication 7 years after the start of the study were no better (or worse) off than those who had been treated in other ways, or those who had stopped taking medication over the course of the study.

    So, my question is this: in your view do the benefits of medication still outweigh the risks?

    Wouldn’t I be better off pursuing behavioural therapy for my daughter since that will have no adverse side effects in terms of stunted growth, stomach-ailments etc.?

    Actually, I have an even more profound question for you:

    Since the NIMH study concluded that the most important predictor of outcomes for children with ADHD was not treatment type but rather the severity of initial symptoms and the socio-economic background of the parents, isn’t it possible that NO treatments currently available for ADHD really work in the long-term and that improvements that we do see in functioning of children with ADHD as they get older are actually just a function of them getting older?

    I would like to see a study that compares the outcomes for children who never received any kind of treatment vs those who did receive treatment, but I suppose such a study would be unethical.

    I don’t doubt that medication can increase attentivity in the short-term, since Harvard students are using it to attend frat parties and write A+ papers at the same time, but since reading the results of the latest NIMH study, I have developed strong doubts about its ability to help in any meaningful way those who really need it.

    Many thanks for any reply you care to offer.

    Sincerely,

    Sarah Lozowski

  3. Sorry – one further addition to my comment above.

    I have seen the latest results of the study by Scheffler, Hinshaw, Levine et al. (Pediatrics, May 2009) about the possible improvements in academic performance among kids with ADHD who have been medicated versus those that have not.

    Yet this study lacks any meaningful comparison with other methods for helping children improve academic performance, in particular tutoring.
    Many tutoring programs guarantee that children will improve their abilities by one academic year with just the equivalent of one week’s worth of tutoring (less than 40 hours). Compare that to the two months improvement that medication produces over 5 years. Not too impressive.

  4. Dear Darrius,

    Our son takes Concerta at 36mg and at one point was Dr. directed to take two a day to equal 72mg. When I called Concerta Pharmaceuticals and asked them if they made just one pill at 72mg, they reacted with shock and concern. They said, “First of all, our product only comes in 36mg because it is an 8 hour time release and this is the highest dose we safely recommend. Second, taking two doses does NOT make our product 72mg.” I explained that this choice was Dr. directed and they stressed highly to stop giving our son the second dose. It was not good for his kidneys or liver.

    I just wanted to pass that information along. You are welcome to call them yourself if you so choose for your safety.

  5. Medication is definetly effective. Since ADHD & ADD will not disapeare in adulthood where lifes demands will become greater and medication will be more imperative it may be preferrable to delay it for later adolesence.Especially for intelligent children where innatention rather than overt hyperactivity can manage adequetly untill their later teens without medication.
    What can suffice are parents remaing aware of the condition to respond appropriately to the symptoms,avoid negative remarks around deficits,give encouragement praising strengths, provide structure in the homelife & academic work,healthy diets (especially including fish oil),provide guidance around behaviour(especially impulsive tendencies),providing enough interesting extra curricular activities and sports.
    The medication can then be given for the latter stage of high school when it’s important for having optimum academic and practical results to maximise course and career options.
    These medications do have degrees of side affects despite providing huge benifits in functioning and often very much appreciated for them when one is maturing.

    The child with extreme levels of hyperactivity who cannot be managed by other strategies to the level they disrupt others & themselves so they can’t learn or be tolerated even by their peers, is the type who would need medication.
    In these cases it’s imperative, no matter what the side affects are as it’s keeping the child from becoming an outcast with impaired self esteem.

    There will also be those children that in early adolescence who are perfectionists and react overly negatively to not coping as well as they expect to as their condition impacts on them as school subjects get more demanding.
    These ones may need medication in early high school.
    This type can start to act out in their frustration.Combined with the condition’s proness to impulsivity,they can enter risky deviant activities,even forming some new identity around these.

    Even when medication is not being used, the parents should keep their ADHD/ADD child monitored by those professionals providing treatment for this condition. For both the guidance and timely recognition when medication may need to commence.
    Obviously, medicated children are already being professionaly monitored.

  6. Hello Dr. Handelman.
    I am twenty years old and taking Strattera. I am trying to survive college with ADHD but it is a real challenge. I am having trouble with several areas of adult life.
    I am having problems with the following areas:

    Expression of emotions comfortably

    Sticking to a plan

    Time management

    Socialization and social norms

    Organization

    Paying attention to details

    If you have any advice that may help, I would appreciated it.

  7. A note for Nick Sam and others: Hang in there! A lot of us have been in the same place you’re in now with the challenges of college and ADHD.

    Here are some things that helped me deal with college and ADD:

    * Drug and Dosage: Check with your doctor to see if your dosage is high enough and whether your drug is the best for you. You need to be a vocal advocate for yourself when something isn’t working. Many psychiatrists will confess that it often takes several tries on different meds and dosages before finding the right one, and trial and error is often the only way to find the correct plan. It took several attempts for me, and now I am on a great regimen.

