Adderall Medication for Attention Deficit Disorder

ADDerall and ADDerall XR are stimulant medications used in the treatment of ADHD - attention deficit hyperactivity disorder - in both children and adults.

Made from a combination of four amphetamine compounds, ADDerall is useful because it covers a broad range of attention deficit disorder symptoms, and because it is a "one a day" dosing. A child with attention deficit disorder usually has to take only one dose of adderall per day to get through school and get his homework done. ADDerall can really help students with their studies, and it is often called "the study drug" by students, especially college students. And yes, it is often abused by college students.

ADDerall

Adderall is a "cocktail" drug, or a mixture of four drugs, all from the amphetamine family. As a result it has a broad spectrum of symptom coverage. It also tends to last for about six hours per dose, so it can cover the entire school day.

It can be less "harsh" than Ritalin. ADDerall might be worth talking to your doctor about as either the first or second medication to try.

ADDerall tablets come in 5, 10, 20, and 30 mg doses offering great flexibility to a physician in targeting the optimum dose for any patient. Even greater flexibility is offered because the tablets are double-scored so they can be accurately split into halves or quarters. This means that ADDerall can be administered in increments as low as 1.25 mg, or adjusted in 1.25 mg increments.

ADDerall begins to work more gradually than Ritalin, or Dexedrine, and the "drop-off" slope is also much more gradual, meaning that there is less of a "trough" time at the end of the dose.

Expectations and Drawbacks of Adderall

ADDerall can be expected to work very well for the "space cadet" ADHD kids. Stimulants (including caffeine) are great for "inattention" or "brain fog" symptoms. We would estimate that 70% of Attention Deficit Disorder - ADHD Inattentive Type kids would respond to Adderall very nicely. For them, Adderall is a very easy treatment intervention.

Hyperactive-Impulsive kids respond less well to the stimulants. Maybe 60-65% will benefit.

Kids with impulsivity or temper outbursts either do very well, or they do very poorly.

These kids may also need something like Extress for temper, or Clonadine for extreme outbursts. We recommend the Extress nutraceutical medicine first. We have seen Extress work very well in reducing temper outbursts. You can buy it at from VAXA International. The Clonadine is like a "sledgehammer," but use it if you need to.

For the best results using a natural homeopathic medicine see our Specific Treatment Strategies, and use "Attend".

The main drawbacks of Adderall that we have observed are loss of appetite (feed a protein shake twice a day to help keep weight up), some irritability or anger (as when you have had too much caffeine), possible short term growth inhibition (though long-term this may not be a problem). Remember, every medication has possible bad side effects, so always closely monitor your child when taking medications!

If there is a problem, don't give the next dose, and call your doctor right away.

Adderall Medication Side Effects

Adderall XR

Adderall XR information from pharmacist YouTube

All stimulants have side effects, and the side effects from Adderall can be serious.

Any amphetamine can be over used and result in drug addiction. It is a commonly abused drug on college campuses, especially around finals. It is often referred to as "the study drug."

Extra: The Brave New World of Adderall

University of Kentucky Communications Professor Dr. Alan DeSantis was so surprised by the use of Adderall on campus that he decided to study it.

Because Adderall is made from amphetamine, it can cause your child's heart to race, elevate heart rate to dangerous levels, and raise blood pressure to dangerous levels.

Adderall side effects include overstimulation of the central nervous system, dizziness, difficulty sleeping, tremors, headaches, hyperactivity, and tics or Tourettes Syndrome.

A common Adderall side effect is a dry mouth, a bad taste in the mouth, diarrhea, constipation, upset stomach, and loss of appetite.

Children often lose weight when taking stimulants.

Stimulants may reduce growth rates in children.

Sexual dysfunction is a common problem in adults using stimulants.

How effective is
stimulant medication when compared to alternative treatments for ADHD?

Read FDA WARNINGS on Adderall

Clearly a stimulant medication for ADHD like Adderall works. But Adderall can also have serious side effects.

Alternative medicines like ATTEND also work, but without the side effects. They only drawback to ATTEND is that it takes about 30 days to really do the job, while stimulants begin working right away.

ADDerall ECONomics : Shire and Generics

Shire Pharmaceuticals has had the patent on Adderall XR for several years. But Shire’s patent on the drug expired in April of 2009. This meant that other companies could begin selling “generic” versions of Adderall XR (which will initially be manufactured by Shire) potentially at prices far lower than Shire’s prices for Adderall XR.

As of today, Shire is manufacturing both the "brand name" and the generic form, and Teva (who recently bought out Barr) and Global are distributing the generic, often at discounted prices.

Barron’s Magazine claims that Shire’s Adderall XR is the most prescribed drug for ADHD in the world with about 23% of the market, and that of Shire’s $2.4 billion in revenue last year, over 40% came from Adderall sales (about $1 billion).

Vyvanse is Shire’s newest ADHD medication, a true pro-drug, where the medication’s precursors are linked to amino acids to make the medications less likely to be abused. At present Barron’s reports that Vyvanse has captured about 7.5% of the ADHD drug market, and that it is not gaining in popularity as quickly as some had hoped.

The Bad News: Shire is actually good for us and we don’t want to see it suffer too badly. Shire Pharmaceuticals is one of the few companies in the entire world that is interested in developing, testing, and improving medications for ADHD children, teens, and adults. Most other pharmaceutical companies just want to tinker with what we already have, what we already know. Shire is willing to try new things, like using pro-drugs, in the treatment of ADHD. If there is ever going to be a really big breakthrough treatment brought to us from the pharmaceutical industry (as opposed to from the nutraceutical medicine industry) for the treatment of ADHD, it will certainly come from an innovative company like Shire.

Stay in touch with your physician on this. So let’s keep our eyes open and see what happens next with Adderall XR.

This book section: ADHD Medications

Douglas Cowan, Psy.D., MFT is a licensed Marriage and Family Therapist in Tehachapi, CA who has been a counselor to children, teens, and adults helping them to overcome ADHD, find relief for depression or anxiety, and solve other problems in life since 1989. He served on the medical advisory board to the company that makes Attend and Extress from 1997 through 2011, and he is the Editor of the ADHD Information Library online resource at http://newideas.net/. His weekly ADHD Newsletter goes out to 9,500 families. Visit his website at http://DouglasCowan.me for more information on achieving greater health, personal growth, Christ-centered spirituality, stress management, parenting skills, ADHD, working out the stresses of being a care-giver to elderly parents and also being a parent to teenagers, or finding greater meaning in retirement years, Dr. Cowan can be a valuable resource to you.

Christian Counselor counseling Tehachapi for ADHD, depression, anxiety, and more.

Douglas Cowan, Psy.D., MFT
27400 Oakflat Dr.
Tehachapi, CA 93561
(661) 972-5953

ADDerall, ADDerall XR, Side Effects

Clonicel. Sciele Pharma, a Shionogi Company based in Atlanta, GA, and Addrenex Pharmaceuticals, Inc., of Durham, SC, are working together to bring a long-acting version of Clonidine to the ADHD treatment regime. They have collaborated on the development of Clonicel, which is in Phase III clinical trials and has shown positive benefits in treating certain symptoms of ADHD, especially when combined with stimulant medications such as Ritalin.

According to the Addrenex Pharmaceutical website, “At the foundation of the long-term strategic positioning is the development of CLONICEL, the company’s lead product. CLONICEL is a patented extended release formulation of clonidine hydrochloride, a drug currently approved for hypertension but also used by clinicians for a large number of conditions related to hyperadrenergia, including ADHD. CLONICEL is being developed to address the unmet need in the marketplace for a longer lasting, better tolerated version of clonidine. Addrenex is pursuing indications in both hypertension (under the trade name Sympres) and ADHD (CLONICEL).”

According to the company’s press release celebrating the Phase III results, “Clonicel is a non-stimulant medication that selectively targets and calms the adrenergic system, a cascade of stress hormones that regulate the body's response to stress and other physiologic factors. An overactive adrenergic system can trigger emotional outbursts, irritability, mood swings and other debilitating symptoms.”

Over the years we have seen Clonidine prescribed to children with ADHD and temper problems, and have called it “a sledge hammer” approach to treatment, as it often just over-whelms a child. And we have never been impressed with Clonidine since we have seen the same benefits from Extress (VAXA International), but without the strong side-effects of Clonidine.

But that is not to say that there are not times with a “sledge hammer” approach isn’t needed, and it is certainly not to say that a better version of Clonidine could never be developed – and perhaps now it has been.

UPDATE

CNS therapies firm Aerial BioPharma launches $12M fundraising ...

www.medcitynews.com10/21/11

The company's lead drug candidate was Clonicel, a compound being developed as a treatment for hypertension treatment as well as attention deficit hyperactivity disorder. Although Addrenex raised no venture capital it did ...

Clonicel - Drugs.com

www.drugs.com10/2/09

Clonicel (modified-release clonidine) is a new drug in development for the treatment of attention deficit hyperactivity disorder. Clonicel information includes news, clinical trial results and side effects.

Addrenex Pharmaceuticals Announces Positive Phase III Clinical ...

www.medicalnewsblog.info9/13/08

The study showed that the new drug, Clonicel, achieved statistically significant improvement over placebo in reducing an aggregate of 18 ADHD symptoms listed by the American Psychiatric Association and used by physicians to diagnose and ...

