Stimulant BASICS: Ritalin and Adderall

Two BRAND names for medications
known for treating ADD/ADHD
GOOD news or bad?

© Madelyn Griffith-Haynie, CTP, CMC, ACT, MCC, SCAC
in the Diagnosis and Treatment Series – Part I

How much do you really KNOW?

When I first learned about ADD, as it was named when I was diagnosed at 38, years ago now, I was overjoyed to learn that there was a medication reputed to help.  Tearfully so.

Still, it took me over a year to give psychostimulants a trial – the first-line medications for ADD.

Meanwhile, I did my research, and continue to do so.

I am dismayed (often appalled!) by how much myth and misinformation I found and continue to find today — in the media, on the web, and even out of the mouths of doctors, sourcing so much needless fear and struggle.

SO, I have always been inspired to share what I learned
with as many people who are willing to listen
with an open mind.

Stimulant Basics

While I endeavor to share some important overview information in this particular article in the Diagnosis and Treatment Series, I’m going to hit the highlights, and save a great many of the specifics for another time and format.

Let’s begin here by going over the similarities between two medications you hear about most often: Ritalin and Adderall.

The Related Links at the very bottom of this article are there for those of you who want more specifics about the differences NOW.

On to those basics . . .

The psychostimulants you hear about most often (also called stimulants), are amphetamines (ex., Adderall & Dexedrine) and methylphenidates (ex., Ritalin, Concerta, Metadate & Methylin).

They are similar in chemical structure, and ALL can have different effects – including side-effects (true with any substance).

Psychostimulants are a broad class of drugs reported to reduce fatigue, promote alertness and wakefulness, with possible mood-enhancing properties (Orr 2007).

Don’t let that term scare you. Caffeine, nicotine and some of the non-drowsy allergy medications are also psychostimulants.

Since the early 1930s, doctors have prescribed either amphetamines or methylphenidate to treat various health-related conditions and disorders, among them obesity, depression & other mood disorders, impulse control disorders, asthma, chronic fatigue, and sleep disorders characterized by excessive sleep or excessive daytime sleepiness (hypersomnolence).

Addiction and Abuse

According to Wikipedia and despite what you frequently read: it is estimated that the percentage of the population that has abused amphetamines, cocaine and MDMA combined is between .8% and 2.1%.^[4]

A study published in the Journal Pediatrics*, showed that individuals with ADD/HD who were treated with stimulant medication had a lower risk of drug abuse than ADD/HD individuals who had not taken medication, and subsequent studies have returned similar findings.

* Biederman et al, Pharmacotherapy of Attention Deficit/Hyperactivity Disorder Reduces Risk for Substance Abuse Disorder, Pediatrics, Vol 104, No 2, Aug.’99.

How they are the same?

Both drugs are in the same medication class: psychostimulants, and it is said that they both work in two ways.  While not exactly accurate, this is basically how they work:

1. They make neurotransmitters last longer in the parts of the brain that control attention and alertness, and
2. They increase the concentration of neurotransmitters in areas of the brain believed to be under-aroused or otherwise under-performing.

In other words, stimulant medications increase the release or block the reabsorption of dopamine and norepinephrine, increasing transmission between certain neurons. Each stimulant has a slightly different mechanism of action, and each may have similar or different effects on the ADD/HD symptoms of any given individual.

For anyone new to the blog, neurotransmitters are chemical messengers that send signals from one neuron (brain cell) to another, increasing the activity in certain parts of the brain, in this case helping to focus attention.

WHY they might be necessary

Contrary to what might seem logical if you’ve ever spent much time around a diagnostic Hyperactive Harry or Chatty Cathy, an ADDer’s unmedicated brain is less active than a neurotypical brain in the conscious “supervisory” areas that FOCUS behavior — in particular, the prefrontal cortex [PFC]. 

That leads to an under-performance of the brain-based mechanisms that make it possible for human beings to observe the environment and supervise responses, guiding decision-making and directing subsequent action effectively.

