A Visual Guide to Stimulants in ADHD: Mechanisms of Action Explained | DexAMPH | MPH

A Visual Guide to Stimulants in ADHD: Mechanisms of Action Explained | DexAMPH | MPH | Bupropion

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Psychiatry Simplified - Dr Sanil Rege

Күн бұрын

Пікірлер: 60

@alexschrijnemaekers8067 5 ай бұрын

Great video as always. ADHD is a tricky disorder to treat, causing a great ammount of suffering for my patients and I am always on the lookout for good content to improve my practice and, therefore, their outcomes

@PsychiatrySimplified 5 ай бұрын

Thanks for the feedback. We do have a comprehensive course for clinicians if it is of help - ( apologies if you already know) in teaching I say - doing ADHD well is doing psychiatry well - it is highly comorbid - www.academy.psychscene.com/courses/clinical-excellence-in-adult-adhd/

@skierprincessakify 4 ай бұрын

@@PsychiatrySimplified Wow this sounds like the kind of course I need to help my patients.

@Watchmemanifest24 Ай бұрын

Finally something NOT dumbed down 🔥

@V8-friendly 5 ай бұрын

Even a little caffeine ☕️ stimulates me like crazy, having GAD and PTSD. 🤯

@anuullannur 6 күн бұрын

Excellent explanation. It is a concise but point to point explanation of the stimulat medications that you have covered, it would be more interesting if you have included the usage ofclonidine, guanfacine like medications to augment the noise in this context(of course you have done ഇതിന്‌ an another video!) The explanation of armodafinil is especially useful. Majority of the experts won't explore this medication. By the way there is an current shortage in the availability of concerta 36 and 56 worlwide, am I right ? Yes I think the best option as the first choice would be methylphenidate in the starting of the treatment of ADHD. It I s the optimal solution fro both perspectives I.e. theraputic and ഏ perspectives.

@adnanmohiuddin1192 2 ай бұрын

Watching this video on Methylphenidate

@Connor-iu3st 5 ай бұрын

Phenomenal explanation! 👏🏼 So good to hear sometime else acknowledge that Dex-Amphetamine unquestionably affects Sert not just Dat/Nat. There are meloncoly depression benefits from Dex-Amphetamine. The Stigma associated with these medications from providers, pharmacists and the DEA in the US is really a issue. I know personally I'm treated like a criminal and looked at as a problem with my Adderall prescription. DEA has terrified providers into avoiding even writing valid legit prescriptions and therefore not providing proper treatment. let me ask you as someone who has been taking Adderall for 20+ years and so far the only solution has been to slightly increase the dosage to provide the ben Treatment needed . What supplements, strategies etc would you recommend to slow the increased tolerance with these medication’s? Thank you

@kavitadeva 4 ай бұрын

@@Connor-iu3st this was a great comment because I'm in the position you are in I take a opioid and a benzodiazepine because I have a very severe case of full body severe restless leg syndrome. If I did not have these medications I would be dead I have been taking them for 20 years and I have not up the dose but still I am looked at like you have said as if I'm some drug addict and a criminal it's disgusting how people that actually need certain medications can't get them or get them and it's a big big hassle of red tape also I'm on Adderall I take 30 mg in the morning and 30 mg in the afternoon why because I have narcolepsy and severe depression that it helps the depression the most. The only thing I cannot get help with no matter how many years I've done all kinds of trauma work is my complex PTSD so I wanted to say thank you for your comment because boy did you speak the truth

@saintessa 2 ай бұрын

My mum has RLS too and pain at night but Drs seem so reluctant to prescribe opioids and she has to take paracetamol every day 😢@@kavitadeva

@Write_Charlie Ай бұрын

There was a Canadian study, I think, that said people diagnosed with dyscalculia should avoid methylphenidate. I jotted down that it reduces the efficacy from 75% to 39%, but I didn't record where I read about the study. Do you know anything about this?

@PsychiatrySimplified Ай бұрын

There seems to be no pharmacological or biological reason for this.

