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The key word in the title of this page is “Adult.” If you’re looking for treatment options for your kid you should look somewhere else. Crazy Meds deals with conditions and treatments for adults. While almost all of the FDA-approved drugs are for both adults and children, the off-label treatments are not necessarily recommended for anyone under 18.
Attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD) are usually considered a childhood disorders. As such, many people think they go away by the time you reach 18. They don’t. ADD and ADHD are just diagnosed more often in children than they are in adults. Since parents and doctors are actively looking for them, ADD & ADHD are more often misdiagnosed in children. The same applies to adults, just for different reasons. In kids the hyperactive form is pretty obvious, in adults…not so much. Unless you had an ADHD diagnosis as a child, being diagnosed with ADHD as an adult is rare. It’s far too easy to confuse ADHD with bipolar disorder. Compare this screening test for ADHD with this screening test for bipolar mania. To confuse things even more, 10-35% of adults with bipolar disorder have a form of ADD/ADHD. I think those numbers are a bit low.
As with most brain cooties, ADD and ADHD have non-drug treatment options that can be tried before medication. In fact the PI sheets for all of the meds approved to treat ADD & ADHD, whether stimulant or non-stimulant, have the following wording (or something similar):
1.3 Need for Comprehensive Treatment Program
STRATTERA is indicated as an integral part of a total treatment program for ADHD that may include other measures (psychological, educational, social) for patients with this syndrome. Drug treatment may not be indicated for all patients with this syndrome. Drug treatment is not intended for use in the patient who exhibits symptoms secondary to environmental factors and/or other primary psychiatric disorders, including psychosis. Appropriate educational placement is essential in children and adolescents with this diagnosis and psychosocial intervention is often helpful. When remedial measures alone are insufficient, the decision to prescribe drug treatment medication will depend upon the physician’s assessment of the chronicity and severity of the patient’s symptoms. --Strattera PI sheet
Sort of how you’re supposed to eat less and better, and exercise more in order to lose weight; and if those aren’t enough then take medication as well. Even the sometimes-dangerous snake oil they sell on TV tells you to eat less and exercise more in order to make the stuff work.
So what is a “Comprehensive Treatment Program” for adults with ADD/ADHD? It’s a lot easier to define than do.
- Learn how to organize your life with various tools like:
- large wall or desktop calendars (helpful hint: it’s easier to prevent a wall calendar from being covered by other stuff)
- reminder notes
- having specific places for keys, mail and other paperwork, children and other pets, etc.
- a filing system for the above mentioned mail and paperwork
- Break down large tasks into smaller, often easier ones.
- Several small steps are easier to manage than one large one.
- Completing each part of the larger task gives you a sense of accomplishment.
- Write your lists in such a way that your smaller tasks are part of the larger ones. That way you get to cross off more things and feel even better about it.
- Just don’t fall into this trap.
- Psychotherapy, especially cognitive behavioral therapy, is an essential part of the ADD/ADHD treatment program.
- Even if you were diagnosed with ADD/ADHD as a kid, you (and other people) may still consider yourself a lazy good-for-nothing slob. While you can blame only so much on having ADD/ADHD, there’s no need to live down to the expectations you and/or other people have about you due to being clinically unable to get your act together.
- It really does need a therapist to get some people to think before acting or saying the first thing that pops into their head (AKA ready, fire, aim), or learn how to resist the urge to take unnecessary risks.
- In addition to seeing a therapist and going to a support group, there’s mutual life coaching. Kids have parents to make them do all of this stuff, adults with ADD/ADHD have each other.
Believe it or not, many of the usual suggestions the mentally interesting get from people who don’t have any brain cooties, but insist we shouldn’t be taking drugs as meds are always worse than whatever it is we have1, are actually helpful when it comes to ADD/ADHD.
- Eat better and exercise more. No wonder that wording about a comprehensive treatment program looked familiar.
- While mileage always varies on which diet is going to work best, when it comes to ADD/ADHD more protein and fewer carbs is the rule of thumb.
- You’ll also want to eat several smaller meals throughout the day instead of two or however many large ones.
- As for the exercise, while going to the gym is all well and good, walking in a park is better.
- When it comes to adults the rate of ADD/ADHD is much higher in urban than rural areas, but that could be due to cultural differences and/or access to shrinks. The data are mixed with kids, but lean toward not much difference between the two populations.
- Still: fresh air and exercise.
- Get plenty of sleep
FDA-approved drugs to treat ADD/ADHD in adults come in two categories, stimulants and non-stimulants. Most people prefer non-stimulants because stimulants sound scarier. Stimulants are far more likely to be abused than non-stimulants, so a history of drug abuse or addictive behavior certainly rules them out. Unless you have a history of cardiovascular problems or chronic insomnia, stimulants aren’t necessarily any more problematic than the non-stimulant medications.
