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So after me and my pdoc has been suspecting ADD/ADHD since spring, I finally got my diagnosis today. (After a loooong ass neuropsych test, which cost me 1000 dollars. Not to mention the millions of forms me and my mom had to fill out... Yes, it's hard to get this diagnosis in Sweden.)

So appearantly I have ADHD, even though I'm typically hyperactive, more like moving my hands and feet all the time.

I'm meeting with my pdoc next monday for medicines, since we didn't have time for that today. My treatment options are Ritalin, Concerta, Provigil or Strattera.

I think my pdoc wants to go with Ritalin, even though I want Concerta. She likes Ritalin since it's available in much lower doses. But from what I've read Concerta is much smoother without peaks and valleys. Being bipolar I'm really sensitive to that. I'm also concerned with the risks of mania, but since I'm on Lithium that shouldn't be a problem, right?

I have snorted Ritalin in the past, and it didn't make me euphoric or speedy like it did to all of my friends. Which is one of the reasons I suspected this diagnosis in the first place.

Any thoughts on medications, coping strategies or anything really? I'm completely new to this and I could use some help.

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With the bp risk Strattera and Provigil are going to be your safest bets.  Amphetamines actually have a better track record with bp that Rit. based stims do.  At low doses of short acting rit there should be no peaks and vallies, but once you get above 10mgs at a time you should consider concerta.

The reason for the peaks and vallies is that many pdocs who have not worked with rit. a lot don't realize that its plateau can be as short as 90 minutes.  I think when I was on it I was taking 20 mgs every two hours or something absurd like that.  Needless to say you have to be on time with the dose or you crash and suddenly find yourself putting the silverware away in the microwave. If your pdoc wants you take it 3 times a day, that likely means you take it then crash, then wait another hour or two until you can take the next dose and repeat the process.

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Meds are only a part of the story. You'll want to read some of the books that give strategies. The  most famous one is "Driven to Distraction". It includes a very SHORT chapter with a lot of specific suggestions for those who can't deal with the whole book. There's a bunch of other good books out there. Plus some people making a living by speaking to people's hopes and fears by denying that it's a real phenomenon or that meds help. My therapist likes "ADD Friendly Ways to Organize Your Life", tho I'm kind of a snob and I find it unpleasant to read. It does have some good ideas, tho. You can also poke around here. You might try the coping strategies thread:

http://www.crazyboards.org/index.php?showt...ping+strategies

Probably a good idea to be seeing a therapist who has experience treating people with ADD. The therapy tends to be a bit more  focused.

Not everyone reacts to the meds the same. Fortunately, the stimulants don't take very long to act or to leave your system. Apart from bureacratic issues, you could try Ritalin today, Concerta the next day, and Adderall the day after that, though it might take longer than that just to understand what the changes are. And, for me, at first Ritalin and Adderall gave me some pretty distracting symptoms, including, on Ritalin, a big rise in blood pressure and pulse. Muscle tension, too. That scared me off Ritalin, tho now I think I would be more patient. Can you try samples? (I bet not, but it's an idea.) Start with low doses in case you are one of those people who doesn't need much of the stuff, altho I suppose if you have snorted Ritalin (ugh!) you won't freak out too easily. I found my (before you were born, Mr. DEA man) recreational experience with funny chemicals made me more relaxed about side effects. If you've had your eyes switch sides on your head, a little muscle tension or shakiness is no big deal.

Lots of people talk about crashing off Adderall, tho I guess not as much as with Ritalin. I don't get the crash for six or eight hours, and then it's barely noticable. Maybe you won't? On the other hand, I know a bunch of people who say the slow release is much better.

Oh, a couple more things to try:

Vigorous exercise, especially early in the day so you feel the effects more when you can use them. Especially if you have problems with being sleepy, particularly in meetings and lectures.

Try to have a little protein with each meal and avoid simple carbohydrates like white bread or sugary breakfast cereal. Granola can be good this way if it's not very sweet, and if you must eat something like white bread you could have beans or something in the same meal to moderate it. Look for items with a low glycemic index, just as a diabetic would. If you do LOTS of exercise, like 50km on your bicycle, you can get away with simple carbs.

Amazing how much testing is required for your diagnosis. I've read that often testing doesn't catch it because the novelty factor of the test is enough stimulation to help someone with ADD focus. My pdoc picked it up on the second visit, based on a note I sent her! (I knew I should have edited that note....) My tdoc was distracted by the fact that I'd made it thru a tough school, tho I guess she hadn't learned it took me 14 years.

I've read that people with ADHD often get a diagnosis of bipolar by mistake. You might want to think about that a bit unless you're very sure of your dx.

I think you'll find that the treatment can be very useful, tho it won't solve all your problems. You may find yourself remembering things better, losing fewer things, staying awake in boring circumstances (if you want to, that is), picking up social cues better, etc. Can take a long while to implement, tho.

Good luck,

LDO

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Speaking of books, the absolute bestest ever is You Mean I'm not Lazy Stupid or Crazy? I forget the authors, but who can forget that title?

For the uterus-endowed there is Women With Attention Deficit Disorder: Embracing Disorganization at Home and in the Workplace by Sari Solden.  My gf loves this one.

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I haven't taken Provigil but i have read good things of it . . . especially if some issues you are dealing with involve sleepiness....the downside of some peoples issues with Provigil seem that it hasn't helped them concentrate as much as the amphetamines, though the up side is that there are also many people that say the opposite...who knows? until u try it....... The UP UP side of Provigil is that the side effects are not as intense as the amphetamines can be, or so what i've read anyways  ;)

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Exercise does not have to equal gym. Walking, climbing stairs, sledding (that can be very intense if you try to get a lot of runs in), playing games (anything from soccer to tag), skating, bicycling, swimming, water fights, pushing a lawn mower, digging holes, walking a big dog, whatever. Just so it involves a fair amount of physical effort. Pick whichever is the most fun, not whichever will have the most effect in the shortest time if you ever could make yourself do it!

Of course, it's not the whole story, but it helps.

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Yay! I got Concerta, which I wanted. Took the first pill ten minutes ago. Let's see if I start feeling like cleaning my whole apartment soon.. hehe.

And on thursday I have a meeting with a tdoc to learn coping strategies.

It's aaaaall good.

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That's great, Helena. I was going to post and suggest that you see someone for ADD coaching skills. I did the med thing here in Japan, with no coaching, and found it impossible to really improve. The meds help with concentration, but the coping skills are really necessary too.

Anyway, sounds like you're doing well! An inspiration to those of us not quite there yet!

lily

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I've been on Concerta for two days now. I feel that I can think more clearly and I'm more focused on everyday tasks. But studying or working? No way! So I called my pdoc and she doubled my dose to 36 mg. We'll see if that works better. I'll keep you guys updated ;)

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I've been on Concerta for two days now. I feel that I can think more clearly and I'm more focused on everyday tasks. But studying or working? No way! So I called my pdoc and she doubled my dose to 36 mg. We'll see if that works better. I'll keep you guys updated ;)

<{POST_SNAPBACK}>

If you're focusing on everyday tasks, it's a good start. I don't think any of the meds have magical qualities (DAMMIT!), so life is still one day at a time.  I believe in instant progress, but not instant cures.

Give it a little time.

Meanwhile, congrats (dishes, laundry, hygiene, dog-walking, meal-prep, etc - hey, wait - in just two days?  - That would be major progress for me)!

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