@snperchannel3242 5 ай бұрын

Could you talk about Wellbutrin and its effect for ADHD

@PsychiatrySimplified 5 ай бұрын

@@snperchannel3242 Wellbutrin is the same as Bupropion - I’ve covered it towards the latter part of the video . It is an NDRI with nicotinic antagonism

@Staceyoz 4 ай бұрын

Awesome video do you have a video on these medications and ones used in Parkinson’s eg pramiprexole, levodopa etc also naltrexone. How they work and what receptors Thank you

@Staceyoz 4 ай бұрын

Also what receptors does caffeine effect? I tried No Doz once and it was one of the worst experiences of my life.

@PsychiatrySimplified 4 ай бұрын

Sure I'll keep these on the list

@Staceyoz 4 ай бұрын

@@PsychiatrySimplified thank you 🙏

@rocketlegs6933 23 күн бұрын

I have a question, doesn't SERT blockade help with anxiety/depression, so would long term use help with these symptoms or are you more concerned with the short term spike? (I might be misunderstanding this bit)

@PsychiatrySimplified 23 күн бұрын

SERT blockade by increasing synaptic levels of serotonin is postulated to have antianxiety effects via action through 5HT2A receptors. The initial action is anxiety increase until down regulation occurs. This is the current understanding . Depression -SSRIs are less likely to treat constructs in depression besides reducing anxiety that occurs at the lower severity of depression. With amphetamine and SERT action this is not significant and hence is overshadowed by the NA and DA potentiation.

@rocketlegs6933 23 күн бұрын

@@PsychiatrySimplified Thanks for the detailed explanation :)

@3manifold 4 ай бұрын

Sir so recently there is journal saying withdrawal antidepressant is rarely severe so how do you quit the antidepressant when to those experiencing severe withdrawal

@PsychiatrySimplified 4 ай бұрын

@@3manifold I’ll be releasing a video about 45 mins long soon on antidepressant withdrawal.

@9me9a92 4 ай бұрын

Hello. Not sure what really is wrong w me. I take buproprion, citalopram and depakene. Been diagnosed w bpd. Not sure if ever BP as well. There was this era o took methadone as well. And I was very functional. I'm a bloody addict and nothing but my natural state. But I know more on opioid side. Sedatives and weed. I need like severe help. I'm now stabilised not much mood swings or emotional overwhelm. But then again no motivation at alllll. Just want to die. Any kind suggestions?

@PsychiatrySimplified 4 ай бұрын

So sorry to hear. Please seek medical advice from a professional as an assessment is needed to develop a treatment plan

@kavitadeva 5 ай бұрын

I have taken Adderall 30mgs in am and 30 mgs in afternoon. I have treatment resistant severe reoccurring chronic depression and COMPLEX PTSD. Those are two very difficult I would call them mental challenges to live with very difficult is my complex PTSD because it's so difficult to regulate my emotions and I get overwhelmed so easily and I just lose it. On the physical side I have ME/CFS SEVERE and full body Severe RLS. AND Narcolepsy. I had to really advocate for myself and look into things much deeper than any of the doctors I have seen have done for me now the one thing that has helped me more than anything as far as being able to function and get enough inertia to get some things done and it has actually changed my life is Adderall. It has also been the best thing for my depression which is very bad. I don't understand why doctors look at me as a if I'm some horrible drug addict and I'm taking it to get high. I don't like getting buzzed on Adderall what I like is being able to get out of the bed and get some things done and in that sense it has been miraculous for me I've been on it since 2003. And what's interesting is I have never upped the dose in fact it's at its lowest dose now going up did not help anything I just know that thank God I'm not an addict so more is not better for me and when I went to hire doses it didn't make a good difference and made a bad I do not have ADHD so that is not why I take Adderall I do want to say for the movement disorder that I have the full body RLS severe I do take methadone Klonopin and Flexeril before I met a neurologist that really understood full body RLS I was ready to take my life. Once he put me on these three medications it went away that first night as long as I take it I don't get the horrific sensations and micro arousals of the brain all night long. The problem is even though this combination of methadone and Klonopin with Flexeril has enabled me to sleep and not have a horrendous movement disorder doctors act like 15 mg of methadone is no way what they are going to prescribe anymore It actually scares me horrifically when I'm leaving a doctor and I don't know if I'll find a doctor who will give me back the medication that has saved my life I have been on that medication since 2004. I have a doctor now who doesn't want to see me anymore because he's afraid of giving out opiates with benzos and I don't think he realizes how dangerous that could be to just literally by September the 6th he will take it away cold turkey after 20 years of taking the medicines for my movement disorder. I got some resources from the RLS foundation of America and they helped me by giving me doctors that treat with the medications I just spoke of because that is the best course of treatment for severe RLS. For God's sake it's even in Wikipedia so it can't be that controversial I don't know what it is a I just really do not like doctors at all I have two doctors right now that literally lied to me say they've done things they haven't done and these are very important things and I just stayed with them because they were giving me the medicine but actually it's serious malpractice what they've been doing so I'm choosing to leave and just pray that I will find a doctor who will give me the medicine I've been on for 20 years without making me feel like I'm an addicted 66-year-old woman looking to get high on stimulants. Thank you very much for this video so informative and thank you for being a different type of a doctor I have lost all faith in our medical system.

