Daytrana is an ADHD patch – a system that delivers methylphenidate, which is the same standard medication accessible in tablet forms such as Ritalin and Concerta. The uniqueness of this system is the way it’s delivered.

It is a relatively new type of medication to manage ADHD. The patch is applied to skin at the hip area and left on for approximately 9 hours while the medicine is gradually absorbed into the body. It is meant to give relief from ADHD symptoms such as lack of concentration and poor organization skills.

Daytrana first came into the market in 2006, offering an alternative to ADHD medications such as pills. Daytrana lets the medicine to be sent directly to the bloodstream without the need to be digested first. Kids who use the Daytrana patch are probably more likely to feel the positive effects of the patch and help them to complete their school work during the day.

The distinct benefit of the product is its ability to let each patient to find out the duration of action of the medication on a daily basis. The patch is meant to be applied for about two hours prior to the medication’s effect is needed, and the effectiveness goes on for up to three hours after the patch is removed.

The delivery of the medication is easy and simple as the patch can be worn throughout the day while performing normal activities like swimming, bathing, or while performing exercises. As the patch is visible externally, parents can make sure that the medication is on when compared to pills and medicine that do not confirm whether the medication has really been taken. One good thing about the patch is that, once applied, it cannot be removed and re-used by others.

The company recommends the patch to be worn for 9 hours, although it can be taken off before that time. It can be helpful especially when the child’s school schedule is short. The patch can also be taken off earlier to minimise the chances for decreasing the appetite or interfering with sleep pattern.

When it comes to cost, all new medications tend to be expensive in the beginning, especially when they are protected by a patent. At the moment, Daytrana is more expensive than the generic types of oral medication, but it may be less expensive than oral ADHD medications that are still covered by a patent.

How does Daytrana work?

Daytrana releases a small doses of medication on an hourly basis so that kids with ADHD have a constant amount during the school day. It is recommended to be applied 2 hours before the medication is required to begin working.

Daytrana is an adhesive patch that securely sticks to the hip of the ADHD child throughout daily actions. As long as it is applied properly, Daytrana is a convenient medication for controlling ADHD symptoms.

Benefits

Parents who are having problems administering medication to their kids with ADHD, now have a better option, especially when kids refuse to swallow pills or who want to avert the stigma of taking medication at school. The Daytrana patch saves parents the fuss of crushing a tablet, mixing it with food or water, and hope their child will swallow the ADHD medicine.

In the case of pills, the medication is swallowed and released in the digestive system, later to be absorbed into the bloodstream. In the case of the patch, the method is different as the medication goes straight through the skin, and is absorbed into the bloodstream avoiding the digestive system. One good thing about the patch is that the same amount of medication is present right across the patch, although in different doses to be worn for shorter or longer periods of time.

Many children with ADHD are using the Daytrana patch to treat their symptoms during the day and help with attention and focus in school.

How to use and dispose the patch

Before applying the patch, make sure the area of the hip that you apply is clean and dry. Do not put it at the waistline as the patch may be moved away by clothes rubbing against it. While applying the patch, securely press it with your hand for about thirty seconds, making sure the edges are completely stuck. The full surface of the patch must be exposed to the skin for the correct amount of medication to be absorbed.

When correctly applied, the patch will stay on and keep producing medicine. However, exposure to water from bathing or swimming could affect its adhesive properties. If the patch falls off, throw it away and apply a new patch to a different region of the same hip, ensuring the total daily length of time does not go beyond 9 hours. Don’t use tape, bandages, or other home adhesives to re-apply the patch.

Disposing of the patch properly is as important as applying it. To protect kids from coming into contact with the medicine, always remember to fold it in half so that it sticks to itself, and then throw it away safely.

Side effects

Side effects of the Daytrana patch include sleep difficulties, loss of appetite, stomach pains, and headaches. As the patch sticks to the skin, it can also cause a rash or irritation. However, this can dealt with by applying the patch to a different area of the hip every day. Do not apply the patch to irritated or damaged skin as it could increase the amount of medication that gets into your child’s bloodstream.

The side effects of the methylphenidate medication are similar to the oral forms, where a child may get irritated, angry, especially if the dose is too high.

The disadvantages of the system include the need for meticulous application of the patch every day, at a different area on the body, normally the hip region below the waistline, and redness can be expected at the area for up to 2 days after patch removal.

Heat must never be applied to the patch like heating pads, electric blankets, and heated water beds, because this could change the rate of delivery of the medication into the system.

There is a possibility of developing an allergic reaction to the adhesive, or potentially to the medication itself.

The most common reactions related with Daytrana (about 5% and double the rate of placebo-treated patients) in clinical trials among children included decreased appetite, insomnia, nausea, vomiting, and decreased weight. Among a adolescents, there has been decreased appetite, insomnia, decreased weight, dizziness, abdominal pain and anorexia.

And also, most of subjects in these studies had a degree of skin erythema where the patch was applied. Leaving the patch on for more than the stipulated 9 hours resulted in a rise of adverse events.

Conclusion

As with all ADHD medications, the use of the Daytrana patch will have to be cautiously monitored by a doctor. It is advisable to discuss this new system with your child’s doctor and then decide whether it’s the right thing for you and your child.

Some of the most common attention deficit hyperactivity disorder (ADHD) symptoms include inattention, impulsivity or hyperactivity that could play a major part in a child’s capability to learn and live with others.

People often make the assumption that an ADHD child’s behavior stems from indiscipline, a troubled family life, or even watching excess TV. But according to research, ADHD is in principal a genetic disorder.

However, there are a few environmental factors that could affect ADHD. Let us look at the myths and facts that could cause ADHD:

1. Pesticides – Research indicates a potential link between ADHD and pesticides. A 2010 study in Pediatrics established that children with increased urine levels of organophosphate (a pesticide used on produce) revealed high ADHD rates.

