Adele Diamond wrote an excellent paper on how the truely inattentive subtype of ADHD is a distinct disorder from ADHD with hyperactivity.
(link (http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1474811))
Attention-deficit disorder (attention-deficit/ hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity)
ADELE DIAMOND
University of British Columbia, Vancouver, and BC Children's Hospital, Vancouver

Abstract

Most studies of attention-deficit/hyperactivity disorder (ADHD) have focused on the combined type and emphasized a core problem in response inhibition. It is proposed here that the core problem in the truly inattentive type of ADHD (not simply the subthreshold combined type) is in working memory. It is further proposed that laboratory measures, such as complex-span and dual-task dichotic listening tasks, can detect this. Children with the truly inattentive type of ADHD, rather than being distractible, may instead be easily bored, their problem being more in motivation (underarousal) than in inhibitory control. Much converging evidence points to a primary disturbance in the striatum (a frontal–striatal loop) in the combined type of ADHD. It is proposed here that the primary disturbance in truly inattentive-type ADHD (ADD) is in the cortex (a frontal–parietal loop). Finally, it is posited that these are not two different types of ADHD, but two different disorders with different cognitive and behavioral profiles, different patterns of comorbidities, different responses to medication, and different underlying neurobiologies.On treatment:Most children with ADHD (perhaps as high as 90%; Barkley, 2001 (http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1474811#R13); Barkley et al., 1991 (http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1474811#R15); Milich et al., 2001 (http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1474811#R113); Weiss et al., 2003 (http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1474811#R167)) respond positively to methylphenidate (Ritalin) and over two-thirds of such children respond positively to methylphenidate in moderate to high doses (Barkley, 2001 (http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1474811#R13); Barkley et al., 1991 (http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1474811#R15); Milich et al., 2001 (http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1474811#R113); Weiss et al., 2003 (http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1474811#R167)). In contrast, a significant percentage of children with ADD are not helped by methylphenidate and those who are helped often do best at low doses (Barkley, 2001 (http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1474811#R13); Barkley et al., 1991 (http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1474811#R15); Milich et al., 2001 (http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1474811#R113); Weiss et al., 2003 (http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1474811#R167)). Many individuals with ADD are helped by amphetamines, such as Adderall. There is considerable overlap in the mechanisms of action of methylphenidate and amphetamines, but there is a significant difference. Although both methylphenidate and amphetamines inhibit reuptake of dopamine and norepinephrine, only amphetamines also promote release of those neurotransmitters. Recent research also suggests that low doses of methylphenidate (the dosages likely to be efficacious in treating ADD) preferentially release norepinephrine in the rat brain (Ishimatsu, Kidani, Tsuda, & Akasu, 2002 (http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1474811#R84)). Possible problems with the neural release of norepinephrine in ADD are relevant to motivational issues discussed later.It's definitely an interesting, albeit long, read. I spent a good while last night getting through it all.

Also, a few good threads on the inattentive type:
Inattentives, I need your advice on stimulants (http://www.addforums.com/forums/showthread.php?t=48710)
Sluggish Cognitive Tempo (SCT) (http://www.addforums.com/forums/showthread.php?t=25541)
ADD and ADHD very different (http://www.addforums.com/forums/showthread.php?t=41941)

Many individuals with ADD are helped by amphetamines, such as Adderall.That's how I've felt regarding meds.. In my case, at least. :) I was rediagnosed of having classic ADD about 3 years ago, correlation? I've always displayed symptoms of both, w/dominant inattentive-impulsive, I suppose. I do get by alright, but notice improvement w/Adderall.

When you get a chance, look into Sluggish Cognitive Tempo (SCT) as a "qualitatively different disorder."

tc
mctavish23
(Robert)

Thanks McT!

Though, i was ORIGINALLY diagnosed ADD in Kindergarten..
Symptoms of ADHD are often seen by the time a child enters preschool. Those with SCT symptoms typically show a later onset of symptoms in comparison to ADHD.Some makes sense, some doesn't concerning SCT and ME..

(Ihave amazed many, as I take a bow, lmao) I have pretty awesome reactioning speed, being a goal keeper in soccer, and 3rd basemen for baseball.. And just being able to compete (even considered an All-Star)whilst being at a mediocre level of disciplined fitness. My muscles are flexible for a man. ok, my horn is tooted.. Okay, plus, pretty much excelling @school up until 4th grade, wheere I couldn't get myself to do the homework, nor long division (eeiii book reports!).. Then I got switched from Ritalin to Adderall, and I gained a bunch of weight.. Lost it, when I started up soccer again in my Sophomore year of HS, heheh

I feel like I have all the problems of all ADD subtypes.. I'm not discounting you, AT ALL, McTish! then again, i have no idea if you were talking to me!

