My 17 year old daughter has ADHD Inattentive. She took Strattera for nearly 2 years but it lost effectiveness. She just tried Vyvanse again (which she briefly tried age 13 but stopped due to anxiety). So age 17 she tried Vyvanse 20mg, 30mg and 40 mg. None worked at all. I started reading how ADHD drugs always lose effectiveness after a while and I came across a study that said ADHD meds help minimize dopamine transporters, which at FIRST enables better concentration. But after a few years of taking the meds, the dopamine transporters come back even harder and will relentlessly continue to do so even as med mg is subsequently boosted. The research studied participants who had only taken ADHD drugs for 1 year. The paper indicated the increased dopamine transporters (which makes it HARDER to concentrate) was not something that goes away after stopping the meds. So I’m thinking of having my daughter take no ADHD drugs (which will prob make her core class grades Cs and a D or two), and then perhaps encourage her to go to community college instead of 4 year college, in the hopes of protecting her growing brain from medicine that could in the long run make her ADHD worse!
Any thoughts on the dopamine transporter issue?
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Cleome
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I’m staying away from meds. The more I read about the way some children react to it, and the side effects., the more I realize these meds are not always the answer. I hope we can all find new ways to help our kids. I don’t trust these drugs our there long term.
I’m still learning about dopamine transporters- sorry I can’t be of much help on this topic. All the best to you and your daughter. Have you tried combination of fist oils, magnesium & other supplements others suggested here? I’m already ordering them... it’s worth a try.
The subject of stimulant tolerance is a bit of a debate, as there are clear signs of both tolerance (most kids will need to increase dose), and clear signs against it (dosage increases seem to level out in the teen / adult years - and some adults even successfully stop taking meds.)
After reading this study - it does highlight an area worthy of further exploration. But this study itself doesn’t actually prove anything besides perhaps that high levels of transporters may not purely be a sign of having ADHD as previously believed. GJ Wang is actually quoted as saying this himself.
Dopamine neurotransmitters numbers actually fluctuate throughout our lifespan - regardless of medication. The study also has a very small sample size (only 18 people) and no control group, so we don’t really have any solid data to compare his results to, nor the ability to really generalize this to the larger population. Nor do we know how long these results lasted - was the numbers of transporters permanently high? Did they change after treatment was extended or discontinued? Does high levels of dopamine neurotransmitters affect anything beyond stimulant tolerance? All things worth further investigation before making widespread changes to effective treatment options. I would be interested to see this study replicated, with controls in place, definitely with a larger sample & maybe a wider age group, and see what the results are, as well as looking at post-study levels.
Stimulants have been used to treat symptoms of ADHD for over 50 years now. So there is a lot of data out there on them already.
Was a mother of a daughter who was on ADHD medication all through grade school and high school , she now has her masters degree in criminalogy.
I didn't hesitate to put my grand kids on medication when they began to have problems in grade school. One has now been accepted into a collegiate program in high school.
Everyone needs to make their own decision on this but I did not want my children to be made fun of and constantly be in trouble because of a neurological disorder that could be helped with medication.
Thank you for sharing your peronsal experiences,.I agree ADHD is so much more than grades. Doe us there is no other option and it is amazing being about to take away the negative symptoms.
On a personal note, this past year I was on vacation w/ a family. One of the boys had forgotten his stimulant meds. This 17 year old boy was a wreck; hunched over, looking sweaty, miserable, and (frankly crazy) with terrible headaches. How is this boy ever going to function in college and his later career without taking stimulants forever? What will that do to his brain? Wouldn't it perhaps be better for him to forgo college and go to trade school thereby protecting his brain from decades of stimulant use?
Why? Because the above is an example of trying to base an illogical argument on an illogical hypothesis and hoping you'll suddenly create something out of nothing. Do yourself a favor and let that sort of thing go. All we know about the situation is that you viewed a person's behavior during a limited amount of time on a vacation. Then you make assumptions about the situation and imply that you might find answers for yourself by transferring and translating any speculation you conjecture to your own situation -- one in which we can only guess at any tangential, factual relation whatsoever. I'm not saying so to negatively criticise but to highlight something we all do that often causes us a lot of heartache and lost time -- overthinking in meaningless patterns where there can be no answer created, ever, whatsoever. The only thing something like this manages to do is judge that person unreasonably, and then, you use whatever you've created to wield judgement on yourself. Just say no, and when you've got medical questions, ask your doctor. And if you do not or no longer trust your doctor, find one you trust. Why trust circumstantial evidence and your own conjecture over a professional focusing on your particular circumstance? In order to help you personally?