In another study in 2010, researchers found that women with high urine levels of organophosphate were expected to have a child with ADHD.

The studies suggest a possible relation, but cannot prove that pesticides are the reason for causing ADHD. Marcy Rosenzweig Leavitt, PsyD, who works with ADHD patients in Los Angeles, recommends consuming organic fruits and vegetables as inorganic ones contain high levels of pesticides.

2. Smoking and drinking during pregnancy – Fetal exposure to alcohol and tobacco is believed to play a part in ADHD. According to research, kids exposed to tobacco smoke prenatally are twice as much likely to have ADHD compared to those who are not.

Mark L. Wolraich, MD, chief of the section of developmental and behavioral pediatrics at the University of Oklahoma Health Sciences Center, believes that fetuses exposed to alcohol are affected by fetal alcohol syndrome, and the symptoms are expressed in ADHD.

3. Exposure to lead – Although lead, a neurotoxin, is removed from almost all homes and schools, but you can still find small quantities of it everywhere.

A study conducted in 2009 suggested that children with ADHD are prone to have increased blood-lead levels compared to other children. The research found that although lead can be toxic to the development of brain tissue and could have continuous effects on the behavior of children exposed to these substances, but it is farfetched to conclude that such exposure could have an impact in the majority of children and teenagers with ADHD.

4. Food preservatives – Most EU countries have banned particular preservatives after a study found evidence of hyperactivity in kids who consumed food that contained mixtures of artificial food colors and sodium benzoate, which is a widely used preservative,

The FDA has stated that food additives are safe only when used properly, and most additives are not needed to be visibly labeled on packaging.

Experts like Marcy Rosenzweig Leavitt consider only a minority of kids could benefit by staying away from brightly colored processed foods that are prone to contain more additives. Cutting down on these additives may or may not aid hyperactive behavior, but many factors play a part in ADHD.

5. Sugar – Parents have often assumed that sugar could cause hyperactive behavior, but it’s so wrong. There have been many studies, but none have been able to demonstrate behavior changes due to sugar consumption in kids.

A study in the Journal of Abnormal Child Psychology found that mothers who believed their kids were given sugar rated their kids’ behavior to be more hyperactive compared to mothers who were told their kids were given a sugar substitute, despite of whether their kids actually consumed real sugar. Cut down on sugar if you are concerned about calorie consumption or dental cavities, but not due to ADHD.

6. Watching Television – There’s no evidence that watching excess TV or playing video games will cause ADHD, while research states that teenagers who spend a lot of time watching TV were prone to more attention problems compared to those who did not. In theory, regular stimulation of television and video games might make it difficult for young people to stay attentive.

7. Poor parenting – Rebellious attitude and bad behavior is often confused with ADHD symptoms and usually it’s the parents who are blamed for their kids’ conduct. However according to the National Resource Center on ADHD (1), there is no hard proof to suggest parenting style could lead to ADHD.

Marcy Rosenzweig Leavitt believes that parents who make use of reward and consequence behavior tools, and provide simple set of expectations could help reduce ADHD symptoms.

8. Brain injury – According to the National Institute of Mental Health (NIMH) (2), children who have undergone particular types of brain trauma may display symptoms parallel to ADHD. As only a small minority of children with ADHD has faced a traumatic brain injury, it is not deemed to be a crucial risk factor.

9. Diet – In the past, food allergies were popularly believed to be the cause of ADHD, but research so far has found no evidence that diet plays a substantial role in ADHD.

However, according to a recent Australian study, particular dietary blocks could affect behavior among adolescents who consumed foods high in fat, refined sugar, and sodium. They were two times as likely to be diagnosed with ADHD compared to other children. Further studies have also associated diets lacking in omega-3 fatty acids could lead to ADHD symptoms as they are helpful for brain development,.

10. Genes – There is strong evidence to prove that ADHD is inherited from parents, but not parenting style. Experts say this heritable psychiatric disorder can affect a child with ADHD, especially if a relative has been diagnosed with ADHD. Research among multiple twins also shows that ADHD often runs in families.

A new study by researchers at Cardiff University in Wales established that kids with ADHD are more likely to have missing or duplicated segments of DNA.

Sources:
1) National Resource Center on ADHD
2) National Institute of Mental Health (NIMH)

The ratio of children and teenagers in America who have a developmental disability such as autism, learning disorders or attention-deficit/hyperactivity disorder (ADHD) has grown 17% since the late 1990s, according to a new study conducted by the U.S. Centers for Disease Control and Prevention.

In 1997-1999, around 12.8 percent of kids were known to have a developmental disability. That figure increased to 15% in 2006-2008, with an additional 1.8 million American children.

This upward drift has been propelled mostly by increase in the number of children with autism and attention deficit hyperactivity disorder. Occurrence of stuttering and learning disabilities has also grown.

The study is published in the June 2011 issue of the journal Pediatrics.

Sheree Boulet, Dr.P.H., one of the study’s authors and an epidemiologist at the CDC’s National Center on Birth Defects and Developmental Disabilities (1) states that it is the first time representative data on developmental disabilities has been gathered on a nationwide basis since 1988.

There seems to be no clear explanations for the increases, but a wider acceptance of developmental disabilities has played a vital role. Boulet explains that with the accessibility to early treatments for conditions such as ADHD has prompted more parents to get their kids screened for the disorder.

According to the researchers, the occurrence of disabilities may be really increasing. Some of the contributing risk factors could be couples opting to have children later in life, premature births, and rise in the use of fertility treatments. Boulet is confident that the findings could pave way for prevention strategies that could help in the long run.

The study was conducted on nationwide basis, involving interviews with about 120,000 children.