Back in 2002 Roger Kurlan, M.D., of the University of Rochester Medical Center in New York, and others, found that the combination of clonidine (Catapres) and methylphenidate (Ritalin) were helpful in the treatment of ADHD and tics (Tourettes Syndrome). The team reported that Methylphenidate primarily improved focus and attentiveness, helping children stay "on task," and Clonidine helped to decrease the symptoms of hyperactivity and impulsivity.

This study had four groups: a placebo control group, a stimulant only group, a Clonidine only group, and a group that received both Methylphenidate and Clonidine. The study looked at both the ADHD symptoms and the TS (tic) symptoms. The report indicated that both the Methylphenidate only group and the Clonidine only group showed improvements over the placebo group, but the best results came from the combination group. However, the study also reported that about half the children who received Clonidine alone experienced the “sledge hammer effect” of sedation (drowsiness), which was the most common side-effect in this study.
Read the study here: http://www.ninds.nih.gov/news_and_events/news_articles/news_article_adhd...

The most recent Addrenex studies have shown that Clonicel (extended release clonidine) improved all of the symptoms of ADHD: inattention, hyperactivity, and impulsivity. “Clonicel was well tolerated and had a favorable safety profile, with mild adverse events such as drowsiness,” according to their press release.

You can learn more about Clonicel here: http://www.addrenex.com/PressR-ADHD-04-23-2009.pdf and here: http://www.addrenex.com/Addrenex-Press09-10-2008.pdf

If your child has ADHD with temper outbursts, or tics, we would still recommend a trial of Extress with your stimulant medication (or with Attend and/or your stimulant medication) first, and we would recommend our eating recommendations as often (but not always) temper outbursts are adverse reactions to eating certain foods or other environmental toxins. Should these recommendations fail to work, then ask your doctor about a combination of Clonicel and stimulant medications once Clonicel becomes available.

This book section: ADHD Medications

Douglas Cowan, Psy.D., MFT is a licensed Marriage and Family Therapist in Tehachapi, CA who has been a counselor to children, teens, and adults helping them to overcome ADHD, find relief for depression or anxiety, and solve other problems in life since 1989. He served on the medical advisory board to the company that makes Attend and Extress from 1997 through 2011, and he is the Editor of the ADHD Information Library online resource at http://newideas.net/. His weekly ADHD Newsletter goes out to 9,500 families. Visit his website at http://DouglasCowan.me for more information on achieving greater health, personal growth, Christ-centered spirituality, stress management, parenting skills, ADHD, working out the stresses of being a care-giver to elderly parents and also being a parent to teenagers, or finding greater meaning in retirement years, Dr. Cowan can be a valuable resource to you.

Christian Counselor counseling Tehachapi for ADHD, depression, anxiety, and more.

Douglas Cowan, Psy.D., MFT
27400 Oakflat Dr.
Tehachapi, CA 93561
(661) 972-5953

Study Comparing Ritalin (Methylphenidate) to Cocaine in the Brain

OK, I have to admit that I didn't see this coming.

Whenever I have heard people comparing Ritalin to Cocaine I have just turned them off as either over-reacting, or uninformed. Yes, both are psychostimulants. Yes, both impact the brain's performance. But other than that, why not compare caffeine to cocaine, as both are stimulants and impact the brain.

I had worked in a psychiatric hospital for a few years, and had seen people who had come because of their cocaine addiction, and they didn't look anything like the kids I saw with ADHD who were benefiting from the use of Ritalin or other stimulants (and I had worked with nearly 1,000 kids who had benefited from treatment with stimulants).

But eventually someone had to do some kind of comparison study between Methylphenidate and Cocaine. And though the study was done with mouse brains, what the researchers found should make us all a bit uneasy. According to one of the lead researchers, "Methylphenidate (Ritalin), which is thought to be a fairly innocuous compound, can have structural and biochemical effects in some regions of the brain that can be even greater than those of cocaine."

Press release dated February 2, 2009

NIDA Study Shows That Methylphenidate (Ritalin) Causes Neuronal Changes in Brain Reward Areas

Similarities and Differences Compared to Cocaine were Found

Investigators funded by the National Institute on Drug Abuse have shown that the medication methylphenidate (Ritalin), which is commonly prescribed to treat attention-deficit hyperactivity disorder (ADHD), can cause physical changes in neurons in reward regions of mouse brains—in some cases, these effects overlapped with those of cocaine. Both methylphenidate and cocaine are in the class of drugs known as psychostimulants. While methylphenidate is widely prescribed, this study highlights the need for more research into its long-term effects on the brain. These research findings will be published Feb. 3 in Proceedings of the National Academy of Sciences.

"Studies to date suggest that prescribed use of methylphenidate in patients with ADHD does not increase their risk for subsequent addiction. However non-medical use of methylphenidate and other stimulant medications, can lead to addiction as well as a variety of other health consequences," said NIDA Director Dr. Nora Volkow. "This study highlights the fact that we know very little about how methylphenidate affects the structure of and communication between brain cells."

The researchers exposed mice to two weeks of daily injections of cocaine or methylphenidate, after which reward areas of the brain were examined for changes in dendritic spine formation—related to the formation of synapses and the communication between nerve cells; and the expression of a protein (delta Fos B) which has been implicated in the long term actions of addictive drugs. Both drugs increased dendritic spine formation, and the expression of delta Fos B; however the precise pattern of their effects was distinct. It differed in the types of spines affected, the cells that were affected, and the brain regions. In some cases there was overlap between the two drugs, and in some cases, methylphenidate produced greater effects than cocaine—for example, on protein expression in certain regions.

"Methylphenidate, which is thought to be a fairly innocuous compound, can have structural and biochemical effects in some regions of the brain that can be even greater than those of cocaine," stated Dr.Yong Kim, lead author of the study. “Further studies are needed to determine the behavioral implications of these changes and to understand the mechanisms by which these drugs affect synapse formation” he added.

Previous studies, including two reported by NIDA on April 1, 2008 (NIH Research Suggests Stimulant Treatment for ADHD Does Not Contribute to Substance Abuse Later in Life) have shown that children treated with stimulants for ADHD early in life have no greater risk of drug addiction as adults.

The National Institute on Drug Abuse is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world’s research on the health aspects of drug abuse and addiction. The Institute carries out a large variety of programs to inform policy and improve practice. Fact sheets on the health effects of drugs of abuse and information on NIDA research and other activities can be found on the NIDA home page at http://www.drugabuse.gov

The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov

Other Opinions on ADHD : Ritalin

Correlation Between Prescription Drugs, Children, Violence

www.youtube.com www.encognitive.com Mind altering drugs may be the cause of violence among school children, according to some doctors and other experts. Millions of children are legally taking drugs similar to cocaine in schools every day. The drugs ...

The Diagnosing and Drugging of 'ADHD' Children -- An American Tragedy Worsens - Huffington Post (blog)

news.google.com

The Diagnosing and Drugging of 'ADHD' Children -- An American Tragedy WorsensHuffington Post (blog)To make matters worse, on Oct. 16, 2011 the American Academy of Pediatrics overrode the FDA and recommended that children as young as age four be diagn ...

Ritalin abuse among students is increasing alarmingly ...

medicalopedia.org10/26/11

But its intranasal and intravenous administration can induce euphoria which is similar to cocaine. Ritalin has proved to be adherent and addictive due to its pharmacological similarity to cocaine and amphetamines. ...

This book section: ADHD Medications

Douglas Cowan, Psy.D., MFT is a licensed Marriage and Family Therapist in Tehachapi, CA who has been a counselor to children, teens, and adults helping them to overcome ADHD, find relief for depression or anxiety, and solve other problems in life since 1989. He served on the medical advisory board to the company that makes Attend and Extress from 1997 through 2011, and he is the Editor of the ADHD Information Library online resource at http://newideas.net/. His weekly ADHD Newsletter goes out to 9,500 families. Visit his website at http://DouglasCowan.me for more information on achieving greater health, personal growth, Christ-centered spirituality, stress management, parenting skills, ADHD, working out the stresses of being a care-giver to elderly parents and also being a parent to teenagers, or finding greater meaning in retirement years, Dr. Cowan can be a valuable resource to you.

Christian Counselor counseling Tehachapi for ADHD, depression, anxiety, and more.

Douglas Cowan, Psy.D., MFT
27400 Oakflat Dr.
Tehachapi, CA 93561
(661) 972-5953

In 2008 the FDA approved the drug Concerta for use in adult ADHD. Concerta is a CNS stimulant medication is used to treat Attention Deficit Hyperactivity Disorder ADHD in children 6 years of age and older, adolescents, and now adults up to the age of 65. It is thought that stimulants work by helping to increase dopamine and norepinephrine, and perhaps blood flow, in the brain.

Concerta is a timed-release form of methylphenidate ( Ritalin is made from methylphenidate ). This is why people like it. Instead of having to take two or three doses of Ritalin each day, with the Ritalin “ups” and “downs” through the day, they can get roughly the same benefits all day long from one Concerta dose in the morning. Concerta has a half-life of 3.5 hours, which is about twice as long as Ritalin.

