ADHD Medications -- Part V Choosing Medications

[@heartandsoulyoga]

Helping my son navigate severe ADHD while being medication adverse and suffering black box response to anti-depressants, I find you singular in your clarity of understanding that ADHD is a neurological-genetic disability (not correlated with intelligence!) but of executive function and how debilitating this is for living in our world. Thank you for your dedication to offering us who suffer or whose families suffer with this often under recognized though over talked about (as in having an "ADHD" moment...) condition that so globally effects those who struggle with it. You offer by far the most clear and well organized presentions of how to understand, treat and support those of us with ADHD that I have come across. I am so sorry for the loss of your twin brother; he knows how much he is loved by you I am sure....

[@russellbarkleyphd2023]

Thank you for writing and for your sympathies regarding the loss of my fraternal twin brother, Ron, one contributor of which was his life long ADHD. That happened some 17 years ago. I hope the information we are disseminating on this channel can prevent that from happening to anyone else . Thanks for watching!

[@kimgreerpuchek1140]

Thanks so much for sharing your unbelievable work on this difficult topic. I’m recently diagnosed at 70 years of age. It’s a godsend that I’ve been diagnosed now. The difference was noticeable the first time I took medication. I’m having other problems with it now, but I’m hoping there is something else that can help me keep going forward.

[@tatianacordova5556]

Thanks Dr. Barkley! You have made a huge difference in my life. There are many doctors who believe they know about ADHD but they do not. You are highly appreciated and needed for many adults and children with ADHD.

[@russellbarkleyphd2023]

Thank you ever so much. Happy New Year! Russ

[@brynnekennedy4323]

Anecdotally, at least among folks who would be aged 21-30 now, I think part of the problem may have been misinformation even among professionals that ADHD can "go away". Not that it never does as you've discussed, but in many cases it doesn't. I was diagnosed young, but as I aged and naturally improved grades/behavior my parents were told that it no longer affected me, and this of course was passed along to me. I would have pursued medication/treatment much sooner had I not been told that I "grew out of it" assuming that doctors and school counselors knew better than me. Many thanks to clinicians like yourself for driving research and awareness in the 20 years since--I hope kids today will have better outcomes in the 20 years to follow!

[@lagomorphia9]

Are there any brain scan studies done on later diagnosed adults that may show similar changes, growth, arising with the use of stimulants...Thanks for sharing your work here.

[@lagomorphia9]

Nevermind... I didnt watch long enough.

[@russellbarkleyphd2023]

Yes, there were two studies with adults showing increased "neuroprotection: as it is called, or improvement in certain brain regional volumes. Most of the research was done with children. And, as I noted, only a minority of people seemed to show the improvement so we need lots more research on this issue.

[@bortstanson2034]

Thank you for this treasure trove of information. I wanted to ask does ADHD medication, such as vyvanse get dimished with the intake of certain foods. I have read some information that vitamin c can diminish the effects of the stimulant medication.

[@russellbarkleyphd2023]

No, not to my knowledge. I am glad my work has been of value to you. Thanks for viewing the lecture.

[@VegabondSam]

The biggest benefit of Guanfacine/Intuniv is increased norepinephrine in the frontal lobe. This is where its benefit as an adjunct to stimulants comes into play, however, it's milder than an NRI like Strattera; this is demonstrated when the sedative effect is fully built tolerance to. It typically occurs within 2 weeks to 1 month. This effect is more noticeable when using dopamine-acting stimulants, like methylphenidate.The second biggest benefit is enhanced pre-frontal cortex activity by heightened glutamatergic transmission This is a long-term benefit that strengthens over time, rewiring your frontal lobe the longer you take the medication. This benefit is seen more subtly and after a month or two, and directly targets executive function in a long-lasting way. This is associated with a heightened sense of identity, improved planning ability, working memory, sensibility, & operating at a "middle ground" instead of extremes. The drug has been a game-changer for me, but it takes a while to see an effect. A real shame that most of the studies were so short-term with this drug.

