Adhd Alternative Treatments Adults - Different Types Of Treatments

Adhd Alternative Treatments Adults

Neurofeedback is one of the more interesting experimental therapies for ADHD. This technique uses electronic machines to teach kids with ADHD to slow down or speed up their brain waves - electronic signals in the brain. In one study neurofeedback was used in kids who attended four 50-minute sessions (twice a week for two weeks). 

In this small study, Ritalin use dropped from 30 percent to 6 percent. The parents reported improvements in inattention, impulsivity, and concentration. More surprising was an average 12-point jump in the kids' IQs. Other studies have also shown positive effects. Controlled studies are now testing this technique.
 
Natural therapies have virtually no research to tell us if they are safe or effective. Nevertheless, they are increasingly being promoted for ADHD - via TV and radio infomercials and on the Internet. Just a few include products like Efalex Focus, Pedi-Active, Kid's Companion Attention/Memory Formula, and many, many others.
 
It's not uncommon to see manufacturers creating a wide variety of formulas based upon either animal research or extremely preliminary and limited human research. Then, they often will make big leaps to claim clinical effectiveness. Here are just a few examples that you might come across. Adhd Alternative Treatments Adults

Essential fatty acids (EFAs), such as gamma-linolenic acid (GLA) and docosahexaenoic acid (DHA), are sometimes low in kids with ADHD ... but so far, there's no convincing evidence that replacing these nutrients helps.

Phosphatidylserine, a biologically active chemical commonly called PS, is normally found in the central nervous system (CNS) - the brain, spinal cord, and nerves. PS has been shown to improve cognitive function in Alzheimer's patients ... but the effectiveness of PS in ADHD has not been proven.

Acetyl-carnitine is used to increase the neurotransmitter acetylcholine in the CNS. It can improve memory in elderly patients with dementia ... hut there's no proof that it's beneficial for ADHD.
 
DMAE (dimethylaminoethanol), also called deanol, is a precursor to acetylcholine. It was marketed years ago as a prescription medication for ADHD called Deaner, but it was discontinued because it didn't work very well. As for deanol, which is still available, the Natural Medicines Cornprehensive Database says, "Clinical studies using deanol for treating attention deficit disorder have produced inconclusive results."

Ginkgo biloba is a natural medicine that is commonly used to enhance cognitive function, but there's no reliable evidence that it will help patients with ADHD and no evidence that it is safe in children.
 
Ephedra (also called Ma huang) has stimulant effects, but it's not necessarily safe or effective for treating ADHD.
Increasing reports of fatalities and severe side effects of this herb are leading more and more experts to condemn its use - especially in children. 

The Natural Database says that the use of Ephedra is "possibly unsafe when used orally. There is concern that use of ephedra can cause severe life threatening or disabling adverse effects in some people." As for its use in childrea, the Database says, "Children can be more susceptible to the adverse effects of ephedra."

In fact, experts are now warning against giving most herbs or supplements to children because of potential side effects. Further, most herbs and supplements have never been tested in children or teenagers. One expert source says, "Steer parents away from these unproven treatments. Remind them that 'natural' doesn't necessarily mean safe."  

Trustworthy Natural Medicines 

Because so much of the advertising about natural medicines (herbs, vitamins, and supplements) is false or misleading and because labeling of these products in the U.S. can be false or deceptive, it is valuable to have an accurate, evidence-based, and trustworthy source for information about these substances. Adhd Alternative Treatments Adults

In my opinion, the two best Web sites are 
(1) the Natural Medicines Comprehensive Database (the best for up-to-date, objective information about herbs, vitamins, and supplements) and 
(2) ConsumerLab.com. 

The latter site is an independent testing lab that has tested hundreds of natural medications. Both sites are expensive and require a subscription to access; however, they are less expensive than a bottle or two of many supplements! (ConsumerLab.com offers many free reports, but more extensive reports require subscription.) To access the sites, go to www.naturaldatabase.com or www.ConsumerLab.com.
 

 

Can I Use Medications Only? 

The proper care for people with ADHD never involves just medication. There are many aspects of living with ADHD that simply cannot be treated with a medication. Nevertheless, in seeking the optimal approach to treating ADHD, medication may play an extremely important role - but it's not the only answer.

On the other hand, as we've discussed, stimulant medications definitely work for the majority of ADHD cases. In most cases, it is not a question of whether the medication works - it works extremely well for most children who have this condition. Nevertheless, medications should be seen only as a tool that helps the child's caregivers implement behavior management, parenting, and teaching strategies that help this child come to more maturity.