It is recommended that children and teenagers begin Concerta with just a small dose (18 mg/day), but the FDA is permitting adults to start with either 18 mg/day or 36 mg/day. We are not medical doctors, so we don’t want to say anything more on this than that you should always start with a small dose and see how you do before jumping to a bigger dose of a medication for ADHD. We’d say this for any stimulant, but especially a methylphenidate product.

By the way, the 18 mg/day dose of Concerta is equivalent to a 5 mg dose of Ritalin, twice or three times per day.

Concerta/Methylphenidate Instructional Video

Indications for use on medications such as Concerta and Adderall for ADHD.

Besides, there are differing opinions by doctors on what the optimum dosage for adults actually is, or even how to figure it out. Some doctors will just stay with the recommended formulas used for children, and figure “x mg of methylphenidate per each kg of body weight.” But this ignores the fact that a teenager’s metabolism is different from a child’s, and certainly an adult’s metabolism is different from either a teenager’s or a child’s. So I’m not sure that the standard formulas used for children are helpful for adults. Often adults need far less medication, per kg of body weight, than children require for an optimal dose.

This is where tools like the TOVA test are extremely helpful, as an adult can take the medication, wait a few hours, and be tested on the TOVA to see if he/she is a responder to the medication, and if that particular dose was “optimal” or not. These computerized testing tools are about 20 years old now, and yet few practices use them still. Too bad.

Although Concerta is more convenient than Ritalin, you will still have to be careful.

WARNINGS AND PRECAUTIONS for Concerta

• Serious Cardiovascular Events: Sudden death has been reported in association with CNS stimulant treatment at usual doses in children and adolescents with structural cardiac abnormalities or other serious heart problems. Sudden death, stroke, and myocardial infarction have been reported in adults taking stimulant drugs at usual doses for ADHD. Stimulant products generally should not be used in patients with known structural cardiac abnormalities, cardiomyopathy, serious heart rhythm abnormalities, coronary artery disease, or other serious heart problems.
• Increase in Blood Pressure: Monitor patients for changes in heart rate and blood pressure and use with caution in patients for whom an increase in blood pressure or heart rate would be problematic.
• Psychiatric Adverse Events: Use of stimulants may cause treatment-emergent psychotic or manic symptoms in patients with no prior history, or eacerbation of symptoms in patients with pre-eisting psychiatric illness. Clinical evaluation for Bipolar Disorder is recommended prior to stimulant use. Monitor for aggressive behavior.
• Seizures: Stimulants may lower the convulsive threshold. Discontinue in the presence of seizures (5.3)
  Visual Disturbance: difficulties with accommodation and blurring of vision have been reported with stimulant treatment.
• Long-Term Suppression of Growth: monitor height and weight at appropriate intervals in pediatric patients
• Gastrointestinal obstruction with pre-eisting GI narrowing
• Hematologic monitoring: Periodic CBC, differential, and platelet counts are advised during prolonged therapy

Adverse Reactions Concerta

• The most common adverse reaction in double-blind clinical trials (>5%) in children and adolescents was abdominal pain upper.
• The most common adverse reactions in double-blind clinical trials (>5%) in adult patients were decreased appetite, headache, dry mouth, nausea, insomnia, aniety, dizziness, weight decreased, irritability, and hyperhidrosis.
• The most common adverse reactions associated with discontinuation (t1%) from either pediatric or adult clinical trials were anxiety, irritability, insomnia, and blood pressure increased.

This book section: ADHD Medications

Douglas Cowan, Psy.D., MFT is a licensed Marriage and Family Therapist in Tehachapi, CA who has been a counselor to children, teens, and adults helping them to overcome ADHD, find relief for depression or anxiety, and solve other problems in life since 1989. He served on the medical advisory board to the company that makes Attend and Extress from 1997 through 2011, and he is the Editor of the ADHD Information Library online resource at http://newideas.net/. His weekly ADHD Newsletter goes out to 9,500 families. Visit his website at http://DouglasCowan.me for more information on achieving greater health, personal growth, Christ-centered spirituality, stress management, parenting skills, ADHD, working out the stresses of being a care-giver to elderly parents and also being a parent to teenagers, or finding greater meaning in retirement years, Dr. Cowan can be a valuable resource to you.

Christian Counselor counseling Tehachapi for ADHD, depression, anxiety, and more.

Douglas Cowan, Psy.D., MFT
27400 Oakflat Dr.
Tehachapi, CA 93561
(661) 972-5953

What is DAYTRANA? Patch ADHD Medication

Is the "Daytrana patch" a Good Choice for You?

When Shire Pharmaceuticals came out with their new version of methylphenidate, called DAYTRANA, it was the first and only patch, or transdermal medication approved to treat the symptoms of Attention Deficit Hyperactivity Disorder or ADHD.

DAYTRANA is methylphenidate (generic name for Ritalin) in a patch, which makes it a very convenient delivery system (one a day dosing).

The response from parents has been mixed. Parents, and patients, like the convenience of a patch. And they also like the fact that children don’t have to swallow a pill.

But the patch can cause side-effects. Skin rashes, sleeplessness, stomach aches and motion sickness are commonly cited. Some parents also complain that they have to fight with their kids to put the patches on, and it leaves a “goo” after taken off.

Daytrana News

You can learn more about DAYTRANA at its website.

Watson Pharma seeks to make generic Daytrana | eqip commissioning

eqipcommissioning.com10/14/11

Noven filed a lawsuit Thursday in the U.S. District Court of New Jersey seeking to prevent Watson from making the generic version before Daytrana's patents expire in 2018. Noven is a subsidiary of the Japanese drugmaker ...

Shire plc Sells ADHD Patch Daytrana to Noven

www.biospace.com8/11/10

MIAMI----Noven Pharmaceuticals, Inc. today announced that it has entered into a Product and Trademark Acquisition Agreement with affiliates of Shire.

Noven Sues Watson Over Daytrana ADHD-Patch Patent Infringement

adhd.awarenessindex.com10/14/11

The latest news and products available on attention deficit hyperactivity disorder, ADHD, with information on getting help and coping.

As always, parents should know that DAYTRANA is a Schedule II controlled substance.

Daytrana Side Effects

It was generally well tolerated in clinical studies, but some subjects had side effects. As with other products containing methylphenidate the common side effects reported in children who received DAYTRANA were

• decreased appetite,
• insomnia,
• nausea,
• vomiting,
• weight loss,
• tics,
• affect lability (mood swings).

It is the same list of side effects one would see with Ritalin in any of its forms.

The manufacturer warns that Methylphenidate should never be taken by children with:

• significant anxiety,
• agitation,
• extreme temper outbursts,
• glaucoma,
• tics or Tourette's syndrome, or family history of Tourette's syndrome,
• current/recent use of MAO inhibitors (a type of antidepressant),
• problems with alcohol or drugs,
• has had depression,
• abnormal thoughts/behaviors,
• visual disturbances,
• seizures,
• high blood pressure,
• heart conditions including structural abnormalities.

The manufacturer warns that abuse of methylphenidate may lead to dependence.

As always, tell your doctor immediately if any of these unlikely but serious side effects occur: blurred vision, uncontrolled movements (twitching, shaking), uncontrollable outbursts of words or sounds (e.g., Tourette's syndrome), unexplained weight loss, mental/mood/behavior changes (e.g., agitation, aggression, mood swings, depression, abnormal thoughts, hallucinations).

Daytrana Drug Interactions

Your doctor or pharmacist should already be aware of any possible drug interactions and may be monitoring you for it. Do not start, stop or change the dosage of any medicine before checking with them first.

Avoid taking MAO inhibitors (e.g., furazolidone, isocarboxazid, linezolid, moclobemide, phenelzine, procarbazine, selegiline, tranylcypromine) within 2 weeks before or after treatment with this medication.

In some cases, a possibly fatal drug interaction may occur.

If you are currently using any of these medications, tell your doctor or pharmacist before starting this medication. Or better yet, just don’t use this medication.

Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription herbal products you may use, especially of: "blood thinners" (e.g., warfarin), clonidine, guanethidine, drugs that can increase blood pressure (e.g., epinephrine, phenylephrine), anti-seizure drugs (e.g., phenobarbital, phenytoin, primidone), tricyclic antidepressants (e.g., imipramine, desipramine), SSRI antidepressants (e.g., fluoxetine, sertraline), other stimulant medications (e.g., amphetamines).

Also report the use of drugs which might increase seizure risk (decrease seizure threshold) when combined with methylphenidate such as bupropion, isoniazid (INH), phenothiazines (e.g., thioridazine), or theophylline, among others. Consult your doctor or pharmacist for details.

Check the labels on all your medicines/herbal products (e.g., cough-and-cold products, diet aids) because they may contain ingredients that could increase your heart rate or blood pressure (e.g., pseudoephedrine, phenylephrine, ephedra/ma huang). Ask your pharmacist about the safe use of these products.

Daytrana: Our Thoughts

We are not opposed to Daytrana, or Ritalin, or Methylphenidate in any of its forms, provided that the “alternative” options have been tried, and have failed.

We are referring to ADHD diet interventions, Attend and other amino acids such as Extress or Memorin, essential fatty acids (omega oils), and perhaps EEG Biofeedback training.