Some of the questions the researchers asked parents was whether their children had been diagnosed with autism, ADHD, learning disabilities, cerebral palsy, seizures, stuttering or stammering, hearing loss, blindness, or intellectual disability.

Boulet states that there were striking variations in diagnosis rates across economic, ethnic, and gender perspectives.

The study also found that boys were more probable to have a developmental disability compared to girls. When compared with white and black kids, Hispanic kids were less likely to be diagnosed with disabilities. Children with public insurance like Medicaid were more likely to have disabilities than children on private insurance programmes.

Boulet proclaims that the increase in disabilities as seen in the study is a wake-up call for a revamp of the health-care system, which needs to bolstered with specialized health, mental health services and therapists. Only then can children be provided with specialized treatment and preventative care.

More awareness needed

Lead study author Coleen Boyle, director of the U.S. National Center on Birth Defects and Developmental Disabilities (2) stressed on the need to invest in programs to assist and facilitate a child’s health-care and their overall development. He suggested that progressive maternal and paternal age, aided reproductive technology and large numbers of premature or late-preterm births, could all play a part in influencing developmental disabilities.

Dr. Nancy Murphy, chair of the American Academy of Pediatrics’ Council (3) on Children with Disabilities considers the increases in these conditions may indicate a greater awareness on the part of parents, teachers and health care professionals to identify children with developing disabilities such as autism and ADHD early in life.

The growth in medical science and technology has helped children born with severe developmental disabilities like neuromuscular or chromosomal disorders increase survival rates when compared to in the past, according to Dr Murphy.

The study concluded that although the proportion of autism and ADHD were on the rise, other developmental conditions stayed the same including blindness and intellectual disability, whereas moderate to profound hearing loss showed a noteworthy decline.

Sources:
1) The U.S. National Institute of Child Health & Human Development
2) U.S. National Center on Birth Defects and Developmental Disabilities
3) American Academy of Pediatrics’ Council

This is an informal test with 33 items designed for adult ADHD – that focuses on the way the condition manifests specifically in adults.

What distinguishes it from most ADHD tests is that a) it is written for adults b) it is behaviorally based.  That means it asks if you have behaviors associated with ADHD.

The limitation to this approach is that it may miss something or that some behaviors may not be restricted to ADHD.

That said, as you read each item, mentally note if, “yes, that’s me.”  If you think “yes” more than a few times, then you may have ADHD.

1)         You sit down to study something you don’t want to.  Five minutes later, you’ve decided that it isn’t worth doing, that it’s not important, that you’re not interested in it – whatever.  You come up with a reason so you don’t have to study.

2)         Someone can be talking directly to you, but you get either really irritated – you want to talk about something else – or start to zone out and not really hear what they’re saying.

3)         Is something boring? If something is boring, then doing it feels like your mind was put into a blender and then sucked through a straw. If something is interesting, however, you can do it for hours without getting tired or losing interest.

4)         You tend to get lost while driving. Additionally, you tend to lose your temper or get frustrated with the other people on the road.  Why do they drive so fast?  Or so close to your car?

5)         You are really excited about a new idea until someone points out a flaw in it.  Then you lose enthusiasm like a deflated balloon.  Many of your great ideas die when they turn out to take more work than expected.

6)         Over the course of a day, you may go from one extreme mood to another.  You may feel like things are great, lose excitement, get bored, get excited and so on – all in the course of a day.

7)         You can watch television, talk on instant message, and do crossword puzzles – all at the same time.  You actually find it relaxing, or that you focus better.

8)        People can sit at the dinner table and talk for hours.  Say it’s just a plain old dinner and not on one of your favorite topics do you leave the dinner as fast as possible?

9)         Are there periods where you get really excited about something and just slip into a zone where that is all you think about? Hours go by like seconds.

It’s called hyperfocus, and if that name “clicks” with you, than it’s likely you have it.

10)       You’re playing video games or doing something fun, when someone you know starts talking to you.  “Why don’t you take out the garbage, please?”

“I said I’ll do it – after I finish doing what I’m doing.  Why don’t you trust me?”

“Because I need it right now.  Please!  You’re not even doing anything right now!”

A fight ensues.

Sound familiar?

11)       You’re in math class.  The teacher is talking: “So if you add 3 + 4 and..”

“it’s 7!” you call out.

The teacher coughs, gives you a black look, and goes on -“So if you add 3 + 4 and multiply by 2…”

12)       Sometimes you can just zone out.  Time flies by, you’re deeply relaxed and thinking about things that have absolutely nothing to do with what or where you are – like life in general.

13)       You’re in Paris with some friends, and deciding what to do.  “Okay, first we’ll see the Louvre, then hit the National Museum, then see a juggling show, then…”

Sound like you?  When you’re in the groove, you’re a powerhouse of energy.

14)       Sometimes you get really angry for no reason, or shout at someone for stupid reasons.  The anger doesn’t make that much sense and it goes away really quickly too.

15)       You’re supposed to do something, but you forgot or lost the things you need to do it.

16)       You notice things all over the room that are extremely random or irrelevant.  Like, for instance, in a meeting, you may notice the clicking of pens, the leaves falling outside, and so on – all while you should be paying attention.

17)       You are wondering if you could be doing something more interesting than reading this list.

18)       When  you start getting bored, you have to move physically or do something different.  Now!  And if you sit still for too long, you almost feel physical pain in your head.  It’s hard to describe.

19) Hitchhiking through the amazons while writing a book and making new friends with the natives – does that sound like an ideal trip?

20)       You’re at the coffee shop with a friend, and you’re ordering.   “That’ll be a triple shot espresso, please!”

Your friend looks at you.  “How are you going to fall asleep?  And…umm, aren’t you a little hyper already?”

