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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by btnd on December 20, 2003, at 14:57:27
I have a son who has ADD-inattentive (quiet) type. He is on Adderall and this medication worked WONDERFUL for him. It made him motivated, calm, non-anhedonic, he had lots of energy and drive to succeed.
After 2 months, he is at highest possible dose (30mg), because the tolerance has risen so suddenly in his case, and the med is now not working at all. It is making him full of anxiety, there is no motivation and energy like before, he tells me that nothing interests him anymore. If I'd only know about substances that block amphetamine tolerance (NDMA antagonists like memantine,magnesium,DXM,L-theanine) - I'd give him with his daily dose of Adderall. But I had known nothing about it back then. What should I do now? I'm really desperately trying to help him out. What to do? Thanks in advance for the response.Brad
Posted by Interject79 on December 20, 2003, at 15:38:17
In reply to ADD-inattentive - Adderall no longer helps - what , posted by btnd on December 20, 2003, at 14:57:27
Two things come to mind: L-Tyrosine or acetyl L-Tyrosine and DMAE. Well, maybe three things: calcium carbonate also. This might help the tolerance, which is likely what's going on.
Some recommend a holiday from Adderall, but that can be a nightmare for everyone. Maybe somebody else has had good experience with it though.
Some of the anti-Parkinson's drugs help (Selegiline comes to mind), but not sure how this goes with youngsters. Memantine usually does some good; it's hard to get though, and I'm not sure about age restrictions (though it's really pretty safe).
Best wishes,
interject
Posted by Jake E on December 22, 2003, at 1:29:08
In reply to Re: ADD-inattentive - Adderall no longer helps - what , posted by Interject79 on December 20, 2003, at 15:38:17
> Two things come to mind: L-Tyrosine or acetyl L-Tyrosine and DMAE. Well, maybe three things: calcium carbonate also. This might help the tolerance, which is likely what's going on.
>
> Some recommend a holiday from Adderall, but that can be a nightmare for everyone. Maybe somebody else has had good experience with it though.
>
> Some of the anti-Parkinson's drugs help (Selegiline comes to mind), but not sure how this goes with youngsters. Memantine usually does some good; it's hard to get though, and I'm not sure about age restrictions (though it's really pretty safe).
>
> Best wishes,
> interjectJust out of curiosity, where did you hear that calcium carbonate helps prevent adderall tolerance?
Posted by linkadge on December 22, 2003, at 7:18:51
In reply to Re: ADD-inattentive - Adderall no longer helps - what , posted by Jake E on December 22, 2003, at 1:29:08
Generally ADD meds are not used for lack of motivation, and anxiety. What I'm getting at is this. Your son may have a combination of ADD symptoms and depressive symptoms. In this case he may do better on certain antidepressants (that also have efficacy in depression/anxiety) Many times ADD meds are used with some sucess in what itinially appears to be ADD, but may infact be underlying depression. Ie. is it the anxiety that is keeping him from concentrating ?.
Best of Luck
Linkadge
Posted by Bill LL on December 22, 2003, at 9:11:40
In reply to ADD-inattentive - Adderall no longer helps - what , posted by btnd on December 20, 2003, at 14:57:27
Brad- I just did a quick internet search and came up with several sites that had 160mg per day as the maximum. I pasted one of them below. The maximum dose of Adderall is about 160 mg per day. It's 3/4 mg per pound of body weight. So if someone weighs 100 pounds, the maximum is 75 mg per day. I would talk to the doctor again about increasing the dose.
"However, the maximum dose of Adderall is thought by many doctors, including the Harvard University ADD Group, to be 3/4 of a milligram per pound of body weight (120 mg per day for a 160 pound person)."
Posted by btnd on December 23, 2003, at 12:03:42
In reply to Re: ADD-inattentive - Adderall maximum dose , posted by Bill LL on December 22, 2003, at 9:11:40
> Brad- I just did a quick internet search and came up with several sites that had 160mg per day as the maximum. I pasted one of them below. The maximum dose of Adderall is about 160 mg per day. It's 3/4 mg per pound of body weight. So if someone weighs 100 pounds, the maximum is 75 mg per day. I would talk to the doctor again about increasing the dose.
>
> "However, the maximum dose of Adderall is thought by many doctors, including the Harvard University ADD Group, to be 3/4 of a milligram per pound of body weight (120 mg per day for a 160 pound person)."
Although I also did an internet search and found exact same info, it makes me really think twice - giving 120 mg of amphetamine to a child ?? Isn't such dose considered recreational ? This would be like giving my child - "speed" ! Just my thoughts on it..
Posted by Interject79 on December 24, 2003, at 0:01:52
In reply to Re: ADD-inattentive - Adderall no longer helps - what , posted by Jake E on December 22, 2003, at 1:29:08
Calcium carbonate helps neutralize stomach acid, in theory allowing better absorption of Adderall, a salt mixture. This typically improves effectiveness, even if there's a mild tolerance. It's helped for me, that's for sure, as has sodium bicarbonate, but this is not good for you except on occasion. The other point is that since calcium carbonate only neutralizes stomach acid, not affecting blood pH, results aren't extraordinary. Absorption does seem to be better though, if only modestly.
(Vitamin B6 is helpful too.)
Best,
interject
Posted by dreaman on December 24, 2003, at 14:41:24
In reply to ADD-inattentive - Adderall no longer helps - what , posted by btnd on December 20, 2003, at 14:57:27
Just to let you know I have had what seems like the exact same experience as your son with stimulants. I have inattentive ADD and was on Ritalin for about 1 year with amazing results till I started to become totally tolerant to it. Upping the dosage really did not seem to help. I switched to adderal and it had no effect either. Also I think the ritalin might have caused some of my depression and anxiety which I really never had before ritalin! I think inattentives might have this tolerance problem alot more often than hyperactive ADDers.
If someone could try to explain the neurochemistry of dopamine, ritalin, or cocaine tolerance I would be very interested to understand it! How does memantine work against this? Could ritalin cause a perminant down regulation for the Dopamine receptors in the brain?
I have decided to try Strattera. Today I will take my first pill 10mg pill. Anyway strattera might be a good next step in trying to conquer your sons ADD, as I have not heard much about tolerance. There is another post <Strattera for inattentive ADD ?> farther down. This tells about ADD effects of Strattera.
If you find something that really does block the effects of adderall or ritaln tolerance, let me know. Memantine sounds like it might help
This is the end of the thread.
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