DAYTRANA Risks

Is methylphenidate over-prescribed? Is it over-used?

Probably. But the reason why Ritalin is used so much is that it works. Think about it. No one would use it if it didn’t make a positive improvement in the life of their child.

But Ritalin, DAYTRANA, and all the other forms of methylphenidate as ADHD medication (in fact, all the other forms of prescription treatments for ADHD) come with the problem of potential side effects. And some of these side effects are severe.

So, please try our recommended ADHD eating program plus the specific Attend treatment strategies first. Consider EEG Biofeedback training if you can afford it.

Try these “alternatives” first if you can and see if they work. If they do not work for you or your child, then by all means carefully consider the use of prescription stimulants.

See our comparison of the effectiveness of your treatment options.

A Parent's Comment on Daytrana

This comment was posted on our ADHD Newsletter website by a parent in February, 2007 following the posting of the above article on Daytrana.

"This patch has been a god send for us!!! If our child washes the glue off and moisturizes the skin area there are very few problems other than decreased appetite."

Parents share experiences with Daytrana as an ADHD Medication below.

sweat and daytrana? - ADD Forums - Attention Deficit Hyperactivity ...

www.addforums.com9/16/11

I know you posted this a month ago and you've probably already made a decision, but just in case anyone else has the same question, I was on Daytrana for a few weeks and never had any trouble with it coming off. You stick ...

Side effects - Daytrana (Methylphenidate) Patch Abuse Leading to ...

www.drugs-forum.comEffectiveness of Daytrana Patches - Health and Life

healthlifeandstuff.com6/19/11

Daytrana is an ADHD patch – a system that delivers methylphenidate, which is the same standard medication accessible in tablet forms such as Ritalin and Concerta. The uniqueness of this system is the way it's delivered. ...

0px'>8/16/11

Side effects - Daytrana (Methylphenidate) Patch Abuse Leading to Rapid Psychosis Concerta & Ritalin.

This book section: ADHD Medications

Douglas Cowan, Psy.D., MFT is a licensed Marriage and Family Therapist in Tehachapi, CA who has been a counselor to children, teens, and adults helping them to overcome ADHD, find relief for depression or anxiety, and solve other problems in life since 1989. He served on the medical advisory board to the company that makes Attend and Extress from 1997 through 2011, and he is the Editor of the ADHD Information Library online resource at http://newideas.net/. His weekly ADHD Newsletter goes out to 9,500 families. Visit his website at http://DouglasCowan.me for more information on achieving greater health, personal growth, Christ-centered spirituality, stress management, parenting skills, ADHD, working out the stresses of being a care-giver to elderly parents and also being a parent to teenagers, or finding greater meaning in retirement years, Dr. Cowan can be a valuable resource to you.

Christian Counselor counseling Tehachapi for ADHD, depression, anxiety, and more.

Douglas Cowan, Psy.D., MFT
27400 Oakflat Dr.
Tehachapi, CA 93561
(661) 972-5953

Dexedrine (Dexamphetamine or Dextroamphetamine) ADHD Medication

Dexedrine is a central nervous system stimulant used as medication in the treatment of ADHD.

It is from the amphetamine family, and is manufactured in 5mg, 10mg, and 20mg pills, and 5mg, 10mg. or 15mg capsules. Dexedrine comes in a very effective Spansule formula for a longer effective dose (one dose a day gets you through school). it is very similar to Ritalin in its benefits to individuals with ADHD. It can be less harsh, as it seems to start more gradually, and come to the end of its dose without the harsh "crash" or "trough period" of Ritalin.

Cognitive Enhancing Drugs - Adderall and Dexedrine

Old news report on Dexedrine and Adderall use by students

Here is an alternative to Dexedrine to consider. In the chart below compare the effectiveness of Stimulant ADHD medication (most of the subjects were using Ritalin, but many were using Dexedrine or Adderall in the study, and all were lumped together into the category of "stimulants") with ATTEND natural homeopathic medicine with specific amino acid combinations. You will find that the ATTEND is as powerful as the stimulants, but is much easier to tolerate, has fewer side effects than Dexedrine or other stimulants, and is much healthier.

Dexedrine ADHD Medication and Side Effects

Even though Dexedrine can be helpful in the treatment of ADHD, the list of drawbacks, or Dexedrine side effects, is very long.

Read the list below, and then consider ATTEND the alternative to Dexedrine.

FDA Warnings on Dexedrine

Do not take monoamine oxidase inhibitors with this drug. Check with your physician if you are taking any of the following: Chlorpromazine, ethosuximide, haloperidol, antihypertensive, medications, meperidine, norepinphrine, phenytion, propoxphene, any beta blocker, digitalis, or thyroid hormones. A variety of neurological toxic effects can occur, sometimes with fatal results.

AMPHETAMINES HAVE HIGH POTENTIAL FOR ABUSE. USE OF AMPHETAMINES FOR A PROLONGED PERIOD OF TIME MAY LEAD TO DRUG DEPENDENCE.

The habit-forming potential is high. Psychological and physical dependence is possible. Addiction is rare in children but a problem with adults.

Long-term effects on children have not been well established (might be a problem). Children who take this drug on a long-term basis should be examined every four to six months.

The physician should:

• monitor height and weight to see if growth is being inhibited as feared might happen,
• check for the presence of tics which may start after using stimulants,
• measure blood pressure and pulse which may elevate unacceptably with stimulant use,
• and ask about other Dexedrine side effects.

Do not take this drug if you are pregnant or if planning to become pregnant. Do not take if you are breast-feeding.

Do not give this drug to children under the age of three.

Do not drink alcohol while taking this drug.

Do not use if: You had negative reactions to this or any other amphetamine in the past. If you have a history of drug alcohol abuse. If you have a psychotic disorder of any type.

Inform your Doctor if:

• You had negative reactions to this or any other amphetamine in the past.
• If you have epilepsy, glaucoma, heart / blood vessel disease.
• If you have high blood pressure, or a history of Touette's syndrome.
• If you are taking any other prescription or nonprescription drug.
• If you will have anesthesia or any surgery in the next few months.
• If you will be undergoing any medical tests.
• If you have a history of drug or alcohol dependence.

Dextroamphetamine : Symptoms or Side Effects

Pretty Common Dexedrine Side Effects include : Nausea, diarrhea, loss of appetite and weight loss, difficulty sleeping, restlessness, and anger.

Less Common, but Serious Dexedrine Side Effects include : Abdominal pain, headache, loss of appetite and weight loss, mood changes, increased temper outbursts, lack of coordination, tics or other unusual movements, Tourette's Syndrome, irritability, dizziness, difficulty sleeping, nervousness, skin rash, hives, blurred vision, sexual problems, or paranoia. If any of these start, SEE YOUR PHYSICIAN ASAP.

Beware of: Nausea, diarrhea, loss of appetite, difficulty sleeping, drowsiness, dizziness, or restlessness. SEE YOUR PHYSICIAN ASAP.

Stop taking the Dexedrine, and see your physician NOW: Abdominal pain, headache, lack of coordination, tics / unusual movements, skin rash, hives, or paranoia.

Why Not Try ATTEND first? ATTEND is a powerul, safe, and healthy alternative to Dexedrine without the potential Dexedrine side effects.

Other Opinions:

The Diagnosing and Drugging of 'ADHD' Children -- An American Tragedy Worsens - Huffington Post (blog)

news.google.com

The Diagnosing and Drugging of 'ADHD' Children -- An American Tragedy WorsensHuffington Post (blog)The scientific literature actually shows that 50 percent or more of children this young when given Ritalin, Focalin, Dexedrine, Adderall and other stim ...

Pharmacies Back Ordered And out of Dexedrine Generic.......in ...

www.addforums.com10/13/11

Pharmacies Back Ordered And out of Dexedrine Generic.......in Socal Dexedrine/Dextrostat.

Dexedrine Abuse Dot Com

dexedrineabuse.com10/3/11

Dexedrine Abuse .com welcomes you to our site which is a formidable resource for the problem of Dexedrine Abuse. Learn more about this problem or talk to our counselors.

Stomach issues with dexedrine - ADD Forums - Attention Deficit ...

www.addforums.com9/19/11

Stomach issues with dexedrine Dexedrine/Dextrostat.

This book section: ADHD Medications

Douglas Cowan, Psy.D., MFT is a licensed Marriage and Family Therapist in Tehachapi, CA who has been a counselor to children, teens, and adults helping them to overcome ADHD, find relief for depression or anxiety, and solve other problems in life since 1989. He served on the medical advisory board to the company that makes Attend and Extress from 1997 through 2011, and he is the Editor of the ADHD Information Library online resource at http://newideas.net/. His weekly ADHD Newsletter goes out to 9,500 families. Visit his website at http://DouglasCowan.me for more information on achieving greater health, personal growth, Christ-centered spirituality, stress management, parenting skills, ADHD, working out the stresses of being a care-giver to elderly parents and also being a parent to teenagers, or finding greater meaning in retirement years, Dr. Cowan can be a valuable resource to you.

Christian Counselor counseling Tehachapi for ADHD, depression, anxiety, and more.