You smile.  “It actually makes me think better.”  (Friend in the back of her mind mumbles, It makes everyone think better…)

You down the coffee and feel calmer.  Then you have an hour long conversation about the new dynamics at work, take a walk and really connect.

21)       You are the first to start new things, like wearing multicolored socks. When things start to become cool, you can be among those who make it so – adopting them before everyone else.  You might find yourself ahead of trends because you’re always looking for something new.

22)       When you love someone, you think nothing of spending hours on them, noticing what’s really important to them, and being very romantic.  Your ability to focus can make you an irresistible charmer – when you’re interested.

23)       “We’re going to have to start using this new program.”  One week later, you’ve pretty much figured everything about it, while everyone else is complaining about the change.  When you have to update all your files to the new format, however, you don’t get round to doing it for a long, long time.

24)       You’re always interested in making new friends.  Frankly, they’re usually more interesting than your old friends!

25)       Since you’ve gotten lost so many times, as long as nothing important is happening, you just enjoy getting to see something new.  It sometimes is fun.

26)       You can be very loyal, sticking with someone when everyone else abandons them

27)       When you find something interesting, you can learn everything about it.  When someone tells you something about it, you don’t forget it, either.  For that one thing, you are a supergenius.

28)       You just finished a lecture and you are the first to start clapping.  Are you among the first to react to things?

29)       Someone walks up behind you, shouts “boo!” You hardly flinch.  You just have a feel for what’s going on in a room, and aren’t easily caught off guard.

30)       Do you quickly forget what happened or the past, or not feel like it’s important?  Are you always doing something new?

31)        Your new boss wants to try a marketing method you feel is highly immoral.

Everyone else in the office tells you to wait, that the approval process for sure will make it cleaner and more appropriate  But you feel you have to do something right away.

When you next bump into your new boss, you blurt out how you feel.

32)       You’re in a meeting when you can’t wait anymore.  You blurt out,  “But why don’t we try doing this?  Am I the only one who noticed we don’t have a real marketing plan?”

Sometimes you seem to notice things others don’t.  That said, sometimes you might say something impulsively that everyone kind of laughs at.  It can be embarrassing.  Because even if you have a good point, if not delivered the right way, it can be taken the wrong way.

33)       When you want to get something done, you get it done.  The way you get there might be totally bizarre, strange, exotic – whatever.  But you get there.

Wow, that described me pretty accurately!

Some people read this test and are amazed at how accurate it is.  They wonder, maybe I have ADHD – what are the next steps, or how can I improve my life?

Click here for more.

You may also be interested in the 4 Secrets to Success with ADHD, which tells you the 4 things you just need to know if you have ADHD.

Life with ADHD

What Sucks & What Rocks About ADHD – what is good about having ADHD, and what is bad?

Medications

In 70-80% of people, when combined with therapy, medication works fairly well to treat ADHD.  See a Full List of ADHD Medications to learn what the most commonly used treatments are and how well they work.

Ritalin: What it is, How it Works – What is Ritalin and how does it work?

ADHD and ADD Online Diagnostic Test

ADHD/ADD Natural Remedy Report

Overcoming ADHD: A Guide For Parents

Ritalin, or methylphenidate, is the most popular medication used to treat attention deficit disorder, with or without hyperactivity (ADD & ADHD).  It works by activating pathways in the brain associated with attention, focus and motivation and is extremely effective for treating ADD/ADHD.

But as a Schedule II medication, Ritalin is a potent stimulant with potentially serious side effects.

How well does Ritalin work?

Ritalin is a stimulant and the stimulants in general work to significantly treat ADHD symptoms in roughly 70-80% of those who take them.  That number, however, is in combination with therapy – without therapy, the response rate is only about 50%.

But why is there such a big difference in efficacy between medication alone and medication with therapy?

The reason is likely because Ritalin makes it possible for you to behave in a less “ADHD fashion” but that you still have to learn to do so.  You may take Ritalin, for instance, and still forget to pack an important item before a meeting because you weren’t organized.

How does Ritalin work?

Let’s first explain the biochemical action then explain what it actually means.

Biochemically, Ritalin has a few effects.  Mainly, it works on the dopamine transporter in the brain, inhibiting it.  This prevents it from removing dopamine from the space outside cells.  Since dopamine remains longer outside cells, it has more time to activate receptors.  This treats ADHD symptoms because dopamine is associated with focus and motivation.

But what does that mean?

When your brain experiences a stimulus, it has to decide whether or not it is important.  If it is important, you pay attention to it.  In ADD/ADHD, an increasing amount of research shows that this attention pathway is dysregulated.

Paying attention to something boring for someone with ADHD is a lot like trying to lift a weight after someone injected a tranquilizer into your arm.  It takes something being very, very important or interesting to achieve the same “this is important” decision that someone’s brain without ADD easily makes.

Ritalin helps your brain process signals and decide which ones are important.  And beyond helping your brain do that, it helps you keep focused on whatever it is for longer than you could otherwise.

Is instant release or extended release better?

A lot of research is starting to indicate that extended release forms of stimulants for ADHD are a lot better than instant release.  It makes a lot of sense!  Would you rather take 2-3 pills a day or just one? 

Beyond the once-daily dosing, extended release formulations provide smooth drug release.  Taking instant release forms of Ritalin is a lot more intense, with drug levels spiking up then shooting down – several times in one day.

Supporting this claim are studies which show that more people experience ADD/ADHD symptom remission on extended release Ritalin (Concerta) than instant release.  In one study, 44% of those on Concerta had complete symptom remission versus only 16% of those on instant release.

Because of these advantages, clinicians tend to prefer extended release forms over instant release.

What are the side effects of Ritalin?

The most common side effects of Ritalin include dry mouth, decreased appetite, moodiness, mood changes including increased sadness or anxiety, decrease in appetite and weight.  This list is not complete; see manufacturer’s insert for more.

