Top Ten Questions about ADD meds


Considering ADD Medication?

©Madelyn Griffith-Haynie, CTP, CMC, A.C.T., MCC, SCAC
Updated legacy post -orig. 09/12/99

line drawing of a middle-aged doctor with glasses: shoulders and headTen Important Things to find out from your doctor or your pharmacist

First Things First: Doctors are only human — OVERWORKED humans.  They also have a lot of patient information to keep track of.

On top of that, it may take a change or three to titrate meds for each patient (find the right medication, the right dosage, the right timing, etc.).

So it’s always wise to double-check your prescription EVERY time.   Make sure the medication, dosage and timing are the same as last time, and point out anything that’s different before you leave the office.  

When you pick up your medication at your pharmacy, check it again.

So that means you’re gonna’ write down the information the FIRST time, right?
THEN you’re gonna’ transfer it to something you will keep in your wallet – or to your PDA or cellphone – something you always have with you, right?
(while you’re waiting for your very first prescription to be filled is an excellent time to do this, by the way!)

I use “ADD” or ADD/EFD, avoiding the “H” unless I am specifically referring to gross motor hyperactivity.  (Click HERE for why).

NOW, on to those Ten Things . . .

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1.  What TYPE of medication is it?

In addition to the NAME of the medication (and it’s generic, if you will be taking a Brand), you want to know the meds class — what TYPE of medication is it?  Stimulant?  Antidepressant?  Anti-anxiety medication? Beta Blocker? Mood Stabilizer?  (For antidepressants you need more info still:   SSRI, Tricyclic, MAO Inhibitor, other?)

For example:  

DEXTROSTAT and ADDERALL are brand names of dextroamphetamine-based stimulants;
RITALIN and FOCALIN are brand names of methylphenidate-based stimulants.

Read More: Stimulant BASICS: Ritalin and Adderall

2. What is the medication designed to do?

WHAT area of functioning is the medication supposed to be helping me with?  If the answer is broadly generic, like “help you focus,” or “pay attention,” respond with simple questions like the ones below:

Can you say more about that?
How will that show up in my functioning?
What might that look like to someone who knows me well now?
What kind of tasks might I be able to do that I struggle to accomplish currently?

3.  WHY this particular medication for me?

Why this type of medication, and why this particular one.

4.  WHY this medication AT THIS TIME.

The most current thinking is that stimulants are the first-line medication of choice for ADD.  This contrasts from much older approaches that had “let’s rule out other diagnoses first thinking behind it. Many doctors are still prescribing one of the anti-depressants first and adding stimulants later, “if necessary.”

There are valid reasons why a doctor might go this way with YOU.  Some, however, are still basing their choices on the older thinking about ADD.

Your doctor needs to explain his treatment approach so that you understand.

Even if your doctor prescribes a stimulant, you still need to ask question number 4!

Listen for answers like the following to let you in on the doctor’s thinking — and to let you know that it is not simply a formula approach to medicating ADD (examples only – not absolutes – see Stimulant BASICS: Ritalin and Adderall for more).

  • Dexedrine Spansules generally require less overall medication than Ritalin to get the desired results and it is easier to titrate dosage.
  • Adderall generally has a slower, more sustained action throughout the day that may help even out some of the functioning swings you report.
  • Methelphinidate (generic “Ritalin”) tends to work better with audial processing disorders and, from what you tell me, that seems to be part of what is going on with you.

By the way, I have personally heard the statements above “straight from the horses mouth.” Your doctor may not AGREE with them, and may well say something quite different.  That’s OK – different docs have different approaches tied to different clinical experience with ADDers.

The important thing is that they HAVE a treatment philosophy and that they are willing to explain it to you.

There is no need for them to defend it — so be aware of your tone of voice and the way you frame your questions so that you don’t, inadvertently, put them on the defensive.

As long as you have a good feeling that your doctor is not defending some cookie cutter approach explained to you as THE way it’s done, you have to be prepared to trust your doctor’s advice, regardless of what you read on some webpage (ahem! including this one).

5.  How will I know if it’s working? 

What is our “end-game?” What functionality or behavioral/emotional control will  be available to me with the addition of this medication that is not available now?

6.  How soon might I notice the effect of the medication?

What might I notice first? What side-effects might show up, and how long do they generally last?

7.  What precautions do I need to be aware of?  

• Is there anything to watch out for that would mean I should call you immediately?
• Is there anything I am supposed to do (or not do) while this medication is in my system?
• Why or why not?

Why or why not?

You’re not being a smart-alec, you REALLY need to ask that question!  You must know what you are risking to know how carefully you have to monitor yourself.

For example . . .
there are certain over-the-counter cold remedies as well as certain foods that MUST be avoided when talking a type of antidepressant known as an MAOI (MonoAmine Oxidase Inhibitor) – many of the cocktail party foods, by the way.

• Most people know not to mix milk with antibiotics.
Why not?  Milk reduces the effect of the medication.

• Some medications must be taken with food.
Why? The medication will upset your stomach if you don’t -or- it won’t be absorbed properly without some food in the digestive pipeline.

• Don’t drink and drive.
Why?  Even ONE drink impairs reaction time and increases the chance of an accident involving others.

ALL good to know.

What could happen if you drink a fizzy cold remedy, pop a sinus pill
or drink a glass of wine and have a few peanuts
when an MAOI is still in your system (up to 3 weeks later, btw)?

