I was recently diagnose with ADD and I got overlooked by dr. for years because I do not have any hyperactive symptoms. After reading up on all the frustrations I was going through in my life I diagnosed myself and went to my dr. with all the stuff I had researched. So here I am now trying to find answers and my dr.and
I are just learning treatment options.

I was wondering if the RX treatments differ for ADHD v ADD?

I am not hyper at all only my mind races sometimes and I don't need my body slowed down at all. I have gained 37 lbs over the past 2 years.

Thanks for all your help!

I was recently diagnose with ADD and I got overlooked by dr. for years because I do not have any hyperactive symptoms. I was wondering if the RX treatments differ for ADHD v ADD? I am not hyper at all only my mind races sometimes and I don't need my body slowed down at all. I have gained 37 lbs over the past 2 years.
Welcome, Denise!

I have the same problem as you have, and I have found that women w/o hyperactivity are often undiagnosed/misdiagnosed. There are threads regarding weight gain, search for weight gain on the site. One bariatric physician in Oregon found that 48% of his obese female patients were ADD.

I have searched for the answers to the same questions, and found that it is different for different people. If you have anxiety, stimulants may not be the right choice, however some people say they do very well on a very low dose of adderall or ritalin. Straterra is sometimes recommended for more anxious people, but some people hate that too for side effects.

I have gone to the sites for each of the medications, and looked at threads for the different meds and read those.

It's a long process. If you have a psychiatrist who is familiar with ADHD I think that is the best place to start.

Good Luck! PJ :p

it depends on the individual ive seen some large fat people 6'5" 300+ lbs who are super-hyper get relief from taking 5 mg of ritalin per day and some small kids need 120 mg of desoxyn (meth) to wake up and focus... typically i think hyper types generally need more but again i am just a patient a very impatient patient

According to my doctor, stimulants are the first med of choice for inattentive ADD, and strattera is his first line med for hyperactive. That's just my doc, though, and there are other things that would come into it (any co-existing conditions, addictive history, health problems that don't go with stimulant meds.)

I read somewhere that low doses of stimulant effects learning and memory(inattentive), while higher doses behavior(hyperactivity). I would say that inattentive adhd in general requires smaller doses.:)

I read somewhere that low doses of stimulant effects learning and memory(inattentive), while higher doses behavior(hyperactivity). I would say that inattentive adhd in general requires smaller doses.:)I'd love to see here you read this :) because I take a very high dose of stimulants for Inattentive ADHD.

OP there is no difference at all. Everybody reacts differently to different meds and different doses, so its a matter of trial and error until you find what works for your particular situation.

There is no difference between ADD and ADHD anymore either ;) we all have ADHD and are differentiated by type, medically speaking. ADD is just the short-form terminology.

There is no difference between ADD and ADHD anymore either ;) we all have ADHD and are differentiated by type, medically speaking. ADD is just the short-form terminology.

I was just about to say the same exact thing! The difference is between the DSM's. The DSM 3 states it as ADD while the DSM 4 states it as ADHD w/wo hyperactivity. Labels get confusing after a while!!

For the most part, the treatment of ADHD hyperactive is not much different from ADHD inattentive.
However, ADDers who are of the hyperactive type tend to be more prone to anxiety and sometimes the doc will treat anxiety along with the ADHD.

In my case (ADHD combined type), I am non a suite of meds that probably won't do much for someone who is inattentive...

I am on tenex, and it does a good job of removing hyperactivity, and reducing impulsiveness, but it does nothing for atention, so my doc put me on a small dose of wellbutrin for attention.
I doubt that someone who was inattentive adhd would benefit much from tenex (your mileage may vary) but I guess the wellbutrin would help...

Me :D

I realize this is controversial but were really not going to get help untill AD/HD-i is no longer considered a part of AD/HD. In a speech barkley gave in 01 or so he directly outlined the reasons that its not the same disorder and why the DSM should re-revaluate it. He also went on to say only 25% of the inattentive children he treats respond to stimulants/NRIs. Im very lucky to be in that 25% because i dont know what i would do.

A good portion of we adult AD/HD-i sufferers have gone through possibly years of psychiatric treatment for possibly the wrong things. Remember all those diagnosed dysthymics in a study i posted a few months back who were just untreated inattentives?

