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ADD Drugs: A Good Idea Or Not?

Murray Hamhandler

21:07 / 10.11.03

Okay. I think I've finally hit a wall and I'm willing to admit to myself that I may need some kind of professional assistance. Despite my best efforts, I have very little focus, very little in the way of an attention span, very little ability to do very simple things that I need to do in order to take any advantage of school and, by extention, to potentially make use of what I'm meant to be learning in my post-collegiate life. This is a problem that has plagued me all of my school-age life (read: most of the past 20 years) and, because of my ability to make good marks in spite of it, it hasn't looked like a problem to anyone else.

So I've read the books and taken the tests and it seems to me that, if I do go to a therapist, there is a quite good chance that I will be diagnosed w/ADD. This attention problem has always been something that I felt that I could overcome if I simply put my mind to it...but that just isn't happening. I, therefore, am most of the way convinced that I need to follow through and see the aforementioned therapist already. However: I am concerned that, while drugs that I may possibly be prescribed might help w/this problem, they might also have adverse side-affects. I know that this is the kind of thing that I should probably discuss w/said therapist when and if I see him/her, am diagnosed w/ADD, and, subsequently, prescribed some mind-altering medication or another, but I figured I'd give it a shot here first, as I know that there are some medical professionals worth their salt on the board. So whaddaya say, gang? Will ADD drugs knock me for a bigger loop than the one I'm already in?

22:37 / 10.11.03

I have been prescribed that and didn't take ritalin. But most of the badly prescribed medications given out like candy for alleged mental disorders are given to children or teenagers and that doesn't seem to be your case. I just suggest not giving too much faith to doctors and phaurmacutical companies that give out free samples to the doctors. Just recenlty I read about a doctor getting sued for giving prozac to someone that was not depressed and did not know that a possible side-effect of prozac is suicide and the man did that and his widow is suing. I also think that ritalin for ADD is a Schedule 2 drug in the same classification that cocaine is. I don't know, I personally am wearry of any kind of drugs, especially mind-altering, so do your own research and don't give to much faith to doctors.

22:46 / 10.11.03

Personally, I'm somewhat dubious of both the diagnosis of adult AD(H)D and its pharmacological treatment. It's one of those conceptually-ambiguous entities which, by dint of significantly broader diagnostic criteria, is a much commoner psychiatric label in the US than almost anywhere else (diagnosed at least ten times more often than in the UK) - and I'm suspicious that, in many, it falls into the 'pathologisation of normal human experience' ballpark.

So... speaking as a UK psychiatrist, I'd be extremely reluctant to seek either diagnosis or treatment with amphetamines. It could very well be argued, however, that since I very rarely come in contact with individuals who've been thus diagnosed, my view is a) largely a personal one, and b) grounded in my own 'local' psychosocial culture.

I'm not saying you shouldn't try the diagnosis for size. I'm merely advising caution in accepting it as any sort of catch-all explanation of your experience. It's not just psychiatric medication that carries long-term consequences; psychiatric (self-)labelling does too.

Murray Hamhandler

23:07 / 10.11.03

Basically: I would, in general, rather work through things like this on my own. I am generally very wary of using drugs to cure psychological problems. Generally, I am loathe to admit that I don't have absolute control over myself. But: I don't. I've tried to work through this nonsense my whole life and it's not happening. So I'm pretty sure that I'm going to finally see a therapist about it. I would love to be given some sort of therapeutic help that aids me in this arena, but I'm honestly about ready to try anything at this point.

I don't know. I can't even focus enough today to give a coherent response! Ha! But I'll certainly check back in here after I've been to the psych. center. Thanks Ganesh & raelianautopsy.

23:12 / 10.11.03

Okay, a short side-rant...

Just recenlty I read about a doctor getting sued for giving prozac to someone that was not depressed and did not know that a possible side-effect of prozac is suicide and the man did that and his widow is suing.

Not an especially useful anecdotal illustration of the cluelessness of doctors, since

a) in the absence of any unequivocal laboratory test, the diagnosis of depression is inevitably a clinical one and thus open to a degree of interpretation - hence "someone that was not depressed" is always a 'challengeable' statement, particularly post-mortem,

b) Fluoxetine (Prozac) is licensed for the treatment of disorders other than depression (particularly in the US),

c) the 'suicide as side-effect' literature is ambiguous, particularly as suicide is a far more common finding in depression, and it's reasonable to assume that a proportion of those treated with antidepressants might actually be depressed. Even in the US.

