Forum topic: Medication questions

Wed Feb 18th, 2009 - 8:28pm by Sueann

Forum: 
Diagnosis and Treatment of ADHD

My husband takes 450 mg of Wellbutrin XR for depression. He had severe depression on Strattera, and had to stop that. (Honestly, he should have been hospitalized, but we didn't have insurance.)

Then the doctor tried Vyvanse, but he seems to have gotten too tolerant of that, and it didn't work well for him any more. His coach said she couldn't work with him until he got on a better medication to make his brain work better.

Then he tried Adderall and it made him jerk and shake, and he had a bad fall. So the doctor put him on Ritalin, but he has to take it twice a day, and he has trouble remembering to take the second dose, and he's still jerking and shaking and falling. He's going back to the doctor next week. I'm afraid he's not going to be able to take medication, and then he won't be able to do his job. But each time he has a doctor's appointment, he loses half a day of work, and that could threaten his job too. And he loses half a day of work so the doctor can spend 15 minutes with him. This doctor works with the ADHD clinic at our local university.

Does anybody have any ideas?

Comments

Submitted by Anonymous (not verified) on Fri Feb 20th, 2009 - 6:23pm

Hi, I have a husband that I know has ADD (after 17 years of marriage and a child and sister that has it also, I highly suspect my H. has it too) and he and I have met with a Psychiatrist instead of a regular counselor in order to receive meds if needed, which I also suspect he needs. My husbad also decided that yes, this was needed or he would lose our marriage at this point, so I am grateful that he made the decision to seek help. Granted, I too have issues that need healing, but that is another thing altogether. Well, after meeting with the Psyc. already, they offered a two page questionare as his diagnosis and I was really disappointed that after meeting with my husband for about a half hour, he decided my husband was suffering from depression and that was the cause of his symptoms. I totally disagree! How can someone meet with my husband and not even ask about how he dealt with some issues during his school years etc....meet with him for 30 min. and come to this conclusion?? I suspect that maybe it was more about the Doctor maybe was more concerned with ongoing therapy or something? I did question the Doctor and ask him "why" he did not think my h. had ADD and he said the a very small population do not "grow out of it" and I think that your husband has depression. Well, I totally disagree! Anyways, I would like some feedback on how to handle this Doctor or if you think that we need to find someone else at this point? The premises for this whole thing was for an ADHD Diagnosis, for crying out loud!! I am really frustrated at this point. The only thing good that came out of it was he did prescribe Wellbutrin, which I think helps ADHD too? I see some on this site are on it. Sorry if I posted in the wrong place, just need some input on this. Thanks!!!! Dana W.

Submitted by Anonymous (not verified) on Sat Feb 21st, 2009 - 2:29pm

My advice is to get a second opinion. Anytime you are not happy with a diagnosis and do not feel right about it, it is always good to get a second opinion regardless of the illness. This doctor does not seem to have his fact straight and is very wrong that most adults grow out of ADHD. Hope this helps!

Submitted by MelissaOrlov on Sun Feb 22nd, 2009 - 2:15pm

You should definitely get a second opinion.  First, many people with ADD also have depression (they get depressed because life with ADD is so hard).  Second, about 20-30% of people who had ADD as kids either "grow out of it" or learn to cope with it well enough that they no longer need treatment.  This is hardly "most" people, and in any event if he is still having ADD-like symptoms, then he might well not be one of them.

That said, there are other things that have similar symptoms to ADD.  So get a full evaluation from a psychiatric group that knows a lot about ADHD and other issues as well.  Worst thing that happens is that they confirm that it is only depression, and you have an answer you trust more. 

Submitted by Sueann on Tue Feb 24th, 2009 - 10:38pm

It's pretty clear to me that my husband has ADD, he shows all the symptoms of the inattentive type, and 2 doctors have agreed.

But, it took months of therapy and meds for depression before his therapist and I, simultaneously, figured out he had ADD. How do these doctors do it in just a few minutes?  He is lucky if he sees the doctor for 15 minutes. Half the time he gets palmed off on the PA. If you feel like your doctor is making a "snap" diagnosis, what do you do about it? Psychiatrists don't get to know their patients any more, or do therapy, they just push pills. Insurance doesn't pay for an endless number of visits, and even then, there's a co-pay that we can't afford. I can't find a physician in our medium-size city who specializes in ADD. On this website, it seems like people who can find a physician who specializes in ADD do well, but doctors who aren't totally up to speed on ADD and specialize in it just do it by trial and error. My husband just got a prescription for his 5th ADD med in a little less than 2 years. His meds have made him dizzy, depressed, nauseated, shaky, and even made him fall. He needs them if he is going to have a career and we are going to have a marriage, but how can he find the right one?

Submitted by Anonymous (not verified) on Tue Mar 10th, 2009 - 8:40am

Hi Can anyone guide me about treatment and medication monitoring for ADHD? My husband is newly diagnosed and I really am not impressed with his treatment so far. He keeps telling the psychiatrist that his meds aren't working well enough and the doctor just keeps giving him the same Rx after only experimenting with one other med. Also should he be talking to the doctor about ADHD and how to cope and dig for whatever else is going on with him? (we both know there is more than just ADD going on with him) It just seems like people on here have more going on with their doctor relationships. This is the second psychiatrist that we've been to for this reason and they just seem to be a place to get a prescription. Any advice? Thanks

Submitted by MelissaOrlov on Sat Mar 14th, 2009 - 11:26am

I'll say it up front - I'm not a doctor.  But here is some information that might help you.

First, finding the right ADD meds often takes experimentation and careful monitoring.  The objective should be symptom reduction without negative side effects (such as nausea, inability to sleep, etc).  Many people try several types of meds at different doses before getting it right.  A doctor needs to be involved.

You can help your doctor by monitoring what's going on, and when.  Keep track of these things:

  • what symptoms are you targeting?  How are you doing against those symptoms with the meds?
  • are there times of day that are better or worse?  In what ways?
  • what time of day did you take the meds?
  • how does being on the medication "feel" to the person taking it?
  • what do people around the patient see?  (usually a spouse, but could be in school or in a workplace)

Track these things and take the information to your next appointment.  The ideal situation is if the person taking the meds can't "feel" it, but others around him or her see obvious reduction in target symptoms.

If you want to see how one person officially tracks this, go to the ADHD Monitoring System set up by David Rabiner of Duke University.  This was set up for parents and teachers to monitor kids, but you could "remake" it to suit your own needs if you are so inspired.