    * Study skills: Many colleges offer study skills courses and seminars on or near campus to help tackle organization issues of coursework. I took a great one and it made all the difference for me.

    * Support group: Check with the on-campus counselor for support groups of students with ADD/ADHD. They often have great ideas for making this easier.

    * Counseling: Check out Dr. Handelman’s video showing the 2001 Swanson study that medication plus treatment yields a 68% success rate vs. 56% for medication alone. Yes, it takes time, and yes, I’ll admit it’s a pain. But it might get you to where you want to be!

    I am cheering for you!

  8. There is no doubt that for ADHD that the stimulant medications do work. Both my eldest son and I were diagnosed as adults with it, him at 18 in his final year of high school, myself at 43.Our becoming diagnosed came out of the suspicion that his younger brother may have ADHD due to his mid high school performance, behaviours and confidence not being commensurate with his intelligence. It was then seeing alist of all the feature of ADHD discovering that both the older son and I had them. Despite my own professional training & my husbands in child development & learning disabilities it had never occured to us as we assumed ADHD was signaled by extreme uncontrolled hyperactivity and negligable attention span. What does happen is that having better intelligence, a stmulating home enviroment,reasonable amount of structure,effort in shaping appropriate behaviour and channeling liveliness in a variety of activities can mask the extremes of ADHD as well as providing the basis for meeting ones potential more once medication is provided. With medication our ability to sustain effective performances, stabalising our cognitive and emotional processes is marked, as long as the general living context is kept healthy and has structure.
    So many of the studies are not looking at that both a stable environment including appropriate goals and medication are required. Since the medication is meant to normalise those with ADHD, it logically follows the environment that is conducive for better performances in non ADHD persons is what has the greatest impact. The medication does not enhance intelligence or ability, it just facilitates a consistent expression of it, rather than the otherwise patchy performance (that can even keep deteriorating through repeated errors & eroding confidence) of those with ADHD.
    Another problem with studies that question the effectiveness of medication is that it isn’t easy to have excluded children that may not have or only have ADHD.
    Children with a more chaotic home life, less responsive parents and living in stressful environments can present with parallel symptoms. In my past when I did some work with childrn in welfare reception homes it was amazing how in less than 3 days they lost their ADHD behaviours by having responsive adults, a healthy diet and stable routine, despite the emotional upheaval of removal from home.
    There are also a number of conditions that can have neurological impairments affecting similar areas of the brain producing parallel symptoms to ADHA in a child, the simplest could be from earlier undiagnosed trauma where some parts are damaged permanently & their chemical receptors can’t respond to stimulants appropriately.
    Then there are those who may have ADHD that have other comorbidities in addition that can limit the results of ADHD medications or even be incompatible with stimulants.
    Furthermore, even an ADHD child without the other complicating factors who’s appetite is too adversly affected isn’t going to show a great deal of improvement spending time verging on hypoglycemia.
    Ironically there has been too little study of adults with ADHD who are at a stage it is easier to diagnose, treat and get feedback on the way they respond to the medication.The children of adult’s with ADHD that are diagnosable as looking to have ADHD are much more reliably likely to have ADHD than a child that crops up as symptomatic of ADHD without any other family history of it.
    In my family it’s probable my maternal grandfather had ADHD from my mothers discription of him, my mother most definetly had it(though refused to consider this), myself and my sons.

  9. Question on medication- I have been on Adderall to treat my ADHD for over a decade. Since amphetamine drugs are obviously stimulants, have their been any studies on the long-term side effects on the heart for taking these medications? I would stay on prescription regardless of the answer, but it would be good to know.

    Thanks in advance for your answer!

  10. To Moving Truck Rental, this isn’t a particularily researched answer,rather some recollections of past articles I’d read and a comment from my psychiatrist.
    Generally these stimulants don’t have much affect on the heart regarding significant damage aside from some rare cases where the reaction was quite immediate and fatal, presumed to be due to another underlying coronary frailty. Therefore in the less likely instance you’d aquire an unrelated form of coronary frailty there isn’t that much chance of it damaging your heart.

    It has been noticed that these stimulants may increase a persons blood pressure.

    Keeping healthy by avoiding excess weight,have a healthy diet that includes foods that have been seen as positive for the circulatorty system, keep salt consumption low,avoid smoking and excesses with alcohol, have some level of excercise, develop ways of controlling stress in your life. That is the basis of keeping a healthier circulatory system & better blood pressure.

    And it’s just as important to have a limited intake of drinks, foods, certain natural substances (like ginseng etc)containg stimulants.

    Most of all you need to be extremely careful with over the counter medicines that contain quite potent stimulants (many cold remedies, nasal sprays etc..) and some prescriptions, all of which you should always confirm with your pharmacist regarding their interaction with adderall.

