Tuesday, April 13, 2021

Comments by Derek

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  • Of course there are behavioural and brain changes associated with the use of ADHD drugs; that is the reason for administration.

    Amphetamines do increase the risk of Parkinson’s disease due to the release of dopamine into cystol something methylphenidate does not.

    Methylphenidate also has a cardio protective effect and can normalise auditory processing, improve empathy and theory of mind.

    In my experience adolescents are often keen to withdraw themselves from psychstimulants due the restriction they have on affect. So often adolescents whose brains have matured since they were commenced on stimulants in earlier childhood will better tolerate better a smaller dose.

    As a rule as the child or patient matures the stimulants are used to target different symptoms through different dosing. A 12 yr old who required 72mg Concerta to control their ADHD may only need 36mg when they are twice the size and 18 yrs old.

    It’s also worth mentioning the Ritalin bounce that many parents see when their child withdraws each afternoon. Whilst the child may have been more settled at school they are worse when they come home. The long acting preparations have largely resolved this issue.

    I’d stop wearing my spectacles except years of use have caused brain and behavioural changes and I’m not willing to give them up. Any withdrawal effect from therapeutic doses of stimulants is suggestive of an ongoing need for them. You can’t just counsel someone’s frontal lobes into maturity. Also check for any additional detriments such as iron deficiency which could be contributing to lowered dopamine.