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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by BUCKEYE FANATIC on November 25, 2006, at 11:42:39
Hi to all,I was thinking of trying something.
I am on 100 mgs of Zoloft and 4-5 mgs per day of Xanax....[b]and I just cannot focus or concentrate![/b]I have a big Exam coming up for my new job...so I was thinking of trying Concerta ( my wife absolutely refused to heed my advice and gOt a script for my daughter's alleged ADD)
I would like to take 20mgs ( 1 tablet) just to see if it would have the same calming down effect it has had on my daughter.
What do you think ?
BF
Posted by BUCKEYE FANATIC on November 25, 2006, at 11:46:44
In reply to Experiment....Any Danger ?, posted by BUCKEYE FANATIC on November 25, 2006, at 11:42:39
When we were in the MD's office with our daughter...I asked him how exactley does taking a STIMULANT ...calm a person down and help them focus.Guess what his answer was.??????
"I Dont Know,,,it just does"....direct quote
BF
Posted by Phillipa on November 25, 2006, at 12:12:47
In reply to FYI...Thought this was sad and funny, posted by BUCKEYE FANATIC on November 25, 2006, at 11:46:44
Do they know? Love Phillipa I think a lot is trial and error.
Posted by linkadge on November 25, 2006, at 13:06:38
In reply to Re: FYI...Thought this was sad and funny » BUCKEYE FANATIC, posted by Phillipa on November 25, 2006, at 12:12:47
I wouldn't take your daughters medication. Even if it does work you will have a heck of a time trying to explain that to your doctor.
There is a big problem with parents abusing their kids stimulant medications. I am not saying you fall into this category, but a doctor would likely think so.
Linkadge
Posted by Racer on November 25, 2006, at 13:17:50
In reply to FYI...Thought this was sad and funny, posted by BUCKEYE FANATIC on November 25, 2006, at 11:46:44
>
> When we were in the MD's office with our daughter...I asked him how exactley does taking a STIMULANT ...calm a person down and help them focus.
>
> Guess what his answer was.??????
>
> "I Dont Know,,,it just does"....direct quote
>
> BFAt least he was honest with you!
For what it's worth, stimulants have a paradoxical calming effect on those with ADHD though their indirect action on serotonin. Experiments in mice show that Ritalin does not increase dopamine concentrations in the brains of DAT knock-out mice, even though it does increase dopamine in normal mice. What does happen, though, is that it seems to affect the sensitivity of certain receptor types, and to help balance the ratio of serotonin and dopamine.
In other words, your daughter's doctor probably didn't know the answer, because he's probably not as dorky as I am...
Posted by linkadge on November 25, 2006, at 14:55:17
In reply to Re: FYI...Thought this was sad and funny » BUCKEYE FANATIC, posted by Racer on November 25, 2006, at 13:17:50
The actions of methylphenidate on serotonin are weak and do not fully explain its effects in ADHD. If the actions of methylphenidate were serotonergically mediated, then one would exect SSRI's to produce a similar calming effect in ADHD which they do not.
SSRI's often make ADHD worse.
Methylphenidate has negligable effect on the serotonin reuptake pump, but significant affinity for the dopamine reuptake pump. So if it affects serotonin, I don't know how.
Linkadge
Posted by linkadge on November 25, 2006, at 15:02:23
In reply to Re: FYI...Thought this was sad and funny » BUCKEYE FANATIC, posted by Racer on November 25, 2006, at 13:17:50
I would avoid methylphenidate. It causes chromisomal abberations.
Linkadge
Posted by notfred on November 25, 2006, at 17:23:22
In reply to Re: FYI...Thought this was sad and funny, posted by linkadge on November 25, 2006, at 15:02:23
> I would avoid methylphenidate. It causes chromisomal abberations.
>
>
> LinkadgeYou are stating this as a fact, please do not generalize. One study it not enought to state this as a fact.
Posted by linkadge on November 25, 2006, at 18:02:55
In reply to Re: FYI...Thought this was sad and funny, posted by notfred on November 25, 2006, at 17:23:22
I would think that if it were not true that ciba (or whoever makes ritalin) would jump on the opportunity to provide counter studies.
This study has been spread far and wide, and undoubtedly has an influence on the rates of prescription of the drug.
I agree it needs to be replicated, but it would concern me as a parent or patient taking the drug.
I would personally discontinue the drug untill it has been ruled out.
Linkadge
Posted by saturn on November 25, 2006, at 18:46:35
In reply to Re: FYI...Thought this was sad and funny, posted by linkadge on November 25, 2006, at 14:55:17
>
>> SSRI's often make ADHD worse.Hey Link,
I don't doubt this is possible, but may I ask how you came to this conclusion? Thanks. Peace...Saturn.
Posted by linkadge on November 25, 2006, at 18:56:44
In reply to Re: FYI...Thought this was sad and funny » linkadge, posted by saturn on November 25, 2006, at 18:46:35
I have heard this conclusion in a number of places. If I come across a link I'll post it.
