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General Medication Discussion This section is to be used for general medication discussion and other medications not broken out in their own respective forums.

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Old 03-03-05, 01:03 AM
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ADD medications are most often prescribed by family physicians

The following is an excerpt from chapter five of The ADD Answer: How to Help Your Child Now by Dr. Frank Lawlis and published by Viking. For more, go to www.franklawlis.com.

Medical students are often warned that "sometimes the treatment can be worse than the disease." I sincerely believe that is often the case when children with ADD are given medication to control their symptoms.

ADD medications are most often prescribed by family physicians not by a pediatric psychiatrist which makes me very suspicious. How much understanding do such physicians have of these very potent drugs? My personal and professional opinion is that they should be used very cautiously and only on a short-term basis with specific goals in mind. Most experienced school counselors concede that such medication loses most of its effectiveness by the teenage years anyway, so medications are not a long-term solution for ADD.

There are better and healthier options for treating your child's ADD, beginning with a strong family environment and a focus on healthy behaviors and goals, as we have discussed already, and including a range of approaches to stimulate the brain and focus the child's attention naturally, which will be discussed in subsequent chapters. I base my understanding of medication on years of experience in working with children and on years of working and researching ADD. Although I have had training in psychopharmacology, I always seek recommendations from referring physicians in matters related to medication. I also want to be very clear that I do not have any direct responsibilities for issuing prescriptions or for making the necessary laboratory assessments critical to any drug protocol, especially with children. However, I consult with a group of medical experts when devising medication strategies.

Let us be fair with doctors. There is an old saying credited to Abraham Maslow, a famous psychologist: "If the only tool that you have is a hammer, everything looks like a nail." Physicians nowadays are asked to evaluate and treat hundreds of childhood problems, and most feel that the only tools they have are drugs. Doctors also rarely observe the daily behavior of the child who is being treated. They usually have to rely on the observations and opinions of parents and teachers not only as a basis for diagnosis but also for evaluating the results. Too often the only feedback the doctor receives on medication is that the parent no longer brings the child in to see him. If the physician doesn't hear anything more, he assumes the medication worked properly. But in truth, it could be that the parents simply looked elsewhere for help, or gave up.

The Circular Firing Squad

Too often when a child has ADD, everyone responsible for helping him is shooting in the dark. Doctors often don't get good follow-up information. Parents get frustrated and make decisions without adequate professional input. Instead of circling the wagons against ADD, we form a circular firing squad and shoot at one another.

Typically, parents, physicians, and teachers find themselves at odds over a child's treatment. Parents are often bewildered about what to do to help and protect their child. School administrators, understandably, are most concerned about the learning environment for all of their students. Too often, busy physicians treat the symptoms, not the child.

That is madness. But it is understandable madness and it is prevalent. We are a pill-popping, quick-fix society. School administrators are under pressure themselves to get classrooms under control. Few physicians are trained adequately to deal with ADD children. I have attended medical conferences on ADD in which the doctors on the dais obviously had no clue about the long-term adverse effects of medicating children. It is a very serious business, especially when dealing with any drugs that affect a child's neurological system.

Until recently, no studies systemically examined the long-term effects of drugs on children, such as Ritalin and amphetamines (Dexedrine and Adderall). Some of the side effects of these drugs can be profound. They can be a greater threat to a child's health than most, if not all, ADD symptoms. Certainly they can cause psychosis, including manic and schizophrenic episodes ...

Unfortunately some physicians typically do not stop medicating when psychotic symptoms appear. Instead, they may slap on another diagnosis, of depression or antisocial personality, and then treat this diagnosis by adding antidepressants, mood stabilizers, or neuroleptics (commonly used for epilepsy) to the treatment mix. It is not unusual for children to be taking as many as five different medications, all based on adult prescriptions. Meds upon meds is madness upon madness ...

