Dr says Adderall is a short term use ... - CHADD's Adult ADH...

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Dr says Adderall is a short term use medication only

Challenged
Challenged

Hi! I am brand new here. Diagnosed at 48 with ADHD after my 9 yo daughter was diagnosed. I recognized her issues right away but not my own until she was formally diagnosed. My dr prescribed adderall 20mg and it has been amazing! I have been taking since May 2019 and it has been life-changing. My self-esteem has improved, my productivity has improved, my depression is much less, and even my diagnosed anxiety has improved but not completely. I have two concerns that I need to address with my dr - this week as I have an appt for med management. She is my GP and not a psychiatrist but has always been a good dr.

1. She indicates that Adderall is meant for short-term therapy only and that I will have to come off of it soon! I am freaking out as this has been a life changer of a med for me.

2. I still experience panic attacks but just so much less frequently than before Adderall. She said that adhd and anxiety cannot be treated at the same time! Huh??

I did seem out a 2nd opinion through a dr my counselor recommended. But I think he might be a quack! He also is not a psychiatrist and quickly told me anxiety medications are evil and that I need to do a vitamin cleanse, start his transcendental meditation class and consider going off of my antidepressant.

Has anyone else been guided in these directions? Heard of not treating anxiety and adhd at same time? Heard of Adderall as a short-term drug?

Feedback and advice are welcomed!

11 Replies
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It's good that you're seeking a second opinion, especially from a psychiatrist.

I'd say if you continue with the current provider, ask why she thinks that the medication is only short term. Most ADHD medications are used long-term to manage ongoing symptoms. Some providers will try to taper off, as they are concerned about providing controlled substances, but in general they're meant to be used ongoing.

Anxiety medications, on the other hand, shouldn't be used long-term due to the risk of dependence as well as other impacts it has on the body. Things like Xanax, Ativan, Klonopin, and Valium are all meant to be short term, with the hope that other things like therapy and coping skills will target the anxiety and mitigate the need for medication. You can't do the same with ADHD, because therapy alone isn't proven to be effective for ADHD care.

If it seems like your doctor really doesn't get what's going on, hopefully the second opinion helps. Sometimes, though, it can be useful to approach the doctor with curiosity and find out why they have certain preferences and what they're basing those preferences on. Depends on your comfort level, however. Good luck either way!

That is really weird because most people will be on them the rest of their lives. Its not for short-term use

I strongly suggest you find a psychiatrist to prescribe your Adderall. And definitely ditch the transcendental meditation quack.

Thank you. I felt so frustrated with the second doctor. I felt like he was taking advantage of me and was treating almost like an addict if some type. I think my family physician is doing her best but treating ADHD may be out of her realm of direct knowledge.

I agree with the above responses- ADHD meds are definitely not just supposed to be short term! Regarding the anxiety- yes drugs such as Xanax are short term but an SSRI or SNRI (Zoloft, cymbalta) are often prescribed long term for anxiety. And they can be taken along with the stimulant for ADHD. (I currently take both Vyvanse and Cymbalta). I agree that you should definitely seek a psychiatrist who is experienced in treating ADHD. When I initially discussed ADHD with my primary dr she recommended that I seek a specialist. She says that she won’t prescribe my ADHD meds until dosing is steady and then she’ll take over maintenance.

You definitely need to make an appointment with a psychiatrist. My psychiatrist stated that some people with ADHD will need a stimulant for the remainder of their life in order to function. My story is similar to yours because it wasn’t until my 7 year old daughter was diagnosed that I began treatment myself. Good luck on your journey ❤️

Hi, can I ask youwho diagnosed you with having ADHD?

I'm asking because I like yourself realised I had it when my son was diagnosed aged 11 he is now 24. I was 27 then and like you went to my GP who agreed he thought I most probably had the condition also.

However I was then referred to a consultant psychiatrist for formal diagnosis and it was he who prescribed me Methylphenidate (Medicinet) and passed me onto my GP who was then able to provide my repeat prescriptions.

I am on 80mg daily and I have always had to be seen by consultant regarding any change in dosage and for 6 monthly reviews. My GP has only ever stopped me using it and restarted me again during pregnancies.

I have been on this medication for over 12 years now but you should be aware most ADHD medication isnt licensed in the UK for use on ADULTS as it isnt known if its effective ir not...... something your GP or other doctors won't rush to inform you of!

Im just wondering if maybe your doctor has put you on this medication shirt term to see if it is effective and I would ask if he intends on referring you into Mental Health Team so your ADHD can be monitored as there should be some sort of other support in place too?

In saying that I wouldn't get your hopes up about actually receiving this as it seems there is a lack if anyone who specialises in ADHD and as for support services etc I have been left to find my own resources online etc.

As my son has it and I also have an 8 yr old girl being assessed just now as well as myself plus a son of 9yrs with Autism I have been lucky enough to have found a few sites I have found helpful.

