{"id":3541,"date":"2010-04-27T06:09:20","date_gmt":"2010-04-27T11:09:20","guid":{"rendered":"http:\/\/wholehealthchicago.com\/?p=3541"},"modified":"2021-09-13T11:56:36","modified_gmt":"2021-09-13T16:56:36","slug":"women-add-and-the-drugs-that-help","status":"publish","type":"post","link":"https:\/\/wholehealthchicago.com\/blog\/2010\/04\/27\/women-add-and-the-drugs-that-help","title":{"rendered":"Women, ADD, and the Drugs That Help"},"content":{"rendered":"\n

In my last couple health tips we\u2019ve been discussing Claire, a woman in her thirties with attention deficit disorder (ADD). Last week<\/strong><\/em><\/a> we reviewed Claire\u2019s non-medication approach. This week, I\u2019ll go over the conventional medications used for this very common condition.<\/p>\n\n\n\n

Let me start by saying that untreated ADD in children can prevent very bright kids from living up to their potential. With ADD meds, there\u2019s no \u201clifetime commitment\u201d or even the need to take a pill every day. Children with ADD often skip their meds over summer vacation or on weekends if there\u2019s no homework. Many adults with mild ADD use the meds on an as-needed basis.<\/p>\n\n\n\n

By far the largest group of medications for ADD are the stimulants,<\/strong> literally \u201cwaking up\u201d the inefficient ADD brain by boosting levels of the neurotransmitter dopamine. The two stimulants are the amphetamines (Adderall, Vyvanse) and methylphenidates (Ritalin, Concerta) and they\u2019re all available in extended-release form, lasting (not surprisingly) a little longer than a school day.<\/p>\n\n\n\n

Keep in mind that the average age of the people taking any of these meds is about 11.<\/p>\n\n\n\n

All the stimulants, taken in the morning, begin to work within an hour and start fading in the late afternoon. People with more severe ADD often take a second dose mid-afternoon to last them until about 9 PM. The main side effects are jitteriness (resolved by reducing the dose), insomnia (ditto), and appetite suppression (goes away in about two weeks). I generally start my ADD patients on Vyvanse because it has a very smooth effect, with a subtle onset of action and gentle decline in the afternoon.<\/p>\n\n\n\n

I reserve the single non-stimulant ADD medication<\/strong>, Strattera, for patients who report not feeling well on the stimulants, or those with a history of anxiety whose symptoms might worsen if stimulated.<\/p>\n\n\n\n

The best description of Strattera is \u201csubtle.\u201d There\u2019s no epiphany like that experienced by someone with ADD given one of the stimulant drugs for the first time. But there\u2019s such a difference between that effect and the non-stimulant effect of Straterra that when patients switch from the first to the second, they\u2019re often convinced it isn\u2019t working.<\/p>\n\n\n\n

Strattera requires patience.<\/p>\n\n\n\n

It works by slowly increasing the brain\u2019s level of norepinephrine, which, like dopamine, can enhance focus and concentration. It usually takes a month to appreciate Strattera\u2019s effect, but once in place its two main advantages are: no stimulant symptoms (some people just feel physically uncomfortable taking stimulants) and it works around the clock. You\u2019re just as focused at 8 AM as at 8 PM with one capsule a day. The main side effect, stomach upset, can be completely prevented by taking Strattera with food.<\/p>\n\n\n\n

The natural therapies Claire had been using were helping a little, she told me, but she was curious about how she\u2019d feel without any ADD symptoms at all. After some discussion, Claire chose Vyvanse. I also recommended two books: Scattered Minds<\/strong><\/em><\/a> for her and Is It You, Me, or ADD?<\/strong><\/em><\/a> for her husband. The second is an excellent book about living with someone who has ADD.<\/p>\n\n\n\n

Claire was back in a week to talk about what she\u2019d experienced. \u201cIt\u2019s amazing,\u201d she began. \u201cI now know what memory is. I can read lists and two hours later, recite the list. I actually read a whole book, cover to cover, and can tell you what it was about. It\u2019s like my mind was given eyeglasses.\u201d<\/p>\n\n\n\n

The big test, she said, would be the following month when she\u2019d be re-taking her real estate license exam, which she\u2019d failed twice in the past.<\/p>\n\n\n\n

Although she kept in touch by e-mail regarding some minor Vyvanse dose adjustments, it wasn\u2019t until one of her e-mails held photos of a condo she \u201cthought I might be interested in\u201d that I learned the ultimate results of her treatment.<\/p>\n","protected":false},"excerpt":{"rendered":"

In my last couple health tips we\u2019ve been discussing Claire, a woman in her thirties with attention deficit disorder (ADD). Last week we reviewed Claire\u2019s non-medication approach. 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