I agree generally with the advice to be cautious of the seemingly widespread drive toward "mind-altering drugs" as a panacea for every psychosocial discomfort under the sun. I'd argue, however, that doctors (at least in my own UK-based experience) are not necessarily the primary engines of this drive, but are responding to (or attempting to withstand) a much wider cultural tendency. One's own "research" may be even less worthy of faith than the advice of one's doctor.

Where adult AD(H)D is concerned, I'd suggest steering clear of a pathologising psychiatric route wherever possible - and, if one does decide to try it, take the whole thing with a large, cynical pinch of salt. The whole conceptual framework is built upon somewhat shifting sand, and neither accepted medical 'wisdom' nor one's own research is to be blindly trusted. None of this stuff is even remotely set-in-stone.

01:56 / 11.11.03

Ganesh is being too generous with the "suicide side effect" thing.

Suicide is not a side effect of Prozac. At least, suicide is not a side effect of the very similar and probably more disturbing SSRI that I have done quite a bit of work on adverse events concerned with, and they're really not all that different from each other in practice.

SSRIs will not make you kill anyone either, for that matter.

02:58 / 11.11.03

What alternatives are there to the "pathologising psychiatric route" for dericgeneric and other people with similar concerns?

07:59 / 11.11.03

Very interesting topic, this. Deric - I hope you get well, through whatever means. I was going to echo aus's comment a little. I'd ask are there any (adult) ADD self-help groups or Ritalin Users groups etc who can comment on your experience?

12:17 / 11.11.03

going slightly out of topic here, but: what would be "unequivocal laboratory test" for diagnosing depression, Ganesh? I submited myself to a polysomnography exam ealier this year, and there were some "non-specific but typical of narcolepsy and mood disorders" findings (I don't have it here with me right now, might check later on what exactly they were), which got me thinking, but are there ways to tell for sure in a lab already?

13:56 / 11.11.03

I haven't tried Ritalin but have heard almost exclusively bad things about it from those who have. However, I used Adderall and Dexedrine (2 other ADD drugs) in college for the purpose of focusing/completing major projects. 5mg, or even 10mg in time-release form, of Adderall is not mind-altering in the least; in fact, the effects of a 5mg tablet are quite mild. It's like a large cup of coffee minus the jitters and plus concentration. (Dexedrine was a little more intense, IMO, though many have a different experience.) The thing is, when you "go on" ADD drugs, you're often prescribed far more than you need or should take. I'd say 5-10mg a day, or when you feel you need it, would be plenty, maybe too much.

Like I said, Adderall (or Dexedrine) is not mind-altering when used correctly (at least, no more than caffeine is mind-altering). But it is an amphetamine, there is the risk of abuse/addiction, and there can be side effects - loss of apetite, irritability, stomach upset, difficulty sleeping (of course).

14:38 / 12.11.03

i went to the doctor last night and she asked me if i ever thought i had ADD. pretty much out of the blue, and it was the first time i ever met her, it was pretty weird. i wonder if she's psychic or something. i said that yeah i wondered sometimes if i had it. but i was there to go back on my depression meds. she had me take this little quiz, and it said i might have ADD. but she told me that i should come back in a month after i've been on wellbutrin and take another, longer, test, and then maybe she'd prescribe me something. i have to say my first thought was, sure, give me the ritalin, cos if it doesn't do anything, i can at least take it recreationally and/or sell it. cos it's like synthetic cocaine, i hear. the doctor told me there's a new medicine that's not ritalin that she could give me. i forget the name of it.
anyway, i think you should try the meds. see how they work. you can always go off them. don't feel bad that you should be curing this yourself or anything. no one tells diabetics that they should just buck up, they say, "take yr insulin."

15:03 / 12.11.03

I am finding this thread fascinating, if only because it shows (I think at any rate) a huge difference between US and UK attitudes towards pharmaceuticals and disorders... it had never even occurred to me that my lapses in concentration might be due to a disorder rather than to simple wandering thoughts and general feh-ness on my part - that it wasn't simply down to me to pull my socks up. I have never heard of anyone my age using ADD drugs (probably because I don't discuss medication with people as a general rule), certainly not as concentration aids in college (Pro Plus about the only think used here, and the occasional dab of speed).

I don't mean to say that I do have an attention disorder, just that the possibility had never ever occurred to me, and it isn disconcerting to see other people who must be about the same age as me bringing it up. Don't know whether to ascribe this more to the pathologisation of the human condition or to greater awareness of disorders and their treatment in the US...