I get a lot if information from a website called ADDITUDE.com even though a lot if info based around America.

Hope this info can give you something which helps you.

Don't be fobbed off !!

My best advice is to educate yourself as much as possible on ADHD and remember you know your own self better than anyone else so if you feel something isn't right for you or is working then let those around you know this.

Good Luck!

vicsl
vicsl
in reply to Kmum2Bs1G

Great recommendation for Additude. So many resources out there but frustrating how we have to scour the net for them ourselves still after so many years. The lack of anything focused on the UK also drives me nuts 🤦🏼‍♀️

Have you seen the NICE update in ADHD from 2018? Thankfully lisdexamfetamine, atomoxetine and some formulations of methylphenidate are now licensed for adults in the UK. Dexamfetamine still is not licensed but at least Dr’s have now got proper guidance from the General Medical Counsel on prescribing non licensed meds. A small step towards having a system that not only recognises adult ADHD but also formally supports the medication needed to manage it 🙌🏻🙌🏻

This is so frighteningly common. If you can, find an ADHD specialist, whether in primary care or psychiatry.

Hi, also new here and just to say another vote from me that your GP, whilst probably well intentioned is most definitely not informed and their advice is fundamentally incorrect.

There is no short term approach for your medication. It’s a long term fundamental part of a global programme including other non medication therapies. You cannot cure ADHD after a period of meds. There is a bit off research about medication effectiveness after 12-24 months but that research outcome has to be seen in conjunction with plentiful research on long term use, the impact of medication cessation for the individual and a medical professional’s in depth understanding of ADHD. You won’t get that from a GP it will have to be a psychiatrist.

Ask what the GP is basing this clinical opinion of ending meds upon. If you’re in the UK they should refer to the NICE guidelines (National Institute for Clinical Excellence - they set diagnosis, treatment & management protocols for every possible medical need from chest infections to sepsis to cancer to ADHD). Other countries have similar national guidelines & protocols though not always as clear.

Here is a link below to the NICE guidance for the UK. It’s a very helpful document to easily understand what you can expect from your medical professionals. It is also taken from the same evidence which has been relied upon to set US standards.

Note at the start it refers to age range (36 months to 60 years) but it can & has been applied to patients beyond 60 years of age

cks.nice.org.uk/attention-d...

You will note there is nothing here about a General Practitioner changing or stopping medication regimes. The only professionals who should in the UK are Psychiatrists.

This link takes you to the numerous “pathways” for ADHD management and again, very helpful tool to us patients to understand what we can expect from our medical professionals.

pathways.nice.org.uk/Search...

You can click on each box to get more information plus links to the research upon which these guidelines are based. NICE is entirely evidence based & all professionals are expected to follow the protocols. Reasons for deviation should be expressed & discussed clearly with the patient. They are the gold standard for healthcare. Case law is also adding a legal obligation to the standards meaning a medical professional who ignores them could face legal consequences.

As for the issue of your depression...Your GP has failed to recognise the co-morbid features of ADHD. This alone shows they are not the person best suited to supporting you. At best, their role should be prescribing meds on a shared care arrangement with your psychiatrist.

Sorry for the long reply. The frustration at old fashioned “I know better just because I am a Dr” has the power still to ruin lives. Thankfully we see it less now but it is still a big and unnecessary part of patient issues. Disagreement with your GP is hard and hopefully having some established care expectations to refer to will help.

Best of luck.

NB: In the US look at AHRQ, FDA & CDC for similar (though less user friendly & joined up) info. Differences in the management of the two healthcare systems makes it hard to have mirror systems for guidelines but bottom line, both systems work off the same research data.

Others have provided good advice. Here's a bit more.

• Find a psychiatrist or psychiatric nurse practitioner who treats adult ADHD.

• If you have a local CHADD support group, you might get some personal recommendations.

• Contact area pediatricians' offices and ask where they refer patients with ADHD when they become adults.

• Ask your GP if she would continue the Adderall therapy until the consult.

• If your counselor notices benefit without aggravation of anxiety, (and she doesn't oppose the Adderall) ask her to speak with or send a note to your GP.

• However, I'd reconsider whether you have the right counselor, referring you to such a doctor. Is she aware that he recommended stopping your antidepressant? He sounds more like a nutty chiropractor than a medical doctor.

• The opioid crisis is making doctors anxious about writing controlled substances but particularly other C-II drugs like amphetamine. Given your anxiety disorder and having to justify the Adderall in your medical records, she is likely outside of her comfort zone.

• It's likely that ADHD is recognized in adults because of adults with kids who have ADHD. That's what brought it to the attention of Paul Wender, the psychiatrist who first wrote about and researched it in the 1970s. Before that it was thought to be outgrown. Old attitudes linger — your GP doesn't make an issue of Adderall being a short-term therapy in your daughter.

Good luck!

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