Douglas Cowan, Psy.D., MFT
27400 Oakflat Dr.
Tehachapi, CA 93561
(661) 972-5953

Keywords: Dexedrine Side Effects and an Alternative to Dexedrine, ADHD Medication

Research published in the British Medical Journal warns that the treatment for ADHD has surged in recent years, leading us to wonder if the rush to diagnose and prescribe medications for ADHD has surpassed our wisdom as health care professionals. We are at the place now where voices from the USA to Europe are warning that many children are being diagnosed with ADHD, and are prescribed medications for the disorder without need.

For example, see our article on the Over-Diagnosis of ADHD in Germany. It reported that ADHD was over-diagnosed because medical doctors don't necessarily go through the process of interviews, testing, rating scales, and more - but sometimes just skip to "I know what ADHD looks like, and it looks just like Johnny." But doctors and other medical professionals simply cannot skip the steps involved in making proper diagnoses. These are children involved here. But to compound the problem, stimulant medications like Ritalin can improve the school performance of most people, whether they need it or not. Improvement in performance at school is not confirmation of an ADHD diagnosis. Stimulants help almost anyone focus better, concentrate better, remember things better. That's why people drink so much coffee around the world.

We have written previously about the jump in prescription medications for children and teenagers here in the United States. And the same thing is happening around the western world. In Australia, prescriptions for ADHD medications increased by 72 percent in the past decade, while in Britain and the Netherlands prescriptions increased by nearly 100%.

Physicians are encouraged to make a proper diagnosis, using all of the available resources. The authors also encourage physicians to wait 10 weeks before prescribing stimulant medications like Ritalin to make sure that the child or teenager actually needs medication. We'd also suggest that using computerized testing with the TOVA, or similar tests, would give physicians immediate feedback on whether or not a particular child or teen with ADHD will actually be a responder to any particular medication for ADHD. But these tools are rarely used.

During that ten week observation time, families could certainly try other remedies such as an ADHD diet, or Attend and Extress, or exercise programs such as the Learning Breakthrough Program to see if they work or not. These are widely available.

This book section: ADHD Medications

Douglas Cowan, Psy.D., MFT is a licensed Marriage and Family Therapist in Tehachapi, CA who has been a counselor to children, teens, and adults helping them to overcome ADHD, find relief for depression or anxiety, and solve other problems in life since 1989. He served on the medical advisory board to the company that makes Attend and Extress from 1997 through 2011, and he is the Editor of the ADHD Information Library online resource at http://newideas.net/. His weekly ADHD Newsletter goes out to 9,500 families. Visit his website at http://DouglasCowan.me for more information on achieving greater health, personal growth, Christ-centered spirituality, stress management, parenting skills, ADHD, working out the stresses of being a care-giver to elderly parents and also being a parent to teenagers, or finding greater meaning in retirement years, Dr. Cowan can be a valuable resource to you.

Christian Counselor counseling Tehachapi for ADHD, depression, anxiety, and more.

Douglas Cowan, Psy.D., MFT
27400 Oakflat Dr.
Tehachapi, CA 93561
(661) 972-5953

Intuniv : ADHD Non-Stimulant Medication

Intuniv is a newer medication for the treatment of ADHD in children and teens that gained its approval from the FDA and was available to pharmacies in November, 2009.

Intuniv is not a stimulant medication, and may be helpful to the estimated 25-30% of children with ADHD who do not benefit from stimulant medications. Instead, Intuniv is a form of Guanfacine (Tenex) which has been used for years as a blood pressure medication in adults, and has also been used as an adjunct medication in the treatment of ADHD individuals with temper or anger problems, or oppositional defiant disorder. Now in the form of Intuniv, this medication seems to have a wider range of symptoms that benefit from its use than just anger or oppositional behavior.

It appears that Intuniv (guanfacine) works in the pre-frontal cortex to help the brain to increase the available supply of glutamate, an excitatory neurotransmitter. About one-third of all neurotransmitters in the brain are glutamate, and working together with dopamine and norepinephrine, glutamate helps to improve the functioning of the pre-frontal cortex - improving focus and attention, decreasing impulsive anger and frustration.

Families will find Intuniv easier to manage then Tenex, as it is a once-a-day medication, where Tenex was twice-a-day dosing. Also, Intuniv is not a stimulant, so it will be easier for doctors to prescribe the medication, and easier for families to pick up a refill at the pharmacy. Also, Intuniv has no known potential for abuse or dependence, so it may be helpful for those with both ADHD and a co-morbid history of addiction.

Early reports on Intuniv indicate that the effects and benefits of the medication are not just one day, but actually have benefit for the next morning with the child or teen wakes up, and many families know that the early morning can be one of the most difficult times of the entire day.

While Intuniv can be used along with stimulant medications, for many children and teens it is proving to be good enough all by itself. One doctor reports that he has seen positive results in his patients with "inattentive ADHD" helping them to focus better and longer. Others report that Intuniv may also help with those difficult, angry, ODD, and perhaps early on-set bipolar disordered kids and teens. And for those kids, Intuniv should be much safer than the antipsychotics that are often prescribed.

There is a lot that remains to be seen and reported. I'm not sure that I'd want my child to get in too early on this medication and take some time to see how others do with it, let it get a bit of a track record. In the studies that Shire had done for FDA approval, there were some significant side-effects reported, and something like 80% of the people who began the study dropped out over the course of the study - though the study was something like two years long so that might be why...

But for many families it will be worth watching, listening, and asking questions of their physicians. It should be a good discussion at your local CHADD meetings.

As always, we would like to see people trying Attend and Extress first, but there certainly are situations where the alternatives simply are not going to be effective enough and a medication like this will have to be used.

It is strongly recommended by some physicians that Intuniv not be used with certain other drugs, especially Prozac, Paxil, Luvox, Trileptal (or Tegretol), Provigil, and others in these classes.

We don't consider ourselves experts on Intuniv, but here are some websites with more information from people who are:

Medicine and Technology by Dr. Joseph Kim

CorePsych Blog by Dr. Charles Parker

Here is a video clipped from YouTube discussing the targeted nature of Intuniv in the treatment of ADHD :

What is the Relationship Between Dopamine, Norepinephrine, and Glutamate? And How are They Related to ADHD?

One-third of the neurotransmitters in the brain are glutamate, and brain research is now looking at the intricate relationships between glutamate, dopamine, and nor-epinepherine in the functioning of the pre-frontal cortex. Research is revealing that the glutamate network neurotransmissions from the pre-frontal cortex to other areas of the brain are enhanced by dopamine and nor-epinepherine. Too little dopamine or nor-epinepherine is a problem, and too much is a problem. And the importance of glutamate in PFC functioning is beginning to come to the forefront in research.

Neuro-science is beginning to move away from seeing ADHD as just a problem with dopamine and/or nor-epinipherine, and is moving toward a better understanding of the brain as a network, and a network of relationships such as the relationship between dopamine, nor-epinipherine, the glutamate exitatory neurotransmitters which are about 30-35% of all neurotransmitters in the brain, and their relationship to ADHD.

And it seems that Intuniv makes more glutamate in the PFC.

Amy Arnsten, Ph.D., Arnsten Lab, Dept or Neurobiology at Yale University. According to its website, the Arnsten Lab "studies molecular influences on the higher cognitive functions of the prefrontal cortex (PFC), with the overarching goal of developing rational treatments for cognitive disorders and mental illness... Research has focused on how the catecholamines norepinephrine (NE) and dopamine (DA), powerfully and dynamically modulate PFC cognitive function and physiology through intracellular signaling mechanisms." The lab helped Shire Pharmaceuticals in the development of Intuniv for ADHD treatment.

The Arnsten Lab has been able show how the relationship between dopamine and nor-epinephrine, really the ratios of dopamine to nor-epinephrine, can impact and improve cognitive functions such as focus, memory, and attention. Too much or too little of either neurotransmitter decrease cognitive functions, both in terms of the performance of brain cells, and in the real world. But when the ratios and relationships are just right, performance is improved.

Their work, along with the work of many others, is often focused on the a2-receptor sites in the pre-frontal cortex. They have reported on the benefits of nor-epinepherine at these sites, and have also shown the benefits of stimulating these receptor sites with the medication guanfacine (intuniv).

It appears that guanfacine improved cognitive functioning in the pre-fronatl cortex. Other research has shown that small doses of methylphenidate actually impact the effects of nor-epinepherine in the pre-frontal cortex than the effects of dopamine in the PFC. This research has also shown that when the a2 receptors in the pre-fronatal cortex are blocked that the symptoms of ADHD can be created in a subject, including lack of self-control, impulsivity, and hyperactivity (Berridg et al, 2006)

This book section: ADHD Medications

Douglas Cowan, Psy.D., MFT is a licensed Marriage and Family Therapist in Tehachapi, CA who has been a counselor to children, teens, and adults helping them to overcome ADHD, find relief for depression or anxiety, and solve other problems in life since 1989. He served on the medical advisory board to the company that makes Attend and Extress from 1997 through 2011, and he is the Editor of the ADHD Information Library online resource at http://newideas.net/. His weekly ADHD Newsletter goes out to 9,500 families. Visit his website at http://DouglasCowan.me for more information on achieving greater health, personal growth, Christ-centered spirituality, stress management, parenting skills, ADHD, working out the stresses of being a care-giver to elderly parents and also being a parent to teenagers, or finding greater meaning in retirement years, Dr. Cowan can be a valuable resource to you.