There have been many reported cases of so called "frontal lobe syndrome" induced by SSRI's. Also called SSRI amotivatonal syndrome.
SSRI's are antiobsessive agents. Their dirty ability to decrease the capacity to obsess, also works to decrease concentration of other forms.
Ritalin is more than a calming agent. You can calm kids with benzodiazapines, but benzo's don't improve attention.
The attention improving effects of ritaline are (in my mind) linked to dopamine only. This is whay other agents (like bupropion) can substitute for ADHD meds, yet have no effect on serotonin.
The fact that methylphenidate still works in DAT knockout mice could imply that its effects on noradrenaline are at work. It doesn't necessarily imply serotonin is the key.
Linkadge
Posted by madeline on November 26, 2006, at 6:44:46
In reply to Experiment....Any Danger ?, posted by BUCKEYE FANATIC on November 25, 2006, at 11:42:39
I quote here directly an excerpt from a respnse to the study written as a letter to the editor in Cancer Letters (the journal in which the original study was published). The complete citation is below the quote.
Comments on ‘Cytogenetic effects in children treated with methylphenidate’ by El-Zein et al.
"There is quite an extensive published literature on the toxicity of the stimulant drugs, methylphenidate (as well as amphetamine), including studies of potential carcinogenicity and genetic toxicity. The available studies have been reviewed in recent reports from the National Toxicology Program's (NTP's) Center for the Evaluation of Risks to Human Reproduction [2] and [3]. As regards carcinogenicity, there was no increase in reports of cancer in humans from methylphenidate (or amphetamine) based on a review of records from a large cohort that had been prescribed these drugs [4]. In a rodent 2-year bioassay [5] and [6], there was no evidence for carcinogenicity in rats given 47 mg/kg bw/day; however, male and female mice of a strain that is susceptible to the development of hepatic neoplasms that had received 56–66 mg/kg bw/day had an increase in hepatic neoplasms. Based on a review of a range of standard short-term genotoxicity assays the NTP concluded that methylphenidate ‘… is not a gene mutagen in bacteria or mammalian cells, but … might have some potential for inducing clastogenic damage in mammalian cells’ [2]. In the context of this conclusion, the NTP further noted that some studies reported increases in sister chromatid exchanges (SCE), but these occurred at highly cytotoxic concentrations and the increases in chromosomal aberrations were not well correlated with dose."
R. Julian Preston et al., Cancer Letters
Volume 230, Issue 2 , 18 December 2005, Pages 292-294I will let you draw your own conclusions.
Since most people will not have online access to the journal, if you would like a copy of the entire PDF just babblemail me. I think babblemail will allow attachments - anyway we will find out...
Posted by linkadge on November 26, 2006, at 9:41:05
In reply to So the question is - does ritalin cause cancer, posted by madeline on November 26, 2006, at 6:44:46
I would have some questions.
For instance, how long were the sample patients taking stimulants or ritalin? How many sample patients were taking such drugs?
Damaged chromosomes will not equate to cancer overnight. Hence studying children who have taken the drug in the past 10 years wouldn't mean anything.
I would be looking for samples of the people who had been exposed to the drug 50 years ago to see if there is any increased incidence of cancer.
Linkadge
Posted by linkadge on November 26, 2006, at 9:44:19
In reply to Re: So the question is - does ritalin cause cancer, posted by linkadge on November 26, 2006, at 9:41:05
I would be looking for somebody to confirm or denounce the findings of the chromisomal study, as chromisomal abberations are a risk factor for cancer.
Linkadge
Posted by naughtypuppy on November 26, 2006, at 12:05:00
In reply to FYI...Thought this was sad and funny, posted by BUCKEYE FANATIC on November 25, 2006, at 11:46:44
What has always fascinated me about the diagnosis of ADHD is that it is nearly always only children that have it. Is it something they magically grow out of untreated or otherwise? Why don't these children grow up to be adults that still have it unless Ritalin is just a convienience to make the teachers life easier?
Posted by Meri-Tuuli on November 26, 2006, at 12:13:33
In reply to Re: FYI...Thought this was sad and funny, posted by naughtypuppy on November 26, 2006, at 12:05:00
Adults have it, but only in America it seems. In the UK children are allowed to have it, but somehow adults don't have it. I don't think they grow out of it, I think they just go 'unnoticed' or something. Or turn to street drugs, or whatever. I reckon there are alot of undiagnosed adults living in the UK.... anyway. But in America, it doesn't so much seem to be a problem with adults getting treatment for ADHD/ADD.
Posted by linkadge on November 26, 2006, at 12:44:06
In reply to Re: FYI...Thought this was sad and funny » naughtypuppy, posted by Meri-Tuuli on November 26, 2006, at 12:13:33
I think there is evidence that it does subside or lesson for a number of people as they become adults. Not to say that it does for all though.
Got to do with the development of the frontal cortex (?)
