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[to PL] Reading; Tolerance 2 stims in ADD - WHAT??

Posted by Zeke on December 8, 1999, at 3:21:44

In reply to Re: Atypical ADD?, posted by PL on December 2, 1999, at 10:48:37

PL said:

> The same thing happens when I read. I can read a whole paragraph and realise I was actually thinking about someting else and have to reread it. Even if it is someting I'm interested in, my mind has a mind of its' own, it seems.

I can really identify with this. It's like the reading becomes mechanical, like doing something with your hands, and meanwhile you're thought veer off on their own.

Now I recently came across an article about ADD posted at the ABCNews site that addressed this:

Many [people with ADHD] also have trouble with
reading, because when they read a new paragraph,
they may have already forgotten the previous
one. As they get older, most people with ADHD
have difficulty simultaneously listening to a
lecture, taking notes and making sense of what
they're hearing.

The study was based on PET scans of ADDers (and non ADDers) and was reported at last week's meeting of the Society for Neuroscience.

see: The Mental Images of ADHD

PL also said

> My Psy Doc does not want me to go to stimulants because of the need to increase dosages after a while to get the same effect.

If you have ADD, then your doctor IS WRONG about the tolerance issue. After some initial adjustment, a fixed dosage should continue to help with the ADD.

Now I suspect that your doc sees just depression, and ergo the tolerance issue. (not that its necessarily true for that either.) Another good possibility is that he's afraid/uninformed about stimulants (and haven't we all known several such docs). He may also have an ancient view of ADD such as 'you grow out of it' or 'stimulants don't work in adults' or 'rule out ALL other possibilities' (you'll likely be old or buried before that happens).

By considering your comments and his, it sounds like he hasn't treated Adult ADD patients (or many)? Ask him!!!

So has he diagnosed you with ADD too? Has he tried (checklists of symptoms, history, certain neuropsych tests)?

Why not get a second opinion (evaluation) from someone familiar with adult ADD? Go for it. (A 2nd opinion is proper and ethical. And YOU pick the doc. Be sure to ask questions about whether he/she treats many with adult ADD. Also GENTLY ask about whether they are opposed to stimulants. Else you may end up with your doc's twin or someone trying to build up a psychotherapy business.) Your local chaptr of CHADD may be able to provide some references.

If you have ADD, the stimulants are usually the treatment of choice. Further they are generally safer than antidepressants -- have fewer side effects -- and this is important when you're taking several different meds. Its possible that go from 3 meds to two -- a stimulant and an antidepressant. Response to stimulants is immediate or rapid, compared to the weeks and months of antidepressants. Abuse among ADDers is rare.

Sorry to go on like this but I'm annoyed at his "need to increase dosages" statement about stimulants. I wasted too much time and money because docs afraid and uninformed. (Take a look at this URL, a chapter on stimulants from a psychopharmacology textbook:




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