@PsychiatrySimplified 5 ай бұрын

Thank you for sharing! I can imagine it must be scary to feel like what has kept you well may be looked at as negatively. Pharmacology is an art and each individual is diffident. Ultimately it comes down to safe prescribing which is about the specific medications + the individual response + dose + individual factors. Wish you well.

@skierprincessakify 4 ай бұрын

I’m sure it depends on where you live but in the state I practice in, pharmacies will not fill a benzo, narcotic and stimulant for the same patient. It’s quite risky to be on all 3.

@skierprincessakify 4 ай бұрын

I do agree that you should not be stopped cold turkey, that is very unsafe and even though I have refused to prescribe patients all 3 at one time, I have always been ethical and empathetic about weaning them off carefully. I understand that some people seem to be fine taking all 3 types of medications, but as I said in the other comment here, no pharmacist in the state I’m in will fill all 3 types of meds. I’m sorry you are going through this. I recently developed RLS in one leg from a terribly traumatic fracture in my leg and it keeps me up all night sometimes, it’s awful.

@kavitadeva 4 ай бұрын

@@skierprincessakify thank God I am able to get the medications I need. I don't take medication to get high ever. I've been on the same doses of methadone and Klonopin for my movement disorder which is living in hell if I didn't have it the medicine that is so I've been taking that for over 20 years and I've never had a problem whatsoever. I understand all the reasons and the hype about it all however if I wasn't getting these medicines I wouldn't be able to live with the movement disorder I have. So I don't get it it's never been a problem yet I hear about how dangerous it is all the time

@richwoodcutterbro8581 5 ай бұрын

What are the implications of nicotine receptor antagonism (aside from smoking cessation? Does this antagonism precipitate any effects on mood?

@EBHoyt 5 ай бұрын

I take Dexmethylphenidate and I noticed that it was not mentioned in the list of stimulants

@PsychiatrySimplified 5 ай бұрын

Broad aspects are covered in this video - so Dex methylphenidate is the D isomer - the MOA will be the same - whats different is that it is formulated for a longer duration and more specific binding of the D-enantiomer to a dopamine transporter in the basal ganglia, whereas the L-enantiomer had widespread, nonspecific binding.

@Staceyoz 4 ай бұрын

Is dexamfetamine (what called in Australia) the same as adderal thanks

@AndrogenReceptor01 5 ай бұрын

How would someone manage sleep with vyvanse? I cannot sleep at all. What may I speak to my psychiatrist about? Vyvanse is great for my focus and memory

@PsychiatrySimplified 5 ай бұрын

How long for ? Have a listen to the videos on insomnia, and the ADHD playlist. Insomnia is a very important part to manage as the medications can ‘lose’ efficacy over the long term. Other issues are also a risk. Please discuss this with the psychiatrist as they will consider implementing a plan to manage this. Options include 1. Ruling out sleep disorders 2. Dose reduction or optimisation 3. Switch - depending on issue 4. Augmentation - e.g clonidine or other agents The above are options but this has to be individualised . Ps not medical advice

@skierprincessakify 4 ай бұрын

@@PsychiatrySimplified I use clonidine a lot for patients with ADHD and sleep issues.

