ADHD Drug Wars-To Medicate or Not Medicate


The debate in the ADHD community for and against ADHD drug therapies can be contentious and divisive.  The folks that advocate for nothing but prescription medication adamantly believe that drug therapy is the "be all and end all" of ADHD treatment and that prescribing any other treatment is sheer quackery. The folks in the other camp believe that to medicate people with ADHD is to poison them and that doctors are greedy cowards whose primary objective is to line the pockets of insurance and pharmaceutical companies. I am constantly distraught about the polarity of these two camps.

This black and white way at looking at this is not productive.  Regular readers of this blog know that I stand firmly in the middle of these two camps.  I believe that for many patients, prescription therapy is the only answer and the only treatment that will make their lives more productive, happier and more meaningful.  I believe that there is a subgroup of patients that have particular symptoms, e.g. impulsive behavior that makes thema danger to themselves or others, that will get the greatest improvements for their symptoms from drug therapy.

Other patients, however, will find that their symptoms improve on therapies that are not prescription drugs and these are the treatments that I am covering in Commanding Attention, the book that I hope to get published soon.  For the majority of patients a combination of treatments, both drug and non-drug is the best solution.  Patients who have improved with drug therapy will find that additional therapies in may enable them to improve their symptoms further.  Other patients will find that these supplemental treatments provide enough symptom improvement to allow them to decrease the dosage or even eliminate their prescription medication.

All ADHD patients do not respond favorably to ADHD prescription medicine. One third of patients will have side effects such as sleep issues, loss of appetite, anxiety, depression or other side effects that will make them unable to take stimulant medication.  This tends to be especially true for people with Inattentive ADHD but even people with the other types of ADHD can have problems with prescription medication.  Two thirds of patients, despite debilitating ADHD symptoms; will no longer be taking their prescription medication a year after it is prescribed. Some will stop because of side effects, for some the medicine will simply not help their symptoms and others will stop for other reasons.

Treating heart disease does not only involve taking a pill.  It involves lifestyle changes such as weight loss and exercise and other interventions such as fish oils and natural cholesterol lowering agents as well.  We must start thinking about ADHD in the same way. 

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