You can't just quit these drugs cold Turkey without a problem. My grandson's psychiatrist said as you get into your late teens ADHD becomes manageable on your own. He plans to start weaning him off medication if he stays stable for a length of time.
My daughter has not been on medication since high school and managed to get on the Dean's list in college.
Not necessarily as a response to the above poster but to anyone who happens by ...
... Whether that psychiatrist said that or not about a certain patient doesn't mean anything about the efficacy of treatment for other individuals and their particular brains and lives, or the diagnosis as a whole.
ADHD is a neurodevelopmental disorder, just like autism, schizophrenia, cerebral palsy, or a specific learning disorder; and just like all those others, it varies substantially. It's not my opinion but how it's categorized in order to most effectively help the most people. Some people need help for life, some do not. Some people are crippled by their inability to complete daily tasks, yet some people "get over it" because being late or forgetting your keys every now and then can be fixed by getting a smartphone. Some people experience noted cognitive fog only when particularly hormonal. Psychiatry considers a person no longer fitting of a diagnosis if and when the traits don't cause enough distress to warrant clinical help, but that doesn't mean the traits are gone. It only means the traits don't cause a life altering problem. ... So, looking at another disorder as example, just because a guy in a wheelchair who can't breathe for himself doesn't look like a girl with an ankle brace doesn't mean they don't both share a medical diagnosis existing only for successful communication and treatment's sake. They both have CP, and you can't expect that guy to breathe on his own because the girl could.
Ageeed. We don't get over our ADHD, we just get better at accommodating ourselves. Accommodations don't help the emotional aspect if it though, not for me and I'm almost 40. I can go long periods of time being "ok" with organizational skills etc but that breaks down after a few months and I backslide. The emotional part though, I still have a REALLY hard time managing and I still do not handle stress well at all.
If you’re not finding effectiveness and on the verge of giving up on medication I’m going to encourage you to look into broad spectrum micronutrients. A lot of good results with my son. We are using Hardy Nutritionals. There is also a second company called True Hope.
Hi. Medication isn't for everyone. I took my son off Vyvanse after I read in the package insert that it could cause his growth to be stunted, and that breaks in taking the medication was advised. I called the company and asked what was recommended (every weekend? Off for 2 weeks every 6 months, what?) and they refused to answer my question, referred me back to my son's pediatrician (who is not an expert in nuances of every stim medication).
After all the research I have read, I firmly believe that nutrition is key to helping those with ADHD prevent disruptions in their neurotransmitter communication. There is no one size fits all, even though we all know most benefit from methylated B vitamins, zinc, iron, calcium, fatty acids, amino acids, magnesium, and correcting gut microbiome, to name a few. Some more than others (and too much of any will make things worse). But don't make it a guessing game, every individual is different and getting labs run is a helpful step, along with working with a trained nutritionist or doctor.
Testing for food allergies, having blood work done to detect any deficiencies, working with an integrative functional doctor, looking into testing with Genova Diagnostics, for example, can help them be the best they can be. I am currently looking into Nutrigenomics, the scientific study of nutrition and genes. I have reduced my son's medication after correcting some of these issues, but I have more work to do as my ultimate goal is to get him off stim meds.
Interesting. And I have read Vyvanse only works when one eats healthy food and gets adequate sleep. I’m going to lower my daughter’s dose a lot and track how she does in school on quizzes, homework, etc. to try to find the correct dose. It seems 20 mg Vyvanse or less works better than 30 or 40 mg. She won’t take the pills on weekends, holidays and the summer. She’s a special case in that she suffered a stroke at birth. She was a great student up till around 9th grade. Her standardized test scores were good till 5th grade, when they nosedived and never recovered since then.
I definitely worry about the long-term effects of meds. I was an adamant proponent of dietary intervention and supplementation for most of my son's life and I saw first-hand that those strategies could be life-changing. Then high school happened. With a whole new level of academic, social and organizational demands, my son started falling apart. The biomedical testing with our ND that had always pointed us in the right direction was no longer giving us any clues. And in the meantime, my son was feeling hopeless. So, I turned to meds about 6 months ago. They are not a cure, but they've created some temporary stability for him and I'm thankful for that. I think at the end of the day, we've all got to do what we've got to do and there's not always a clear path.
Like another poster pointed out, no one makes assumptions based on one study. That's not what research is for. It might have been completely irrelevant. Especially with a small sample size. They have to do work on it. That's the job. Researchers don't ever make the claim one study does anything, even if it's long lived and full of good data. Might it point to something? Maybe. Might it be a coincidence? Equally possible.
The question of whether this study pointed to anything valid isn't our question to ask; not because it's not our concern but because there's no way we can answer it.