@frankcarrijo 2 ай бұрын

@@skierprincessakify What are your thoughts on Guanficine? vs Clonidine? just wondering

@saintessa 2 ай бұрын

@@skierprincessakifyI'm on catapres/clonidine for sleep too but found I had to increase my dose if my vyvanse dose was higher. It usually works, but sometimes I take a sleeping vitamin with my catapres or magnesium.

@Medsyria1 4 ай бұрын

Dr can propranolol cause depression or lower mood ?

@PsychiatrySimplified 4 ай бұрын

There is an association yes. “Propranolol was found to cause depression as a side effect with a statistically greater frequency than the control medications used in these trials. As other side effects of propranolol include fatigue, diminished energy, decreased libido, anorexia and poor concentration, it is suggested that propranolol is a cause of organic mood disorder, depressed type.”

@dratatianacostella7985 4 ай бұрын

Hello how can I schedule an on-line appointment?

@PsychiatrySimplified 2 ай бұрын

Sorry I haven’t replied . I missed the comment. Due to medicolegal reasons I don’t do Tele health or international appointments

@dratatianacostella7985 4 ай бұрын

I was very compensaded from my Adhd until I had an extrusal hérnia and had severe drug drug interactions with a lot of extrapiramidal syntoms probably by quetiapine and gabapentin , and now I can start Ritalin again because I get worse of the EP syntoms when the dose drop, should t it be the opposite? Thinking about a dopaminergic hipersensivity? Unless it is actually a Tardive discinesia and ritalin don t make a steady level, can it be that every time the dose drop I make syntoms of withdrawl? Real need an appointment with you, do you make online appointments? I am from Brazil and nobody is being able to help me here

@3manifold 4 ай бұрын

Sir my psychiatrist prescribed me a stelazine for social anxiety disorder my question is why? Should i switch psychiatrist? My symptom is im always feeling like judged, im afraid to date someone, whenever i encounter a pretty girl i would avoid it at all cost, i keep thinking about embarassing moment of mine and inhibiting to that feeling, , i do not hear any voice or see somethingno psychosis whatsoever. My diagnosis is paranoid schizophrenia

@PsychiatrySimplified 4 ай бұрын

Its a difficult question to answer as your psychiatrist should be the one to answer this for you. Stelazine is prescribed for psychotic symptoms but the psychiatrist may prescribe it if they deem the social anxiety to be mediated by the paranoid symptoms. But this is a discussion to have with the psychiatrist as any medication is prescribed through informed shared decision making between doctor and patient .

@3manifold 4 ай бұрын

@@PsychiatrySimplified im afraid that he misdiagnosed me, im sure its social anxiety not paranoid schizophrenia.

@3manifold 4 ай бұрын

@@PsychiatrySimplified he doesnt want to have any chat with me, it looks like talking avout that is a waste of time for him, everytime i go to him he always want to be hurry up, like he was off the bus

@3manifold 4 ай бұрын

@@PsychiatrySimplified if i complain he just take it as my schizophrenia symptom emerge, he takes it as an aggression

@CatalinaFOIA Ай бұрын

@3manifold I would definitely get a 2nd opinion from a medical professional. You may have social anxiety disorder resulting in panic attacks. A low dose benzo would be more beneficial if you have panic attacks due to severe social anxiety. You'd want a fast acting medication to take as needed/as prescribed. In the meantime I'd continue to follow your doctors orders pertaining to taking your medicine. Good luck to you. Anxiety can be very debilitating 😢

@ukachuchris499 4 ай бұрын

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