Christian Counselor counseling Tehachapi for ADHD, depression, anxiety, and more.

Douglas Cowan, Psy.D., MFT
27400 Oakflat Dr.
Tehachapi, CA 93561
(661) 972-5953

This question was submitted by a reader:
Is Risperdal a medication that is used to treat ADHD? What are the mental illnesses that it is used for?

Risperdal would not typically be used as an ADHD medication, and I have never heard of it being a first drug to try. I suppose there might be reasons if there were a lot of symptoms of anxiety, obsessive-compulsive symptoms, or explosive temper or irritability. Or if the doctor thought that it was really tourettes syndrome, or schizophrenia just breaking out.

It is an interesting question that you ask. And it is hard to give an opinion without it looking like giving medical advice. Talk to your doctor and pharmacist. If the situation is very serious, you certainly have to take the steps necessary to stabilize things. Read the side effects information too.

Here are some websites with general information that would be more helpful to you than any answer I might give:

http://www.janssen.com/janssen/products.html
http://www.drugs.com/risperdal.html
http://en.wikipedia.org/wiki/Risperdal
http://www.fda.gov/foi/warning_letters/archive/g4628d.htm

Talk with your doctor and your PHARMACIST if you have more questions.

Doug Cowan

Other Opinions:

Warning for Risperdal (Nov. 2003)

Now a warning about the drug RISPERDAL or risperidone, manufactured by Janssen Pharmaceutica and used to treat schizophrenia. The WARNINGS section of the label for this drug now describes cerebrovascular adverse events in elderly patients being treat...

The ADHD Information Library at http://newideas.net
Over 500 Classroom Interventions at http://www.ADDinSchool.com

The information in this email is not to be considered medical advice on ADHD medication. Always
consult your own physician or health care provider. The information at the ADHD
Information Library and from its staff is for educational purposes only.

This book section: ADHD Medications

Douglas Cowan, Psy.D., MFT is a licensed Marriage and Family Therapist in Tehachapi, CA who has been a counselor to children, teens, and adults helping them to overcome ADHD, find relief for depression or anxiety, and solve other problems in life since 1989. He served on the medical advisory board to the company that makes Attend and Extress from 1997 through 2011, and he is the Editor of the ADHD Information Library online resource at http://newideas.net/. His weekly ADHD Newsletter goes out to 9,500 families. Visit his website at http://DouglasCowan.me for more information on achieving greater health, personal growth, Christ-centered spirituality, stress management, parenting skills, ADHD, working out the stresses of being a care-giver to elderly parents and also being a parent to teenagers, or finding greater meaning in retirement years, Dr. Cowan can be a valuable resource to you.

Christian Counselor counseling Tehachapi for ADHD, depression, anxiety, and more.

Douglas Cowan, Psy.D., MFT
27400 Oakflat Dr.
Tehachapi, CA 93561
(661) 972-5953

Ritalin and ADHD Treatment

Ritalin is the most common ADHD drug, and it has been used for the treatment of ADHD for over sixty years. but just the mention of the name "Ritalin" can cause a wide variety of emotional reactions among people. Some love Ritalin as an ADHD medication, as they have seen it help a loved one, and will defend it forever. Others hate it, and see it as a part of the plan of evil psychiatrists to try to drug children and take over the world (yes, really!). They will attack it whenever they can.

Most people simply don't know what to think.

Ritalin - Medication for ADHD

Ritalin is a "brand-name" for a medication made from Methylphenidate. Methylphenidate (MPH) is a stimulant used to treat Attention Deficit Hyperactivity Disorder, or ADHD, in both children and adults.

Ritalin, or one of its Methylphenidate cousins, may also be used to treat symptoms of traumatic brain injury, narcolepsy, and even chronic fatigue syndrome (though many other treatments are far better).

Other Methylphenidate-based medications are also discussed in this section, and they include:

• Concerta
• Focalin
• Metadate
• Daytrana

Ritalin as a "brand-name" medication comes in three forms, and in various doses:

• Ritalin: 5 mg, 10 mg, and 20 mg tablets;
• Ritalin SR: 20 mg tablets;
• Ritalin LA: 10 mg, 20 mg, 30 mg, and 40 mg capsules;

Ritalin in the Treatment of ADHD

Stimulants have been around for about 60 years. Overall, they work very well. Ritalin and Dexedrine are moderately beneficial, or very beneficial, for about 70% to 75% of those who try them.

There is an unbelievable amount of research done on children and Ritalin, less with Dexedrine, ADDerall, and Cylert (do not ever take Cylert). We have heard that Ritalin is the most widely studied medication prescribed to children in the world, and we would not dispute that claim. It seems that every doctoral candidate writing his dissertation for psychology does something with Ritalin. Stimulants, whether Ritalin or the amphetamines such as Dexedrine or ADDerall, all have benefits for children and adults with Attention Deficit Hyperactivity Disorder - ADD ADHD.

Ritalin will increase the brain's ability to inhibit itself. This allows the brain to focus on the right thing at the right time, and to be less distracted, and less impulsive. Ritalin will increase the "signal to noise ratio" in the brain.

Ritalin will also increase both gross motor co-ordination and fine motor control. For several years the sales brochure for Ritalin simply had pictures of children's handwriting before Ritalin, and with 10 mg of Ritalin in their system. The changes were dramatic, and physicians wrote a lot of prescriptions for Ritalin.

Ritalin may be "over-prescribed" in America, it may not be. But if it is "over-prescribed" it is because it actually works! If it didn't work, sometimes dramatically, it wouldn't be "over-prescribed."

Are we great advocates for the use of stimulant medications?

No. We would prefer that patients at least try the nutritional medicines like ATTEND and Extress, or EEG Biofeedback training first. However, there is a time and a place for the use of Ritalin. And we want you to have accurate information.

ADHD - To medicate or not?

Dr Russel Barkley talks about ADHD and treatment against the problem. Advantages and disadvantages. adhdhistory.com

Getting the Most out of Ritalin

Ritalin is a pretty good medication. We have seen hundreds of kids benefit greatly from Ritalin. But doctors and parents must be observant and conservative.

We have also seen some horror stories with Ritalin, including very serious seizures in children. It must be used carefully, and started slowly and cautiously. It is not a toy.

Ritalin can cause serious side-effects.

We have found that the short-acting pill is better than the timed-release pill. Patients report that the timed-release pill seems to "release" whenever it feels like it, rather then when the patient expects it. So using the short-acting pill gives most patients greater control with the Ritalin.

We have found that the brand name “Ritalin” is much superior to the generic “Methylphenidate.” Generic pills can vary is dosage as much as 20% either way, stronger or weaker. For example, what is a 10 mg Ritalin pill in the generic form may be effectively as little as 8 mg or as much as 12 mg, a 50% potential variation. Always begin your "trial" of medication with the real Ritalin. If that works, then feel free to see if the generic will work as well as the “real stuff.”

Ritalin begins to work in about 15 or 20 minutes. It peaks in effectiveness at 1.5 to 2.5 hours, and lasts for about 3.5 to 4.0 hours.

Some kids have "withdrawals" or a “trough period” from coming off of the dose at about the 4 hour mark. They may "crash" and become irritable, tearful, emotional, or bratty. This lasts for 15 to 30 minutes, and tends to be worse with doses of 15 mg. or more.

The best remedy for this that we've found is a 12 oz. Mountain Dew at about the 3.0 hour mark. The caffeine "deflects" or "flattens out" the angle of withdrawal. This trick works well.

Ritalin Myths

Statements often heard about Ritalin, but are not supported by research, include:

• "Drug treatment should not and need not be indefinite and usually may be discontinued after puberty." Most children with ADD ADHD will still benefit from medications through their teenage years, and more than 50% of children with Attention Deficit Hyperactivity Disorder will still benefit from stimulant medications into adulthood.
• "Start with 5 mg twice daily, before breakfast and lunch." Studies show that the ADHD medications work better if taken with or after meals. Just be consistent as to when you take it.
• "Administration of amphetamines for prolonged periods may lead to drug dependence and must be avoided." While this is one aspect of treatment to be concerned about, another side of this is that studies show, over and over again, that (1) ADD ADHD kids who are never treated will have higher rates of drug use than non-ADHD kids, (2) ADD ADHD kids that ARE treated, whether with medications, or biofeedback, or with anything, will have LOWER rates of drug us than non-ADHD kids. There is no evidence that using stimulant medications increases rates of drug use among adolescents or adults. Rather, the opposite is true.

FDA Hearings and Warnings About Ritalin and ADHD Medications

We have lots of discussion about the recent FDA hearings on Ritalin and other stimulant medications that we want you to read and become familiar with.

We also have the "black box warnings" for you to look over.

It is an issue of "full disclosure" to you. These medications can be very helpful. But we recommend that you try Attend, Extress, and the ADHD diet first. They also work well without the potential side-effects of Ritalin.