In one study, about 10% of adults taking Ritalin and 5% of adolescents stopped taking Ritalin due to side effects.

Does Ritalin work if you take it daily for a long time?

There is limited research into whether or not tolerance into stimulants like Ritalin develops.  That said, most researchers and clinicians believe that tolerance is quite rare – but possible.  In most cases, once you find a dose that works for you, you can take it daily for years without tolerance developing.

ADHD and ADD Online Diagnostic Test

ADHD/ADD Natural Remedy Report

Overcoming ADHD: A Guide for Parents

This article was written by a new addition to our team who has significant personal experience with the ADHD medication Vyvanse.

None of the ADHD medications I had tried, Ritalin, Adderall, Strattera and Wellbutrin had helped me much.  Vyvanse has.

First, I go over 10 things I’ve learned from taking Vyvanse for about a year that may help you if you are taking or considering taking it.

These are things you can pretty much only know if you have been taking it for a while – that would have made my life a lot easier had I known when I was starting!

And if you want to learn more about ADHD, see here.

The 10 Things You Should Know About Vyvanse

1) Vyvanse is extremely long lasting

Its half life is about 9 and a half hours give or take an hour or two.  That means that in most people, the medication has some effect for up to 14 hours!  But there is more to the story – see element 8.

2)You can take Vyvanse daily

You can take it every single day of the week, every day of the month, and every month of the year – and it still works!

You hear all the time about people saying they develop tolerance to ADHD medications or they stop working – so I was very scared.  I didn’t want to take Vyvanse every day because it helped so much and I couldn’t stand the thought of it not working anymore.  But thankfully, it seems you can take it daily and it still works!

Online ADHD/ADD diagnostic test

3) At the right dose, you might start thinking that it isn’t working anymore eventually.

It seems that a lot of people who take ADHD medications, when they find the right dose and are consistently taking it, don’t really feel like it is doing anything.

Which is wonderful!  Because, for me at least, it means that my personality and who I am are 100% intact – I take Vyvanse and I feel like it doesn’t do anything (but it does!)

Now when I tell you that the Vyvanse still works for me and that I very often worry it has stopped working, you may feel doubtful.  The reason I can say this for sure is that if I try a slightly higher dose, say 50mg instead of 40mg, then I feel way, way, overfocused.  If the 40mg had stopped working, this would not be the case.

4) Vyvanse is d-amphetamine

It turns out that Adderall is made out of d and l-amphetamines.  The l-amphetamine type may be responsible for the weird feeling some people get on Adderall.  It does provide more of a motivational kick, however – but I much rather not have it and feel like myself.

5) Vyvanse is mostly digested in the blood so what you eat likely won’t affect it so much

With some ADHD medications, your diet content really affects how the drug is released.  It turns out that with Vyvanse, most of the action takes place in the blood.  This means that your diet likely won’t affect it so much, but I still don’t drink orange juice in the morning on it.

6) It takes an hour to kick in, and two hours to fully kick in

I take Vyvanse in the morning with a cup of water and have a snack 20 minutes later.  It starts having an effect I can notice at 20 minutes and is ‘fully’ operational (to the point where I trust myself to send emails or work on something) at about 1 hour.

7) Exercising does not seem to change its effects very much.  I can get a 20 minute high intensity cardio work out and still feel the Vyvanse working normally.  This is very important because I love exercising.

8) It becomes weaker at night

When I first took Vyvanse, I felt the difference from 9am in the morning to 9pm at night.  With time, I felt like it stopped working at 7pm and then, increasingly, that it stopped at 5pm.  9am to 5pm is 8 hours.  I started getting depressed and was not able to do things past 5pm; figuring out what’s really going on got me back on track.

At 5pm or 8 hours in, the levels of Vyvanse are about 60% of their peak (for me, at least, and in my estimation).

At 7pm, or 10 hours in, the levels are about 40% of their peak.

At 10pm, or 13 hours in, they are at about 20% of their peak.

How do I know all this?  First, this is my personal experience.  Second, I am basing it off my experiments with Dexedrine instant release.  See the next item.

9) I think there are about 3.3mg of Vyvanse to 1mg of Dexedrine instant release.  I can’t find a number from a reputable site for conversion, but this ratio seems to work and I’ve heard it in several places.

This is important because I’ve found that I need to start taking small doses of Dexedrine at night to keep my levels of d-amphetamine where they need to be (yes, I know how horrible that sounds.  ADHD is not always fun.)

What that means is as follows:  I now take 2.5mg of Dexedrine IR at 6-7pm, 2.5mg at 8pm, and ~4mg more somewhere around 9-10pm. (This is all based on my taking Vyvanse at 9am but I usually take it earlier these days.   When I started, I was so depressed that I was sleeping a lot.)

The reason this is important to you is that you may have a similar experience to mine in that you might need to work on things that take focus or need ADHD symptom relief even at night.  Vyvanse works really, really long, but at the low dose it is at night, I simply can’t function in what is now ‘normal’ to me.

10) Being on Vyvanse for a year has given me stability

I have had more than 40 hobbies in my life and I’m just a college student.  I would go from learning calligraphy, to conducting medical research, to crashing parties, to bike riding, to swimming, to hip hop dance, to studying infectious diseases to… you get the drift.

The ads for Vyvanse say something like “consistently Vyvanse.”  I hate ads and you do too, probably.  But, for the first time in my life, someone called me ‘consistent.’

If being consistent means sticking with a job and performing well, getting promoted and professional recognition, studying for classes, developing meaningful friendships and relationships over time, being able to remember things that happen to me – being happy, sure I’ll take it.

