ADHD Medications for the elderly

[AnonymousBob]

I'm a 69 year old man with ADHD. My forgetfulness and distraction is driving my wife crazy and she's at the end of her rope. Actually, she's been hanging on at the bottom of that rope for years. I have read enough stories to know that ADHD meds have been a mixed bag of horror stories and hope for people. But I really fear side effects. But it's to the point that living with more clarity and focus would make my life so much better. There is almost no research done on ADHD meds for the elderly that I have yet found. What suggestions do you guys have for specific meds, doses and experiences.

Thanks so much for the help.

Bob

[dgoodman]

Hi Bob:

I'm an adult psychiatrist specializing in ADHD with a expertise in older adults with ADHD. For your information, I did a webinar on this topic for CHADD ( chadd.org/attention-article... ) a few years ago and viewing that would be helpful. I am also giving an update of this topic as a webinar for Additude magazine on Feb 16. ( additudemag.com/webinar/adh... )

There is some scientific literature on this subject including a scientific world wide literature review that I published 4 years. ( link.springer.com/article/1... )

So to the point in regards to medication. Older adults with ADHD respond equally to those medications we frequently use for children/adolescents/adults. Given medical considerations of medical conditions, other psychiatric disorders, and concurrent medications, dosing is usually a slow increase in order to evaluate benefit and side effects. We generally recommend long acting stimulant medication with a single morning dose to last up to ~10 hours when dose is right. The medications options are just too many to elaborate in this brief response and have to be tailored to each individual. In addition to medication, therapy addressing organizational skills and forgetfulness is also often recommended.

The Adult Self-Report ADHD Scale is 18 symptoms for ADHD patient scored based on frequency of symptoms. This is useful to establish and monitor target symptoms in response to treatment. This scale is available online without cost. ( nyulangone.org/files/psych_... )

I would encourage you to see an adult psychiatrist with an expertise in adult ADHD. I have patients in their 70s and 80s on medication for ADHD. It is never too late for effective treatment. Hope this helps point you in the right direction.

Good luck.

David W. Goodman, M.D. ( ADDadult.com )

[AnonymousBob in reply to dgoodman]

Thank Doctor. This is indeed a good start.

[RollingThunder]

Hi, I am 69 too, I do not consider myself elderly and neither should you . I am on meds for Depression and anxiety so I can not speak for any of theADHD meds, sorry. 🤗

[IgnoranceWasNotBliss]

Hey Bob! I just want to thank you so much for doing this for your wife!!! OMG there are days I just do not realize how my husband managed and our lives have completely changed since I got diagnosed and started medication for adhd. I 100% understand your hesitance with medication. I’m the type of person that reacts to pretty much everything! I’m allergic to a lot of medications. The ones I’m not allergic too I could write the booklet on the symptoms. I always get every one and more! For that reason I’m very resistant to a lot of modern medicine and prefer a more holistic and/or prophylactic type medicine. I was so nervous to try medication for my condition but my life was such a mess and my dr assured me that the medication would help with things that I didn’t even think were adhd related. I had also read bad things online. It only added to my worry.

So eventually, I told myself, there’s no harm in trying. If I don’t like it or it causes any problems, I’ll stop. No worries. Well, I was shocked at the results. Like, completely blown away! Not only did it completely change my life, I DID NOT have the laundry list of side effects that normally accompany medications for me. In fact, I would say of all medication I’ve ever had my whole life, this gave me the least problem! The very small and manageable things that did pop up, didn’t last. They went away quickly as I kept taking the medication. Those little things didn’t even bother me! What the medication was fixing for me was far worse than any side effect it could have produced. I’m convinced it’s because my body actually needed it. I had a genuine deficiency and my body was happy to accept a fix for it. I take Adderall.

I have a sister with undiagnosed adhd. She’s been treated for depression for 15 years. She has had numerous failed treatments with antidepressants becomes like me, she gets awful side effects to just about everything. There was only one “antidepressants” that never gave her any side effects. It was the longest she every stuck with one medication. That was Wellbutrin. Wellbutrin is an antidepressants that is actually also used to treat adhd. It’s a non stimulant. The dr’s were trying everything for my sister before she started this and it was manic for her. Obviously be jade she actually had undiagnosed adhd. She had zero side effects. The only one ever to not negatively effect her. Again, I feel like it’s brocade she actually NEEDED it. Her body happily accepted a medication to balance her deficiency.

There are non stimulant medications that can be used like Wellbutrin, Strattera and intuniv. Some dr’s even use modonifil off label. The dr would be best to walk you through your options. Perhaps for you a mixture would be good. Try the basic stimulants like Adderall or Ritalin and if you need a higher dose, add a non stimulant of that makes you feel more comfortable. Then your Ritalin type medication can become like, your coffee of the day while the non stimulant is like your buffer. You won’t know until you try and I highly recommend trying. I’m so glad I did! 40 years, I never knew how much easier my life could have been. Or my husbands.

Good luck bob! We’re all here for you.

[AnonymousBob in reply to IgnoranceWasNotBliss]

Thanks so much for the support and insights.

[Alan0127]

Hi Bob,

I am 68 and was diagnosed with ADHD four years ago. I struggled with the same questions you have brought up. I think adverse reactions and side effects are individual but on the whole, if your doctor is responsive and helpful, the side effects can be managed and navigated. I take 10mg of adderall about every 4-5 hours. I took the time release type but there was an hour or two before the second dose released that I sunk back. It has been very hard to detect what the difference is between the adderall working and not having it in my system. I have often felt like having the adderall in my system was like watching the altimeter on a plane. Two things are happening at the same time. My elevation is changing and the adderall is readjusting the altimeter. The result is that it has taken a very long time to sense when it is working and when it is not. My doctor said that adderall in someone my age posed some dangers of heart attack. I went to a cardiologist and had an echo cardiogram (I think that's what they called it) and I check my BP regularly. It has helped assure me it is okay. The benefit I get from it far outweighs even the fear of side effects. Now that I know what it is like not having ADHD symptoms, I really would never choose to have them and if there is a risk, I am willing to take it.

I hear you though. It is unnerving to take any of these drugs because as far as I have understood, no one can say why or how they work in you. They can add neurotransmitters to synapses in your brain but with 86 billion neurons tied together in a Gordian knot and tied completely differently in everyone, we are forced to settling for some level of trial and error.

[AnonymousBob in reply to Alan0127]

Thanks Alan. That was helpful.