    Have your blood pressure checked on a reasonably regular basis.
    That is important.For if you’ve carried out what was listed before, your blood pressure should be fine while taking adderall,.. BUT people can vary in their sensitivity to stimulants raising their blood pressure. Or separately have another medical condition – unrelated to a stimulant – creating increased blood pressure requiring treatment(usually the adderall can be continued).

  11. At one point someone mused that I may have ADD. I took the tests online…end result of it, said that I show strong signs of having ADD. I am more cynical, as time goes by. I have done plenty of research on big-pharma, how most medical journals tend to be sponsored by pharmaceutical companies. I think about how unethical it is to treat children as lab rats.

    We all know that the drug studies done all over in sub-contracted pharmaceutical testing centres where adults are locked up for days or weeks at a time to get a cheque cut to them. Many of them do hop from study centre to study centre, I happen to know people that did do that. I don’t think these centres exist for children, to my knowledge anyways. So all the testing is done outside of the lab by seeing how little foster kid Johnny responds to 10 milligrams to this, and 5 milligrams of that, and if he has a bad reaction we will give this or that to him to curtail the side effects. Next thing you know little Johnny is so full of chemicals he wants to commit suicide.

    When I do some some thinking I can see how ENFP personalities are quite bothersome to the rest of the population, so I guess it is a lot easier to put an pharmaceutical straight-jacket on them.

    Some little things parents could do to prevent hyperactive kids, is not feed them soda pop at all, and start reading and understanding what is actually in the processed foods everyone has conveniently switched to. Could the microwave be at fault for ADD?

    A word to the wise, keep away from high fructose corn syrop. I am interested in a response doc.

  12. I had to do a rewrite because I exibit ADD tendencies.

    At one point someone mused that I may have ADD. I took the tests online…end result of it, said that I show strong signs of having ADD. I am more cynical, as time goes by.

    I have done plenty of research on big-pharma, how most medical journals tend to be sponsored by pharmaceutical companies. I think about how unethical it is to treat children as lab rats. We all know that the drug studies done all over in sub-contracted pharmaceutical testing centres, where adults are locked up for days or weeks at a time to get a cheque cut to them. Many of them do hop from study centre to study centre, I happen to know people that did do that. I don’t think these centres exist for children, to my knowledge anyways. So all the testing is done outside of the lab by seeing how little foster kid Johnny responds to 10 milligrams to this, and 5 milligrams of that, and if he has a bad reaction we will give this or that to him to curtail the side effects. Next thing you know little Johnny is so full of chemicals he wants to commit suicide.

    When I do some thinking I can see how ENFP personalities are quite bothersome to the rest of the population, so I guess it is a lot easier to put an pharmaceutical straight-jacket on them.

    Some little things parents could do to prevent hyperactive kids, is not feed them soda pop at all, and start reading and understanding what is actually in the processed foods everyone has conveniently switched to. Could the chemicals they put in the food so that we can easily microwave our foods, be at fault for ADD? The salad dressings are full of so many chemicals with very long hyphenated words for ingredients, nobody really seems to research what the heck it is.

    A word to the wise, keep away from high fructose corn syrop. I am interested in a response doc.

  13. emile you just largely restated a few points that I made in my earlier emails:
    Those that pertain to children who are not recieving the care an appropriate environment should provide in regard to a proper diet, structure and other developmental needs being met. Yes, this will result in erratic behaviour for children without ADHD & even with a treated ADHD child (that at least may have a slight drop off in symptoms for the condition though not enough).

    While there are some studies that are not perfect, it isn’t in the favour of the pharmaceutical companies to do them on children where ADHD isn’t most likely the one and only condition from an optimum type of developmental environment,to see the outcomes of the medications’ efficacy.These are the children that indicate the most limited benefits , if any, for the medications compared to alternative interventions and the most disadvantages.
    Most persons without ADHD when given the medications to treat this condition, end up feeling and acting worse. If lucky, they may have the brief impact of a stimulant regarding an initial sense of alertness that is usually followed by negative reactions, ranging from illogical irrability,extra activity, feeling awful to exhausted.
    True ADHD responds by actually becoming calmer, more focused, cognitively more alert and productive, despite during the initial stage of medication sometimes producing the discomfort of some greater muscular tension, teeth clenching , and appetite disruption.There generally isn’t a need for continual increasing of the dosage rate ( or is it desired) once the optimum dosage and medication has been found for true ADHD. This is very different from a non ADHD person having it work as a stimulant like amphetamines for them, of those that like the temporary effects of an upper.

    There have been more and better discriminating later studies, neurological investigations, plus some studies taken over a longer time scale. Many of these have demonstrated increasing evidence of the benefits of medication as well as ways of identifying this condition in neurological aspects.

