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Attention Deficit Hyperactivity Disorder

ADHD in an adult

05/06/2008

Question:

This is going to be a strange question, but let me ask it anyway..I have had ADHD (previously called "minimal brain damage") since I was a young kid, with all of the usual symptoms..unable to complete anything, impulsive behavior, memory impairment etc...........anyway, in high school, my symptoms became so bad that I moved out (my family had enough) and I drifted along until I was referred to a "child psychiatrist" (yeah, I was 17) and she convinced me to take ritalin....to make a long story shot, I then went from being a disorganized idiot to a college grad and the next 20 years were really good. The MHMR doc that I was seeing has died; I tried to see other docs, but as soon as I mention ritalin, they all freak out...........I have been off it for 2 years and now I`m back to baseline, which is back to being a disorganized idiot.. Is even such a mild stimulant medication so horrible???? And now I`m getting very depressed over my life`s downward spiral; is there anyplace that I can go for treatment??? If not, it`s o.k. thanks

Answer:

It's unfortunate that there are still doctors who refuse to prescribe stimulants for an FDA-approved indication despite the abundant literature supporting their effectiveness at all ages. Possibly one of the doctors would be willing to prescribe atomoxetine, a nonstimulant medication for ADHD, which also has FDA approval and documented evidence of effect in adults. Numerous other drugs also have good solid evidence of efficacy in ADHD, albeit off-label (i.e., without FDA-approved indication). Most of those do not have the same emotional and political bad press as stimulants, and your doctor would probably be willing to consider one of them. They include tricyclic antidepressants, MAO inhibitors, bupropion, modafinil, and guanfacine. More details can be found in my handbook "A Family's guide to ADHD" (Handbooks in Health Care, Newtown, PA, 2004, www.HHCbooks.com ), which also talks about the relative value of different treatments at different ages.

You might want to search the internet for the drug names above by adults by ADHD and find a few references to take the next doctor visit.

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Response by:

L Eugene Arnold, MD, MEd L Eugene Arnold, MD, MEd
Professor Emeritus of Psychiatry
College of Medicine
The Ohio State University