Basically, in a person with an ADD diagnosis, the brain’s filtering & focusing areas are not operating well, so its “juggling ability” is limited by the number of “attentional balls” it is forced to juggle already.  These are elements filtered out automatically by neurotypical brains.

Regular readers of this blog may recall that the PFC has “regulation responsibility” for what we term the brain’s executive functions, which include planning, organization, and critical thinking as well as time management, effective judgment, and impulse control.

The “normal” human ability to sift through options, plan ahead, use time wisely, focus on goals, maintain social responsibility and communicate effectively is heavily dependent on a PFC that is up to the task.

Stimulants do just what they sound like they’d do, and seem to work particularly well on the area that most needs it: they stimulate sluggish neuro-perfomance, waking up the PFC so that it can do its job.

Connecting the Brakes

Found HERE

While ALL stimulants are activating for certain parts of the brain, they often seem to help calm a person with ADHD.

That is frequently referred to as the “paradoxical effect” — leading to erroneous claims that ADD meds are “sedating” kids into compliance.

NOT SO – that’s not how they work!

Whenever the PFC under performs, other areas of the brain, effectively, step up to compensate. You can see the difference on a brain scan.

So the filtering and focusing areas are, essentially, down for the count, and there’s suddenly more activity that needs filtering and focusing.

• See the problem when the PFC’s “offline”?

No filters, MORE to filter = BRAIN CHATTER, distractibility or hyperactivity, problems with short-term memory – swimming upstream!

• Once the PFC is stimulated to come back on line, the rest of the brain can relax (filters working better – less to filter). Suddenly, we can get things done – swimming WITH the current!

As soon as the PFC is stimulated into action, the rest of the brain can calm down – leading to a calmer individual.

A study reported in the Jan. 1999 issue of Science* suggested that methylphenidate also elevates levels of serotonin, which may account for some of its calming effects as well. Methylphenidate has never worked that way in my own brain, however, it makes me jittery.

* Gainetdov et al., Role of Serotonin in the Paradoxical Calming Effect of Psychostimulants on Hyperactivity, Science, Jan. 15, 1999: 397-410.

So WHICH medication is better?

Take Me Out to the BALLGAME!

Life gets GOOD

Once you understand
how to drive the very brain you were born with
— even if it’s taken a few hits in the meantime™

by Madelyn Griffith-Haynie, CTP, CMC, ACT, MCC, SCAC
Part of the Diagnosis & Treatment series

A lot of people have ADHD,
but they don’t want to talk about it.
But I am who I am,
and I don’t feel bad about it.
~ Major league baseball player Andrés Torres

©Phillip Martin, artist/educator

Late to the Party

I have to admit that, because I’ve never been the world’s biggest sports fan, I’m more than a bit late to this particular party.

Maybe some of you missed it too?

I just read a heartwarming human interest sports story about Andrés Torres, a ball-playing superstar who couldn’t get to first base until he accepted that he needed to get real about a treatment protocol for his AD”H”D.

As the New York Times article began:

“Discerning a fastball from a changeup is difficult enough; imagine doing it with untethered focus, attention meandering.

This was precisely the obstacle impeding Andrés Torres, who stumbled for a decade through baseball’s minor leagues, working for a break, always falling short.

Only when Torres accepted the extent to which he was debilitated by attention deficit hyperactivity disorder, finally embracing the medication and therapy prescribed five years earlier, did he begin to blossom as a ballplayer.”

And blossom he most certainly did!

In case you don’t follow baseball very closely either, after many disheartening years of limping along, barely functioning in an arena that was incredibly important to him — no matter how hard he worked — his story took a dramatic turn for the better.

In 2010 Torres helped the San Francisco Giants win the World Series —
before moving on to play center field and bat leadoff for the Mets.

If you aren’t already aware of his story, and especially if you are still struggling yourself or are the parent of a child who is struggling, click to read a few of the links in the Related Content section, always at the end of my articles.

Ring me in

As the founder of the ADD/EFD Coach Training field, co-founder of the ADD Coaching field, an ADD/EFD advocate, coach, trainer & speaker for over 25 years now [and the ADD Poster Girl herself], I can assure you that this article was RIGHT ON in terms of their point of view.