You can also look for more information at Adhd Alternative Treatments Adults.

Adhd Drug Abuse College - Stimulant Medications and Drug Abuse

Adhd Drug Abuse College

Some experts believe that children who take stimulant medications are at increased risk for drug abuse. There has been a lot of concern and debate about this over the years, causing some parents to shy away from using Ritalin or similar medications for ADHD.
 
Fortunately, this does not appear to be true. Research suggests that giving kids stimulants for ADHD does not increase their risk of illicit drug abuse later on. Interestingly enough, it may be that just the opposite is true. Children who are not treated for ADHD are more likely to abuse drugs than those who are treated. In fact, treating ADHD with prescription medications seems to reduce the risk of drug abuse by 84 percent.

If you think about it a bit, I bet this will make sense to you, Children with uncontrolled ADHD are more impulsive and likely to take risks, have lower self-esteem, and have fewer friends - all of which increase the chance they may experiment with alcohol or illicit drugs. Adhd Drug Abuse College

However, when it comes to tobacco use, one study has reported that kids with ADHD who were treated with stimulants had increased rates of daily smoking and tobacco dependence as compared with ADHD kids not treated with stimulants.

Every medication has undesirable side effects and should be administered only when indicated and appropriate. Ritalin, for example, has a number of potential side effects. It can reduce the appetite and cause insomnia in some patients. Nevertheless, for the vast majority of ADHD patients, prescription treatments are remarkably effective and safe.

Dr. James Dobson assures parents, "If your child has been evaluated and diagnosed with ADHD by a professional who is experienced in treating this problem, you should not hesitate to accept a prescription for an appropriate medication. Some dramatic behavioral changes can occur when the proper substance is given to the proper child. A boy or girl who sits and stares off into the distance or or one who frantically climbs the walls is desperately in need of help. To give that individual a focused mind and internal control is a blessing. Medication often provides that opportunity - sometimes for the very first time."

One caution, however. The main danger of drug abuse from stimulants is from your child's friends or classmates who do not have ADHD and want to use the stimulant to "get high." In one study, 16 percent of ADHD children had been approached to sell, give, or trade their medication. The problem of Ritalin abuse seems to be worsening.
 
A January 2001 segment on NBC's Dateline reported widespread abuse of Ritalin among college students. A national survey showed that 2.8 percent of high school seniors in 1997 had used Ritalin at least once in the previous year without a physician's prescription. These data agree with the testimony before Congress of the Drug Enforcement Administration (DEA) reporting that in 1999, 3 percent of high school seniors had used Ritalin without a doctor's prescription. Adhd Drug Abuse College

Worse yet, there has been a tenfold increase in emergency room visits for abuse or use without a prescription of methylphenidate among children from 10 to 14 years old. The unauthorized use of Ritalin is now as likely as the use of cocaine. However, long-acting formulations of these stimulants are much less likely to be abused.

So, to protect your ADHD child's friends, be sure to carefully supervise his or her use of stimulants.
 
Herbs and Other Alternative Therapies 

Alternative treatments used for ADHD include neurofeedback, homeopathy, herbal medicines, iron supplements, and dietary modifications or supplements - and many others. One recent review of all of these therapies, and the evidence for and against them, was published in a respected alternative medicine journal. These authors concluded, "Although anecdotal evidence is surfacing to support the efficacy of these alternatives, further research is needed before they can be regarded as effective, reliable treatments for ADHD. Therefore, the use of more conventional treatments should be considered if alternative interventions prove unsuccessful."

Next post, we'll go into different types of alternative treatments and listing their advantages and disadvantages. At mean time, if you like to find out more, you can check out Adhd Drug Abuse College.

Medication For Adhd Inattentive Type - Combined Medications

Medication For Adhd Inattentive Type

If a trial of an initial medication at one or more dosages doses is not helpful, then the addition of a trial of a second or third medication is in order. However, some physicians will add a second medication early in the course of treatment and report that such additions are helpful. Whether it takes one or two medications, most physicians will aim to use the lowest effective dose. In addition, frequent follow-up with the physician is necessary to provide the best possible care.