Even if the ADHD part of me does not, does not in any way shape of form like being called ‘consistent.’ =)

Adult ADHD:

ADHD can be different in adults than children.  If you are concerned that you might have ADHD and are over 18, see an ADHD Test Made For Adults.

And knowing the 4 Secrets to Success with ADHD may make your life a lot easier.

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ADHD and ADD Online Diagnostic Test

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Overcoming ADHD: A Guide for Parents

What does it feel like to take Ritalin or Adderall in a therapeutic way for ADHD?  To answer that question, we’ll provide a story.

The following stories both start the same exact way.  An 18 year old freshman in college has just come to the library to get some studying done.

Version A:  Not medicated, normal ADHD

Looks at watch.  Okay, it’s 3pm, time to study some chemistry.  Soo boring!

Pulls out books, starts reading, taking notes. This is so boring.  Darn, it’s just so hard.  Looks at paper, blankly.  Didn’t I just read that paragraph?

Rereads paragraph, tries to take some notes on it.  Notices two people who just walked by and that they’re talking about the College band. This is driving me crazy!  The text is just so dense – who writes this stuff?

Tries again to read the first few pages.

Version B: Took an ADHD medication

Looks at watch.  Okay, it’s 3pm, time to study some chemistry.  Soo boring!

Pulls out books, start reading, taking notes. This is so boring.  Darn, it’s just so hard.  Look at clock – only 5 minutes?  Is the Ritalin doing anything?

Okay, I just have to focus.  Now what are the main classes of chemical bond?  Starts drawing a neat flowchart that summarizes the material quickly but thoroughly.

Looks at watch.  30 minutes have passed.

30 minutes?  That went by so fast!  And I don’t feel like ripping the book into pieces, running out the library, and doing something completely different!

What it should not feel like:

Just took a high dose of Ritalin to get some studying done, enter room, see clothes on the floor.  Wow, that’s so messy.  I have to clean it up.

2 hours later, lots of stuff cleaned but no work done.

Remember

When taken at the proper dose, medications like Ritalin and Adderall can make life a lot better for people with ADHD. It is true and can not be denied that they also are popular as drugs of abuse.  But that doesn’t change the fact that for people with ADHD they improve the quality of life consistently, effectively, and – in general – safely.

Many medications used therapeutically can be abused.

ADHD and ADD Online Diagnostic Test

ADHD/ADD Natural Remedy Report

Overcoming ADHD: A Guide for Parents

Concerta vs Adderall XR

Concerta and Adderall XR are two very common and popular treatments for ADHD.

They are both long acting forms of two similar yet different medications: one Ritalin, and one Adderall.

How well do they work?  And how do they compare?

If you want to learn more about what Ritalin is and how it works, see here.

Concerta

Concerta is a long acting form of Ritalin, also known as methylphenidate.  On a biochemical level, it acts on dopamine and norepinephrine receptors.  It temporarily blocks their ability to remove those neurotransmitters from the space in between cells.

And since dopamine and norepinephrine stay around for a longer time, they have a stronger effect.  This leads to better focus concentration and motivation.

Adderall XR

Adderall XR is a long acting form of Adderall.  Adderall is a mix of different amphetamines, including both the l and the d form.  Amphetamines, like Ritalin, also act to prevent the removal of dopamine and norepinephrine from the space inbetween cells.

Unlike Ritalin, however, Adderall may also cause the cell to pump out dopamine.

Efficacy: Concerta vs Adderall XR

About the same percentage of people will get benefit from Concerta as will from Adderall XR.  They work at almost the exact same rates.  Around 70% of those who use either medication along with therapy will have very significant improvement in ADHD symptoms.

We recommend that you read our analysis of Ritalin vs Adderall to learn more about the specific differences between the two.

That said, it is possible that someone will respond better to Concerta than to Adderall.  Dr. Tuckman, a clinician with significant ADHD experience, reports that roughly 1/3 of patients will respond best to a Ritalin type medication, 1/3 best to an amphetamine, and 1/3 will respond equally to both.

Long lasting form

It is important to note that both Concerta and Adderall XR are long lasting forms of stimulant medication.  They both last for an extended period of time, roughly 10-12 hours.

This is important because clinicians report superior treatment results with long lasting forms as opposed to the instant release.  Studies are also starting to strongly support the superiority of long lasting treatment versus short lasting.

In one study of 70 patients, for instance, 97% preferred the long acting form of Ritalin over the short acting.  In another, 44% of those on long lasting form of medication had ADHD symptom remission, as opposed to only 16% of those on short acting.

Side Effects

Both Concerta and Adderall XR have similar rates and similar types of side effects.

The most common side effects from both include anxiety, insomnia, and trouble eating.  Some studies have indicated that side effects for the medications tend to diminish over time.  This may be due to the body becoming used to the med.  It may also be because those for whom it is a significant issue, discontinue use.

It is possible that long term use of either medication is associated with slight decreases in weight and/or height in children.

Related Articles:

1. The 4 Secrets to Success with ADHD
2. A Full List of ADHD Medications – Explained

ADHD and ADD Online Diagnostic Test

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Overcoming ADHD: A Guide for Parents

Dr. Ari Tuckman is the author of “More Attention, Less Deficit: Success Strategies for Adults with ADHD” and “Integrative Treatment for Adult ADHD: A Practical, Easy-to-Use Guide for Clinicians”.

He has treated hundreds, if not thousands, of adults with ADHD.  He generously took the time to answer questions that readers of mine have submitted over time.

What attracted you to ADHD?

I actually fell into it around 1998/99.  I was starting out and was approached about working with some patients who were adults and had ADHD.  They needed help dealing with their condition and with life management.  I took the opportunity and it was a good fit.

At that point, things were different.  If you knew three things about ADHD – than you were an expert on it.  It’s better now, but still not good enough.