Unfortunately, the scientific point of view is under-reported, most likely because the complex nature of Executive Functioning disorders makes them difficult to recognize and harder still for anyone who isn’t highly ADD/EFD-literate to diagnose.

The Wisdom of Compensating for Deficits

Brain-Change vs. Compensation
TIME is of the Essence

© Madelyn Griffith-Haynie, CTP, CMC, ACT, MCC, SCAC
from the Self-Help Series – Part I

Arguing with YouTube

I have been watching a lot of brain-based TED Talks of late – talks from notables like the following:

• Daniel Amen on the importance of brain health
• Barbara Arrowsmith Young on overcoming brain-based problem through cognitive exercises
• Max Cynader on how plasticity can be improved

I added links to those videos above so you can click to watch them too.

Their Advice for Us

Each of them hopes to direct the focus of the world to healing the problem rather than working at the level of symptoms.

That makes A LOT of sense, right?
I LIKE these experts, and applaud their efforts.
I have known about the things they espouse for many years now,
and I think each is a great idea.

Found HERE

HOWEVER, something about each of their talks left me with a sense that something was off, or missing — or that, in the way they came up with their advised solutions, they devalued or overlooked a point of view that was important.

It took me a bit of noodling, but I finally figured out what was bugging me.

Three things:

1. The advice was presented in an either/or, better/worse, black and white fashion that, in some subtle manner, left me with an uneasy feeling. I was left with an impression that they each believed that their way of working was the best way for ALL individuals to proceed — and that we would be somehow foolish to approach finding a solution to compensate for our challenges instead of “fixing” the root cause.
2. They seemed oblivious to the reality that, for a great many of us, some of their solutions are absolutely out of reach financially (Do you have any idea how much it costs to get a brain scan for diagnostic purposes, for example?)
3. They left out the TIME factor altogether – and didn’t quite explain who was going to support us while we set about changing our brains by getting more sleep, changing our diets for optimal brain health and healing, or working through exercises that will improve short term memory (for example).

Few of us can afford to take a year or more OFF while we take advantage of the miracle of neuroplasticity to give our brains a fighting chance at “normalizing.”

Don’t Drink the Kool-ade

Choice vs. Fear-mongered Reaction

by Madelyn Griffith-Haynie, CTP, CMC, ACT, MCC, SCAC
Another Reflections post

©Phillip Martin, artist/educator

 

“Ritalin, like all medications,
can be useful when used properly
and dangerous when used improperly. 

Why is it so difficult for so many people
to hold to that middle ground?”
~ Dr. Edward Hallowell

As I wrote in a prior article, in response to one of the far too many opinion pieces made popular by the soundbite press:

• You don’t have to believe in medication.
• You don’t have to take it.
• You don’t have to give it to your kids.

You don’t EVEN have to do unbiased research before you ring in with an opinion on medication or anything else having to do with ADD/ADHD/EFD.

HOWEVER, when you’re writing a piece to be published in a widely-read paper of some stature, or a book that presents itself as containing credible expertise, it is simply unprofessional — of the writer, the editors, and the publications themselves — to publish personal OPINION in a manner that will lead many to conclude that the pieces quote the sum total of scientific fact. 

It is also incredibly harmful.

SHAME on the nasties who pirate Intellectual Property

Grumpy again today
– another [unfortunate] addition to the languishing Series
Monday Grumpy Monday –

© Madelyn Griffith-Haynie, CTP, CMC, ACT, MCC, SCAC

AGAIN – Discouraged, Weary and Worried

Our world seems to be rapidly going to hell in a handbag, as they say.

SOURCE: Clipart Panda

I just read an article put together by Daily (w)rite author Damyanti Biswas.

In it, she takes on the topic of “pirating” in a courageous and thought-provoking article: Are Readers Entitled to Read Books for Free?

