The debate in the ADHD community for and against ADHD drug
therapies can be contentious and divisive.
The folks that advocate for nothing but prescription medication
adamantly believe that drug therapy is the "be all and end all" of
ADHD treatment and that prescribing any other treatment is sheer quackery. The
folks in the other camp believe that to medicate people with ADHD is to poison
them and that doctors are greedy cowards whose primary objective is to line the
pockets of insurance and pharmaceutical companies. I am constantly distraught
about the polarity of these two camps.
This black and white way at looking at this is not
productive. Regular readers of this blog
know that I stand firmly in the middle of these two camps. I believe that for many patients,
prescription therapy is the only answer and the only treatment that will make
their lives more productive, happier and more meaningful. I believe that there is a subgroup of
patients that have particular symptoms, e.g. impulsive behavior that makes thema danger to themselves or others , that will get the greatest improvements for
their symptoms from drug therapy.
Other patients, however, will find that their symptoms
improve on therapies that are not prescription drugs and these are the
treatments that I am covering in Commanding Attention, the book that I hope to
get published soon. For the majority of
patients a combination of treatments, both drug and non-drug is the best
solution. Patients who have improved
with drug therapy will find that additional therapies in may enable them to
improve their symptoms further. Other
patients will find that these supplemental treatments provide enough symptom
improvement to allow them to decrease the dosage or even eliminate their
All ADHD patients do not respond favorably to ADHD
prescription medicine. One third of patients will have side effects such as
sleep issues, loss of appetite, anxiety, depression or other side effects that
will make them unable to take stimulant medication. This tends to be especially true for people
with Inattentive ADHD but even people with the other types of ADHD can have
problems with prescription medication. Two
thirds of patients, despite debilitating ADHD symptoms; will no longer be
taking their prescription medication a year after it is prescribed. Some will
stop because of side effects, for some the medicine will simply not help their
symptoms and others will stop for other reasons.
Treating heart disease does not only involve taking a pill. It involves lifestyle changes such as weight
loss and exercise and other interventions such as fish oils and natural
cholesterol lowering agents as well. We
must start thinking about ADHD in the same way.