    Possibly in the USA in larger cities where medical practioners and welfare agencies are under massive preassure to seem to deliver some possible response ASAP combined with a greater acceptance of ADHD as a condition & treat it may seem to produce the “foster” kids etc.. possibly medicated wrongly, for a time.
    Where I am in Australia, there is a tendency to under diagnose, under treat, limited numbers of practioners dealing with ADHD, an almost phobic fear of giving out these ADHD medications plus a much narrower range of pharmaceutical products for this condition. This then results in a far greater caution in treating suspect cases.

    Most of all our welfare system is extremely careful and fearful of having any children in their care medicated with any psychotropic medications. This avoidance of these children being treated with psychotropic medications means it is hoped that social interventions will suffice, at whatever level they can. That is even when medication looks the better option.
    Only the most extreme situations with non custodial parent consent end up medicated.
    While it may be a bit more laissase faire in some sectors of the USA I’m sure a lot of it is responsible and has had a lot of more recent substantial progress with ADHD.

    In Australia some children who look likely to have ADHD ( but may not have had it or with another comorbidity or unrecognised social environmental defecits) with desperate parents do occasionaly get treated ,for a trial period which usually ceases.
    No one here with the diagnosis of ADHD can continue recieving scripts without constantly being reviewed.Medication will only be available for more than a trial where there is evidence of sustained improvement of the symptoms being treated untill becoming an adult. Then no matter how much it is still needed, it becomes far harder to get the ongoing treatment.
    Australia has a real paucity of service providers who will or have the preparedness or confidence in their expertise to treat adults with ADHD.

    I’m fed up with the simiplistic pop critiques of ADHD and the benefits of medications to treat this by people who have not done extensive background exploration of scientific explorations and multiple studies of ADHD with their only appraisal based on a drop of commonsense basic child rearing & odd distant understanding of suspect child situations.

    The medications are not a cure all for all facets of what has come with this condition as nor is any other medication for all other types of conditions weather they are from physical or psychological pathologies.

    The ADHD medications only facilitate the brain chemistry to become closer to that of the “normal” brain permitting an improved capacity to sustain focus,appropriately timed alertness, properly considered responses, enactment of these etc., permitting more control over impulsive & distractable tendencies that create an overwhelmed exhausted fragmented mental state thus facilitating the expression of the persons true capabilities .

    The person will still be subject to the same limitations of any defecits of diet, life style, psychosocial factors, stressors etc. In additiion they will often be dealing with the direct consequences that came with ADHD impacting earlier on them and whatever other limitations & frailties they have themselves and background had.
    The positive for someone with ADHD who is treated with the medication with additional support in techniques to overcome such problems is that a treated person is in a better position to more effectively deal with these limitations at some levels.

  14. emile as you appear to have a great deal of confidence I am pressuming you can cope with answering my question, regarding what your own level of formal education, the disciplines and subjects, including those regarding research methodologies.
    We are contributing here as lay persons who have been exploring this condition with varying levels of understanding through personal experiences, some even coming through work observations and attempting to digest articles that cover this area where we have had a chance to follow them up.

    At present I am not attempting to write anything in the mode of even my background studies and profession.
    I do actually have an awareness of how to evaluate research (excluding that reliant on detailed terminology & knowledge of medical, pharmological & other specific technical areas) and a multimodal knowledge( theory/practice applic) base – to a fair extent – on psychosocial, physical and other general environmental factors in their impact. I’ve a BA in social science followed by a BSW. I have worked as a social worker (amongst other things earlier) and had to do for my course and assisted others in some research.
    On the personal side I’ve got ADHD, and so have my sons. We are significantly far more capable on medication while frustratingly patchy (for us and others) in our performance and general living skills without it.

    Our formal studies, the disciplines we come from and then had to apply through work end up shaping the way we process things as much as our personality and background.Likewise not having a formal degree when intelligent and becoming self educated involves other processes regarding how one evaluates things. I’m not suggesting that any is superior over another, but contain differences in the mode & methods of evaluation and use in the terms of appraisals.

    Recognising differences like these facilitates the understanding of the semantics used helping a diversity of people to get on the same page. Different disciplines and everyday life can have subtle differences in the meanings terms and words hold when they are being used.

    When you stated that you had “done plenty of research on ….etc..” I realised I really was unclear of what and how you may have dealt with it or how general you meant your conclusions to be taken plus another example you’d used. I’d only be guessing in my responses without knowing where you were coming from more fully.

  15. emile there is just one more thing, one does not appear more intelligent by using the abbrieviated capitals as a shorthand without the first time having written what it is pertaing to in full with the abreviated form in brackets directly afterwards outside of very few situations. Like this being an ADHD forum doesn’t need the term first or there isn’t the remotest possibility of the initials used in another area. Plus it’s considered rude regarding readers from other backgrounds possibly not familiar with that thing being unsure of what it is or research the possible thing those initials stood for.Your article should be readable in one hit or you add coloured clickable file extensions that travel to a site elaborating on it ( for example Wickepedia has click ons for terms). This (mis)use of capital abbreviations can make a person appear to be pretending to be elitist of an in crowd at the wrong time.
    Ordinary typo errors and spelling mistakes etc are reasonable as contributions are valued more than nothing through attempting time perfecting writing.