Ramble over (concentration completely out of the window as it is nearly time to go hoooommeee....)

16:09 / 12.11.03

I also think that ritalin for ADD is a Schedule 2 drug in the same classification that cocaine is.

Its actually something like 10 times as effective at raising seratonin levels as cocaine. Snorted, its tremendous fun, better than coke, I'd say. I can't understand why this seemed a good idea to give to children.

Adderal, like ibis says, is quite useful in 5-10mg doses, and can help adults with focus problems without being too mood altering. Yet I've seen the stuff proscribed to kids at the 20mg(!) level. At 20mg, I've taken it as a substitute for ecstacy at parties, and it very much lives up to expectations. I can't imagine anyone, let alone an 8 year old, taking that daily for medicinal reasons.

As an alternative, I recommend some B-vitimins, 5-HTP, amd DMAE as a safer brain cocktail. Add a bit of chromium if you really need the speed. I believe magnesium helps with seratonin production as well. The old version of this cocktail had effedrine instead of DMAE, but I've found using the precurser rather than the psudo-amphedimine is a lot nicer on your system. Other approaches are ginko, ginsing, and sugar. Ginko and ginsing improve your brains processing of sugar, and thus generally pick things up a bit, especially when taken with some sweets. Or eat a lot of legumes and basmadi rice.

My point: if you don't want to do to a doctor, try GNC. There's a lot you can do with over the counter stuff, or even diet, that can have an effect.

Cheap. Easy. Cruel.

17:28 / 12.11.03

I do have ADD. I was prescribed Ritalin when I was five years of age, but due to some odd side effects, my mother took me off of it. Other than that, I have never taken any drugs for it. My oldest sister is ADD as well and much more severly than I am. The drugs really have not helped her at all. The only effect they have had is to make her very weepy. My nephew has ADD as well and has been on the medication. He hated it, he would only take it during the school year, and then very reluctantly. As soon as he was finished with school, he gave it up. I have realized my strengths and weaknesses and have adjusted how I do things. I am very fortunate to have a job that allows me to jump from one task to another.

18:06 / 12.11.03

I understand they are prescribing SNRIs for AD(H)D now.

I was prescribed an SNRI, I can't remember the name exactly, a while back. I took it for a total of about a day. I felt fantastic, but I thought that a drug that meant I couldn't sit still, sweated constantly and raised my heart rate to about 100 probably wouldn't be good for me long term.

The point is that, while the exact nature of what we call ADD may be a bit of a mystery, one thing it isn't is an amphetamine (or noradrenaline) deficiency, like diabetes involves insulin deficiencies. ADD drugs help people cope with their particular behaviour but they're not directly addressing a biochemical problem.

I find the issue very interesting because of the verbal hoops that people try to jump through to avoid admitting that basically they are giving kids speed, because you have to keep demonising amphetamines don't you? Oh no, it's not speed. We'll give it a whole new name. Okay, maybe they are amphetamines, but they have a *completely* different effect on people who have this *disease*. Really. Other people who take them will die or become addicts, honest.

Unconnected (I assume) but I've heard there's increasing problem with people taking ferocious American meth in the Midwest... is this true?

18:09 / 12.11.03

it is a slippery business, deciding what constitutes a real medical problem, and what is, say, "artistic temperment." mos def the u.s. is way more into prescribing drugs than the u.k. the amount of people diagnosed w/ADD is much much higher here than elsewhere, and you can't say that as *people* we're that different. it's what we do! a pill for every ill! hooray! [/half sardonic]

18:13 / 12.11.03

The point is that, while the exact nature of what we call ADD may be a bit of a mystery, one thing it isn't is an amphetamine (or noradrenaline) deficiency, like diabetes involves insulin deficiencies. ADD drugs help people cope with their particular behaviour but they're not directly addressing a biochemical problem.
yeah, you are right, my metaphor's not perfect.

Cheap. Easy. Cruel.

20:15 / 14.11.03

fridgemagnet

Unconnected (I assume) but I've heard there's increasing problem with people taking ferocious American meth in the Midwest... is this true?

There is an increasing problem with meth in the American midwest. There is also a rising occurence of home meth labs being busted in the midwest. A house just down the street from where I used to live was set on fire by somone attempting to manufacture meth inside. It was quite a nice neighborhood, not the type of place one would associate with the manufacture of illegal methamphetamines.