[Bibliophile]

I am on Adderall XR and my appetite has diminished considerably while it is active. That being said, I find I have to ensure I remember to drink or else my eyes feel dry and strained. You could try switching to decaf as all that caffeine on top of the stimulant meds can’t be good for you. I was only on Concerta for three days (it made me feel tired) so I can’t comment on that one. I did find that I needed to up my water intake with the Concerta for the same reason as the Adderall.

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[Bibliophile]

Valerian is often used as an herbal remedy for sleep disorders.

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[Bibliophile]

There is a theory that ADHD is actually an impairment of the brain’s executive functions. Executive Function (EF) refers to brain functions that activate, organize, integrate and manage other functions. It enables individuals to account for short and long term consequence.

Barkley breaks executive functions down into four areas:

1. Nonverbal working memory

2. Internalization of Speech (verbal working memory)

3. Self-regulation of affect/motivation/arousal

4. Reconstitution (planning and generativity)

Brown breaks executive functions down into six different “clusters.”

1.Organizing, prioritizing and activating for tasks

2. Focusing, sustaining and shifting attention to task

3. Regulating alertness, sustaining effort and processing speed

4. Managing frustration and modulating emotions

5. Utilizing working memory and accessing recall

6. Monitoring and self-regulating action

source: National Research Centre on ADHD, http://www.help4adhd.org/faq.cfm?fid=40&varLang=en

Here is an article from blogspot on ADHD treatments and their addictive nature (http://adhd-treatment-options.blogspot.com/2008/10/how-addictive-is-ritalin.html). What I think your doctor is worried about is that with Ritalin in a non-long acting form, you are going to have to take multiple pills throughout the day. This could lead to you taking too much. Remember that Ritalin is also ground up and injected or snorted for a high by drug users too.

The fact that your doctor Will prescribed Concerta is not necessarily a bad thing as it may help you the same way. It is the same thing as Ritalin, just in a controlled release form.

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[Bibliophile]

Yes, they are both methylphenidate. I believe she is in favour of the long acting ones as you take one capsule in the morning that is released throughout the day. Ritalin is an addictive substance and can be abused so she might be reluctant to have you manage the dosage yourself. Unfortunately, just because you saw a positive benefit with the stimulant does not necessarily mean that you need to take it to compensate for executive function deficiencies, e.g. inattentiveness and impulsive behaviour.

Sprinkled means that you can open the capsule up and sprinkle the globules onto yogurt or something else that you don’t chew. This is good for young kids and adults that cannot swallow a capsule.

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[Bibliophile]

Ritalin is Methylphenidate, which is classified as a psycho-stimulant drug (see http://en.wikipedia.org/wiki/Methylphenidate for more information).

Concerta is a long acting Methylphenidate that uses the osmotic-controlled release oral delivery system (Oros) technology (basically a pump) to gradually release the methylphenidate throughout the day.

Biphentin is another long acting Methylphenidate, but it uses suspended release capsules whose dissolve rate is different so that it is released throughout the day as well.

Biphentin can be sprinkled, Concerta cannot.

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[Bibliophile]

Have you had your Thyroid checked? Exhaustion is one of the symptoms of thyroid gland disorders. Have you done a blood glucose check (fasting test) for diabetes? How is your sleeping? Are you getting up frequently in the night or have an inconsistent sleep pattern?Just some ideas.

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[Bibliophile]

I saw a resident yesterday as my doctor was unavailable (My clinic is in a teaching hospital). The resident went on and on about how I need to boost my self esteem and was unconvinced in the benefits of drug therapy, which he recognized would treat the symptoms of ADHD. I am presently on 10 mg of Adderall Xr. My biggest issue these days is dealing with my anxiety related issues. I think he has it backwards, my self esteem is so poor from years of underachieving and failure, not that I am feeling like I am underachieving because of low self esteem. He recommended talk therapy, i.e. counselling. I am not saying that it won’t help, but I am skeptical that this will help with my anxieties and self esteem. The latter would benefit from a series of tangible successes, not talking about things.

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I have watched that one and the CADDAC one on YouTube. Dr. Barkley’s interpretation of ADHD resonates with my own experiences and what I have seen in others. On the other hand, some family members whom I recommended the video to found his language somewhat negative, his outlook a bit bleak, and went balistic about his use of the word “retarded,” even though it was used in its proper medical context. Granted, they were in the “ADHD is a gift” and “ADHD people are more creative” camp. I should note that neither of the people I asked to learn about Barkley’s perspective have ADHD.