  16. On a somewhat lighter note, I read with great interest Brigitte Jones’ comments on the effects of medications on ADHD patients vs. non-ADHD patients. The reason I first identified that I had ADHD was by accidentally taking one of my son’s medications (long story in and of itself). While the medication was a stimulant, it had no stimulation effect on me, but did make me much more focused. I ended up going through the full diagnosis process and confirmed that I was in fact an ADHD sufferer. The rest of the process was pretty easy after that. :-)

  17. Can some others who have had positive outcomes from their medications after ADHD was diagnosed for them or their children, including those that found certain meds needed to be altered earlier share their experiences?
    I’d love to quit commenting seeing a greater balance regarding treatments.

    Movers and Moving Companies, thanks for your contribution. It is helpful to balance the picture for those who really have the ADHD condition and what the medication does for them.
    While my oldest son was going through a lengthy assesment (the appointments available were spread out) and his final high school exams were approaching we tried him on a friend’s sons tablets.Identical response as yours as the straight forward conclusion from the assesments (final results were great, especially in the maths, a Distinction -without the scatty errors of their practice test failed due to those). It’s the same with me.

    My youngest a decade ago gave into the wheedling of a disorganised friend to get a couple of tablets “to get high”. The result was the friend worked hard at all school tasks effectively being well behaved for the day, the only day in the whole year. Unfortunately this boy being the son of a Filipina widow with limited English never was assesed and since has had a chaotic life. A decade ago I persuaded my extremely exhausted husband ( a person who has not any signs of ADHD & is very capable, organised & efficient) to try just 1 and a half tablets to “help?” him with a teaching deadline. He regreted it as those around him enduring the tablets impact on him.He complained of his mind racing , feeling hyped up and was behaving verbally aggresively & just holding off similar actions, all this lasting for a day and a half saying it was like when he’d tried a purple heart at Uni, AWFUL. I’d never give this med to another after that plus discovered it wasn’t legal to do so.

    It’s an important contribution when those who with ADHD treated with the medication with definite improvements relay this. Thus more with the condition or their parents become more encouraged to seek proper assesments & access treatment if appropriate.

    My sons seemed to have half of their school year friends made up of kids that were bright with ADHD characteristics, a couple got assesed & had it.All were performing at juniour levels the same ( my sons weren’t diagnosed or treated then).By 19 yo the assesed, yes ADHD, treatment lot, commenced performing really well, & now at 29 are doing well professionaly & personaly. The other ADHD suspects, not assesed by 19, appeared to decline, never achieving anything matching their earlier brightness and friendly dispositions. It can’t be known if they really have ADHD, but if it was, being so responsive to treatment it’s a shame the unrealised potential in our current competative limited employment market.

    It’s especially the doubts about the value of treatment,misconceptions around ADHD that deter a lot regarding the seeking assesments. A fair proportion of those with undiagnosed ADHD earlier in life have had this condition raised as a possability.

  18. My son is 9, and was diagnosed with ADHD at 4, although it was obvious long before then. (I have 4 kids, none on ADHD meds other than him). He started medications at 7 because I refused to put him on drugs due to the media hype and the scare that it would stunt his growth. I tried everything. No sugar in diet, fish oil, focus factor, then adding sugar and caffine in sodas… My mother holds a masters in childhood development and is a certified teacher for k-8 and 9-12. We researched every alternative “remedy” would could find and tried them all. Nothing, and I mean nothing worked.
    He is now on Vyvanse, 50 mg. It works beautifully! He started out on Concerta a few years ago, (with great results although it took a while to get his dosage correct) but started having headaches recently with vomiting (migrains). He also never ate and although he has grown, he never gains weight.
    BUT THE MOST AMAZING CHANGE came when I took him out of public schools, where he had 5 teachers per day, (and I lived up at the school, not because of any behavior violence, but because he just wouldn’t do his work, ever) and put him in Catholic school, with only 2 teachers per day. Also, the principal holds a doctorate in child physch and is retired from our local public school system as a counselor with 25 years experience. Within one week, we were able to adjust his medications because they really worked one-on-one with me and Jonathan! I met with both of them every single day after school. His principal noticed that his pupils were dialated and he was loopy in the afternoon, as well as extremely tired. We cut his does of Concerta to half. That worked better in the afternoon, but in the mornings he was still having trouble doing any (and I mean ANY) work although the other children had long since been finished. The doctor switched him to Vyvanse 50mg (the same amount of Concerta according to your website calculations that he was on originally). Teacher and principal noticed that he wasn’t as loopy, no dialated pupils, but still the medication did not kick in until about 10:30, and tests are early in the morning, but the afternoons were better, he was eating lunch, and no headaches.
    We tried getting up at 5:30 am, giving him his medication, and then letting him go back to sleep to see if the medication was just wearing off too soon, or didn’t kick in soon enough. It worked! We now wake him up at 7 am, he eats breakfast and lunch (he is hungry on this medication, yeah!), his school work is all A’s. He is catching up to the rest of the class. He is no longer in “Title One.” He stays on task! He finishes his work! He is a beast at football and all of his other sports! Please keep in mind, his father and I are both professionals. I am a lawyer, father an engineer, with graduate degrees. Our other children are all in gifted classes. He is the baby and our entire night, including the other children, revolved around helping Jonathan with his homework, which has taken up to 8 hours to complete before medication. He wasn’t allowed to participate in sports, because all of his time was spent doing homework. He now finishes his homework on the short 15 minute bus ride home from school!!!