What kind of experience do you have with adult ADHD?

I’ve been focused on that area for 10 years now and a significant percentage of my clients have ADHD.  If I had to put a number, I’d say I’ve treated hundreds if not thousands of patients with adult ADHD.

Why do we not know enough about Adult ADHD?

The problem is that doctors, especially primary care physicians, aren’t good at recognizing it.  And even if they are, they’re not in a good position to do something about it because they simply don’t have the time for a thorough evaluation, which can take a couple hours.

Very often people have ADHD and their doctor just doesn’t notice.  It’s tough for the doctor, of course, because clinicians have to know a million things.  But when it’s your life, you expect them to get things right.

Why is this a problem?

Very often a doctor will notice that someone with ADHD has anxiety or depression and treats only that.  They are then surprised when there isn’t such a good response and think “I guess this person just doesn’t respond well to treatment.”

And it’s unfortunate.  Untreated ADHD is a big set-up for a lot of problems.  We have hundreds of studies that show the kind of bad impact it has on your life.

Can you elaborate on the problems ADHD causes?

It’s a big misconception that having ADHD is no big deal.  It has severe consequences on people’s lives.  ADHD has measurable effects in all areas of functioning.  Everything is affected by it – social life, work performance and more.  Its effects can even go as far as your credit rating!

ADHD has the most impact of almost all psychiatric diagnoses because it is always present and always causing problems.

If you could tell a Doctor two things about ADHD, what would they be?

First, that even if someone was hyper as a kid, they don’t have to be hyper now to have ADHD.  And they might not be restless or overactive in your office.

Second, that having ADHD doesn’t mean you’re not successful.  On the contrary, there are some really successful people who have it.  But it comes at a great cost and they have to work harder to achieve their success.

Remember, I’m a psychologist.  That means that I prefer talking to people.  But for ADHD, I am a big fan of medication because it works.  And it works well.  Proper use of medication sets people up for success so that other strategies will be more successful.

Medications for ADHD like Ritalin and Adderall have their fair share of controversy.  What’s your opinion on that?

I’m certainly not advocating that everyone has ADHD or should take ADHD medications.  Everything stems from a proper diagnosis.  Once that’s done, choosing to use an ADHD medication is a lot like choosing to use painkillers.  You do it if you need to, and otherwise don’t.  I had surgery, for instance, and for a short time, needed to use strong painkillers.

It’s not a matter of good or bad, but rather how medication fits into your overall treatment plan.  Medications for ADHD tend to be very effective.

What are your thoughts on the proper use of medications like Ritalin and Adderall?

First, I’ll repeat that it’s absolutely essential that a proper diagnosis be made before using any medication. I have a saying that accurate diagnosis guides effective treatment.

It’s also important to have realistic expectations.  You can take a pound of medication and still not do any work.  The fact is, you still have to choose to put in the effort.  Medication puts you in the ballpark, but you still have to swing the bat.

How do you choose a medication?

Typically, I recommend an extended release.  That means either Adderall XR, Concerta, Vyvanse, or Focalin XR.

To choose between them, I find the rule of thirds to be quite useful.  Roughly one third of patients will respond best to Adderall or Vyvanse, one third to Ritalin/Concerta/Focalin, and one third will respond equally to both.

You can’t point at a hundred people and say that for everyone Adderall or Ritalin would work best, but for any one person there may be a better or worse response.

For my patients, it can be hard, but they have to realize that it can take some time to figure out the right dose.  It’s not a magic pill, and you have to be somewhat lucky to get the right dose on the first try.

Doctors sometimes are too cautious and might use a child-sized dose in an adult.  Then they’re surprised when they don’t get good results.  That’s like wondering why half an aspirin doesn’t help an adult with a headache. It doesn’t mean that a larger dose wouldn’t be more effective–up to a point, obviously.

What are some issues you see in treating adults?

Adults who are diagnosed or deal with ADHD are different from kids because they’ve been dealing with their situation undiagnosed for most of their lives.  They’ve had to come up with explanations for why things are not going so well in their lives.  And they’ve constantly been telling themselves, “Now it’s going to be different.  I’m going to get that report in on time, listen more when people talk, spend my money better, etc.”

They’ve had a lot of failures.

For a kid, there aren’t those years and years of struggle.

Most adults when diagnosed have a tremendous sense of relief.  It puts things in place.  And it’s an explanation that isn’t pejorative or judges them badly.  They’ve probably heard way too many times things like, “you’re irresponsible,” or, “you’re lazy.” A diagnosis of ADHD is much better than that.

How do you diagnose ADHD?

I typically do a 2 hour interview.  If possible, I have a parent or romantic partner come along to give additional input.  I try to get as much data as possible, including old report cards which can be particularly telling.  Of course doing so is often hard in someone over 25.

We look at how the person is doing now and at prior points across a broad range of situations.  Looking at just one area can be misleading – how are they performing overall?  And does ADHD fit the pattern of data?

How would you respond to critics of diagnosing ADHD?

For most psychiatric – and even a lot of medical – diagnoses you look at symptoms and history.  Blood tests can’t tell you everything.  The best diagnosis, of course, has to be thorough.  If you do a good job, you’ll look for the right things while not asking leading questions.

Some symptoms are more obviously associated with ADHD.  What are some of the more unusual or harder to notice things?

A lot of people with ADHD have difficulty retaining what they’ve read, and may not actually read books that often.  Magazines and websites are easier to digest.  It’s common to have to reread things.

Other areas include careless mistakes in math.  They know how to do something, but mess up on the small details.  Everyone has brain glitches like that but they are more common in people with ADHD.

