Posted by ed_uk on August 29, 2005, at 16:00:13
In reply to Re: Ritalin 80mgs-not doing it anymore?- Restlessness, posted by utopizen on August 29, 2005, at 15:31:51
Hi John,
>So moral of story: I'm not discounting Ed. I'm also not suggesting Ed has depression alone, or has depression, or doesn't have depression. This isn't even about Ed.
??? Indeed, it's not about me.
I was suggesting a non-stimulant treatment since Paul appears to be tolerant to Ritalin.
Desipramine can be effective for ADD. There are numerous controlled trials, here is an example........
Am J Psychiatry. 1996 Sep;153(9):1147-53.
Six-week, double-blind, placebo-controlled study of desipramine for adult attention deficit hyperactivity disorder.
Wilens TE, Biederman J, Prince J, Spencer TJ, Faraone SV, Warburton R, Schleifer D, Harding M, Linehan C, Geller D.
Pediatric Psychopharmacology Unit, Massachusetts General Hospital, Boston 02114, USA.
OBJECTIVE: Despite the increasing awareness of attention deficit hyperactivity disorder (ADHD) in adults, there are a limited number of controlled pharmacologic studies of this disorder; most of the trials have focused on the psychostimulants. Because the tricyclic anti-depressant desipramine has been found to be effective in treating ADHD in pediatric groups, the authors tested its efficacy in adults with ADHD. METHOD: The authors conducted a randomized, 6-week, placebo-controlled, parallel-design study of desipramine at a target daily dose of 200 mg in 41 adult patients with DSM-III-R ADHD. They used standardized structured psychiatric instruments for diagnosis and, as the dependent variables (outcome), used separate assessments of ADHD, depressive, and anxiety symptoms at baseline and at each biweekly visit. RESULTS: There were highly significant differences in the reduction of ADHD symptoms between adults receiving desipramine and placebo. Within the desipramine-treated group, there were clinically and statistically significant differences between baseline and the week 6 end point for 1) reduction of 12 of 14 symptoms of ADHD and 2) decreases in the broad categories of hyperactivity, impulsivity, and inattentiveness. In contrast, placebo-treated patients showed no differences between baseline and end point for any of the ADHD symptoms assessed. According to strict, predefined criteria for response, 68% of desipramine-treated subjects and no subjects in the placebo group were considered positive responders. Response to desipramine was independent of dose, level of impairment, gender, or lifetime psychiatric comorbidity with anxiety or depressive disorders. CONCLUSIONS: These results, similar to findings in children and adolescents with ADHD, indicate that desipramine is effective in the treatment of ADHD in adults.
Kind regards
~Ed
poster:ed_uk
thread:547904
URL: http://www.dr-bob.org/babble/20050827/msgs/548243.html