I saw a doctor yesterday regarding my inability to concentrate, going completely BLANK on tests, etc. after doing some research on my symptoms.

He said I may have adult ADD and referred me to another doctor. He sat down with me and we chatted for about 45 minutes... and he gave me a test.


MY QUESTIONS IS:

He had asked if I had ever taken a friend's medication who was on ADD/ADHD meds - I haven't.

He also asked me if I had ever taken lortab before. I had for a root canal and he asked what the effects while on lortab was. What is the relevance of asking that question? And how does it pertain to people with ADD?

Thanks for any help you can send my way!

Hi AliB,

I am not an expert by any means, but I can guess that he asked about the ADD meds, because often a person who does not have ADD/ADHD will feel very hyper and jittery (like an overdose of caffiene) with stimulant medications, while someone with ADHD will feel more able to focus and calmer. As for the Lortab, I am not sure. Not having much of a knowledge base about adult ADD (though I suspect I have it), I can say that Vicodin and other types of Narcotics can increase dopamine in your Prefrontal Cortex area of your brain (the part of your brain that is also affected by ADD). In essence, perhaps the doctor was wondering if you noticed any increased ability to concentrate while on Lortab. I think that many people that I have treated in rehab units (on a psychiatric unit), who were addicted to pain killers, were actually self medicating an undiagnosed problem of ADD/ADHD. I do not have any research to back this up - but perhaps you can do a google search for effects of Vicodin on ADD or ADHD.

Personally I am allergic to narcotics, so I have no way of knowing if they would make me focus better, nor have I taken my son's Concerta to see if it would be helpful - but at some point I will talk with my doctor about this (have enough going on in my life and health at this moment in time - lol).

I wish you luck in your search for answers.

At Heart

*(PS - I have worked as a nurse for many years, and have seen this first hand - people who take narcotics to feel "normal") Before my allergy to narcotics, I only noticed them make me drowsy.

He was probably screening you to see if you were there to get drugs or if you were prone to addiction. Addicts lie, steal and do practically anything for a fix. Some doctors are careful about that.

Ironic that you're a nurse. The tests I was referring to were nursing school tests.

Ever since I was a kid, I was always the hyper kid who wasn't bouncing off the walls, but always had outburts. I never had disipline problems (probably b/c my father put the fear of GOD in me). I started going to college 7 years ago. Before nursing school, I had a 3.9 GPA in all my pre-req's and never cracked a textbook - mostly because I avoided reading and studying like the plague. Reading was always difficult for me - I'd skip around, get distracted my pictures, and sometimes even feel dizzy.

When I entered nursing school, I stuck to my old habits of cramming before a test, never reading the book, and "winging it" because "winging it" always had a good outcome. I always passed every class with the BARE MINIMUM in nursing school (80% to 87%) and as the classes progressed, I wasn't retaining what was taught in the previous class - and everything in nursing school is a stepping stone to the next subject. I've always had difficulty taking tests... as soon as the test hits my desk, I feel like I can't get my brain to start. It's like trying to pull the crank on a lawnmower and it never starts.... and you read the question over and over.... you're torn between 2 questions... and you convince yourself that the right answer is wrong... or you just can't put the puzzle pieces together....

And then when I review the test with my teacher one-on-one afterwards, I look at the questions I got wrong and say "DUH! I knew the right answer!!"

I've also always found it hard to get organized during patient care on the floor. I have 50 million things to do.... and I run all 50 million things thru my head... and after 30 minutes, I've gotten nothing done. Or I go into a pt. room, forget something I need, go get it, forget something else I need, go get it, forget something else, and go get it... over and over.... I swear I walk 7 miles on a 12 hour shift.

I've also noticed that a ramble a lot, forget what I said.... and have always had a problem following people when they talk. Sometimes, I find myself just waiting for their mouth to stop moving so I can say what's in my mind before they distract me and I lose my point I wanted to make. Some thing with class - I see her mouth moving - but I don't hear anything.

But then there are other things that interest me that I am AWESOME at. Like running lights at concerts. I love doing it. It's calming. And it requires a lot of prediction, thought, and concentration - but it's also repeatative.

And there I went! I just rambled my head off! I'm known for really really long emails of pointless stuff.