A really interesting phenomenon I see is that sometimes people with ADHD will have done homework assignments but forget to hand them in.  This is particularly telling because there isn’t an alternative explanation.  If someone doesn’t do their homework, for instance, you could say that they just don’t want to do it.  Blame it on motivation.  But there’s really no reason you’d choose not to hand in an assignment that you did.

Another area is losing things, both in the house and out in the world.  There’s really no advantage to losing your cell phone, for instance, so doing so is an indication that ADHD may be an issue.

Some psychoanalysts might say losing your phone is a sign of subconscious conflict?

That just doesn’t seem very likely.  Remember, that psychoanalytically based treatments have not been shown to work that well for treating ADHD.  That’s not to say it can’t help with other issues that folks with ADHD or other people might have, but it won’t change the underlying condition.

Some research has shown that low levels of iron in the blood has been associated with ADHD.  What do you have to say to that, or claims that bad diet causes ADHD?

I’ve heard things like that often.  Parts of those claims may be true, but you have to remember that correlation does not mean causation.  While it is true that men in general are taller than women in general, being tall, for instance, doesn’t make you a man.

A possible explanation, however, could be that people with ADHD may not have as healthy diets.  It’s important to remember, however, that dietary treatments have not been shown to a valid treatment for ADHD.

How do you decide to use a medication or not?

It’s a question of weighing the demands of things going on in your life against your abilities to manage them without medication.  What other strategies, for instance, could you useto handle your life?  If the demands of your life outweigh your ability to handle them, that’s an indication that medication might help.

Of course, if someone shows up in my office, they’re probably not doing as well as they would like!

And of course there are different situations.  You may need to take medication during the week but not so much over the weekend.

One of the biggest fears people have is that their ADHD medication will stop working.  In your experience, does tolerance to, say, Ritalin or Adderall develop?

Not usually.  It is my experience that, once you find the right dose, you can keep taking it for years, even on a daily basis.

That said, there are some factors that may change the right dose.  Sometimes there is significant weight change which can change how effective a dose is.  Also, someone may find that their lives require them to perform at a higher level when  they might get a promotion with more responsibility and really have to be on their game.  Or when they have a new baby.

What are some thoughts you have on ADHD in general?

Getting diagnosed with ADHD can be really life changing.  Suddenly things make sense.  I have to tell my clients that I understand how hard things have been in the past.  But now they’re in a new situation.

With medication, things can be quite different.  And, although they’ve already heard a million suggestions, in therapy we look at new strategies that are based on a solid understanding of how people with ADHD tend to process information, so we can create strategies that are more likely to be helpful.

Anything else?

Today I’m having a client who is living out of the country and coming back home here in America to visit his family.  He’s driving four and a half hours here and another four and a half hours back, a total of nine hours driving, just so we can spend two hours to officially diagnose him with ADHD.

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Strattera or Atomoxetine is a new treatment for ADHD that was approved in 2002 and the first medication approved for treating ADHD in adults.

It is a norepinephrine reuptake inhibitor, which means that, like Ritalin and the stimulants, Strattera increases the level of norepinephrine that cells are exposed to.

This hopefully results in increased attention, focus and motivation – reducing the symptoms of ADHD.

Unlike the stimulants, however, Strattera takes up to 8 weeks to work.  The exact reason for this delay is unclear, but it is reminiscent of behavior more typical of an antidepressant.

The main benefits: Strattera provides full day coverage with one or two doses, is not a stimulant, and is hard to abuse.  May work when stimulants don’t or are not a good idea.

The main disadvantages: Strattera isn’t as effective as the stimulants, is expensive, and takes a while to start working.  Plus it has its own array of side effects.

Efficacy:

Strattera is definitely better than placebo at treating the symptoms of ADHD.  Beyond that, however, the studies have been modestly positive.  In one study, for instance, of several hundred people treated for 10 weeks, scores on the AISR scale went from an average of 38.5 to 24.5 for those treated with Strattera.

The AISR scale consists of 18 questions each rated on a scale of 0-3, where 3 is most severe and 0 is not significant.  The max score is 54.  As such, a reduction from 38.5 to 24.5 is fairly impressive.

Unfortunately, the placebo treated group went from an average of around 39.2 to 28.9.

The difference between Strattera and placebo of 4.4 means that a few questions were answered as less severe than originally.  So there is an effect, and it is positive, but it is not as significant as with the stimulants.  Strattera shows similar if slightly better efficacy in other studies.

Roughly 25% of people who use Strattera stop specifically because they feel it does not work well.

Dosing:

Strattera is typically started at .5mg/kg and raised to 1.2mg/kg for a maximum of 100mg per day in adults.

As it is digested by the CP 450 system, medications such as Prozac may interfere with Strattera.

Strattera Side effects:

Anywhere from 10-25% of people report side effects as a reason for stopping Strattera.  They are mostly mild.  That said, over several years of use, the risk of having some sort of serious side effect becomes not insignificant.

People who use Strattera typically lose a small amount of weight.

Most common:

>50% report headaches, some issues with digestion, nausea or upset stomach, and sleepiness

~13% report abdominal pain

Some studies report increased rates of vomiting and constipation on Strattera.

~5% report dry mouth, urinary hesitation, erectile dysfunction

Less common side effects:

Low but possibly increased rates of sinusitis, impaired digestion,

Depression, thoughts of suicide (in one study, 11/714 had suicidal thoughts, or 1.5%), appendicitis.  New aggression or irritability is not common but not uncommon side effect of Strattera.

Rarest side effects:

Heart murmur, prolonged QT on ECG, liver issues, upper abdominal pain, diabetic ketoacidosis

This list is not complete; see manufacturers insert for more.

Use:

Most people who use Strattera have tried stimulants in the past and had adverse reactions or preferred to try a different medication.  Stimulants generally don’t work in about 30% of people with ADHD who try them.  Additionally, in some groups, stimulants are contraindicated.

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