    The moral of this story: Parents, don’t wait too long to try the medications and find a school that is willing to work with you and your child! He was constantly in trouble at school and ADHD children are generally very, very sensative! The trouble at school constantly put him in an “aggravated emotional state.” He cried a lot, yelled a lot, threw a ton of tantrums. It was horrible. I cried a lot. I got a divorce (yes, I do believe that my son’s ADHD was a major contributor, because my husband never got any attention as my son required ALL of it, and we constantly fought over him). His teacher is wonderful, a true blessing and God send. I believe that the combination of his teacher closely monitering him throughout the entire school day, and his principal checking in on him throughout the day and noticing his dialated pupils and lethargy, was the key to finding the right dosage and medication for him. I know that his doctor (who by the way is excellent, and my first cousin), would tell me I needed to watch how he responds to the medication during the weekends, but I can assure you, watching him on the weekends while he rambunciously plays, has nothing in common with the setting he is required to function in during school. I do not give him the medications during the weekend, holidays, nor summer. I want him to eat. I don’t know if it has stunted his growth, because he is quite tall (one of the taller children in his class), although not near as tall as his other siblings were at that age (but I am very short so this could just be the size he would have been off the medications). For comparison purposes: my 10 year old daughter is 5’2, 88 lbs, 7.5 USA women’s shoe; 13 year old son is 5’10, 120 lbs, 11 men’s shoe. They are all VERY thin, like their father, so I can’t be for sure that the medication is causing Jonathan to lose weight, although he doesn’t eat near as much as the other children and before the medication he was not as thin as the other children.

    I blame the public school’s policy of having mulitiple teachers each hour of the day for the delay in correcting his dosage, and the lack of keeping experienced teachers–all of Jonathan’s teachers were fresh out of college. I met with these teachers constantly, and the principal, and all I kept hearing was he works fine for me (math teacher as usual) and he does nothing for me (language arts teacher as usual). He was put into the classes for low achieving students or “Title One” which is federally funded, but making A’s with the note that he was below grade level. They suggested counseling, everything. My son has now been in Catholic school for just three weeks, and God has answered my prayers! If his teacher sprouts angel wings, I will not be surprised!

  19. My 8 year old stepson was started on 10mg a day of adderal Xr when he was 7 and just starting 2nd grade in September, for ADHD. His father and I have never seen any ADHD symptoms from him, so we were concerned. Over the next few months, his mother continually took him to the doctor telling them that the medicine wasn’t working. By December he was up to a 30mg dose once a day. He was falling asleep after school, not sleeping at night, very irritable, never smiled, nothing would make him happy. But his mom refused to tell the doctor about the side effects, so we took him in, and they wanted him off the medicine immediately, but he had to be weaned off, and it was literally like an addict coming off cocaine. After a few months of being off the medicine, everything was fine. Then he started 3rd grade this September, and here’s the kicker, he DID NOT retain anything he learned last year. He has always been an A-B student, so we thought he was learning and retaining, now they tell us he is at a 1st/2nd grade level in all subjects. Now we don’t know what to think. How can a kid get good grades and still be behind, and why did he not retain anything when he was on the medicine?

  20. Brigitte,
    you make some excellent points, especially about the complexity of the situation. My diagnosis came about at the age of 46 as we tried to trace the source of my daughter’s distress. She also had ADHD. It proved that my best intentions as aparent simply weren’t enough – simply because I was too chaotic- too lax one day, too strict the next, forgetting parenting agreements and plans I had made with my wife to deal with discipline conerns, sometimes getting angry quite unpredicatably. I most certainly did not present a model of organised behaviour that my daughter could model.
    Both of us improved dramatically on the first tablet of stimulant- so dramatically that noone was in any dout that we had gone down the right path. The gains continue to be broedened. My daughter had tutoring to catch up on her weak spots – and to help her lose her false idea that she was stupid.I spent months clearningup the chaos i had een leaving behind me ad finally decided that what I really needed to do with my restored learning capacity was learn about paying attention ( the standard coaching stuff was way too “little picture” for a real ADD mind like mine. I started relaxation courses, and then meditation, and finally knuckled down and immersed myself in the Buddhist ethics I had alway loved. That really helped.