Ten years ago this disorder didnt even exist and it was placed with something considered a behaviour disorder. This is not right at all...

(i dont wish to knock anyone with any of the other diagnosis, theres nothing wrong with you but we are not the same thing)

My MD says that about 20% of the people he treats for adhd do not respond to medication at all. He did not differentiate between inattentive and hyperactive subtypes.


If ADHD PI and ADHD +H are separate disorders, what about the people who are combined type? Do those people have two concurrent disorders ?

Me :D

In theory combineds are simply hyperactives that got a bit older and learned coping skills am i correct? Or at least partially?

We need a reliable way to test the AD/HD-I people for information processing problems because thats where the real problem is in the disorder. Were not properly processing stimulus and not placing the right importance on the right stimulus. Its not that were bouncing from subject to subject its that were not even aware of the subject/stimulus and when we become aware we automatically assume it must be meaningful.

We may even have to break the inattentives into two categories for things to make sense.

I need a day or so to think this over.

I think inattentive adhd and hyperactive adhd are completely different disorders.

Adhd hyperactive people seem not to feel the normal anxiety or fear that others feel in given situations. For example, most people fear the consequences of speaking out of turn or disturbing the class, while the adhd hyperactive does not. (hope I don't offend somebody)

People with inattentive adhd are dealing with issues of reward deficiency, they become bored quickly, daydream, don't follow thru, etc. Inattentive type also tend to suffer from learning disabilities, which is probably tied in with reward problems.

Perhaps adhd hyperactive is deficiency of nore/dopamine, Inattentive is a general slowing or underactivity of the whole CNS.

Which subtype suffers from more depression and anxiety? I would say Inattentive. Could be wrong.:eyebrow:

I can see how inattentive adhd and depression could be confused.

I think adhd is a bunch of different disorders with similar observable symptoms. It shouldn't matter what treatment is used, only that it works.:)

I think inattentive adhd and hyperactive adhd are completely different disorders. And where do you then place the Impulsive Combined type?

Adhd hyperactive people seem not to feel the normal anxiety or fear that others feel in given situations. For example, most people fear the consequences of speaking out of turn or disturbing the class, while the adhd hyperactive does not. (hope I don't offend somebody) I do not find this to be true for the hyperactives I know. And then you have someone like me, who has outgrown the Impulsive trait of Combined type and lemme tell ya, I am still occasionally unable to make myself care whether I speak out of turn or not and my current DX is Inattentive.

People with inattentive adhd are dealing with issues of reward deficiency, they become bored quickly, daydream, don't follow thru, etc. Inattentive type also tend to suffer from learning disabilities, which is probably tied in with reward problems.Oh boy! My child and I do not have any type of learning disability other than the PI ADHD, and I happen to know a moderator here who is DXed Hyperactive and Dyslexic.

Perhaps adhd hyperactive is deficiency of nore/dopamine, Inattentive is a general slowing or underactivity of the whole CNS.I don't know about this stuff, but HF has some theories on it :) it always baffles me.

Which subtype suffers from more depression and anxiety? I would say Inattentive. Could be wrong.:eyebrow:

I can see how inattentive adhd and depression could be confused.I cannot adequately state this for myself since much of my own depression seems for related to my bipolar, with me using my ADHD as yet another reason to get hysterical when depressed. I do know that I was Dxed chronic for many many years yet my PI ADHD went unnoticed.

All this adhd stuff is complicated. I guess the most important thing is finding a treatment that works and sticking with it. :)

All this adhd stuff is complicated. I guess the most important thing is finding a treatment that works and sticking with it. :)I couldn't agree with that statement more :). Its right in line with my silly "Pudding Theory of Mental Disorders" that states:

"I do not need to know the process by which ingredients become pudding. I either have pudding, or I don't, and it really doesn't matter which flavor of pudding I wind up with." (c) Crazy~Feet @ ADDF :D

Perhaps adhd hyperactive is deficiency of nore/dopamine, Inattentive is a general slowing or underactivity of the whole CNS.