Damyanti is one of the many writers who follow and support what I do here on ADDandSoMuchMore.com. It’s my turn to support back, even though this is sort-of “off-topic” when you consider the usual scope of my articles.

Calling out all pirates

It has come to my attention that the beyond nasty practice of “eBook pirating” (let’s call a spade a spade: STEALING) seems to be getting increasingly worse — to the point where more than a few of us are inspired to spend even more of the precious minutes of our lives to call out the perpetrators, adding to the hours we spend to make it possible for us to publish what we write for the benefit and enjoyment of all.

In addition to linking to a site that helps you find out if anyone is pirating your work, Damyanti cites and links to Sarah Madison‘s article taking on the eBook piracy topic as well, in an even more strongly worded fashion: Dear Broke Reader: Your Sense of Entitlement is Killing Me.

There is NO justification for stealing an author’s work. Ever!

As Megan Lembach reminds everyone in her comment on Sarah’s article:

The cost of an eBook is 1-2 cups of coffee at Starbucks and often books are much less than a cup of coffee at Starbucks.

Damyanti nicely handles the “too broke to buy” lame excuses within her article:

“There are various ways of reading books for free or for small change: libraries, Bookbub, Kindle Unlimited to name but a few”

Even if you don’t have time to actually read these posts, I would consider it a personal favor if every single one of you who has ever benefited from anything I post here for free would take a minute to click the links above, then click “like” or leave a quick comment to show support for the respect that article and book creation deserves.

Because, believe it or not, those scummy thieves seem to be receiving more support than the hard-working authors! Internet Trolls have banded together to actually defend the practice, attacking the authors in a number of truly nasty ways.

How to Get your Doctor to Prescribe you Adderall

Promoting Student Amphetimine Abuse
while marketing non-pharms
When profit seems ALL that matters,
then BOYCOTT is our most effective response

© Madelyn Griffith-Haynie, CTP, CMC, ACT, MCC, SCAC
in the Diagnosis and Treatment
and What Kind of World do YOU Want? Series

Almost impossible to believe!

Irresponsible articles like the one written by supposed student Stephen McLaughlin – with a title the same as this article’s title [How to get your doctor to prescribe you Adderall] – encourages student amphetimine abuse, despite the Limitless Cognition LLC site’s supposed “disclaimer” posted just under the articles sub-title:

“Adderall can be nearly impossible to get, but we have the strongest nootropics available right here in our online store, such as Adrafinil, the pro-drug to prescription Modafinil** (lasts for 12 hours) and has effects similar to Adderall…just…legal;)”

**Modafinil is a medication prescribed for narcolepsy and shift work sleep disorder – sometimes used off-label for ADD/AD(h)D

What’s wrong with the article?

In addition to offering other students a detailed description of how he faked ADD/AD(h)D to secure an Adderall prescription, despite the presence of his “helicopter parent” mother, articles like McLaughlin’s also contribute to a significant problem that makes it difficult for those who need and deserve a valid diagnosis along with treatment medication to obtain them.

The article has been published on a dot com site named smartdrugsforcollege – capriciously supported by a company clearly intent upon using any method possible in their attempt to sell non-pharmaceutical alternatives that they claim are “just as good” – along with those that they claim add to or protect from the effects of pharmaceutical stimulants.

It is being passed along on Pinterest as well, pinned and repinned using a [non-site] graphic of a pill bottle with MAKE ME CONCENTRATE on the label, linked to the article.

Medication Fears

Grumpy again today
– another addition to the languishing Series
Monday Grumpy Monday –

© Madelyn Griffith-Haynie, CTP, CMC, ACT, MCC, SCAC

Discouraged, Weary and Worried

I started my day today on Pinterest, where I came across a pin with a picture of a little girl that brought back memories of myself as a child: sitting on the stairs after doing something “wrong,” head in hands, sad and worried – fearful of what my father’s reaction would be when he heard about it.

The words across the photo were, “Why Punishments Don’t Work for ADHD Kids (But What Works Better!).”

For readers who have not yet explored Pinterest, Pins are graphic snippets “pinned” to a virtual bulletin board, similar to cutting a picture out of a magazine and pinning it to an actual bulletin board.