The side effects are not restricted to psychiatric problems. Stimulants excite the whole body, not only the brain. Stimulating medications also affect the cardiovascular system. One of the side effects of Ritalin is that it boosts the activity of the heart and the cardiovascular systems so that they develop beyond what is considered normal. There is also some danger of liver damage from medications used to treat ADD and side effects. Sleep and appetite problems resulting from medication are also of concern ...

Parents need to understand the potential dangers used to treat ADD. Although only 50 percent of children with ADD can be helped through drug therapy, the ones who respond to drug treatment face the following side effects:

nervousness
insomnia
confusion
depression
agitation
irritability
stunted growth and development

Other side effects, in a lower rate of incidence, include:

exacerbation of behavior symptoms (hyperactivity)
hypersensitivity reactions (allergy-type reactions to environmental agents)
anorexia (eating disorder)
nausea
dizziness
heart palpitations (heart rate fluctuations)
headaches
dyskinesia (movement-of-the-body problems)
drowsiness
hypertension (high blood pressure)
tachycardia (rapid, racing heartbeat)
angina (heart pain)
arrhythmia (heart rate changes)
abdominal Pain
lowered threshold for seizures
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Old 03-03-05, 02:22 AM
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Interesting. I got this off his web site, btw:

Quote:
>BIOGRAPHY<

Frank Lawlis, Ph.D., is a renowned psychologist, researcher, counselor, and an innovator in the field of behavioral medicine with more than thirty-five years' experience working with parents and children with ADD. He has been named director of The Angel Foundation Research Institute for Neuroplasticity and he is a fellow of the American Psychological Association. In addition to being the primary contributing psychologist for the Dr. Phil television show, he is editor at large for Dr. Phil McGraw's newsletter, The Next Level. He lives in Sanger, Texas.
Maybe this guy is where Dr. Phil gets his info on ADD?
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Old 03-03-05, 04:55 AM
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That post is way to long for most of us to read. You are very passionate, but for those of us who have made a mess of our lives, until suddenly had the lite-bulb turn on with medication, you have not a clue. Stimulants are my valium.
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Old 03-03-05, 07:19 AM
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But Tractor, my Klonopin which is related to valium is as bad as stimulants. I'm going to get off this stuff if it killls me. My alternative to no benzo is deafness earlier than necessary.

But I am starting to believe that it is not worth the other risks to remain on Klonopin. Doesn't anyone else feel this way about stimulants? I am not talking about my procrastination, I'm talking about my hearing. I just don't get it. We are all poisoning ourselves.

Perhaps some of us are "passionate" about drug use. Why? Because we care. I wish with every fibre of my being that I had been told Klonopin was a drug of dependence. I had no idea.

I do now.
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Old 03-03-05, 07:38 AM
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I wish with every fiber of my being that I had known what I know now about medication before I started stimulants for ADHD .... I might have still used them but I would have done it a different way . The problem that I had and was that the Dr.'s started prescribing other drugs for the side effect of the stimulant . As the stimulant started to produce depression and insomnia I was given anti depressants and benzos . I had never had depression or insomnia until I started taking ADHD medication . This is something that Dr. Frank Lawlis talks about here .
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Old 03-03-05, 08:03 AM
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This could go back and forth forever with those who believe in medication and those who don't. Everybody has the right to decide what they want to put in their bodies, and I have no right to impose otherwise on anyone who chooses not to use medication to help deal with ADD.

I know I'm dependent on my meds. I don't like it much, but it's better than the alternative to me. Not to make this personal or anything, but if it were my hearing at stake, I would do everything my doctor said to the letter. But, that's just me. I've even had some of the side effects on Dr. Lawlis's list. That won't stop me from taking my meds, though, because I need them.