FDA-Approved Non-Stimulant Drugs to Treat Adult ADD/ADHD
- Intuniv (guanfacine)
- Strattera (atomoxetine)
FDA-Approved Stimulants to Treat Adult ADD/ADHD
- Adderall (dextroamphetamine and amphetamine)2
- Cylert (pemoline)
- Desoxyn (methamphetamine)
- Dexedrine (dextroamphetamine sulfate)
- Ritalin (methylphenidate HCl) and its variants
- Concerta (extended-release methylphenidate HCl)
- Focalin-XR (dexmethylphenidate hydrochloride)
- Vyvanse (lisdexamfetamine dimesylate)
- Nuvigil (armodafinil)
- Provigil (modafinil)
- Wellbutrin (bupropion)
If you have any questions about ADD/ADHD and its treatment that weren’t answered here, check out our forum on adult ADD/ADHD.
2 Only the old immediate-release version of Adderall is approved to treat ADD/ADHD in adults.
Treatment Options for Adult Attention Deficit / Attention Deficit Hyperactivity Disorder by Jerod Poore is copyright © 2012
Author: Jerod Poore. Date created: 08 September 2012 Last edited: June 12, 2013, at 05:14 PM Last edited by: Jerod Poore on June 12, 2013, at 05:14 PM
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All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on the Crazy Meds Forum.
The information on Crazy Meds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else.
Know your sources!
Nobody on this site is a doctor, a therapist, or a pharmacist. We don’t portray them either here or on TV. Only doctors can diagnose and treat an illness. While it’s not as bad as it used to be, some doctors still get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don’t be a cyberchondriac, thinking you have every disease you see a website about, or that you’ll get every side effect from every medication1. Self-prescribing is as dangerous as buying meds from fraudulent online pharmacies that promise you medications without prescriptions.
All information on this site has been obtained through our personal experience and the experiences family, friends, what people have reported on various reputable sites all over teh intergoogles, the medications’ product information / summary of product characteristic (PI/SPC) sheets, and from sources that are referenced throughout the site. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or patient information leaflet (PIL) that comes with your medications and never ever throw them away.
Crazy Meds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
All brand names of the drugs listed in this site are the trademarks of the companies named on the PI/SPC sheet associated with the medication, sometimes on the pages about the drugs, even though those companies may have been acquired by other companies who may or may not be listed in this site by the time you read this. Or the rights to the drug were sold to another company. And any or all of the companies involved may have changed their names.
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1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.
2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.
3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?
[begin rant] I rent a dedicated server for Crazy Meds. It’s sitting on a rack somewhere in Southern California along with a bunch of other servers that other people have rented. The hardware is identical, but no two machines have exactly the same operating systems. I don’t even need to see what is on any of the others to know this. If somebody got their server at the exact same time, with the exact same features as I did, I’m confident that there would be noticeable differences in some aspects of the operating systems. So what does this mean? For one thing it means that no two computers in the same office of a single company have the same operating system, and the techs can spend hours figuring out what the fuck the problem could be based on that alone. It also means that application software like IP board that runs the forum here has to have so many fucking user-configurable bells and whistles that even when I read the manual I can’t find every setting, or every location that every flag needs to be set in order for a feature to run the way I want it to run. And in the real world it means you can get an MBA not only with an emphasis on resource planning, but with an emphasis on using SAP - a piece of software so complex there are now college programs on how to use it. You might think, “But don’t people learn how to use Photoshop or Adobe Illustrator in college?” Sure, in order to create stuff. And in a way you’re creating stuff with SAP. But do you get a Bachelor of Fine Arts degree with an emphasis on Photoshop?
Back in the Big Iron Age the operating systems were proprietary, and every computer that took up an entire room with a raised floor and HVAC system, and had less storage and processing power than an iPhone, had the same operating system as every other one, give or take a release level. But when a company bought application software like SAP, they also got the source code, which was usually documented and written in a way to make it easy to modify the hell out of it. Why? Because accounting principles may be the same the world over, and tax laws the same across each country and state, but no two companies have the same format for their reports, invoices, purchase orders and so forth. Standards existed and were universally ignored. If something went wrong it went wrong the same way for everyone, and was easy to track down. People didn’t need to take a college course to learn how to use a piece of software.
I’m not against the open source concept entirely. Back then all the programmers read the same magazines, so we all had the same homebrew utilities. We even had a forerunner of QR Code to scan the longer source code. Software vendors and computer manufacturers sponsored conventions so we could, among other things, swap recipes for such add-ons and utilities. While those things would make our lives easier, they had nothing to do with critical functions of the operating system. Unless badly implemented they would rarely cause key application software to crash and burn. Whereas today, with open source everything, who the hell knows what could be responsible some part of a system failing. [/end rant]
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