The biggest difference – and what makes it useful – is that the graphic snippets are automatically linked to the source, which is frequently an article that turns out to be well worth reading.

————————————————————————————————–
I use “ADD” to include AD/HD etc. Check out What’s in a Name for why.
—————————————————————————————————

Source HERE

What an Excellent Idea for an Article!

Clicking this pin led me to a wonderful article on an extremely useful ADD/HD focused blog by The Distracted Mom.

I was smiling broadly as I read her description of a well-reasoned, learning-oriented approach to parenting her son through a melt-down – an approach that many of us who know ADD/EFD well agree is one of the best for ADD/EFD kids.

HUGE on attribution, I was especially pleased with her generous linking to other useful resources (for example, the Lives in Balance website of Dr. Ross Greene, author of The Explosive Child: A New Approach for Understanding and Parenting Easily Frustrated, Chronically Inflexible Children).

Having devoted over 25 years of my life to making a difference in this field, it is such a pleasure to read articles like hers, that allow me to believe that perhaps the world is finally changing its attitude toward what I like to call The Alphabet Disorders.

Only later, as I read through the MANY comments to her article, did my hopeful mood slowly to turn to dismay.

Medications vs. Non-Pharm Alternatives

Educated Opinions
Informing personal CHOICE

© Madelyn Griffith-Haynie, CTP, CMC, ACT, MCC, SCAC
from the Non-Pharm Alternatives Series

Expanding a Comment

The genesis for this article is my response to a comment left on an earlier article, my first on a recently new non-pharmaceutical alternative claiming wonderful improvements to the brain’s Executive Functioning: entitled  Neuroflexyn: BUYER BEWARE.

By the way, I’m still reserving judgment on the value of Neuroflexyn until I’ve been able to give it a solid one month trial, as promised. Life events interrupted my trial after two weeks, so I plan to begin anew before reporting my experience. Meanwhile, my jury’s still out.

Why expand a response to a comment on an earlier article?

Since my articles tend to be lengthy, I know that many of you seldom read the comments – especially since,  at times, some of my replies seem almost as long as the original posts.

I believe that the particular point I was making subtly in one particular response to a comment cannot be stressed too often, so I have decided to expand it into a blog post of its own, quite a bit more overtly.

Demonizing is Dumb

Source: finedictionary.com

As I continue to affirm, I believe it is a big mistake to demonize pharmaceutical approaches OR non-pharmaceutical alternatives simply because they didn’t work for us personally.

People are different and brains are different – and each of us has the right and responsibility to decide for ourselves what we will or will not ingest.

Doctor answers ADD/ADHD Medication Questions – LIVE

Remember – links on this site are dark grey to reduce distraction potential
while you’re reading. They turn red on mouseover.

Find out how much better you COULD be doing — directly from Dr. Charles Parker

 by Madelyn Griffith-Haynie, CTP, CMC, ACT, MCC, SCAC
An article in the ADD Advocacy Series

THIS is your shot – free of charge

As I said on an earlier post, Dr. Charles Parker, fellow ADD advocate, is one of the physician crusaders for specificity – of diagnosis and of treatment approaches – and he will be at your service on March 14th, 2013, no matter where you are in the world, at no charge whatsoever.

Neuroscientist, adult and child psychiatrist, Dr Parker is the originator of CorePsych, and the creator of an amazing amount of high-value web content in various formats on the CorePsych Blog.

He is also the author of two books containing information you are unlikely to be aware of or to fully understand unless you got it directly from his books, his blog, or the man himself.

I know I wasn’t, and I didn’t — and regular readers of this blog will attest that I personally know and understand A GREAT DEAL about ADD and the brain-body connection.

*NEW* ADD/ADHD Medication Rules: 5 Resources

Remember – links on this site are dark grey to reduce distraction potential
while you’re reading. They turn red on mouseover.

