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some s/e are not treatable

Posted by zeugma on January 28, 2005, at 14:21:46

In reply to Re: Treating side effects » ed_uk, posted by zeugma on January 27, 2005, at 18:59:13

Aust N Z J Psychiatry. 1998 Oct;32(5):650-7.


Attention deficit hyperactivity disorder and anxiety: is there an association with neurodevelopmental deficits?

Vance AL, Luk ES.

Maroondah Child and Adolescent Psychiatry Service, Victoria, Australia. avance@papyrus.mhri.edu.au

OBJECTIVE: The co-occurrence of attention deficit hyperactivity disorder (ADHD) and anxiety is a well-established clinical observation. However, its status as a clinical construct is debated. We review the prevalence of 'ADHD and anxiety', its definitions, and its clinical correlates and we hypothesise that neurodevelopmental deficits may be increased in 'ADHD and anxiety'. METHOD: The authors identified empirical studies in the psychiatric and psychological literature. The search categories included hyperactivity, attention deficit hyperactivity disorder, attention deficit disorder and anxiety. RESULTS: 'ADHD and anxiety' is considerably more common in clinical than epidemiological samples. There are a range of definitions which address the situational variation in both ADHD and anxiety symptoms and the use of categorical and continuous variables to define them. Yet the nature of the anxiety is still unclear. It is associated with a poor response to psychostimulant medication treatment, and alternative pharmacotherapy approaches have been suggested. There is a controversy about whether neurodevelopmental deficits are associated with hyperactivity alone, or anxiety, or both. CONCLUSIONS: 'ADHD and anxiety' is important clinically because it is common and less responsive to psychostimulant medication. Important research issues include its heterogeneity which necessitates the collection of parent, teacher, and child self-reports of symptoms' presence or absence and the hypothesis that neurodevelopmental deficits may be increased in this group of children.

It wouldn't matter if I were able to solve the cardiac side effects, since the anxiety is so overwhelming, and is only mitigated by being at peak plasma levels, which calms me- but then once they drop (and it's a quick drop) I'm anxious as h*ll again and would have to re-dose at an even higher level to calm down. It's not practical. And taking more klonopin is no solution. Off ritalin for 2 days I can't stay awake, but at least my anxiety is falling.

The only exception I would make to the statement in the abstract is Provigil. It woke me up AND did not worsen anxiety. If you are severely anxious and have ADD or some other condition requiring a stim, I would try that first. Failing that, a TCA or strattera or both.

-z


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poster:zeugma thread:446337
URL: http://www.dr-bob.org/babble/20050128/msgs/449228.html