One theory that is out there is that hyperactive ADD is an unusually low amount of activity in the prefrontal areas (low dopamine activity, that is), and a high amount of dopamine activity in other areas (perhaps meaning low serotonin -- not much inhibition). That theory states that inattentive ADD is like that, but without the dopamine overactivity to compensate.

Underactivity of much of the CNS probably describes depression (without anxiety), not inattentive ADD. In my experience, inattentive ADD is very much different than depression. While people with inattentive ADD lack motivation, they usually do not have mood problems/swings without a comorbid disorder, and their moods are probably more stable than their hyperactive counterparts. In depression, low dopamine and norepinephrine levels are supposed to be related to decreased serotonin levels (according to the catecholamine hypothesis of depression), whereas with inattentive ADD, it's probably more specific and is not related to the serotonin regulation of other neurotransmitters.

I think they are different, too.

And i think they all change with age. It is rare to see a physically hyperactive adult who is as active as a hyperactive male child.

Hyperactive and/or impulsive children seem to sometimes grow up to be tired, overweight, anxious/or/depressed adults. (Seen this happen to a more than a few kids.)
======================

There are Gender Issues too:

e.g. Females

Impulsivity in females tends to be manifested in a "verbal" sense. Females are not physically impulsive (hitting, etc), as much as they can be/become, "verbally impulsive" with age-ing out of childhood.

Quinn and Nadeau call them "Chatty Cathy" girls. They talk too much and tell too much. They exhaust those around them, or people think they are **weird** b/c they disclose too much personal info. (Low self-monitoring; boundary issues never taught; never learned non-verbal social rules for establishing an appropriate 'tit-for-tat' rapport; tells anyone anything.)

N.B. These are profiles I have seen in my life, and school experiences, and not true for all individuals, ofcourse. Just "trends" and "illness trajectories" that i have seen. Noone fits a mold.

I was very hyperactive as a kid and have an inattentive diagnosis these days -- apparently the hyperness found other avenues of expression. I can still swing to hyperactive in a very stimulating (emotionally or intellectually) envirornments, but can look like a slug at other times. Fortunately weight hasn't been a big problem, but the anxiety part fits. One thing that I know both from the reading I've done on the subject and from personal experience, is that aerobic exercise can make a big difference for either kind of AD(H)D. Hallowell and Ratey (Delivered from Distraction) state that it's like taking a dose of Ritalin and Prozac holistically because it releases additional serotonin and dopamine. Mel Levine (The Myth of Laziness) discusses how movement can use physical energy to boost up the sagging mental energy since many folks with attentional problems have a dysregulated/low mental energy flow.

I've read that generally stimulents don't work quite as well for inattentive and work better at lower doses than for folks with the H. Strattera also may work better for inattentives. I took a low dose of stimulent medication which helped a lot, but I had to discontinue it because I developed tics. I hope you find a combination that works for you.

Scattered

hyperactive hyperactive hyperactive vhyperactive thats me iam like that a lot the time
seen both add adhd an there total diff to dpression....we look at dopmine an sertoine
but i would if its more smiply than that....maybe a part ofve it....but not the case ofve it
merycondrin.....the power house ofve all cells i think something there is more like the key to this....ive seen no studys in this so far but i think it might show some light....

when you combin food E NUMBERS WITH DOPMINE /WITH DYS AN ,,,,SERTION NOW ADD MYACORNDIN YOU GET A PICHER BUILD UP.......ONE HAS A KNOCK EFFCT ON EACH OTHER,,,,AN YOU DONT NEED ERRORS IN DNA RNA TO ACCONT FOR THAT

thory........this might show on steimlests that dont work well on ADD

just though.......... dorm

People with inattentive adhd are dealing with issues of reward deficiency, they become bored quickly, daydream, don't follow thru, etc. Inattentive type also tend to suffer from learning disabilities, which is probably tied in with reward problems.

Oh boy! My child and I do not have any type of learning disability other than the PI ADHD, and I happen to know a moderator here who is DXed Hyperactive and Dyslexic

Yea what Crazy~feet said- :p

I am the dyslexic hyperactive moderator by the way. I have ADD with “H” factor deluxe. Matter of fact my ADD trait #1 is hyperactive I am only moderately impulsive and only inattentive when not paying attention . . . actually I experience inattentive symptoms when my medication first begins to wear off. Once completely out of my system I begin the hyperactive “wind up” .

