We believe this is why, after taking thousands of doses of stimulant, the MTA kids ended up in the same spot as their non-medicated peers.įortunately, there’s a good workaround for tolerance - taking regular stimulant breaks, as our prescribers recommend at our clinic. To anyone who has taken stimulants for more than six months, this idea isn’t controversial. Eventually, you hit a ceiling, where you can go no higher, and often that ceiling is well past the maximum recommended dose. The more you increase the dosage, the more tolerant your body becomes, and (you guessed it) the less effective the medication becomes. The less effective it is, the more you want a dosage increase. Simply put, the more you take stimulant medication, the less effective it is. We think that the problem identified in the MTA study is that of stimulant tolerance, a rarely discussed topic that seems oddly controversial among prescribers. People who need to be on stimulants nearly always have a love-hate relationship with them, so nobody is going to stay on them if they aren’t benefitting. Nobody seems to understand how this makes sense. The longitudinal Multimodal Treatment of ADHD study found that some children who use stimulants for years end up no better off than their peers who didn’t take medication. ADHD Medication: Addressing Stimulant Tolerance And that is the definition of “being behind” in school and in life. But if the symptoms persist, and you don’t treat your child’s neurological condition, he will grow up having missed critical learning, both academic and social, that other kids have. It’s OK to try those things for a reasonable time, and if the symptoms are more manageable, you can declare your child ADHD-free. And if he is impaired, talk therapy or supplements or nutrition or exercise or discipline isn’t going to resolve that. If he does have it, he is either impaired, or not. The problem with this perspective is simple: Your child either has ADHD or he does not. Others fear the Zombie Effect - that stimulants turn playful children and teens into robotic, Stepford Children, overriding their natural personalities. Some people are just plain upset by the idea that prescribers give kids “speed” and claim that it calms them down. Skeptics ask, “Aren’t we just treating kids for being kids?” or worry that children are too young to make the choice, or will suffer long-term consequences. One of the biggest critiques of medication management for ADHD is reserved for the treatment of minors. Despite this, the popular press still questions the inclusion of medication as equal with therapy, leaving many parents somewhere between bewildered and opposed to using it with their kids.Įvery week, we receive intake requests from young (and not so young) adults who note something like, “My parents knew I had problems in school, but they didn’t believe in diagnosis or medication” or “I was tested in fourth grade and they said I had ADHD, but my parents thought I was just immature.” Others admit, “We knew I had ADHD and I took medication for it until I was 14, but I didn’t like taking it so I stopped.” Each request comes from someone having a really hard time in work, school, or relationships. Integrative ADHD treatment - combining stimulant medication with directive cognitive behavioral therapy - has been accepted as the gold standard of ADHD treatment for decades.
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