    SOme people say that their kids appear “glazed” or subdued on stimulants. To me they have been a liberation from a really awful experience that lasted many years. What’s even better I am now often just as good without medication- and I mean really good- attentive, engaged, contributing- alive.
    Certainly there are a few challenes yet to be beaten, mostly old wrinkles in relationships. Nothing seems insurmountable now though.

    A small comment for Melissa- when we aare not totally decompensated our ADHD symptoms are usually worst in areas of greatest emotional challenge. I see my ADHD as having arisen from possessing more emotional sensitivity than I could handle. When the symptoms are very situational it pays to look hard at the situation in which they arise.

    I often thought when we were struggling that I needed to set up a wecam at home so I could go back and look at where I was going wrong. I wish I had- it was not a bad idea at all. Mind you I was so disorganised that a webcam would have been too hard!

  21. Ok, So I just wants your thoughts on whether or not you think we chose the right route. I am 13 years old and I was recently diagnosed with ADHD predominatley inattentive. My parents decided to go with the stimulant route, choosing CONCERTA. I just wanted to know if anyone else had as amazing effects. Its my first day on 18mg concerta and I am amazed… It seems like I can put of wall around unnescessary comments and actually focus on… persay.. math, or whatever is needed of me at the time… I’m amazed, truly.. I am also (my parents and I think) hyperactive… and now I can be calm… its great.

  22. My own experience is almost identical to the original poster- except that it took me till age 47 to get diagnosed. ( I must comment here that I believe that at least the last 2 psychiatrists who missed it were negligent in their incapacity to keep themselves up to date wit current research based knowledge in their field. I am a family physician myself so I do not make that comment lightly).

    Going on to medication was like the difference between night and day.
    Certainly I had a few side effects- but they were minor and could be worked around. The real effect was that the improved focus produced dramatically better performance at work but much more importantly as a husband and father.

    After I had a neck problem treated ( which improved my concentration by a number of mechanisms that are too complex to detail here) I was able to learn meditation. The result of that was that about 19 months after starting treatment (dexamphetamine 50mg/d in divided doses, with valproate for my irritability) I was able to cease medication. I have been off all medication now for 9 months and can honestly say my focus and attentiveness is better than it ever has been on or off medication and continues to improve daily with ongoing meditation.This should not be taken as any form of disparagement of medication- none of this improvement would have been possible without being correctly diagnosed and treated.

    I now treat a significant number of ADHD people- and would comment on the above debate that the suitable dosage for methylphenidate (ie Concerta) and other stimulants is a highly variable and individualised affair. Though it is not common to exceed 60mg of methylphenidate per day in Australia, I certainly know of people who have done very well on double that dose and would question the company concerns about a dose of 72 mg.

    As a more general comment I would suggest that pharmaceutical companies are very conservative on answering inquiries about unusual variants of usage of their o=products and that conservatism often reflects medicolegal fears rather than realities. If in doubt about higher doses – check with your prescribing doctor. As a rule you will be likely to find that the unusual dose is supported by personal research and clinical experience. That is, after all, what any worthwhile doctor is good at.

  23. As a response to Sarah Losowski, on long term effectiveness of ADHD I would comment that ADHD arises in complex situations. Issues like the happiness of the family home and the child’s experience at school have to be addressed as well- otherwise you will just end up giving the child a drug that will help them focus on an environment which they find distressing and they would rather zone out of.
    As an ADHD father of 2 ADHD children I am confident that our success with helping our kids settle has only been possible because we have a adopted a very multi-modal approach to treatment- which especially involved treating their often very hyperfocussed ad emotionally unavailable father- me!

    The thrust of thought in ADHD management has been to avoid blaming anyone ( which is a good policy) but this fundamentally ignores the fact that the perception of the ADHD sufferer is that significant parts of their daily experience are pretty horrible. I still remember how much I hated school how much I thought many of the teachers were hostile aggressive monsters who hated me and how badly I suffered from bullying at school.

    My diagnosing psychiatrist comments that hating school is almost diagnostic of ADHD.

    Medication is a vital part of treatment, but treatment that is not holistic will be hit and miss. I guarantee that those studies you quote will not have been sufficiently holistic or sufficiently focussed on allowing the child to deal with the parts of his environment that he finds distressing.

    As a rule kids have great difficulty verbalising their dissatisfaction with their environment to people in authority ad as a result they are often not properly or effectively consulted as to the nature of their own experience. It is much easier for us adults.

  24. I’m 40 recently diagnosed with ADHD. I took my first pill of 30 mg Vyvanse this morning. I don’t feel any different but dizzy all day long. How is this med supposed to work? On the first day or in a week? Will you notice immediately if it really works well for you? If it doesn’t work, it means it’s not the right medication? My psych doctor didn’t explain me much. I’m truly concerned because this is the first time in my life to see a psychiatrist and take this kind of medication.
    Thank you in advance for all replies.

