Attention Deficit Order & Stimulant Medication

The Stimulants and Attention Deficit Order

We have been reviewing medications used to bring about 'Attention Deficit Order. Most people diagnosed with Attention Deficit Dis-Order will at some point be treated with a stimulant medication. This is considered the mainstay of Attention Deficit Treatment and like all treatments that bring some degree of Attention Deficit Order; stimulants have their advantages and disadvantages.

The stimulants (Adderall, Vyvanse, Concerta, Focalin, Metadate and Ritalin) are considered to be the “Gold Standard” of medication treatment for ADHD.  Stimulant medication studies are plentiful and they have, by and large, concluded that the stimulant medications are safe and effective. Most people with ADHD are first started on a stimulant medication.

There is not necessarily one medication that is best for ADHD, for Inattentive ADD or for Sluggish Cognitive Tempo. This is because individuals, regardless of the type of ADHD they suffer from, will react uniquely to every single medication on the market for ADHD.

We can make generalizations and say that the best treatment for ADHD-PI is  Adderall when compared to Ritalin but individual response to medication will be the ultimate test of what medication brings symptom relief and Attention Deficit Order to each person diagnosed with ADHD.

Drug therapy for ADHD will more often than not require trial and error with a variety of medications. The stimulants come in short acting (4 hours of duration), long acting (6-8 hours of duration) and very long acting (12-14 hours of duration).

Many people experience a period of irritability or increased moodiness as the stimulant medications begin to wear off. Physicians call this irritability, “stimulant rebound” and for some patients with ADHD the rebound period is so troublesome that added medication must be given to decrease the severity of this rebound effect or, in some patients, the rebound is so unpleasant that the stimulant medicine must be changed.

The length of stimulant duration is important because it not only determines how long the medicine is effective; it defines the length of time that the side effects (loss of appetite, wakefulness) will be present. Some children are not awake long enough in a day to warrant the use of a very long acting stimulant and this, as well as the effectiveness of symptom control and the severity of the ‘rebound’ effect are some of the many considerations that will have to be taken into account when deciding on the best stimulant to prescribe.

Most people with symptoms of  Attention Deficit Dis-Order will be treated with stimulant therapy at some point in their lives. For many people stimulant therapy will perfectly correct their attention and motivation problems and bring Attention Deficit Order to their lives. For others, the stimulants will not be the answer.

In part three of this Attention Deficit Order medication review we will discuss the other medication options available for the treatment of Attention Deficit Disorder.

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  1. Tess,
    Recently on there is an article that says there is a new study out that says prolonged Stimulant medication use causes Parkinson's disease . I was wondering if you have heard about that yet & what are your thoughts on that study?


  2. The stimulants have been found to be both a cause of Parkinson's disease and a protection against Parkinson's disease. There seems to be an increased rate of Parkison's disease in people who abuse amphetamines but these risks have not been consistently seen in people treated with stimulants for ADHD.

    The thought is that people with ADHD have dopamine and neurotransmitter issues that the stimulants remedy rather than impair. This study below showed that Ritalin was neuro-protective and might actually decrease the risk of Parkinson's disease.

    Caffeine has been found to be protective against Parkison's disease as well.

    The jury is not completely out on the question of the role that ADHD stimulants play in terms of protecting or increasing the chances of developing Parkinson's disease.

    Great question Britt. Thanks for your comments!!

    Curr Neuropharmacol. 2008 Dec;6(4):379-85.
    Neuropharmacological mechanisms underlying the neuroprotective effects of methylphenidate.
    Volz TJ.

    Department of Pharmacology and Toxicology, University of Utah, 30 South 2000 East, Room 201, Salt Lake City, UT 84112, USA.
    Methylphenidate is a psychostimulant that inhibits the neuronal dopamine transporter. In addition, methylphenidate has the intriguing ability to provide neuroprotection from the neurotoxic effects of methamphetamine and perhaps also Parkinson's disease; both of which may likely involve the abnormal accumulation of cytoplasmic dopamine inside dopaminergic neurons and the resulting formation of dopamine-associated reactive oxygen species. As delineated in this review, the neuroprotective effects of methylphenidate are due, at least in part, to its ability to attenuate or prevent this abnormal cytoplasmic dopamine accumulation through several possible neuropharmacological mechanisms. These may include 1) direct interactions between methylphenidate and the neuronal dopamine transporter which may attenuate or prevent the entry of methamphetamine into dopaminergic neurons and may also decrease the synthesis of cytoplasmic dopamine through a D2 receptor-mediated signal cascade process, and 2) indirect effects upon the functioning of the vesicular monoamine transporter-2 which may increase vesicular dopamine sequestration through both vesicle trafficking and the kinetic upregulation of the vesicular monoamine transporter-2 protein. Understanding these neuropharmacological mechanisms of methylphenidate neuroprotection may provide important insights into the physiologic regulation of dopaminergic systems as well as the pathophysiology of a variety of disorders involving abnormal dopamine disposition ranging from substance abuse to neurodegenerative diseases such as Parkinson's disease.

  3. what is a good medication (or alternative natural medicine) for chronic fatigue syndrome, depression, and ADD all in one! I have all 3!
    Thank You in advance!
    Daisy, Cape Cod


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