Answers Even More Challenging Treatment Questions
You already know this: one can’t go far down the road with most ADHD treatment plans without running up against stimulant side effects. Stimulants, those meds associated most often with either methylphenidate [MPH] or amphetamine [AMP] molecules, often bring associated problems with these excitatory challenges:
- Increased blood pressure
- Increased anxiety [cognitive, mental - and somatic, affective]
- Increased agitation, irritability
- Increased sleep problems, usually dosage related
- Decreased compliance due to the profound effect of immediate release prevalence
Too often many simply can’t take stimulant medications with these several challenges.
ADHD Medication Rules
I wrote ADHD Medication Rules simply because so many do have troubles with the side effects of stimulants, the first line medication – often because they are adjusted without thinking about underlying biomedical issues. The good news is that the Vyvanse , Adderall and MPH products are very helpful, but just as with any medication from aspirin to birth control, dosing strategies become the key challenge in preventing side effects. See this series of videos for ADHD Medication Tutorials regarding the stimulants.
Four Exceedingly Key Intuniv Solutions Straight From The Trenches
I have had several individuals who just can’t deal with the agitation and increased cognitive anxiety with stimulants. Careful dosing just doesn’t solve the problem as you will see from the many Intuniv posts and hundreds of comments there . If you want a more simple review of materials and links you can see a comprehensive page over at Squidoo.com collected there for your reference.
1. Hypertension Resolution/Improvement
I’ve seen an outstandingly good response from some adults with growing blood pressure problems and stimulant meds. Intuniv not only solved the problem by not increasing the blood pressure, but significantly diminishes the associated somatic and cognitive anxiety, and worked better than the stimulant meds first tried.
2. ADHD and Anxiety Resolution/Improvement
Others with refractory anxiety that appears more cognitive than affective, more mental worries than somatic feelings have responded very well to even low dose Intuniv – adults with only 1-2 mg in the AM and it lasts all day, and, yes, it helps with the associated ADHD.
3. ADHD and Sleep Resolution/Improvement
Those children with sleep issues may significantly improve with dosage at night. I know that the first blush of usage recommendation seemed best as dosage in the AM, – and it often does work best after that protein breakfast. But we have seen an increasing number of patients, especially children, who respond so much better with a PM, bed time dose, and still do quite well the next day.
4. Intuniv With Stimulants: Recent Study Out
A recent ADHD study also documents what we have seen in the office – that using the two med types, Intuniv and stimulants, together often will turn the ADHD tide more effectively. Often the sedative, quieting effects of the Intuniv compliment the greater efficacy of the stimulants in some individuals. Careful titration watching both side effect profiles [documented repeatedly in these pages and in the many previous Intuniv posts] will obviate any challenges as the metabolic pathways show no concern about drug interactions. The advantages of one seems to address effectively the side effects of the other with good result. No this will not be the standard of care, but let’s face it, the combination does work well, just as Wellbutrin with Effexor does over in the land of “antidepressant augmentation strategies.”
Interesting new points for treating ADHD – press on…