Legitimate Concerns About Medications for ADHD 

Parents, medical professionals, and the general population have expressed concerns about the widespread use of medication for ADHD. Indeed, these concerns are legitimate. According to a 1998 report from an expert panel convened by the National Institute of Mental Health, there are "many important questions regarding treatments [of ADHD] that remain unanswered." Here are their concerns:

• No major studies have been published that have examined the long-term effects or effectiveness (more than two years) of either behavioral therapies or prescription medications.
• There are no national guidelines (or even reliable guidelines) on the treatment of the inattentive subtype of ADHD.
• There are no national guidelines for treating adolescents or adults with ADHD.
• There are no proven therapies for targeting some of the specific problems seen with ADHD, such as deficits in language processing or impaired working memory.

This is not to say that there are no therapies that can be applied to each of these situations and are being used successfully - at least based upon anecdotal reports. Nevertheless, more research is needed to conclusively answer these questions. Medication For Adhd Inattentive Type

Evidence for the Use of Medications in ADHD 

One group of researchers assessed the effectiveness of prescription stimulant drugs using a comprehensive systematic review of the many studies that have been published. The authors identified 18 randomized controlled trials that used behavioral rating scales to measure the effect of stimulant medications, The review concluded that three drugs-methylphenidate (available as a generic and in the brands of Ritalin, Metadate ER, Methylin ER, Ritalin SR, Metadate CD, and Concerta), dextroamphetamine (available as a generic and in the brands of Dexedrine and Dexedrine Spansules), and pemoline (Cylert) - were all significantly more effective than placebo.
 
Studies have shown that some children who are unresponsive to or intolerant of methylphenidate have tolerated or responded well to dextroamphetamine, and vice versa. So, if one medication does not work, a trial of the other is usually considered appropriate. 

Another group of researchers looked at all the studies evaluating the effectiveness of the stimulants and reported on 18 studies that compared stimulant drugs. In general, rnethylphenidate, dextroamphetamine, and pemoline were found to be equivalent.
 
These same researchers found nine studies that compared the effectiveness of tricyclic antidepressants with placebo: Five of six studies showed that desipramine (Norpramin) was more effective than a placebo. They also found one of three studies of imipramine (Tofranil, Tofranil-PM) reported a similar benefit to desipramine. Four studies compared stimulants with tricyclic antidepressants - sort of a head-to-head comparison. Unfortunately, the results were inconsistent.

One caveat about the stimulant medications: We simply have no long term studies of either their safety or effectiveness. Countless people living with ADHD can attest to their safe and long-term use, but that anecdotal evidence is not nearly as helpful as actual research studies. One study, published in 1999, showed that taking stimulants for ADHD was both safe and effective for at least two years. Other long term studies are currently being performed. Medication For Adhd Inattentive Type

Drug Vacations

When I was in my medical training at Duke, we were taught to try to give our ADHD patients drug holidays. The advice was to try to avoid medications on weekends, holidays, and vacation. Some physicians still ascribe to this practice; however, not only is there no evidence supporting this theory, there is evidence that this may, for some kids, be harmful. 

Why? Simply because those with ADHD, who are being successfully treated with medications, find that their social and family functioning is so improved on the medication that withholding it may actually contribute to peer rejection, family conflict, and reduced self-esteem.

Medication is a double edge sword. You have to be the master to control it and not letting it control you.If possible, try all natural methods before medication. To learn more, you can check out Medication For Adhd Inattentive Type.

Antidepressant Adhd Medications - Antidepressant Use in ADHD

Antidepressant Adhd Medications

For older adolescents and adults with ADHD, there's an increasing interest among medical professionals in using a newer class of antidepressants called SSRIs when there is concurrent depression or anxiety. These Selective Serotonin Reuptake Inhibitors help regulate the neurotransmitter serotonin in the brain. Some of the more common SSRIs that are used in ADHD include fluoxetine (Prozac and Prozac Weekly) and sertraline (Zoloft).

There is a newer drug, one of the so-called "designer antidepressants," called Bupropion (Wellbutrin and Wellbutrin SR) that is now being used to treat adults and adolescents with ADHD and depression. However, it may take several weeks to see a benefit. 

Other antidepressants (Paxil, Paxil Weekly, Effexor, and Effexor XR) are best not used in children and teens. The reason? Although Paxil and Effexor are still used in children and adolescents, both have recently received criticism from the FDA, AAFP, and Effexor's company because of the inability to show benefit (for depression) and a slight rise in "suicidal behaviors." No suicides have resulted from these unpublished trials, but for now we should use other SSRIs and SNRIs instead for children and adolescents.