[@user-xv5gq7ne3e]

4th week in and all I want to do is nap! Did you find this got easier? I’m going up to 4mg this week and I’m worried I’ll be asleep all day and night 😂

[@dg389]

Muito obrigado Dr. Russel pelas valiosas informações ! Tenho 37 anos faço uso de medicação a 7 anos , parei meu tratamento com Venvanse de 70mg pelos três fatores citados, o primeiro efeito colateral (insônia e ansiedade), segundo alto (custo) do medicamento e terceiro achar que teria bons resultados tomando o medicamento apenas por (comodidade) de maior concentração para economizar. Comecei agora com Atomoxetina aqui no Brazil chamado de Atentah 40mg neste mês e depois vou aumentar para 80mg no próximo. Tenho déficit de atenção e já estou tendo bons resultados, resolveu minha ansiedade e insônia consideravelmente e o foco vai melhorando aos poucos, um pouco de irritabilidade mas nada igual aos estimulantes, mais sinto que está próximo. O que percebi sobre o uso da Atomoxetina é que ela limpou a quantidade de pensamentos diversos e em minoria depressivos que vinha tendo contribuindo com o sono e acabando com a quantidade de vezes que eu acordava para ir a banheiro a noite. Abraço Dr. !!

[@thinkingloud1988]

I wonder what do people like me should do, if we cant afford to seek professional help or buy medication?

[@Intothelight94]

Thanks for this info. Dr Barkley! My son was on a stimulant adhd medication for 7 years. It greatly improved his ability to succeed overall at school academically and behaviorally, although it wasn’t perfect. He’s close to graduating from high school now and unfortunately can’t handle the side effects of stimulants-we tried a 2 year break and tried to re-start at a low dose and now he gets extremely anxious (panic attacks) and is very irritable even on a lower dose than he used to take. It’s too bad about the stimulants because even he acknowledges they worked for him rather well before the side effects got unbearable. Haven’t really found a non stimulant that works well enough for the adhd…yet. Hoping to find something to help. He really struggles with his executive function. It’s all we can do to get through high school. I worry how he’s going to make it driving as well. (We delayed that privilege for now and he’s fine with that).

[@heartandsoulyoga]

I SO hear you. My son the same and is heading to college-- not driving yet as it is too dangerous and while he is not pleased with this, somewhere he understands. Send you and your family blessings.

[@russellbarkleyphd2023]

I do hope you can find a better medication for him.

[@tomsakurai3620]

I'm on dexedrine for ADHD and started getting anxiety after some time. Daily magnesium and B complex vitamin supplentation has allowed me to keep taking my medication.

[@jenjenkins]

Dr. Barkley, thank you for sharing your expertise. I would like to know your thoughts on combination therapy of atomoxetine and a low dose simulant.

[@russellbarkleyphd2023]

It works well for some people as each affects brain networks somewhat differently. While not standard therapy, for those with comorbid anxiety or emotional control problems the combination might be indicated. Speak with your physician about all this. Be well.

[@jenjenkins]

@@russellbarkleyphd2023 thank you. I will do just that.

[@matthewtraversmusic]

Dr Barkley - I'm a huge fan and have benefited tremendously from your work and your educational outreach. Thank you. I have a question about an observation that I have heard you and others make that 'stimulant medication is among the most effective medications in the treatment of any psychiatric disorder'. I hope you'll forgive my paraphrase and correct it if I'm mis-quoting or misunderstanding you. I'm struggling to find research that references this conclusion. It's a bit of data that I'm eager to share in my own discussions and I'd like to be able to reference primary sources in addition to pointing people to your talks. Can you help?

[@russellbarkleyphd2023]

See my recent video here on Why ADHD is among the most treatable disorders. The short answer is because stimulants produce larger effect size changes in symptoms for a higher percentage of people and with a higher rate of normalization and a wider benefit across domains of impairment than drugs for other disorders.

[@angeegriffinofficial7663]

You are absolutely correct with everything that you said about this medication. Today was my 1st time taking it and with in a few hours I felt the best I have ever felt and for the 1st time in my life I can concentrate my brain feels better. 🌤️Thank you for knowledge.

[@kenhaze5230]

D-meth isn't off-label. Protriptyline is also one with evidence of efficacy among the tricyclics.

[@camellia8625]

What is SCT symptoms?

[@sisqissanitorium1403]

Thank you for sharing these very informative videos. You mention that according to ethical standards no research can be done on children to see what the effect of children with versus children without medication would have on the growth or development of the brain. Would such a study be viable on adults taking into account that some adults don't or even have ever taken medication? I realise research might be easier on kids due to the neuroplasticity of the brain which is less in adults but I wonder if this could be a way forward into finding out if any of the medicine indeed improves the development of the brain?

[@russellbarkleyphd2023]

The evidence for the widespread benefits of the medications in reducing harm and risks is so substantial that placing someone on a placebo for months or years as a control group to compared to those with medication would be unethical due to putting them in harms way. No university research review board would allow it.

