As the previous blog explained, there are chemical differences between the common ADHD medications. While chemically different, the medications do share a common set of potential negative side effects. In our experience the most common are: loss of appetite, decreased sleep, and increased irritability or mood changes. Less prevalent but still noted often enough to be considered as potential side effects are: headaches, dizziness, dry mouth, nausea, and tics. These can decrease across time. It is up to the informed consumer to weigh the degree of benefit against the degree of negative side effects relative to their individual situation. The ideal case is, of course, all benefit and no negative side effects, but in our experience most psychotropic medications cause some type and degree of unwanted side effect. There are, of course, common sense ways to try to decrease negative side effects. For example, if loss of appetite is noted, one can plan a good healthy meal for the time of day that the medication effect is wearing off. Also, one can see that healthy snacks are available for whenever the individual in question feels at all hungry.
While the psychostimulants share common potential negative side effects, different medications can have differing effects on any one individual. So, just because you cannot tolerate a methylphenidate does not mean that you would not tolerate an amphetamine salt. This, of course, has led to the “trial and error” method of prescribing a medication. Another note on side effects: What are listed are the “common” side effects. Everyone’s brain is different. Whenever you start taking any medication it is advisable to monitor yourself for any unexpected changes you might experience and to contact the prescribing physician if you notice anything that seems to correspond to when you began to take the medication.
A potential way to decrease the trial and error process is emerging. This is the qEEG (quantitative electroencephalogram), which is described elsewhere in this website. In brief, this is a way to measure the electrical activity in a person’s brain and compare their activity against a normative database. How this can be relevant to ADHD and ADHD medication is as follows. First, for simplicity sake, let us say that brain waves are composed of slow waves and fast waves. The most common form of ADHD in terms of brain waves involves an excessive amount of slow-wave activity in certain areas of the brain. As it turns out, psychostimulant medication is known to decrease slow-wave activity and increase fast-wave activity. This is great if you are dealing with a case of excess slow-wave activity and no other “abnormalities.” But, what if the person also happens to have excess fast-wave activity to begin with. You give them a psychostimulant and now they have even more fast-wave activity, which raises the probability of unwanted side effects emerging. A qEEG can help to guide the safe and effective prescribing of medication. This is an emerging science, so it certainly has its limitations, but it is something to consider based on your situation.
Any way you look at it, the ability to attend, or to focus, is extremely important. It is not only people with ADHD who can benefit from improving their attention. The better you focus, the better you will be able to do whatever it is you are going to do. This applies to work, school, sports, relationships, and everything else. There is a perfect, positive correlation between how well you perform and your ability to focus. A friend and colleague, Lawrence Edwards, Ph.D., has written: “Attention is an extremely valuable commodity. Without attention nothing flourishes. None of your relationships, your goals for a career, your hopes and dreams, nothing comes into being or is sustained or grows without attention” (Awakening Kundalini: The Path to Radical Freedom (2013) pp. 242). (more…)
Angelika and I, as Executive Director and Board President of the Northeast Regional Biofeedback Society (NRBS) respectively, were involved in the recent three-day conference on ADHD: Biomarkers, Biofeedback, and Interventions. Angelika was instrumental in the setting up and running of the conference, which was well attended and well received. The Conference had much to say about diagnosis, treatment, ethical questions, etc. (more…)
Many parents and others are somewhat bewildered by the seemingly endless array of so-called ADHD medications. While I am not a physician, our work with children and adults dealing with ADHD brings us into regular contact with these medications. Consequently, I feel I have sufficient general knowledge of these medications to offer the reader what I hope will be some clarification about the various types of ADHD medications.
Three Types of Medications for ADHD
There are basically three types of ADHD medications: amphetamine stimulants, methylphenidate stimulants, and non-stimulants. Both types of stimulants also have short-acting and long-acting varieties. The non-stimulant versions are long acting. All of the amphetamine stimulants (e.g., Dexedrine, Adderall, Vyvanse) are variations of the basic chemical compound phenythylamine. The methylphenidate stimulants are variations of the basic chemical compound piperidine. Both general chemical compounds act as stimulants to the nervous system. The amphetamines are seen as affecting chemicals in the body that ultimately have an effect on one’s ability to control one’s actions. The methylphenidates are seen as increasing levels of dopamine in the brain, which is theorized to have a causal relationship to ADHD symptoms. The non-stimulant medication Strattera is seen as working on other receptors in the brain than dopamine. Strattera is thought to increase the amount of norepinephrine which consequently increases one’s attention span. Intuniv and Kapvay are variations of medications that were initially used to control blood pressure but were found to have a side effect of improving attention and impulsivity in people prescribed the medication.
In summary, one way of categorizing the ADHD medications is into categories of stimulants that are meant to affect body chemicals and ones meant to affect brain chemicals. The same can also be said of the non-stimulant medications. Given that we now know that ADHD is not a single entity, but a constellation of symptoms that appears in people as various subtypes, the question arises as to if there is a way, other than trial and error, to find the medication most apt to help your ADHD symptoms while minimizing your negative side effects. A future blog entry will address side effects and the emerging science behind qEEG and ERP analysis that can help to give direction for ADHD treatment depending on the subtype.
There is possible confusion and misunderstanding regarding the terms ADHD (Attention Deficit Hyperactivity Disorder) and ADD (Attention Deficit Disorder). ADD is an old term that has been replaced in the official diagnostic language by ADHD. But ADHD can “officially” come in four forms: ADHD-combined type; ADHD-predominately inattentive type; ADHD-predominately hyperactive-impulsive type; and, ADHD Not Otherwise Specified. People in the field recognize that individuals with ADHD can also have difficulty with organization, difficulty completing tasks, problems with working memory, and problems with various, so-called executive functions. Further confusing the picture is that attention/concentration can be adversely affected by many things, such as anxiety, depression, sleep deprivation, etc. (more…)