Yesterday a patient posed a familiar dilemma: did she have depression, or ADHD, or both?  Did her depression result from having ADHD, or did it worsen the symptoms of her ADHD?   Could all of her symptoms be explained by ADHD?
This is a familiar problem, since there is overlap in the symptoms of both disorders. In both [...]
If you are starting a trial of CNS stimulants for ADHD, how fast can you increase your dosage?  The usual guidelines are to increase the dosage once a week. For extended release amphetamine, such as Adderall XR, that would be by a  10 mg increase a week. The usual dosage range for Adderall XR in [...]
Many adults with ADHD are demoralized by their life experiences. Often, despite their best efforts, things have not gone well.  If , as a result, they are depressed, their depression needs full treatment, including with antidepressant medications. (The medications we tend to use first for depression, the selective serotonin reuptake inhibitors, are helpful for a number of psychiatric [...]
I have an interesting new twist on ADHD. For some time I’ve been dissatisfied with the diagnostic term “Attention Deficit Hyperactivity Disorder.”  The problem in ADHD is not a deficit of attention. Patients with ADHD often can pay sustained attention to something that interests them, such as a Washington Redskins game. They just can’t pay attention [...]
Well, why not?  If we suspect that ADHD symptoms last from childhood into adulthood, why would they not occur in some elderly persons?
Clearly we have to refocus our diagnostic lens for diagnosing ADHD for the elderly. What would be likely clinical problems?   Symptoms of inattention could include difficulty managing medications and physician appointments….. disorganized taking of medication or of other [...]
It’s only natural to worry about the impact of stimulants on the central nervous system, especially about whether or not they cause or worsen seizures.
Clinical trials have shown that there is no risk of seizures in patients taking stimulants, especially at therapeutic doses.    Studies that compare children with seizures versus those without them show no [...]
The Central Nervous system stimulants we use to treat ADHD (methylphenidate and amphetamine, in varied preparations) can impact the cardiovascular system.   ”Impact” means worrisome things: myocardial infarction (a “heart attack”), stroke, or serious arrythmias leading to sudden death.  Studies indicate that short-term and long-term cardiovascular effects of these medications vary,  and they are typically modest.Â
For example,
- heart rate increases 3 to 10 [...]
Distractability, lack of organization and focus, inability to complete projects: these can be symptoms of problems other than ADHD. For starters, they can be normal human behavior. They can be a response to being overwhelmed or tired. They can be part of a larger picture of another medical condition, such as hypothyroidism or diabetes mellitus. As [...]
Strattera (atomoxetine) is the only non-stimulant medication approved by the FDA for the treatment of ADHD in adults. When it works, Strattera can help significantly. But like other medications, it has side effects that impact patients.  Such side effects include nausea, dry mouth, dificulty starting the urinary stream, problems getting and maintaining an erection, and delay in reaching orgasm.Â
Sometimes [...]
In a recent study, adults with ADHD reported that they were angier on the road and drove more aggressively than adults without the disorder. Participants in the ADHD group were 56 adults (41 men, 15 women), whose median age was 32 years. Comparing themselves with a group of college students whose median age was 19, the ADHD [...]
