From The National Review of Medicine. A Harvard Adult ADHD research study by Dr Thomas Spencer, published in the March 2005 issue of Biological Psychiatry suggests that the typical dose of methylphenidate (i.e., Ritalin, Concerta) 0.6mg/kg/day may not be enough for adults with ADD.
The authors note “only modest improvement in ADHD symptoms with MPH at the lower daily doses attained after the first weeks of treatment.” But they later found that “an average oral daily dose of 1.1mg/kg/day was consistently more effective than placebo … suggesting a dose-dependent response to treatment of adults with ADHD.” In addition, the response wasn’t affected by gender, social class, psychiatric co-morbidity or age.
“The results confirm that methylphenidate at daily doses of up to 1.3mg/kg is a well tolerated and effective treatment for adults with ADHD,” notes the Harvard team in its study. It is clear from its research that more attention needs to be paid to the treatment of adult ADHD.
As someone who’s spent a lot of time searching The National Library of Medicine’s medical database, Medline for studies on ADHD, (9337 items when you just type in adhd as a keyword) I’ve noticed the vast majority of these studies are focused on ADHD in children and very few are focused on ADHD in adults. How many adults with ADHD are not getting the right dose of medicine or are giving up on ADD medication because the dose is too low? In most cases I hope the doctor adjusts the dose up but I know of some people that try ADD medication do so very reluctantly and sometimes give up if it doesn’t work the first time.
While I don’t give medical advice since I’m not a doctor I do suggest that if people try ADD medication that they at least give it an honest try.
That is, it may take some time to find the right ADD medication or combination of medications for their unique neurobiology. One size does not fit all. After finding the right med or meds they then may have to work with their physician or psychiatrist to adjust the dose so it’s right for them.
Would you eat a peach and if you didn’t like it decide that you would not eat any more fruit? Probably not. Same thing with medication.
This is certainly a wake up call for more research on adult ADHD.
Does anyone know if there are similar studies on other dosage differences of other ADHD medications (i.e., Strattera, Wellbutrin, Dexedrine ) for adults?
An interesting article came out recently in The Guardian, a british paper, talking about the importance of fish oils in helping a number of disorders, including ADHD. Apparently they can be as effective as Ritalin, in some cases. They also seem to help with reading and writing. Really fascinating. You can read more about it here: http://society.guardian.co.uk/publichealth/story/0,11098,1475359,00.html
cheers
Jessica
http://www.ldstories.com
Hi:
First, a comment about the one comment you have so far; whe oh when will poeple stop sugggesting that anything you can do with your diet can change ADHD? I took cod liver oil (given to me by my mother form infancy) and later willingly as an adult (for its Vitamin A and D components). I still have ADHD. So in my case, fish oil did nothing to prevent ADHD from disrupting my life disasterously.
On the the commment about the Harvard Medical report. The one article I’ve found that is similar in nature is this rather dated one (from 1996).
On January 26, 1996, Dr. Moïse Maurice Benchitrit addressed the Ontario Psychiatric Association Annual General Meeting in Toronto asking that the CPS be updated because it was badly out of date. He cites his own practice in which he found that the amounts needed to treat each patient were often drastically different that indicated in the CPS. As well, he seems to have a similar experience with his patients that I have had personally; that is that a small amount of Dexedrine at night keeps the intrussive thoughts silent that have preented me from sleeping in the past.
http://www.benchitrit.com/content_lng01/03/03_01/03_01.html
I was please to chance upon that link becuase it also debunks the idea that using stimulant medication promotes an addiction to them. My own GP has stresssed the difference beetween addiction and dependance. Perhaps we should be more concerned with our “dependance” on signle occupancy vehicles, perhaps thats and addiction then.
Some doctors seem to understand that different peopel react differently to drugs and that what is enough for one person doesn’t treat another.
DF.
thanks for the link Jessica. Other studies have shown Essential fatty Acids have been helpful to people with ADHD if they have low levels of EFA’s which many ADDers do. David may not have low levels so it may not effect him at all. Also the EFA’s can be helpful but they’re not a magic bullet. I wouldn’t rely on that alone but it can be part of the equation for some.
ADDers aren’t “addicted to their meds” if they were they wouldn’t forget to take them, some ADDers do forget.
You might want to see this article on the blog relating to med dosing problems https://adultaddstrengths.com/2005/05/17/adult-adhd-medication-dosing-problems/
Also this article
Does Stimulant Therapy of ADHD Beget Later Substance Abuse?
http://pediatrics.aappublications.org/cgi/content/abstract/111/1/179
Pete