Posted by BowTie Bob on October 7, 2005, at 7:32:05
In reply to Re: Which ADD med is most chemically similar to » rainbowbrite, posted by zeugma on October 3, 2005, at 21:11:50
> hi (sorry I gave you a short answer to your earlier question, this will be a little longer):
>
> Stimulant dosing is tricky. It seems that stimulant dose response is a function of dopamine transporter polymorhisms (variations in the genes for the pharmacological target of Ritalin). Also, optimal dosages for Ritalin vary on the effect desired: if you're trying to address executive function (issues involving planning, organization, and getting on task) a lower dose is advised, at least according to one study I read; while for alertness and pure 'focus', a higher dosage is advised. I can say, at least, that for me higher dosages of Ritalin kept me alert and focused for longer periods of time and gave a better quality to my attention, while lower dosages were moderately effective for alertness and attention but not at all for planning and organization. So perhaps I am responsive to the alerting effects of Ritalin but not to the other effects. The truth is that doctors start people on low doses and see what happens.
>
> When you ask if Ritalin increase adds to AD effect, the answer is that yes, for a time at least a higher dose may make you feel better. But higher doses also cause more insomnia and behavioral activation while decreasing appetite, so what you gain on the one hand you may lose on the other. I found that Ritalin can cause major dysphoria due to excessive activation. It can intensify moods, including negative ones. The effect is something like that of NE-active meds such as tricyclics (not surprising in that Ritalin is also an NE reuptake inhibitor), but with more of a tendency to cause 'moodiness' and much less of an overall AD effect.
>
> -zGood Morning Z,
I always thought that clinical efficacy for Ritalin was a result of receptor sitmulation that induces the NE and dopamine effects. Also, Ritalin is comprised of 2 isomers, the d and l, with the d being the pharmacologically active one. It makes sense that if the 2 compete for the same receptor they may be some variation in efficacy. I am interested where you found the information about the dopamine transporter polymorphisms.
Thanks.
poster:BowTie Bob
thread:562267
URL: http://www.dr-bob.org/babble/20051003/msgs/563997.html