Linkadge
Posted by 10derHeart on November 26, 2006, at 13:52:28
In reply to FYI...Thought this was sad and funny, posted by BUCKEYE FANATIC on November 25, 2006, at 11:46:44
I have ADD and used to take Ritalin (only switched meds due to HTN issues which predated the stimulant), which absolutely did help, enabled me to focus maybe for the first time *ever*, allowed me to come closer to being able to disentagle all the racing thoughts in my ADD brain and make choices, prioritize, organize like others do. It was quite amazing.
This may not be accepted scientific fact, or substantiated (as yet) by the necessary studies, but the brain being *properly* stimulated, particularly in inattentive-type ADD (seems more common in girls) WILL improve focus and attention. Has to do with the area controlling executive function (prefrontal cortex, I think) which appears sluggish on certain scans in ADD pts....
So...when the brain is *stimulated* and can work as those of people without ADD, the person may be able to do the things I listed above. Of course if your daughter appears to you to be mostly "hyper" instead of disorganized, inattentive, forgetful, overwhelmed by the day-to-day stuff...then I see why the stimulant seems to make less sense. But - and these are just best-I-can-recall laymen's terms - I think it works the same way. An area of the brain is activated (stimulated) by the MPH, and therefore the person has a vastly improved ability to control talking, interrupting, jumping around, staying on task, etc., whereas without the med it's nearly impossible.
I think that's the general, rough theory.
And please, please, don't take your daughter's Concerta. It's a controlled substance, and it's not prescribed to you. You may well be breaking the law doing so. Also, I think you're maybe saying that anxiety is the issue with the Big Test, if I got that right? For someone without ADD, Concerta could very well make you feel worse, more anxious even, from what I've heard and read.
I'd just hate to see you get in a bad situation - medically or legally - later on. Maybe there are other ways to try to calm down for the test? I'm not sure wht you're tried before, but I'll bet all the brilliant folks here will have some ideas...
Good luck, BF.
Posted by madeline on November 26, 2006, at 16:13:23
In reply to Re: FYI...Thought this was sad and funny » naughtypuppy, posted by Meri-Tuuli on November 26, 2006, at 12:13:33
your post almost made me spit my coffee on my computer.
Too funny and yet too sad.
Posted by Racer on November 26, 2006, at 19:50:33
In reply to Re: FYI...Thought this was sad and funny, posted by linkadge on November 25, 2006, at 14:55:17
>
>
> Methylphenidate has negligable effect on the serotonin reuptake pump, but significant affinity for the dopamine reuptake pump. So if it affects serotonin, I don't know how.
>
>
>
> Linkadge
>
>There's an increase in extracellular dopamine, of course, because of the DAT blockade. That leads to a downregulation in the 5HT2c receptors, which is the serotinergic effect.
Of course, that's also based on limited studies.
Then again, that fits with other studies showing that SSRIs work by downregulation of the 5HT2c receptors, which reduces the inhibition of dopamine release...
Posted by linkadge on November 26, 2006, at 21:01:02
In reply to Re: FYI...Thought this was sad and funny » linkadge, posted by Racer on November 26, 2006, at 19:50:33
>There's an increase in extracellular dopamine, >of course, because of the DAT blockade. That >leads to a downregulation in the 5HT2c >receptors, which is the serotinergic effect.
I suppose. Although, if like you mention below, downregulation of 5-ht2c results in more dopamine release, this would additionally point to the dopaminergic effects of ritalin.
>Then again, that fits with other studies showing >that SSRIs work by downregulation of the 5HT2c >receptors, which reduces the inhibition of >dopamine release...I don't know if I'd say work by this mechanism. Consider it this way. Even if the drug downregulates 5-ht2c, thats not to say you have more dopamine released, just that the brain is trying to compensate for the SSRI induced inhibition on dopamine release.
So, you may have downregualted 5-ht2c, which will result in more dopamine release only when drug levels drop. So long as drug levels remain high, you have excessive stimulation of 5-ht2c. So, *excessive stimulation* of a *dowregulated receptor*, may just result in normal dopamine release.
Linkadge
Posted by Steven D on December 7, 2006, at 14:40:42
In reply to Re: So the question is - does ritalin cause cancer, posted by linkadge on November 26, 2006, at 9:44:19
IMO, the study is very concerning yes. I have read another study which concludes that human hepatic enzymes can convert methylphenidate into a mutagenic metabolite. So I think there was no correlation with dose because the effect is dependent on the amount of specific enzymes. Methylphenidate did not induce tumors in rats because rats I think do not have these enzymes.
I would tell the entire world to stop giving the drug to children or they would sure regret it, even if a good cancer cure/ cancer prevention strategy would become available within decades.
The cytogenetic changes could cause cells to lose their ability to divide, therefore causing growth attenuation, as seen in many studies. Furthermore, mutations initiate the carcinogenic process, that results in the creation of tumors.
This is the end of the thread.
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