Stroke or heart attack.

VERY different risk.  

If you don’t ask, what’s the likelihood you’re going to understand it THAT clearly and succinctly?

Do it NOW

Don’t rely on yourself to read the patient insert that comes with most medication – that’s for backup! ASK this question and make sure you get an answer that makes sense to you.

Many ADD/EFDers struggle with reading (concentration, not literacy!), and those inserts are deadly dull reading.  I don’t even read the darn things half the time, and I’m an avid reader.  But I always ask question #7 for any change in medication (even if I think I already know the answer)!!

8.  What do I do if I don’t like the effect of the medication?

How long do you generally give the titration process before we stop working with this medication in ANY dosage and switch to another medication?

What signs will we be looking for to tell us that this is or is not the best medication for ME?  If this doesn’t work well, what will we likely try next?

9.  What is our next course of action if this works well?

Will we be adding anything else?  What? When?  In what circumstances?

10.  Can someone in your office help me with a titration log?

A titration log is a type of chart that allows you to track some specifics of your medication history. Titration log documentation captures some specifics day-to-day, and really helps to shorten the time it takes to find a treatment plan that works well for you.

Not all doctors offices offer this service, and those that do offer varying levels of support. Your goal is simply to find out what’s available through the office and what’s up to you to find another way to handle.

If you don’t track it, you really don’t think you will remember, do you?

ADDers tend to remember the highlights, not the specifics – and then only the most recent or the most dramatic.  Your doctor needs more than that to be able to do his or her best job.

Click HERE for another Top Ten Questions List for your Doctor

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About Madelyn Griffith-Haynie, MCC, SCAC
Award-winning ADD Coach Training Field founder; ADD Coaching field co-founder; [life] Coaching pioneer -- Neurodiversity Advocate, Coach, Mentor & Poster Girl -- Multi-Certified -- 25 years working with EFD [Executive Functioning disorders] and struggles in hundreds of people from all walks of life. I developed and delivered the world's first ADD-specific coach training curriculum: multi-year, brain-based, and ICF Certification tracked. In addition to my expertise in ADD/EF Systems Development Coaching, I am known for training and mentoring globally well-informed ADD Coach LEADERS with the vision to innovate, many of the most visible, knowledgeable and successful ADD Coaches in the field today (several of whom now deliver highly visible ADD coach trainings themselves). For almost a decade, I personally sponsored and facilitated seven monthly, virtual and global, no-charge support and information groups The ADD Hours™ - including The ADD Expert Speakers Series, hosting well-known ADD Professionals who were generous with their information and expertise, joining me in my belief that "It takes a village to educate a world." I am committed to being a thorn in the side of ADD-ignorance in service of changing the way neurodiversity is thought about and treated - seeing "a world that works for everyone" in my lifetime. Get in touch when you're ready to have a life that works BECAUSE of who you are, building on strengths to step off that frustrating treadmill "when 'wanting to' just doesn't get it DONE!"

10 Responses to Top Ten Questions about ADD meds

  1. These are great questions for your doctor whenever any medication is prescribed, Madelyn. I have worked as a nurse for so long, I’ve come to question everything. Not that I don’t trust my doctor because I do. It’s just that as a consumer and advocate for myself, I don’t take medication lightly. And I teach the patients I work with the same thing. Excellent post, Madelyn!

    Liked by 1 person

    • Thank you so much. I am always amazed by how many folks I talk to who have no IDEA what they’re taking or what it is designed to do (even why its essential to take the ENTIRE course of antibiotics, for example – or why it’s a lousy idea to decide to stop taking a medication without checking with their doctors).

      Educating patients is sooooo important!

      My hat’s off to you, btw. I helped out at a nursing home for a few days during a nurses strike in NYC many years ago and have never taken nurses for granted since!!
      xx,
      mgh

      Liked by 1 person

      • Thank you Madelyn. I am also shocked at how many people take pills without questioning it. And thank you for the tip of the hat to nurses. It certainly isn’t a profession for wimps by any means. XO

        Liked by 1 person

        • Hat tip and genuflection!! Nobody ever tells you until you get there that you have to be a weight lifter!! And a maid. And a social worker for the families and a babysitter for the docs — in addition to knowing how both brain and body work, the names for all the parts, what meds do what, dosages. etc. and more!

          My colleague’s daughter recently began nursing school – and she’s always flipping through the flash cards she made to aid in all the memorization required. Most people have NO idea! Not for wimps on any level.
          xx,
          mgh

          Liked by 1 person

          • You are right Madelyn. The eduction and training of a registered nurse involves a lot of disciplines from organic chemistry to sociology. And then the clinical training is difficult and intense. All this to enter a demanding and moderately paid profession. I was so mad the year The View made fun of the Miss America candidate whose talent was a monologue about her work as a nurse. I even wrote a blog post about it pretending to find new sponsors for The View (they lost a lot of heavy hitters over it).

            Liked by 1 person

            • I didn’t know about that episode of The View (no TV), but good for the sponsors for pulling out! I hope they got letters of support for that action.

              Some things simply aren’t funny – and making fun in this case was simply lacked taste and good sense. Perhaps they all make so much money now they’ve gone over to the dark side — more like Orange and his more than three stooges than the rest of the country.
              xx,
              mgh

              Liked by 1 person

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