That's how I, and, I would guess, many others of us who feel we must take these drugs to live a normal life feel.
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Just tell your doctor what's going on. That's what they're there for, and I'm sure they've heard it all, your not alone in what's going on. -- jazzper
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Old 03-03-05, 08:41 AM
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Iexeter I understand what you are saying and can respect your decision . For me the line I had to draw was when the side effects started to outweigh the benefits and I was put on other drugs just to deal with the side effects . Some people have no side effects or little at all . Then there are other for whom the side effects are very hard to live with and controlling them with more and different drugs starts to really take its toll . This is another reason I think it is important to see an experienced psychiatrist who specializes in ADHD rather than the family physician who for many is the one who is treating many ADHD patients , this was something else Dr. Frank brought up .
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Old 03-03-05, 05:50 PM
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Most prescriptions will be written by family practitioners - they're the workhorses of the medical profession. Do you know how difficult it can be to find a psychiatrist that will see you in a reasonable amount of time? Now trying to find an expert in ADHD. If you're not in a big city, you aren't even likely to find a psychiatrist. And without medical coverage, it'll cost you a fortune to boot! It's easy for "Dr Frank" to say that it's important to see an expert - of course it's preferable - but practical, that's a different story. Most doctors are quite qualified to do basic diagnosis and treatment. When there are problems, complications, co-morbid conditions and such, that's when having an expert in your corner will really make a difference. From his web site, I have doubts about Dr. Franks expertise and motivations - he's selling books and feathering his nest by advocating:The role of nutrition; Environmental modifications and bio-cleansing; Advances in biofeedback and neurotherapy; The positive effects of counseling and goal-setting; Crucial strategies to improve sleep; Getting effective help from schools, therapists, friends and family; The importance of engaging the family's beliefs and faith..... Sounds nice, but will it work? For some, maybe, but I can tell you that none of this type of stuff has worked or would work for me. Never tried biofeedback or "neurotherapy" but those two therapies are very expensive and those that offer it don't give you a money back guarantee. I haven't heard of one person who has said that they work in the long term and where worth the money.
The fact is that the most cost effective treatment for ADHD is medication, it helps a larger percentage of people and it's available anywhere there is a pharmacy vs traveling several hours to see a behavioral therapist because you live in a rural area.
I don't beleive that I'm "poisoning myself" by taking meds - not one bit. And I'm not concerned about dependance - if you're taking meds as prescribed by a prudent doctor, you are not going to become an addict - I'll grant there could theoretically be exceptions - as MEE has claimed - but this would be very rare.
"Rapsody", you say: "my Klonopin which is related to valium is as bad as stimulants. I'm going to get off this stuff if it killls me. My alternative to no benzo is deafness earlier than necessary." Honestly, this makes no sense. Why would valium be bad, per se? And stimulants aren't "bad" either - saying it does not make it so. Clearly you are not serious when you say "I'm going to get off this stuff if it kills me" but if you would honestly choose early deafness over taking a benzodiazipine, then the logic you are using to make such a decision eludes me - I'd consider the choice a "no brainer", but perhaps I'm just overly fond of my hearing.
There's no question that there is a lot of "passion" in this debate, but there is a great deal more disinformation happening here too, and this bothers me. I'm continually hearing opinions that are bandied about as facts in an attempt to make people afraid and this is not helping people - manipulating people's behaviour through fear so that they do as you do is quite despicable, even if you mean well. I don't have to look farther than myself to rationalize the importance of acurate information - medication has made a huge positive difference for me and If I had been afraid to try it, I would be in far poorer mental as well as physical health. Furthermore, I know my parents were afraid to try medication when I was a child and the negative effects of that decision are far reaching and profound - I know now what difference they would have made - I unquestionably would have been a happier and better adjusted child/teen/adult, with better grades and more friends. My parents didn't consider this in their decision - their fear won, I never tried stimulants, and I lived most of my life in what Thoreau has described as "quiet desperation" - but at least I wasn't poisoned by some evil doctor, working in concert with and getting secret bribes from the "big pharma" conspiricy who only want to get rich by druging any child who behaves like a child until they are zombies, with full approval of school teachers and principals......
Give me a break and give it a rest!
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Old 03-04-05, 05:42 AM
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Mee,

If your goal in posting many iterations of your basic point is to push poorly educated (with respect to their ADD) individuals with ADD to become better educated (with respect to their ADD) .. then all well and good, this is a useful point.