Naturally biologically speaking when I was diagnosed I did not have any inattentive traits. I will mention back when I was diagnosis there was ADD with and without hyperactivity. . . .I am with. . . . .




hyperactive hyperactive hyperactive vhyperactive thats me iam like that a lot the time

Make that two hyperactive dyslexics!

I have met more dyslexics that are either hyper or combined than I have dyslexics who are inattentive alone.

ADD is the most common co-condition found in those who are dyslexic. I think the figure is about 50% of dyslexics also have ADD, which is pretty high. The article I read did not specify ADD sub-type.




One theory that is out there is that hyperactive ADD is an unusually low amount of activity in the prefrontal areas (low dopamine activity, that is), and a high amount of dopamine activity in other areas (perhaps meaning low serotonin -- not much inhibition). That theory states that inattentive ADD is like that, but without the dopamine overactivity to compensate.

I can agree with about 75% of this. I believe the hyperactivity could be a compensating method, this would line up with my experiences. However I do not know about the serotonin any time my serotonin is pharmologically changed I have bad reactions to it. . . apparently my serotonin is fine if left alone.

I do not fit DSMV criteria for depression, my mood swings tend to hormonally related but being ADD does help me forget about them – :D !

I tend to think SB and his discussion about ADD and histamine also has some merit. We associate histamine with allergies only but there is more than one kind of histamine and histamine also regulates arousal which would account for the BA =boredom aversion portion of ADD!

Of interst is the hyper link in this post
from WesleyT's post (http://www.healthrecovery.com/HRC_2006/Depression_06/D_roller_coaster.htm)

here (http://www.addforums.com/forums/showpost.php?p=364487&postcount=1)

Note to self :I should move this topic over here in scientific area. Wonder if I will remember by the time I am finished editting and posting this? So HF if it isn't over here then I have forgotten. . . .oh yea discussion (pill time me thinks)

Tyrosine (precursor to thyroid) is a differential factor when discussing the difference between hyperactive and inattentive(IMHO).

I think Hyperactive and inattentive have the same cause but the body’s coping methods is where the difference will eventually be found. I think throsine will be part of that finding as well.




In my experience, inattentive ADD is very much different than depression.

Agreed!

Inattentive although not physically hyperactive often do complain of feeling mentally hyper active. . . . my mind wonders and goes a million miles an hour what makes me hyperactive is my body tends to wander off with my mind where those who are more inattentive tend to physically stay put.




And i think they all change with age. It is rare to see a physically hyperactive adult who is as active as a hyperactive male child.

Some may change with age perhaps but in my expereince others (like me) hang on to hyperactive boy hood as long a physically possible. . . .which means this next part doesn’t fit at all

Hyperactive and/or impulsive children seem to sometimes grow up to be tired, overweight, anxious/or/depressed adults. (Seen this happen to a more than a few kids.)

Not me in the least. I plan to wiggle until they plant me six feet under. My experience is we grow up to be hyperactive adults who can’t sit still for longer than five minutes. . . constant wiggles tend to keep the weight in check. . . some of us are even skinny although I will agree skinny is much easier for the male version to pull off after 40 some thing. . . . being female I am now considered normal weight almost. . .

Now what was the original question Do they treat inattintive ADD the differently than hyperactive? . . . . The medical overall answer from what I have read . . . .no they don’t!

emedicine source (http://www.emedicine.com/med/topic3103.htm)

History: The 3 types of attention-deficit/hyperactivity disorder (ADHD) are (1) predominantly hyperactive, (2) predominantly inattentive, and (3) combined. The DSM-IV-TR criteria are as follows:
•Numeric codes indicating type based on criteria (adapted from DSM-IV-TR) are as follows:
o314.00 ADHD: Predominantly inattentive type if inattention criterion is met for the past 6 months, but hyperactivity/impulsivity criterion is not met
o314.01 ADHD: Predominantly hyperactive/impulsive type if hyperactivity/impulsivity criterion is met for the past 6 months, but inattention criterion is not met
o314.01 ADHD: Combined type if both inattention and hyperactivity/impulsivity criteria are met for past 6 months (Note that this code is the same as that used for the predominantly hyperactive type.)
o314.9 ADHD not otherwise specified (NOS): Other disorders with prominent symptoms of attention-deficit or hyperactivity-impulsivity that do not meet DSM-IV-TR criteria