Interesting! I'm fully inattentive ADD male(I know that sounds stupid!) and only been using methylphenidate. First 4x10mg, now 1x54mg concerta.
I feel, well read my other post from today in adult forums, "cured" and I have little to no side-effects anymore whatsoever. I start to wonder now if maybe Adderall could help me with minor motivational issues I still have.
I don't wanna start feeling like a labrat so I stick to my concerta for now but hmmmmmmm. Well, I need more time anyway cause also motivational issues are still improving. Next week is an important test for me, I'll keep you guys posted on that one.

I completely agree that inattentive type is a distinct disorder! I know several ADHD people and I really have very little in common with them, they don't have exactly the same problems I have, although they're similar.

I actually have had more success with methylphenidate(specifically Concerta) until very recently. I just switched to Vyvanse and I'm noticing I have better control of focus and I'm experiencing less side-effects. When I was on Adderall before I was on too high a dose so I switched back to concerta without really giving adderall a chance.

@musikgeliebter

I'm not completely convinced about this. To me it seems that people with physical version have some sort of mechanism that tunnels the same "mental/chemical imbalance" to physical symptoms instead.

Funny thing is I recognize these people very well just like I probably do with fully inattentive people.(more rare though and the higher percentage of women with this type, haha, well its very hard for me to "feel" women in general so hmmmm dunno)
Even funnier! When I was young there were several boys with other disorders in "authistic spectrum" drawn towards me quite strongly. But as I do have the social skills it felt weird right away but I did play with them a lot cause I was easy to play with in general and, haha, pretty "special" and "gone" too in my own way...

Sometimes I find it amazing that there's ýet so little knowledge about all this stuff. I know that everybody is different but I recognize myself 100% in the stuff that is known but at the same time I really feel that there would have been like 4 times more facts on this stuff if they took more time on listening very well to experiences of(maybe by brainscans I read about somewhere else) a large group of 100% certain and more severe cases. Especially the inattentive people are extremely sensitive and probably that also makes them like the perfect "labrats" for measuring difficult things like emotions and mental condition...

Hmmm;) No I dont want to be caged and experimented upon!!! Haha

I am the mother of a 10 year old girl who has struggled with sensory integration issues and attention issues since birth. I jsut learned the term Sluggish Cognitive Temp last week when we visited a devolopmental pediatrician. Just the term fits my daughter so well. She is very bright, but always in a fog and lethargic. She is perfectly content to lie in her bed all day long and read. It is such a catch 22 though as lying around makes her more tired, but trying to make her use her body (which actually wakes her up) is such a struggle. Anyway, I have been reading about this sct and am very interested in others experiences. Our biggest problem is having the energy to simply participate in life and stay on task. Interestingly the dr is looking at the quality of her sleep. Even though she is exhausted, she has great difficulty falling asleep. We are trying some melatonim...

Thanks Cathie. Yes, this sounds like me. I have felt for years that I was just slightly low on energy and attention, low enough so that a lot of my grand ideas never saw more than planning notes scribbled on the edges of papers, but close enough to the surface that on those occasions when I had a new boyfriend, or a new field of interest, or a new job or dwelling, I had the energy and focus to start (but seldom finish) a big and impressive project. (I mean, impressive to people besides me. :p )

It's like having a really good car which only has all its cylinders in operation about 5% of the time. "Wow! Look at it go! ... oh, wait a sec."

PS I'm retired. The pattern has been in place since age 6 or 7.


Ducky

Even though she is exhausted, she has great difficulty falling asleep. We are trying some melatonim...
wow ya, spot on, for me.. as well... though I'm old enough not to care anymore about "bed time"... so the sleeping thing is just ya..

getting out enough energy while awake is key to falling asleep...

My sister and I are kind of like what you described.. though it's not an all day thing for me, at least..

the energy to simply participate in life

how often are you driving your child to places?? maybe a bicycle or skates or make her walk or something... just might help.. oh and make sure, possibly, that her shoes are tied right and fit her feet properly..

ts very hard for me to "feel" women in general so hmmmm dunno)lmao:rolleyes:

Cathie -- have her thyroid checked, and not by pediatrician. only an endocrinologist - someone to check her thyroid by hand and check her reflexes and who will not just go by the blood test numbers... sounds like my son, who wasn't dx'd with thyroid disease until 14. Was lathragic and used to suddenly lie down in stores like he was a little deflated balloon (when he was young). He is brilliant and likes to read for hours; adhd has never made sense to me for him, with all the misdiagnosis and medication trials and errors thyroid meds helped the most. However lately as an older teenager we're trying alternative medications to stimulants since he doesn't tolerate those well... clearly he has motivation and focus problems (that goes with thyroid probs too) and perhaps because he was child when it developed he will always have some congnitive effects, that look like ADHD (or maybe he has ADHD too.) ADHD seems like a melting pot for many disorders that effect cognitive speed and clarity. Take care. :^)