This week, I am guest blogging on a colleague’s site (ADHD Man of DistrAction with Kelly Babcock) and thought I’d share it here…

I’ve always been willing to answer questions regarding ADHD medication, but I’m not a healthcare professional. I’ve read extensively on this subject, but I’ve always had to qualify my answers.

So it is with great pleasure that I tell you all that today’s blog and Friday’s will answer some of the questions I hear most often about ADHD medication.  These answers are provided by someone whom I am honored to have share her expertise, Laurie Dupar, PMHNP, RN, PCC. Laurie is a certified ADHD coach and trained nurse practitioner. Her web page can be found at www.CoachingforADHD.com. Her contact information is also there (at the bottom of her page).

Laurie graciously agreed to answer some questions for me. I forwarded Laurie questions from myself, from one of our commenters, and a newly diagnosed acquaintance. Today, we’ll deal with the submitted questions. On Friday, we’ll review Laurie’s answers to the other questions.

The Q&A

Karen’s question: I started taking methylphenidate (Concerta 18mg.) about two weeks ago. The effect was rather amazing. I had focus. I was mindful. My calmness reduced my stress so much that my blood pressure went down. Now, I find myself drifting again. Can one get used to a certain dosage? I know that 18mgs is pretty low. Should I consider asking my doctor to increase my dosage?

Laurie’s answer: Hi Karen! People often experience a dramatic effect, such as you described, when beginning to take ADHD medication. Such a response is considered positive and likely means you are on the right type of medication for you. You may just need the dose adjusted.

Commonly, the initial dose needs some upward adjustment to find that “sweet spot” where you are on the lowest dose with the highest benefits. I suggest you go back to your prescriber and tell them what you described here and see what they suggest; it may be time to consider trying the next dose.

Be alert to the positive benefits you described initially, that is what you are looking for with ADHD medication. People typically experience an almost hyper-focused, agitated feeling when the dose is too high. Remember, you are looking to find just the right dose for you.

Maha’s question (submitted by comment): Why do psychiatrists insist upon doping adults with thoroughly diagnosed ADHD with anti-depressants? Anti-depressants do not help but cause another set of problems, like racing thoughts, OCD, and even exacerbating depression.

Laurie’s answer: Hi, Maha! This is a great question. Because we have only recently realized (in the past 15 years or so) that the majority of people do not outgrow ADHD, many prescribers are not sure how to pharmacologically manage their adult ADHD clients. That, and not understanding the high incidence of co-existing conditions with ADHD.

Having ADHD means that an adult has a nearly 50% chance of having a co-existing “anxiety” disorder, such as OCD, and an almost 30% chance of having a co-existing depression. Often, it is hard to determine which came first: ADHD, depression, or anxiety. Many adults will say that having ADHD is depressing and causes great anxiety in their lives. It may also be true that individuals who are genetically wired for ADHD may also have a genetic component to depression or anxiety.

Finally, it might be that adults with ADHD are treated with antidepressants and anxiolytics because the treatment of anxiety and depression is more understood and has more pharmacological options than the treatment of ADHD. I encourage clients to work with a prescriber who specializes in ADHD and understands the high incidence of co-existing conditions that occur with ADHD.

Stay tuned for more ADHD Medication Q & A  from Laurie Dupar on Friday

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