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Old 01-22-2011, 05:05 PM   #19
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Re: ADHD education of critical importance

Syborg,

Whew, I got some work to do on my implusiveness. As I walked in the door, I had this terribly thought. Good God help me if Syborg is one of those duoterrry language types that speaky FRENCH and English. Please tell me God Syborg ain't from Quebec. Please, please, please.

There is a God and he does answer prayers. Actually I love French speaking Canadians.

Another clip from ***** that I think you'll find helpful. "The behaviors of ADHD can mimic mood disorders (for example, bipolar disorder or depression), anxiety, or personality disorder. Those conditions must be ruled out or adequately treated before a definitive diagnosis of ADHD can be made."

Protection is my driving force behind this thread. We must deal with a very emotional issue. "5) separating emotions from reason;" is a problem every human has with or without ADHD. I do not like the idea of using stimulant medications. The "why" is purely emotional. I can't break the gut level feeling link between the therapeutic use of amphetamines with the abuse of amphetamines.

Check this one out. "The use of psychostimulants in children should be scrutinized carefully. Fortunately, methylphenidate (Ritalin [and its long active formulation, Concerta], historically the most widely prescribed medication for ADHD) has been available for many years. This long period of clinical experience has shown that this is one of the safest medications used in children." - *****.

I "feel" reservations about medicating children with stimulants even though I'm confident "that this is one of the safest medications used in children" statement rests on mounds of evidence from that "long period of clinical experience." And even though the quality of my life certainly would have been improved if was medicated as a child. My reservations are based purely in emotion with no logic attached. None whatsoever.

I've known for a very long time that "Stimulants used for ADHD do not cause addiction. Although tolerance usually develops for the stimulant-associated effects of anorexia, insomnia, or mild euphoria, tolerance does not develop to the increased levels of neurotransmitters." - *****

Some of this board's members have expressed concern over developing tolerance in a week or two. They are experiencing "titration" not tolerance. But they are taking close to the maximum recommended 40 mg dose, what to do?

"The type and severity of symptoms vary greatly among people with ADHD. The severity of symptoms depends on the degree of abnormality in the brain, the presence of related conditions, and the individual's environment and response to that environment."

What if the neurotransmitter deficits are so low that 40 mgs is grossly insufficient to counter the severity of the symptoms? Can 60, 80, 100, 120 mgs or more be safely used? Yes if two criteria are meet satisfactorily. 1) The dose does not cause the neuro values to go over normal. Over boost is indicated by failing to meet the next condition. 2) The patient tolerates the dose well. That is, no excessive BP or heart rate rise, and eats and sleeps sufficiently to maintain good heath.

Emotion, this case, doctors fear of the Feds is the "why" they are so reluctant to go much over the recommended 40mg. I assume if I can read the reports, read about the controls researchers used to keep out corrupting data, read where the researchers admit to the possibility for a few leaks here and there, then read how their results are consistent with many previous studies, and read their evidence based conclusions and recommendations soundly based in scientific logic, that "fear of the Feds" can be the only reason most doctors in this country will not prescribe the doses some patients need to control their symptoms.

But doesn't escalating dose to such high values end up in addiction. NO. If both criteria are met. I do lack research study documentation to back up my next statement. It's based on the patterns reported by patients on the high doses. High doses are not needed for very long. Once the symptoms are controlled, the dose can be decreased over time to under the 40 mg ceiling and in some cases can go to zero.

I found some evidence in the biology that could explain that pattern. Neurons that fire frequently gain synaptic connections with their neighbors. What's more, the number of synapses possible from one neuron to another is far in excess of one. Frequent firing strengthens the one-to-one neuron relationship by increasing the number of synapses binding them together. Once we get those buggers firing, overall network connectivity is benefited. "Neurons that fire together wire together" is truth. The network "learns" how to move information efficiently and effectively.

We can chuck the whole package down the toilet if prevailing public opinion pressures us away from the very medications that will help. Down the toilet it goes for quite a few parents who have gone beyond every thing in their power, worried sick over their children, who come to this board looking for a solution, when dissuaded from seeking a medical solution.

Down the toilet it goes when doctors won't prescribe medications needed by their patients who come to them trusting the doc bases his decisions on medical science. Most never realize that their being stuck in ADHD eternal hell stems from the good doctors fear of the Feds not their best interests.

None of this will budge the naysayers. They have no evidence now and are not interested in any evidence to the contrary. Their position is based solely in emotion and plays on the emotions of those of us with ADHD.

Bob

 
The Following 2 Users Say Thank You to addprogrammer For This Useful Post:
RANDOL (02-01-2011), syborg (01-23-2011)