In one report, bupropion was shown to be effective in treating adolescents with ADHD and conduct disorder problems. Some experts are even using bupropion for ADHD in children. These medications affect one or more of the brain's neurotransmitters that are not targeted by other antidepressants. And, many experts are starting to use these antidepressants as first line drugs - even before trying stimulant medications. Antidepressant Adhd Medications

Some physicians like to use the designer antidepressants instead of the stimulants. They feel they have less potential for abuse - by your kid's friends! In addition, they can be used for adolescents or adults with ADHD and depression or those who don't respond to stimulants.

One last class of antidepressants still used by physicians in the treatment of ADHD is the tricyclic antidepressants. This is an older class of medications that have been available for decades. Examples include desipramine (Norpramin) and imipramine (Tofranil, Tofranil-PM). In one study of adults with ADHD, it was reported that desipramine worked as well as Ritalin. 

The tricyclics are much less expensive than the brand name SSRIs or designer antidepressants. However, they may have more side effects, including drowsiness and dry mouth. Typically these side effects decrease over time. In addition, case reports of sudden deaths in children taking tricyclics have caused concern. Although a rare side effect (and it is still questioned whether the tricyclic actually caused these deaths), most parents who are made aware of this possibility will choose other options.

In addition, case reports of delirium and tachycardia (a racing heart rate) in adolescents who take tricyclics and smoke marijuana cause some parents to choose other options for their teenagers. 

Other Medication Options 

Besides stimulants and antidepressants, there are several other medication options your physician may consider:

MAOI

The monoamine oxidase inhibitor (MAOI) tranylcypromine (Parnate) has been reported to help some children with ADHD. However, taking it requires a significantly restricted diet and the avoidance of a number of over-the-counter drugs (including some common cough syrups, herbs, and supplements) and prescription drugs. 

In addition, fatal reactions have been reported when MAOIs and SSRIs have been taken together. Because of these interactions, most physicians use a MAOI only if no other options seem to work as well, This class is usually prescribed only by psychiatrists. Antidepressant Adhd Medications

BuSpar 

The antianxiety drug buspirone (BuSpar) has been reported to help some children with ADHD and is currently being studied in children and adolescents with ADHD.  

Catapres 

The alpha-2 antagonist clonidine (Catapres) is one of the most common "add-on" medications for ADHD. In other words, if a stimulant or antidepressant is not fully effective, many physicians will "add-on" clonidine as a second medication, especially for those children who have more problems with impulsivity, aggression, or oppositional symptoms.

This medication affects the neurotransmitter norepinephrine, an important chemical in the process of concentration. Uncommon side effects include dizziness, dry mouth, drowsiness, or constipation, which usually lessen over time. Also, clonidine can cause the heart to slow down and missing doses has been known to cause tachycardia (rapid heartbeat) and other problems. A handful of deaths in children taking clonidine and Ritalin have been reported. Therefore, some experts recommend children be evaluated for heart or kidney problems.

Provigil (modafinil) 

Approved only for the treatment of excessive daytime sleepiness associated with narcolepsy, modafinil significantly improves the symptoms of ADHD in children, according to a study conducted by Dr. Joseph Biederman, professor of psychiatry at Harvard Medical School. Optimum dosing may take some time to determine, yet it seems to be a good alternative for those patients who do not respond positively to stimulant therapies.  

Strattera (atomoxetine HCI) 

In January 2003, Strattera was released with FDA approval. In studies, the drug was shown to have fewer side effects than stimulants and controlled substances, and no risk of insomnia or addiction. It was the first new drug to be approved for ADHD in nearly three decades, and also the first nonschedule II drug. It is indicated for the treatment of adolescents and adults, and therefore may become first line therapy. 

Clinical Studies have not yet proved its effectiveness as opposed to stimulants, but as a selective norepinephrine reuptake inhibitor, researchers believe it may have a better ability to regulate norepinephrine than Catapres and with fewer side effects.

Other medications 

Some physicians also use a similar to clonidine, guanfacine (Tenex). It causes less drowsiness than Clonidine.

The anti-Parkinson's drug Sinemet (levodopa/carbidopa} has been given to kids with Restless Leg Syndrome (RLS). Kids with RLS and ADHD who have been treated with Sinemet have been reported to show improvement in their ADHD. More research is currently being done on this medication in kids with ADHD.

Next post, we'll go in combined medications. At mean time, you can find more details at Antidepressant Adhd Medications.