Other Opinions on Ritalin

Researchers give Ritalin a clean bill of health - Times LIVE

news.google.com

Times LIVEResearchers give Ritalin a clean bill of healthTimes LIVEParents who rely on the drug Ritalin to stabilise their hyperactive children can breathe a sigh of relief. A study published in the New England Journal of Medicine has confirmed that ...

Ritalin For 4-Year-Olds? - KRDO

news.google.com

Los Angeles TimesRitalin For 4-Year-Olds?KRDOThe revised guidelines recommend that doctors first prescribe behavior therapy for four and five years old, but say that drugs like Ritalin or Concerta may be prescribed if that doesn't work. The Food and ...

Lawrence Diller, M.D.: The Ritalin Wars: Understanding America's ...

www.huffingtonpost.com9/19/11

Children with extreme degrees of impulsivity, distractibility and hyperactivity are easy to diagnose with ADHD. However because these behaviors vary (from none to many) in a bell shaped distribution curve, most of ADHD ...

This book section: ADHD Medications

Douglas Cowan, Psy.D., MFT is a licensed Marriage and Family Therapist in Tehachapi, CA who has been a counselor to children, teens, and adults helping them to overcome ADHD, find relief for depression or anxiety, and solve other problems in life since 1989. He served on the medical advisory board to the company that makes Attend and Extress from 1997 through 2011, and he is the Editor of the ADHD Information Library online resource at http://newideas.net/. His weekly ADHD Newsletter goes out to 9,500 families. Visit his website at http://DouglasCowan.me for more information on achieving greater health, personal growth, Christ-centered spirituality, stress management, parenting skills, ADHD, working out the stresses of being a care-giver to elderly parents and also being a parent to teenagers, or finding greater meaning in retirement years, Dr. Cowan can be a valuable resource to you.

Counselor counseling Tehachapi for ADHD, depression, anxiety, and more.

Douglas Cowan, Psy.D., MFT
27400 Oakflat Dr.
Tehachapi, CA 93561
(661) 972-5953

Ritalin and ADHD Children : Long Term Effects?

"Ritalin Use for ADHD : Does It Alter a Child's Brain?" This was a common headline in the media regarding another of the really interesting studies published this summer. The actual name of the study was: “Methylphenidate Administration to Juvenile Rats Alters Brain Areas Involved in Cognition, Motivated Behaviors, Appetite, and Stress.”

The study attempted to answer questions regarding the consequences of using Ritalin (Methylphenidate) long-term in ADHD children. The researcher’s had concerns that no one really knows what long-term use of Ritalin does to a child’s brain, so they studied the impact of Ritalin use on 16 areas of the brains of young male rats, hoping to find clues. The rats were first given Ritalin at 7 days old. Some rats were studies after 35 days of use (rat adolescence), while others were studied after 135 days (rat adulthood).

Changes were found in the rats who were given Ritalin, compared to the control group that was never given Ritalin. “The changes we saw in the brains of treated rats occurred in areas strongly linked to higher executive functioning, addiction and appetite, social relationships and stress. These alterations gradually disappeared over time once the rats no longer received the drug,” according to the study’s lead researcher Dr. Teresa Milner from the Weill Cornell Medical College.

The study revealed Ritalin-associated changes in four main areas:

• First, there were alterations in brain chemicals such as catecholamines and norepinephrine in the rats’ prefrontal cortex, which is the part of the brain responsible for higher executive functions and decision-making;
• Second, there were also significant changes in catecholamine function in the hippocampus, a center for memory and learning;
• Third, there were alterations in the stratium, a key region for motor function;
• Fourth, there were changes in the hypothalamus, a center for appetite, addictive behaviors, and vigilance.

The rats given the Ritalin also lost weight, a common side-effect to stimulants.

Dr. Milner reported that it is too early to say whether the changes found in the Ritalin-exposed brains would be of benefit or harm to humans, but warned that physicians need to be very careful in their diagnosis of ADHD before prescribing Ritalin to children because the brain changes from the use of Ritalin might be helpful in “battling the disorder” but harmful if given to a child with a healthy brain.

One good indication was that three months after discontinuing the Ritalin treatment the rats’ neurochemistry largely had resolved back to the condition they would have been in had they never received treatment – normal rat brains.

This finding gave the research team hope that short-term Ritalin use might be OK, but that Ritalin use should be replaced by other treatment options for the long-term.

Dr. Milner said, “We are concerned about longer-term use (of Ritalin). It’s unclear from this study whether Ritalin might leave more lasting changes, especially if treatment were to continue for years. In this case it is possible that chronic use (long-term) of (Ritalin) would alter brain chemistry and behavior well into adulthood.”

The study was funded by the U. S. National Institutes of Health. Weill Cornell Medical College is Cornell University’s Medical School located in New York City.

Keywords: Ritalin, ADHD, ADHD in Children, Long Term Use of Ritalin for ADHD

Strattera : Is It For You ?

Strattera is the first FDA-approved treatment for ADHD that is not a stimulant and is not a controlled substance under the Controlled Substance Act. As a non-controlled substance, Strattera provides the convenience of physician samples and phone-in refills. Strattera has gathered a lot of publicity, and a lot of marketing money, which makes it seem like the best medication since antibiotics were developed. But its short history is filled with controversy.

There are a lot of serious questions to be answered about Strattera:

• Just how effective is Strattera?
• What are the short-term side effects of Strattera?
• What are the long-term side effects of Strattera?
• How does it compare to Stimulants in terms of effectiveness, or safety?
• How does Strattera compare to alternatives natural medicines like ATTEND in terms of effectiveness, or safety?

Strattera Information

Strattera is a norepinephrine reuptake inhibitor, a class of ADHD treatment that works differently from the other ADHD medications available. Strattera works by selectively blocking the reuptake of norepinephrine, a chemical messenger, or neurotransmitter, by certain nerve cells in the brain. This action increases the availability of norepinephrine, which is thought to be essential in regulating impulse control, organization and attention.

See our discussion on norepinephrine here.

Taking Strattera Carefully

Take Strattera exactly as directed by your doctor. Strattera offers flexible dosing, once or twice daily. Discuss a convenient schedule for taking Strattera with your doctor. Do not take Strattera with any other medications, even over-the-counter medications! You must talk with your doctor first! Talk to the Pharmacist too!

• Our reports indicate that there can be serious problems taking anti-depressants with Strattera.
• Our reports indicate that there can be serious problems taking even Benedryl with Strattera.
• Our reports indicate that small doses of stimulants may be OK with Strattera, and may enhance treatment.

Lilly to Put Suicide Warning on Strattera Label

Thursday, September 29, 2005 from Reuters News - Foxnews.com

CHICAGO — Eli Lilly and Co. (LLY) Thursday said it will add strong warnings to its label for Strattera used to treat attention-deficit/hyperactivity disorder, including the risk of suicidal thoughts among children and adolescents.

Strattera will now carry a "black box" warning the strongest required by U.S. regulators. Such warnings typically hurt sales of products by raising concern among doctors and patients about the safety of a drug.

The Indianapolis drug maker said a review of clinical trials data identified a small but statistically significant increased risk of suicidal thoughts among Strattera-treated children and adolescents.

Risk of Suicidality in Children Treated w Strattera (Dec 05)

FDA recently alerted health care providers that treatment of children and adolescents with Strattera increases the risk of suicidal thinking. Strattera (atomoxetine) is approved to treat ADHD in patients 6 years and older. The increased risk of suici...

About Strattera (atomoxetine)

Our reports indicate that it takes 4 to 6 weeks for Strattera to work well (to reach therapeutic levels).

We believe that Lilly will experience the same problems that VAXA has in getting people to stick with Attend, which also takes 4 to 6 weeks to work well. The problem is that parents usually only give an intervention 2 weeks to work, and then they move on to something else.

Stimulants like Ritalin, when prescribed with the correct dose, work in about 20 minutes, so parents tend to go back to using them, even with the harsher side-effects. After all, the parents don't experience the unpleasant side-effects - the kids do. But the parents do enjoy the benefits of the medication around the home.

Our reports also indicate that Strattera, like Attend, has fewer "ups and downs" than stimulants.

There can be some stomach problems, but there is less of a "rebound" effect. By the way, for reducing the "rebound" effect of stimulants, try drinking a Mountain Dew at the 3 hour mark (for Ritalin). This seems to help a great deal to eliminate the "crashing" off a dose of Ritalin, and make a smooth landing.

In one of the Strattera studies the researchers reported the following adverse events occurring in some patients:

• Rhinitis (33.3%),
• Headache (20%),
• Anorexia (16.7%),
• Dizziness (16.7%).

No serious side effects were observed and no patients stopped medication or discontinued the study due to adverse events.

There have been reports of prostate problems in men with ADHD from Strattera.

Warning on Liver Injury from Strattera (March 2005)

FDA is advising health professionals about a new warning for the drug Strattera, used to treat attention deficit hyperactivity disorder in adults and children. The drug's labeling is being updated with a bolded warning about the potential for severe ...

In each of six clinical trials, Strattera was statistically superior to placebo in reducing the symptoms of ADHD in children, adolescents and adults. The positive effects of Strattera were seen for overall ADHD symptoms including hyperactive /impulsive symptoms and inattentive symptoms.

Ummm. Coffee is better than placebo.

Would you take a medication that was not better than a placebo?