My point was - I was taking my very last nursing class before graduation. I failed the class the first time and took it over. I just failed it again. This time, I forced myself to read the book. It only made things worse - I had way more indepth information and it all got stirred up - and when I took the tests, I couldnt pull out of the big pot full of information what I needed to answer the question b/c everything I knew from my notes and the book was flashing in my head... Picture my head my a conveyor belt - if you don't grab the right things at just the right moment, its gone... then you chase after it and can't find it among the other stuff on the belt.

I'm going to look to see if codine/narcotics increase the amount of dopamine. My drugbook doesn't go too indepth about hydrocodone.

THANKS!

He was probably screening you to see if you were there to get drugs or if you were prone to addiction. Addicts lie, steal and do practically anything for a fix. Some doctors are careful about that.That crossed my mind too (second nature to assume he was trying to find a trend in drug use as a nurse)

But I'm just curious if lortab and ADD meds have somewhat of the same effect on the brain. Or if patients with ADD who take pain killers display something that the non-ADD patient wouldn't.

Thanks!

It does sound like he was screening you for abuse potential.

Diagnosing adults is, in my opinion, more difficult than kids.

The main reasons are the length of time involved between school and early development.

A good adult screen incorporates feedback from multiple sources who know the person well (family members, close friends, spouses,significant others, teachers,etc.)

Old report cards, transcripts, (or dropping out) employment history, speeding tickets,are all relevant.

The same screening questions also apply to the rest of the family, as well.

In addition, ADHD Risk Factors regarding pre,peri & post-natal care, as well as birth complications,accidents, head trauma,failing a grade, special ed placement,etc.,all help build the case.

Those are all taken into account; along with the DSM-IV TR symptoms.

Please keep in mind though, that even though they're researched based, the sample population was heavily weighted towards boys, and the oldest subject was 16 yrs old.

Those data do work though,however, the clinician must read the research to keep up.

For girls, they are more likely to internalize their symptoms via excessive anxiety & depression/irritability, and their hyperactivity is more likely to present as excessive talking.

As opposed to boys,their hyperactive behavior tends to increase at puberty.

However, much like boys, they present as restless adolescents;instead of "bouncing off the wall."

Then there's the Inattentive type, part of which group are referred to as Sluggish Cognitive Tempo (SCT).

Kevin Murphy is the best known Adult ADHD researcher.

The above references are from Sandra's Rief's "How to Reach & Teach Children with AD/HD."

good luck

tc
mctavish23
(Robert)

Hi AliB,

Having worked with many psychiatrists in the past, I really can't tell you what your doctor was after in asking those questions (re. lortab anyhow - many doc's will ask if you have had ADHD meds in the past to either determine if you felt better with the med.) Med seekers are easier to spot than many think. Having worked in the ED and having developed a special file for the people who are/were frequent visitors to get narcotics or other meds, it often crosses our mind if someone asks for pain meds or other controlled substances, whether or not they are seekers.

I do know that it crossed my mind as it did for others above, but honestly, I think that if he only asked about Lortab, knowing that Hydrocodone increases dopamine levels, I would suspect that was more the reason.

So, are you working as a nurse - or were you referring to clinical time when writing about having a million things to do? Having been a nurse who has worked in many different specialties for the past 15 years, I can tell you that it takes tremendous organizational skills to be a nurse in a hospital - particularly in the ICU or ER. It took me a long time to really become organized at work, so I would venture a guess that it will probably take you some time too.

Good luck,

At Heart

Hi Mctavish,

I was interested to find out that girls present with hyperactivity that is expressed through excessive talking. I know that it is harder to diagnose adults than children. I have not really pursued determining if I have ADD or not - though I have long suspected that I do (my brother had severe ADD, as well as dyslexia), because of the difficulty determining diagnosis. I know you mention Kevin Murphy as a well known researcher, have you read any good books about adult diagnosis? Perhaps if I read enough I can determine whether or not it is worth pursuing.

At Heart

For girls, ... their hyperactivity is more likely to present as excessive talking.

that must mean that all 14 year old girls have ADHD ;) ;)

j/k

that must mean that all 14 year old girls have ADHD ;) ;)

j/kActually, fourteen year old boys are often more chatty than the girls in the classroom . . . wait a minute . . . there's a connection here somewhere isn't there?