Medical Care: Recent data suggest that carefully crafted stimulant therapy is more effective than behavioral therapy or regular community care (medication management by pediatricians). For related areas of functioning, such as social skills and academic performance, medications combined with behavioral treatments may be indicated. Pharmacotherapy includes the following:
•Stimulants (methylphenidate, dextroamphetamine)
oThese are first-line therapy and probably the most effective treatment.
oAll stimulants have similar efficacy but differ by dosing, duration of action, and adverse effect profiles in individual patients. C ***End Quote

I think it's kind of a stimulation thing... either daydream or chase something to occupy your attention, either way you're understimulated... I was also a rare-ity as far as becoming more hyperactive as an adult (a bit of PTSD there too) and was told I was manic because "Adults with ADD arent hyperactive" and well Manic people aren't staying that way they "cycle" etc.

"Adults with ADD arent hyperactive"

Says who?

I think it's kind of a stimulation thing... either daydream or chase something to occupy your attention, either way you're understimulated... I was also a rare-ity as far as becoming more hyperactive as an adult (a bit of PTSD there too) and was told I was manic because "Adults with ADD arent hyperactive" and well Manic people aren't staying that way they "cycle" etc.Adults with ADHD certainly CAN be hyperactive, and the form of BP known as Cyclothmia manifests more periods of hypomania than depression. I myself cannot sit still during hypomania cycles...well, I can? But its very uncomfortable and my mind races when I try to :o and my ADHD DX is inattentive, not hyperactive. Unless I am manic? I am a virtual sloth. Unless one is hyperactive as a child, it is unlikely (IMHO) that one will become more hyperactive as an adult without something else entirely different from ADHD going on. The high anxiety of PTSD (I also have extensive experience with this DX) may also lead to an inability to be still.

I've read that generally stimulents don't work quite as well for inattentive and work better at lower doses than for folks with the H. Strattera also may work better for inattentives.

I think my doc told me the exact opposite about Strattera. I don't take anybody's word for anything though. You look through the forums here and there's a whole whole lot of people wondering what they're supposed to do with innattentive ADD, and it's hard to get reliable information.

I don't seem to be getting much out of a low dosage of Adderall, and Straterra may be my next stop.

I was also a rare-ity as far as becoming more hyperactive as an adult (a bit of PTSD there too) and was told I was manic because "Adults with ADD arent hyperactive" and well Manic people aren't staying that way they "cycle" etc.

Okay I am wanting to make sure we are all seeing the same rrreality going on here. . . .

Adults with ADD can and are hyperactive this is true but we are born hyperactive. . . . I was wiggly in the womb.

Non-hyperactive ADD adults do not normally become hyperactive as an adult.

Non-ADD adults do not normally become hyperactive either.

Anxiety can cause increased activity in some. For a majority increased irritability also accompanies the increased activity which can be confused with bi-polar hypo-mania. . It shouldn't even be close to adult hyperactive ADD.

ADD in the born with biological sense is some thing we are born with even though many with inattentive or a non-hyper active combined may not have noticeable problems until the demands and expectations increase as they mature. Those of us with a hyperactive component can become less active as adults which will qualify then for the combined category however not all of us loose the physical hyperactive.

Hyperactive adults that are moody can change moods every five seconds with the changing of the moment. However anxious adults with increased physical activity will not . . . the bi-polar varieties will usually have some sort of depression or alternate mood state thus the term bi (two) - polar (think of north pole vs. the south pole on opposite ends of the planet) They can cycle fast but not every five seconds fast like the hyper ADDers. . .

Just to add to all the confusion there is the co-existing possibility.

Personally most of the people I have met with ADD and bi-polar fall into the combined or inattentive ADD category. I have never met a purely hyperactive adult with Bi-polar. I am not saying they do not exist I am saying I haven't met any. Hyperactive ADDers are hyperactive every day of their lives Their activity level doesn't change unless they become very ill. The two most common conditions I have seen in fellow hyperactive adults is dyslexia for most , and anxiety for a few. . . .