Remember, Attend makes statistically significant improvements on the computerized TOVA CPT test in 70% of subjects, and 80% improvement on Parent Rating Scales; Ritalin makes statistically significant improvements on the computerized TOVA CPT test in 85% of subjects.

Is Strattera better than either of these?

One of the studies [Heiligenstein J, Kaplan S, Harder D, et al.: Atomoxetine: Clinical outcomes in pediatric ADHD with comorbid ODD.] reported the following:

"The results showed that ADHD RS, CGI and CPRS ADHD Index scores from baseline to endpoint were markedly improved in patients taking atomoxetine compared to the placebo group, with no significant difference attributable to the presence or absence of comorbid ODD.

"In the atomoxetine group, clinical response was 65.4 percent for those with ODD and 58.9 percent for those without the comorbid disorder versus 36.4 percent and 29.3 percent in the placebo group (all p values less than or equal to 0.007).

ATTEND had a statistically significant response from 70 percent of those without the comorbid disorder.

"The most commonly reported treatment-emergent adverse events were headache, rhinitis and abdominal pain. Diarrhea was the only statistically significant side effect that occurred more often in children with comorbid ODD when compared with those without ODD."

It looks on the surface like Strattera may be very helpful in treating children and teens with Oppositional Defiant Disorder and ADHD. However, the results may not be as good as either Attend combined with Extress, or stimulants.

In six placebo-controlled studies, two in children, two in children and adolescents, and two in adults, Strattera significantly reduced core symptoms of ADHD, and was well tolerated. In all studies, participants met Diagnostic and Statistical Manual, 4th Edition (DSM-IV-TR), criteria for ADHD.

Both Strattera and older treatments, like methylphenidate (the active ingredient in Ritalin and Concerta), are effective in treating ADHD.

ADHD News : Strattera

ADHD Drugs Not Linked To Heart Attacks In Kids - ThirdAge

news.google.com

USA TodayADHD Drugs Not Linked To Heart Attacks In KidsThirdAgeCooper and colleagues examined the medical records from four health plans involving 1.2 million patients taking ADHD drugs including Ritalin, Adderall, Concerta and Strattera from 1998 to ...

This book section: ADHD Medications

Douglas Cowan, Psy.D., MFT is a licensed Marriage and Family Therapist in Tehachapi, CA who has been a counselor to children, teens, and adults helping them to overcome ADHD, find relief for depression or anxiety, and solve other problems in life since 1989. He served on the medical advisory board to the company that makes Attend and Extress from 1997 through 2011, and he is the Editor of the ADHD Information Library online resource at http://newideas.net/. His weekly ADHD Newsletter goes out to 9,500 families. Visit his website at http://DouglasCowan.me for more information on achieving greater health, personal growth, Christ-centered spirituality, stress management, parenting skills, ADHD, working out the stresses of being a care-giver to elderly parents and also being a parent to teenagers, or finding greater meaning in retirement years, Dr. Cowan can be a valuable resource to you.

Counselor counseling Tehachapi for ADHD, depression, anxiety, and more.

Douglas Cowan, Psy.D., MFT
27400 Oakflat Dr.
Tehachapi, CA 93561
(661) 972-5953

Vyvanse for the Treatment of ADHD

Vyvanse (Lisdexamfetamine)is a stimulant medication for the treatment of ADHD. VYVANSE is a prodrug that is therapeutically inactive until metabolized in the body. In clinical studies designed to measure duration of effect, VYVANSE provided significant efficacy compared to placebo for a full treatment day, up through and including 6:00 pm. Furthermore, when VYVANSE was administered orally and intravenously in two clinical human drug abuse studies, VYVANSE produced subjective responses on a scale of “Drug Liking Effects” (DLE) that were less than d-amphetamine at equivalent doses. DLE is used in clinical abuse studies to measure relative preference among known substance abusers.

Shire Pharmaceuticals received approval on their third medication for the treatment of ADHD named VYVANSE, to go along with ADDerall XR and Daytrana. All three ADHD drugs are once a day dosing. As we reported in 2007, Shire paid New River Pharmaceuticals $2.6 Billion in cash to partner with them in the production and marketing of Vyvanse for ADHD. Randal J. Kirk, New River’s Chairman and Chief Executive Officer, remarked, “VYVANSE’s approval signals a new era in the treatment of ADHD. Upon product launch, patients will have a novel treatment option combining the effectiveness of a stimulant – long considered the gold standard in ADHD medicines – with other potential benefits.”

VYVANSE will be available in three dosage strengths: 30 mg, 50 mg and 70 mg, all indicated for once-daily dosing.

New River developed VYVANSE as a new ADHD medication designed to provide lower potential for abuse, in which d -amphetamine is covalently linked to l -lysine, a naturally occurring amino acid. The combination is rapidly absorbed from the gastrointestinal tract and converted to d -amphetamine, which is responsible for VYVANSE’s activity.

Joseph Biederman, MD, director of Pediatric Psychopharmacology at Massachusetts General Hospital, was lead investigator on the pivotal clinical studies testing lisdexamfetamine dimesylate for the treatment of ADHD. These large multi-site studies showed that the drug significantly reduced ADHD symptoms throughout the day with a predictable tolerability profile. “Our studies showed that this next-generation stimulant medication's unique chemical profile offers an option for physicians and their patients in the treatment of ADHD, with outstanding efficacy and duration of action” said Dr. Biederman.

Vyvanse Side Effects

We want to like this medication, but after reading the side effects and warnings, it is hard to want to encourage people to take this medication. We hold out hope for the future of prodrugs, but we may not be there yet. Read on...

• difficulty falling asleep or staying asleep
• sleepiness
• uncontrollable shaking of a part of the body
• dizziness
• jitters
• headache
• dry mouth
• stomach pain
• diarrhea
• nausea
• vomiting
• loss of appetite
• weight loss
• fever
• sweating

Some side effects can be serious. If you experience any of these symptoms call your doctor immediately:

• fast or pounding heartbeat
• chest pain
• shortness of breath
• fainting
• slow or difficult speech
• weakness or numbness of an arm or leg
• seizures
• hallucinating (seeing things or hearing voices that do not exist)
• believing things that are not true
• feeling unusually suspicious of others
• aggression
• irritability
• mood swings
• frenzied, abnormally excited mood
• seizures
• tics
• hives
• rash
• swelling of the eyes, face, tongue, lips, or mouth
• blurred vision or other vision problems

Vyvanse (Lisdexamfetamine) may cause sudden death in children and teenagers, especially children and teenagers who have heart defects or serious heart problems. This medication also may cause sudden death, heart attack or stroke in adults, especially adults who have heart defects or serious heart problems. Talk to your doctor about the risks of taking this medication.

Lisdexamfetamine may slow children's growth or weight gain. Your child's doctor will watch his or her growth carefully. Talk to your child's doctor if you have concerns about your child's growth or weight gain while he or she is taking this medication. Talk to your child's doctor about the risks of giving lisdexamfetamine to your child.

Lisdexamfetamine may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [ 1-800-332-1088 1-800-332-1088].

Warning Vyvanse (Lisdexamfetamine) can be habit-forming. Do not take a larger dose, take it more often, take it for a longer time, or take it in a different way than prescribed by your doctor. If you take too much lisdexamfetamine, you may find that the medication no longer controls your symptoms, you may feel a need to take large amounts of the medication, and you may experience symptoms such as rash, difficulty falling asleep or staying asleep, irritability, hyperactivity, and unusual changes in your personality or behavior. Overusing lisdexamfetamine may also cause sudden death or serious heart problems, such as heart attack or stroke.

Tell your doctor if you or anyone in your family drinks or has ever drunk large amounts of alcohol, uses or has ever used street drugs, or has overused prescription medications. Your doctor will probably not prescribe lisdexamfetamine for you.

Do not stop taking lisdexamfetamine without talking to your doctor, especially if you have overused the medication. Your doctor will probably decrease your dose gradually and monitor you carefully during this time. You may develop severe depression and extreme tiredness if you suddenly stop taking lisdexamfetamine after overusing it.

We always recommend trying our ADHD eating program, Essential Fatty Acids, and ATTEND and/or EXTRESS first, depending on what type of ADHD one has.

This book section: ADHD Medications

Douglas Cowan, Psy.D., MFT is a licensed Marriage and Family Therapist in Tehachapi, CA who has been a counselor to children, teens, and adults helping them to overcome ADHD, find relief for depression or anxiety, and solve other problems in life since 1989. He served on the medical advisory board to the company that makes Attend and Extress from 1997 through 2011, and he is the Editor of the ADHD Information Library online resource at http://newideas.net/. His weekly ADHD Newsletter goes out to 9,500 families. Visit his website at http://DouglasCowan.me for more information on achieving greater health, personal growth, Christ-centered spirituality, stress management, parenting skills, ADHD, working out the stresses of being a care-giver to elderly parents and also being a parent to teenagers, or finding greater meaning in retirement years, Dr. Cowan can be a valuable resource to you.

Counselor counseling Tehachapi for ADHD, depression, anxiety, and more.

Douglas Cowan, Psy.D., MFT
27400 Oakflat Dr.
Tehachapi, CA 93561
(661) 972-5953