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[Bibliophile]

What you want is music that will just sit there in the background and that you won’t really pay attention to that much. If you respond to it or sing along with it, the chances are it is too distracting.

Music that I use for background noise is usually quieter stuff, e.g. REM, Enya, Pink Floyd, Roger Waters, and a lot of classical and baroque music. It depends what I am doing and how repetitious the action is. I can listen to faster stuff if what I am doing is repetitive. Jazz changes rhythm too much for me to study with it on in the background.

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Very well put, Wgreen. I call this the Dr. Lara Honos-Webb vs. Dr. Charles Barkley conflict. The former representing the gift side with its anecdotal examples of success and the latter following the certainly less heartening doctrine that ADHD is a curse that must be struggled with constantly.

I have to admit that the latter camp is more appealing to me. From my own experience, the creativity and the speed of coming to a decision or understanding a concept do not make up for the inability to put those concepts into action or lead to problems when they are not suited to a situation that calls for careful review. Improper focus and inhibition have led to social, educational and professional failure on numerous occasions in my own life. This is the “does not achieve at the level of one’s ability” criterion that so often applies to ADHD.

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[Bibliophile]

Yes, I am a government librarian and used to cook for a living (trained at college for a year). I couldn’t continue with the latter as restaurant work requires an excellent memory, ability to repeat actions ad nauseam and day after day, and consistency above all other things. I like my work as I do everything in the library so it is not as repetitious as it would be if I were a specialist, say a cataloguer.

I manage my IC with diet alone. I am treating my Crohn’s though. I flare up for a number of reasons so I am reluctant to blame the Adderall XR for one case. I would certainly stop if frequency jumped above the norm. I had to give up coffee/tea for the IC. Caffeinated drinks are a major no-no in the IC diet. I had to give up Black teas anyways as I have to be on a low oxalate diet because of the Crohn’s.

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The problem with viewing ADHD in this manner is that you have the same neurophysiology as other human beings as does the autistic boy in the article I would imagine. The neurochemistry and active parts of the brain are the differing factors. People with ADHD, of which I am one, think different because of the active parts of the brains and the chemicals being accepted, etc. It is important to stress that we are NOT a different species or mutation, e.g. X-Men. We lack the ability to control our attention, which has both positive and negative repercussions. ADHD sufferers are not savants generally speaking and should not be grouped with that sub-type of autism at all.

I prefer the analogy that ADHD people are drivers who drive too fast and do not perceive the rules of the road rather than as merely speed demons. We don’t just think fast, but lack the ability to control how long we think about something or when it is time to move on to a new topic. This includes hyperfocusing/perseverating about things irrelevent to the task at hand.

I am sorry, but my view is that ADHD is crippling in a world where adults are asked to conform to the expected norm.

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Thanks for the response, jeneticallymodified. I recently started Adderall XR and it is going well so far. Might have to up the dose a bit, but sideeffects are minimal, i.e. just a slight lightheadedness. Focus is better, but not where I want it to be yet. I spoke to my psychiatrist about going the SSRI route over the stimulant route, but she wanted to try stimulants first.

The anxiety issues are the worst for me. For example, I bought a shirt and tie yesterday and obsessed over whether I overspent, got decent quality, bought the right thing for hours afterwards, even after I accepted the purchase in my head as required. Not sure how they will treat that, but have to wait and see.

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[Bibliophile]

I suffer from the same problem of an overactive mind once stimulus has been reduced at bedtime. A sleep machine that places nature sounds helped me for a long time (don’t have a good one at the moment as I gave mine away). Listening to music would distract me, but prevent me from sleeping unless it was repetitive and quiet (ambient and classical worked best). Speakers were better than headphones as the headphones themselves would keep me up. I am still a terrible sleeper.

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[Bibliophile]

While the Internet is chock full of interesting information, it can be very tempting for an ADHD mind. I know that I sometimes perseverate/hyperfocus on tangential material and see hours of my time wasted at work. It is a double-edged sword; we now have access to more information and services than ever before in history, but this information or these services may not be related to what we need to accomplish or should be doing.

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