  25. I was recently diagnosed with ADD at the age of 24 in the UK. This is after completing both an undergraduate degree and a masters degree both in Law. I was never singled out as having issues because people thought I was just annoying/weird, luckily I was accepted as that way. I also had a split personality, sometimes being very outgoing, and others completely insular and quiet. My teachers described me as ‘someone who must stop relying in natural talent’ and also as ‘an enigma; sometimes he is manically hyperactive and others completely unresponsive’. It also affected my relationships especially with girls as they thought I wasn’t interested anymore. Combine this with an inability to convey emotions, a ridiculous temper which flared up at nonsense and didnt show when I actually needed it, and you would see what my life was like. My family just thought I was strange, but as they loved me they accepted me. My siblings lamented my annoying habits, but we were still very close and protective of each other. My school results were always good even though I could barely do any work, as reading was impossible I couldn’t read without getting frustrated. But as I have a photographic memory I didn’t find it much of a challenge. For these reasons, noone ever raised any questions.

    However completing my degrees was ALOT harder I couldn’t study up until the very last night before an exam and would stay awake all night studying the entire syllabus in one sitting. As ADD sufferers know, tryin to concentrate is physically difficult, frustrating, so imagine forcing yourself to read textbooks, case law, articles. I was literally screaming to vent. But, being of a very determined nature I always battled through and I achieved good marks in my undergraduate Law degree.

    The masters was equally bad and it culminated in having a week to write my 15000 word dissertation on International Finance Law, which I have to say was HELL, I was broken after that and decided I cannot continue simply forcing my way through life relying on my memory to do last minute work. Even though I did well in my Masters I was very frustrated, and eventually all previous determination dissolved and I was at a loss of what to do, because my confidence was so dented I wasn’t looking for work as I didn’t think I could handle it. It was then that I went to a doctor to tell him about all of this, and he immediately suspected ADHD. When I had all the tests and psychiatric consultation, the condition was confirmed.

    I have been prescribed with Concerta and I went through trial periods of 18mg, 36mg and 54mg. 18 + 36mg had no effect whatsoever. However, 54mg was such a revelation that at the time I became emotional and cried. I can now sit calmly and have conversations all the time, and actually be interested in what people are saying, rather than thinking in my head “what the hell is this guy on about..” I am now outgoing all the time while I am on the drug, without being hyperactive. I started reading books + articles for fun rather than forcing myself. I am now looking for work in London as a solicitor as this medication has given me the confidence + determination I had before as well as the ability to sit and work all day long. I am even helping out with an academic at my university as a research assistant for a book he is writing. I am LOVING developing a work ethic that is not concentrated into one impossible task, loving finally being able to organise my time without despairing or thinking that I have a million things to do and not knowing what to prioritise. Previously I would waste time playing my X-Box, going out and getting drunk to try and forget the stress + frustration I felt every single day.

    I have no side effects other than insomnia sometimes, however I attribute this to taking my tablet later than I should. The other thing I noticed is that sometimes I feel the effects waning a bit when they shouldn’t be. I am not sure why this is, I try and drink water to increase the reaction rate (this is my own theory and it may not have any basis in science whatsoever, still, drinking water is never a bad thing !). Also, and I am not sure if this is wise or not, but I have a small amount of tea sometimes or lucozade, and the caffeine seems to increase the power of my concentration.

    The other thing is the comedown, sometimes at the end of the day I find myself being VERY irritable…however, I do not wish to be a slave to this drug and even though it is difficult I tell myself that I have to behave and have some discipline towards my actions. Even though it is close to being a miracle cure for me, I know it isn’t perfect. But we have to work on ourselves WITH the help of the medicine in order to live the normal life that we crave.

    The reason I am writing this is to show that its not just people who fail at school or are constantly hyperactive who suffer from ADHD. I also want to show that even if you are suffering, there is NO subsistute for spirit, determination to not be beaten, and DISCIPLINE!! And of course I am aiming this at adults like myself, not children. I keep thinking how my life would have been different if I had been diagnosed as a chile. My ‘good’ results might have been ‘outstanding’, and maybe I would still be with the girl I loved. I have no regrets however. Finally I just want to say, good luck to everyone, I hope my story ends out well and I achieve the lucrative job that I dream of, and maybe I can portray that no matter how hard it seems there is ALWAYS a way through if you are willing to work hard.

    Thanks for reading,

    F

  26. Dear Sir,

    My 6 year old has been having adhd traits. The doctor here has given a medicine 10mg -2 tablets in the morning and 1.5 tablets in the evening. As a mother I can see he is losing appetite. I have also heard from one of his teachers that ADHD medicine taken for too long can cause adverse effect- nervousness in the child. Can we avoid medicine ?. Will therapy help.? His school here in kolkata (India) doesn’t have a counsellor. Does he need to shift to school with a counsellor?

Leave a Reply