Stimulants not always the answer for Attentive Deficit Hyperactivity Disorder

In my practice, I’m amazed about how many people come to me and have taken some test online and have self-diagnosed themselves with ADHD or ADD and want me to give them stimulants. It happens every week. I also don’t know how many times I’ve had to tell these same people that stimulants may not be the answer to their problems and can even make their mental health symptoms worse! Let me give you a case in point of when stimulants may have done more harm than good.

Larry, (not his real name) is a 53 year old male who reports that he has taken Adderall or the equivalent for 30 years. He reports it makes him organized. It makes him be able to focus and concentrate and complete tasks. I take careful note but also observe that this same guy is very rigid, angry and irritable during our visit. He has a history of attempted suicide and has been hospitalized several times. He also tries to hide the fact that he lived in a reclusive situation away from civilization for years and has been unable to work for authority figures. He also reports he is estranged from friends and family.

Yes, it is true that stimulants help many people with focus and concentration. It is also the fact that ADHD is not the only condition that makes a person disorganized, unfocused and unable to complete tasks. For instance the guy above ended up being diagnosed with Schizophrenia. Other conditions like Bipolar Disorder, Depression, anxiety disorders and Thyroid Disorders can look like ADHD. Giving the above patient stimulants can bring out his rigidness, his anger and irritability and even psychotic symptoms. If one has tendencies toward obsessive compulsive disorder it would be especially important to avoid taking stimulants. Stimulants can make the OCD worse. A better way to go might be to effectively treat the OCD symptoms and the patient may find that their ADHD like symptoms greatly improve.

Sadly, years of stimulant misuse for the above patient made him so rigid in his expectations that he was psychologically unable to consider other possibilities for his problems. This is why it is so important that when suffering from ADHD like symptoms that a specialist who works regularly with the various mental illnesses be called upon to do the initial evaluation. It can potentially prevent years of problems and help a person become quickly more functional to reach his goals. I wish this guy could have been spared all the pain he went through! Can you imagine the implications for posterity and other family members?

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An aspirin a day keeps Schizophrenia away?

According to a recent article in the Journal of Clinical Psychiatry, aspirin therapy reduces symptoms of psychosis in Schizophrenia Spectrum Disorders. It is speculated that inflammation is causing havoc in the brain as well as the body now. This reminds me of a study published I believe in the early 2000’s that suggested Ibuprofen may prevent Alzheimer’s Disease, another prevalent brain disease. 

Does that mean that we should all start taking aspirin daily? I wouldn’t do this without consulting with your psychiatric mental health nurse practitioner or psychiatrist. For some people aspirin and other anti-inflammatories can actually irritate the digestive tract and may even cause inflammation, so if you are in the category you may not be a good candidate for aspirin. Like anything, it is important to weigh the benefits with possible consequences. No two people are alike… However, it is the middle of the day and I am feeling a little cognitively fuzzy (and I have Schizophrenia and Alzheimers in the family)…not much of a caffeine drinker—just an occasional diet coke—perhaps I should try an aspirin? Hmm….

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