![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by River1924 on October 19, 2005, at 1:37:16
HI,
My nephew, Luke, 28 yeare years old, has been told he will probably be dead by age 37 due to very abnormal liver enzymes. His liver is diseased, apparently, by obesity, drinking, and an exuberant if brief use of every illegal drug available.
Well, I think, (and contrary to his current doctors) he should take medication for ADD. His liver enzymes are very messed up. Yes, that's true. His doctor says he needs to exercise and eat right. Okay. Obvious.
I think, the dangers of harming his liver further with ADD medication is, greatly, outweighed by this: He is much more likely to eat right and exercise and live a healthier lifestyle if he is on the right meds. Right now, he is depressed. He thinks he is dumb and a loser. He is bored easliy, has been given a death sentence and he can't sustain interest in his own life and health. He can't really sustain any real interests/activities unless it involves high risk activities. Self-confidence and friendships would help his body recover. I think he is less likely to drink, eat poorly, do drugs, or live passively on ADD meds.
Does this make sense? Am I crazy? Are stimulants so bad for the liver that they aren't worth the benefits?
I'd appreciate any input. Thanks. River.
More background: I'm not a big believer in ADD. It is too easy to label a child with ADD when his real affliction is his enviroment. BUT, I'm sure Luke has it and continues to be afflicted by it. I asked him about his previous use of cocaine. I expected this answer: it didn't make him really wired or give him courage to do stupid things. On cocaine, he felt normal. He had conversations and thought about the future, etc. As a child, he managed to pour house paint on the living room floor and not realize the consequences of the pretty stuff flowing out of the can until he heard his mother screaming at him. When he was in seventh grade, I gave his mother a small book on ADD and she realized, "hey, he isn't dumb, a deliberate troublemaker... he must have ADD." For a few years, he took ritalin and he made friends and his grades improved and he seemed more content and happy.
Then, his father's not-so-subtle insistence that his kids don't need drugs encouraged him to discontinue meds. (IE: If my boy takes ritalin it means he isn't normal and that makes me look bad. Plus, men... manly men don't take psychiatric drugs.) So, Luke stopped his medication and pretty soon he was always tardy to school and failing and bored and dropped out in high school.
Ten years later, he has been given a death sentence. It is so frustrating.
Posted by Declan on October 19, 2005, at 2:56:20
In reply to Treat adult ADD or not? Stimulants and the liver., posted by River1924 on October 19, 2005, at 1:37:16
Hello River
It is frustrating, the waste in this world. If he were my son though I think I'd like to try a combo of SAMe and deprenyl, 400/3 or something. But if he can take stimulants and not have to use other drugs, and if they help him, then why not?
I'd want to deal with the liver thing and get the LFT within normal range if possible.
Declan
Posted by Phillipa on October 19, 2005, at 19:15:18
In reply to Re: Treat adult ADD or not? Stimulants and the liver. » River1924, posted by Declan on October 19, 2005, at 2:56:20
Do you know for a fact that ADD meds damage the liver? A good doctor and pdoc would know that. And I've heard the liver can rejuvenate itself. They are now doing liver transplants using only a piece of donor liver. It grows back in the donor too. Fondly, Phillipa
Posted by Declan on October 19, 2005, at 19:54:51
In reply to Re: Treat adult ADD or not? Stimulants and the liver., posted by Phillipa on October 19, 2005, at 19:15:18
Hi PJ, I wasn't suggesting that ADD drugs damaged the liver. But there is some evidence that SAMe can help the liver regenerate (and of course improve mood).
Liver transplants are not for the dissolute. I had some friends who wrecked their livers and they were fortunate not to have one. It wouldn't have worked for them, and besides they were completely wrecked, more or less.
Declan
Posted by River1924 on October 19, 2005, at 19:58:03
In reply to Re: Treat adult ADD or not? Stimulants and the liver., posted by Phillipa on October 19, 2005, at 19:15:18
"Do you know for a fact that ADD meds damage the liver? " No, I don't. I wish I knew his doctor's decisions were based upon something like science/research. River. Thanks for putting my question so succinctly.
Posted by River1924 on October 19, 2005, at 20:18:05
In reply to Re: Treat adult ADD or not? Stimulants and the liver. » River1924, posted by Declan on October 19, 2005, at 2:56:20
Does SAMe help ADD? (I tried it for depression and it gave me the worst headaches I've had in my entire life... so I have a prejudice against it.) I wish it weren't so expensive but, even just for his liver, SAMe would be beneficial.
Addiction doesn't seem to run in my family. My nephew can use illegal drugs or not use them. In general, those in my family with mental health issues tend to go off necessary medications because we hate feeling dependent. If anything, if he uses any meds for his ADD, he'll stop them at times despite their benefits. I don't know if most people go through this... but it took me years to accept that I needed my medication and felt more like "me" on them.
Posted by Declan on October 19, 2005, at 23:53:04
In reply to Re: Treat adult ADD or not? Stimulants and the liv » Declan, posted by River1924 on October 19, 2005, at 20:18:05
SAMe gave you headaches, eh? I've heard of people finding it overstimulating. I've just been thinking that for me SAMe+deprenyl is almost indistinguishable from low dose Parnate, and that's a speedy sort of calm feeling, which I thought might be useful, and of course good for the liver, which sounds serious in your nephew's case.
Declan
Posted by alohashirt on October 20, 2005, at 21:06:50
In reply to Re: Treat adult ADD or not? Stimulants and the liv » Declan, posted by River1924 on October 19, 2005, at 20:18:05
As an adult who was diagnosed with ADHD at the age of 37 I woul dheartily encourage medication. It's worth encouraging the guy to find an ADHD specialist, a psychitrist who is upo to speed on current medications. The medications available for ADHD in 2005, an dthe research results are completely different than five years ago. Ritalin and dexedrien based medications are still eth most effective but longer acting formulations like Focalin XR, Concerta, dexedrine spansules, are more convenient than teh shorter acting meds for some people.
Remember that "the pill won't give you the skill" The medication helps you focus. i am still learning to plan and structure, and estimate time an dstay tidy and find my keys and get my med forms submnitted on time, and ...
> Does SAMe help ADD? (I tried it for depression and it gave me the worst headaches I've had in my entire life... so I have a prejudice against it.) I wish it weren't so expensive but, even just for his liver, SAMe would be beneficial.
>
> Addiction doesn't seem to run in my family. My nephew can use illegal drugs or not use them. In general, those in my family with mental health issues tend to go off necessary medications because we hate feeling dependent. If anything, if he uses any meds for his ADD, he'll stop them at times despite their benefits. I don't know if most people go through this... but it took me years to accept that I needed my medication and felt more like "me" on them.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.