If we find ourselves on this type of topic, we have to ask ourselves what we're really wanting to know. (Because the above isn't it!) It's going to be something like:
"Will my child need pharmacological treatment for life?"
"What other options are there? ARE there other options?"
Firstly, the answer to the latter is, always. Honestly, I don't believe any good ADHD focused professional would ever suggest just medication and only medication. Everyone knows that no matter what the issue is, everyone turns out better when they treat *anything* with responsible life choices. It doesn't matter if it's a "normal" change resulting from aging, or pregnancy, or something similar, or a "problem" presenting from illness or another disorder. Being healthy is being healthy. Eat well. Exercise. Sleep well. Fix your posture. Don't drink too much. Don't smoke. Don't snort your neighbor's cat litter. Smell the roses. Don't be alone. Don't wallow in hatred. Don't sit in a deadend job with an abusive boss telling yourself you're a failure just like your father always said. See what I mean? It keeps going. Go to therapy. Join a group based on your issue as well as see someone privately -- to talk about your experiences and problems in an educated and open place with someone who knows what the heck they, and you, are talking about. That's what they're there for. On top of that, yes, take medication ...if the professional who specializes in what you need tells you it's frankly needed. If all you do is eat oranges to control your cognition when you can't drive a car straight it's just as bad as the other way around.
We also have to ask ourselves: Why am I taking it upon myself to ask about this? Beyond the simple fact of loving my children and wanting to know what's going on with them? ... that, in my mind, addresses the former question. Have they shown themselves capable of small tasks other people would find average, or not? Is my child self aware and capable of having this conversation on his or her own? Then finding a good alternative? Can I see them making healthy decisions given the support of a program/coach/boss/understanding spouse/management app/etc? If not, why not? ...
If your child is 6, and someone (let's say they are beyond reproach) tells you they should try medication for a few years, it's reasonable to assume the kid might settle down as their brain and body age. About half of them do. It's also reasonable to ask the professional which medication they suggest, why, and if there is an alternative because of the patient's age. That type of conversation happens with disorders all over the map. HOWEVER. Let's now really consider what the alternative to treatment is if they age past puberty and the ADHD is still hugely prevalent. These are not happy, well adjusted, successful people for the most part. And the real pity is, the thing that really bothers me, is that most of that is preventable. There are people with no familial contact, no friends, on the street, in jail, addicted to things most people will never touch, all because they cultivated behaviors they didn't need, that didn't help them, because they were looking for a way to control themselves, to cope, and to self soothe. I'm not trying to judge, it concerns me because I've seen it many times. A kid causing the deaths of other people's children because they were too messed up by ineffective treatment not to be so desperately irresponsible? I've seen it. There are people out there with completely manageable problems that don't get addressed because someone somewhere didn't understand the depth of the issue, and it all ends up getting way out of hand. The question is not if we can deal with our kids not being married or not taking over the family business or not graduating traditionally or whatever. Those are separate issues. We need to ask ourselves if we're supporting them in making, for themselves, the healthiest choices possible, for where they are right now.
(And yes, taking it back to the OP, I realize healthy choice comparison is what is going on; only that I see people sometimes getting caught up with the question of treatment suitability when there is no better option presented simply because somebody poo-pooed medication. If the choice is between an out of control brain which your teenager is skipping school to self-medicate and taking advised medical treatment under the care of a professional which has always worked before? ... But I read that's not the case with the OP.) What the post as written makes me wonder is if the teen has ADHD at all (or if that's the main problem), since the poster writes that none of the medications have worked. That by itself (none of the stimulants working) would be odd. Everyone is different with how their body responds to what, when, but there's usually some sign. Are the other lifestyle choices in line? Is she taking the medication on time regularly? Are there other things going on? I'd also be more interested in looking at the anxiety closely. Have you had second opinions? I don't doubt that some people have that reaction on Vyvanse because I've seen it, but, in the situation I'm thinking of, there were co-occurring disorders. Not that I'm a doctor or see a huge amount of people in that predicament because I'm not and I don't, but it's a thought, since you took the time to write. (EDIT: Noticing I overlooked the line about the stroke. This would further make me curious. Have you have her evaluated for other NDDs? That could offer more lines of help.)
I really hope all that helps someone crystallize their own thoughts. It's never simple.
[Addition -- Sorry, but I was thinking about this earlier today and it hit me that the entire idea of making the ADHD worse by becoming addicted to the medication rests on the premise ADHD is only about dopamine, which it's not, so in that respect, what it might do is make the brain and body addicted, yes, but no one is challenging that. So that puts us back in the spot of, "Is it needed? Why or why not?"]
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