Free downloads – gifts from Dr. Charles Parker

 by Madelyn Griffith-Haynie, CTP, CMC, ACT, MCC, SCAC
An article in the ADD Advocacy Series

If you haven’t been over to Dr. Charles Parker’s “new and improved” CorePsych Blog yet – for a wealth of information you won’t find anywhere else – maybe a “bribe” or five might move it to the top of your list.

“There ain’t no IS about ADD” ~ mgh

Fellow ADD advocate (originator of a TON of web content and author of two “Rules” books now), Dr. Parker is one of the physician crusaders for specificity – of diagnosis and of treatment approaches.

He insists that we need to take a detailed look at a whole lot more than
many of his collegues realize, and that the look must be individual specific.

The checklist below is from his download link page — another of my “reblog” work-arounds: a few points to consider as you think about why YOU might be interested in what he has to say.

Full Disclosure: he doesn’t even know I’m doing this, so he certainly isn’t paying me to do it!

ADD Meds Info for Moms – Part I

 Remember – links on this site are dark grey to reduce distraction potential
while you’re reading. They turn red on mouseover.

Titration Trials!
(Medication for YOUR child)

ADD Med’s Info for Moms Series: Part I
by Madelyn Griffith-Haynie, CTP, CMC, MCC, SCAC

The intent of this series is to provide Moms with information and context — to help you evaluate the risks and the benefits of medication for your children.

I want you to have access to the facts and figures and theories and underlying rationale to be able to come to a decision, rather than jumping one way or another in reaction to the fear-mongering, sound-biting and personal opinion pretending to be information for a while now.

BACKGROUND: (article starts below) The genesis of the information in this series was actually a reply to a thread on the ADDitude Magazine Website.

I’m reposting it here because their site stripped the paragraph formatting at post time, making it WAY too difficult to read.

Since I’m adding it here anyway, I expanded its focus, added new content, and “edited a bit” so that it would make sense to those of you who don’t ever click the link to ADDitude Magazine for context (there’s tons of OTHER great stuff over there for those of you who do).

This series is my response to a number of medication concerns and comments posted in a section supporting Moms of ADD kids. There were various medication concerns, each detailing symptoms and side-effects in their children, hoping to get some advice from the other Mom’s with ADD kids.

Read *ALL* ADD info with your Brain Engaged

Even though I am The ADD Poster Girl, known globally for my ADD expertise  —  working with ADD for a twenty-five years, and even though I:

• Know, literally, hundreds and hundreds of ADDers, and 
• Co-founded the ADD Coaching field, and
• Developed and delivered the world’s first ADD-specific coach training curriculum, and
• Have helped hundreds of ADDers turn their lives around

I am NOT a doctor or a scientist!! 

This article is NOT what is considered a “primary source.”
Neither is most of the ADD information you will run across on the internet, most of what you will find in books, or anything in the popular press.

That doesn’t mean the info you find there
is not valuable or accurate,
but it also doesn’t mean that it IS.  

Top Ten Questions about ADD meds

Considering ADD Medication?

©Madelyn Griffith-Haynie, CTP, CMC, A.C.T., MCC, SCAC
Updated legacy post -orig. 09/12/99

Ten Important Things to find out from your doctor or your pharmacist

First Things First: Doctors are only human — OVERWORKED humans.  They also have a lot of patient information to keep track of.

On top of that, it may take a change or three to titrate meds for each patient (find the right medication, the right dosage, the right timing, etc.).

So it’s always wise to double-check your prescription EVERY time.   Make sure the medication, dosage and timing are the same as last time, and point out anything that’s different before you leave the office.  

When you pick up your medication at your pharmacy, check it again.

So that means you’re gonna’ write down the information the FIRST time, right?
THEN you’re gonna’ transfer it to something you will keep in your wallet – or to your PDA or cellphone – something you always have with you, right?
(while you’re waiting for your very first prescription to be filled is an excellent time to do this, by the way!)

I use “ADD” or ADD/EFD, avoiding the “H” unless I am specifically referring to gross motor hyperactivity.  (Click HERE for why).

NOW, on to those Ten Things . . .