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Child Behavior (Expert Forum)
adderall
Answered by
Kevin Kennedy, Ph.D. - Child and Adolescent Psychotherapy, Family Therapy, Crisis Intervention
Harvard Vanguard Medical Associates
This forum is for questions and support regarding child behavior issues such: Child Discipline (behavior management), Normal Child Development, Parent-Child Communications, Social Development
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Doctor's Answer
by Kevin Kennedy, Ph.D., Nov 27, 2002 12:00AM
, Nov 27, 2002 12:00AM
Adderall is one of a number of stimulant medications employed to treat ADHD. It is often used as a front line treatment of ADHD, as an alternative to methylphenidate alone (although methylphenidate is one of the active ingredients in Adderall). Many children tend to tolerate Adderall better than they do methylphenidate, and experience less of a rebound impact as the medication is metabolized.
These are the questions I pose.
1.Is adderol a combination of all 3 of the above referenced
drugs?
2.Why is adderol a better choice of medication used for the
treatment of ADHD versus some of the other medications?
3.When the drug adderol or any of the other drugs listed here are
prescribed for the treatment of ADHD, what are the guidelines
for increasing the dosage versus no increase, and what are
the reasons for the increases?
4.What are the side affects to observe from overdose and or
underdose?
5.What are some of the indicators to observe to alert, that the
dosage is the right one, versus indicators to alert you that
it is the wrong one?
I am familiar with some of the side effects as far as nausea, suppressed appetite, weight loss, headaches, and most of all insomnia.
Would you say that insomnia is an idicator of to much or too little a dose? Insomnia would seem to be a negative side affect, considering that sleep, and restful sleep, is most crucial to ones health and well being. This is very much a concern I have in regards to using adderol as a treatment for ADHD. Too, what about being prescribed the medication Imipramine for sleeping aid along with the adderol? One drug prescribed to combat the side affects of another doesn't sound practical, does it?
Adderall might benefit someone who may not have had good results from Methylphenidate, for example, either due to clinical ineffectiveness or to bothersome side effects. In addition, some patients experience less (or absence) of rebound symptoms when they use Adderall, even when both are effective relative to target symptoms.
The major reason for increasing the dose of any of the stimulant medications is the impact on the target symptoms. Usually these targets involve hypermotoric behavior, inattention and/or impulsivity.
Inadequate dose would be indicated by failure to remedy (or improve) the target symptom(s), accompanied by clinical effectiveness at a higher dose.
Insomnia can be a side effect of stimulant medications, though this is less likely if the medications are taken at a time which allows for their metabolism well before time for sleep. With children, clonidine (at a very small dose) is often prescribed to assist with sleep. Imipramine is not generally prescribed for this purpose. If a patient achieves significant benefit from medication for ADHD, but experiences insomnia as a side effect, it is perfectly reasonable to ise another medication to treat the side effect. As is often the case with medications, decisions can be made on the basis of a careful weighing of the benefits vs the risks.