[@lynuslim6851]

Hi Dr Barkley, I really appreciate these videos and your work in general - they've really helped me understand myself and my condition better. I was just wondering what your stance was regarding the "appropriate" usage of ADHD medications. I have been on Ritalin for about one and a half years and my doctor tells me to "use it as needed". But I'm having trouble interpreting that - do I take it anytime I work on school assignments, or only when I'm rushing overdue work and *really* need that boost? Is it okay to take it when I'm working on my personal projects/during my "off days" too, or should meds be kept only for situations where I really need my functioning to be unimpaired? I know a lot of factors like cost and side effects probably come into play, but I was hoping to hear your general thoughts on this matter. Is the end goal of treatment to taper off ADHD meds entirely, or to live alongside them? Should I be worried about relying on meds to perform at the level I am now? Thank you very much.

[@russellbarkleyphd2023]

Unless your ADHD is adversely affecting just certain settings and tasks, most medical experts on these meds recommend daily use as ADHD can adversely impact not just work and school but driving, handling money, social relations, child rearing, and even binge or impulsive eating, etc, for many.

[@lynuslim6851]

@@russellbarkleyphd2023 Ahh that makes a lot of sense! Thank you so much for the reply!

[@kkadz]

Thank you. huge shot in the dark. i'm the 30 yo who realized he had a problem but i'm immune to adderall and the xr version at max dose. I may have missed this in the video but is this when someone would try another class of adhd medication? my psych wants to try antidepressants to help with motivation but that doesn't sound right. i don't have the money to keep doing random appointments. i've already had to take a break to save money because this is so expensive. everyone talks about stimulants working but i can't find anything online about what someone did when adderall didn't work. thank you. fingers crossed.

[@Drnonstop]

Sounds tough! Try mailing him! Good luck and hope you get well

[@kkadz]

@@Drnonstop thanks buddy!

[@Drnonstop]

@@kkadz how's the last 6 months been?

[@kkadz]

@@Drnonstop lol, i forgot. My bad. Nothing new. Tried Quelbree but it gave me insane insomnia.. like 30 mins of sleep a night for 2 weeks. Ritalin/focalin xr but give me headaches from clenching my teeth. Still have others to try. Eventually. Or I’m brain damaged. Who knows. Keep you posted. Getting meds is hard.

[@P.08]

I was put on Bupropion ( wellbutrin ) XL , to help my adhd also help me quit smoking and drinking heavily. It did help me a bit with my adhd ( am on minimum dose tho 150xl ), also helped me with quitting alcohol which had effect on my adhd indirectly. I have also been put on ritalin for the past 2 weeks ! Wellbutrin helped with my executive function more and ritalin with focus ! Btw am also 30 and started meds couple months ago

[@CynicAtheist]

What do you think of the clinical trials on LSD for ADHD being run by Mind Med?

[@benjaminmirt5029]

At easter I took a micro dose of lsd and a bit more of mescalin for the first time in my life. I am to get adhd meds soon. (Was diagnosed as child, never got meds until maybe soon now in my 30ies) the amazing thing was: I reacted almost completely opposite of my friends, while they faded 8:55 out and seemed very drugged I just became very calm clear and focused, the storm of input faded and i had more freedom of selecting and reacting. It felt as if I couldn’t see and someone handed me glasses. It was Amazing. If Guanfacine does a 1/4th of that it will be bliss.

[@Aliibrahim-yx4pl]

In my experience, all acid does is makes you more aware of your adhd, and makes you more motivated ( short term ) for a change. I think it can certainly provide short term relief, make you more aware of the problem, maybe long term help with anxiety, depression etc but thats it.

[@Aliibrahim-yx4pl]

It also puts you more in flow for the duration of the trip. If youre dancing for example, you could just get lost in the tune and lose alot of that adhd mind during that process, but it still there and will remain after it is over

[@benjaminmirt5029]

@@Aliibrahim-yx4pl First of all I didnt want to promote self medication! The clinically aaccepted ones shuld be used. I just wanted to add my experiences. Also the acid was a very low micro dose, what really worked differently for me was the mescalin. I just wanted to report because my experiences as adhd person where vastly different from the others but I also have a residual/light cptsd and it could also be that the drugs dampened my cptsd symptoms so they didnt add to the adhd. cheers.

[@ronnynolegs]

❤