And you have made it.

And your posts will be accessible for posterity, due to the search facility that is offered here.

There's a burden of responsibility that one must bear when one posts here, or anywhere for that matter.
This burden can be understood and is explored in threads on this site which describe the 'bilateral nature of communication.'

As one enters the realm of potentially highly emotive issues, the need to embrace this idea becomes of ever greater importance.

SB.
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Old 03-04-05, 06:47 AM
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Quote:
If your goal in posting many iterations of your basic point is to push poorly educated (with respect to their ADD) individuals with ADD to become better educated (with respect to their ADD) .. then all well and good, this is a useful point
Thank you.
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Old 03-04-05, 07:28 AM
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Quote:
"Rapsody", you say: "my Klonopin which is related to valium is as bad as stimulants. I'm going to get off this stuff if it killls me. My alternative to no benzo is deafness earlier than necessary." Honestly, this makes no sense.
Gregster, I know the statement sounds illogical to you, but if I wrote I was taking 80mg per day of Diazepam, would that have changed your perspective a little?

I ask this because until recently, I had no idea that my 4mg dosage of Klonopin is equal to 80mg of Diazepam. I don't know how I stand up.

I was never given the chance of a lower dose and then a work up if I needed it. I was not told of tolerance, and I certainly wasn't told that the withdrawals can be sheer hell.

As for the rest of your post, I understand where you are coming from, but at NO time has my intent been to scare anyone. Gregster, I wish someone had been honest with me. They weren't. No one told me what 4mg of Klonopin meant.

As for stimulants, this is from a private email to myself from "the horses mouth" so to speak. It does add weight to your side as well/
Quote:

In terms of the long-term effects, according to the PDR no long-term effects are known.

Also, although hundreds of controlled studies involving more than 6,000 children, adolescents and adults have been conducted to determine the effects of psychostimulant medications -- far more research evidence than is available for virtually any other medication. There are no studies on the use of psychostimulant medications for more than a few years, but many individuals have been taking these medications for many years without adverse effects.

Longer term controlled studies cannot be done because withholding treatment over many years from some patients suffering significant impairments, which is required in a controlled study, would be unethical.

I hope this information has been helpful and I wish you and your husband the best.

Sincerely,

XXX XXXXXXX
But.....I'll go easy

Last edited by RhapsodyInBlue; 03-04-05 at 07:57 AM.. Reason: lost past edit and got confused..
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Old 03-04-05, 07:49 AM
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Quote:
Originally Posted by Gregster
even if you mean well.
I used to be an overt advocate of medical research.

I used to try and convince all of my peers who had embarked on this route to stay with it, because it was the morally correct option.

And then one of my friends questioned me.

And the rigid reality model that I had defined which lead me to adopt this stance crumbled.

But it was replaced by a new model, which accommodated the conversation that I had had with this friend.

And it continues to develop.

And strengthen.

The road to Hades is paved with good intentions.

SB.
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Old 03-04-05, 08:07 AM
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Quote:
Originally Posted by SB_UK
I used to be an overt advocate of medical research.

I used to try and convince all of my peers who had embarked on this route to stay with it, because it was the morally correct option.

And then one of my friends questioned me.

And the rigid reality model that I had defined which lead me to adopt this stance crumbled.

But it was replaced by a new model, which accommodated the conversation that I had had with this friend.

And it continues to develop.

And strengthen.

The road to Hades is paved with good intentions.

SB.
SB, can you explain what changed you? I mean, if you feel like responding. If you left rigid reality models behind, what did you replace them with?

I am genuinely interested in your opinions.
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Old 03-04-05, 11:31 AM
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From the biography of Dr. Frank Lawlis:

In addition to being the primary contributing psychologist for the Dr. Phil television show, he is editor at large for Dr. Phil McGraw's newsletter, The Next Level. He lives in Sanger, Texas.

Seems as though Dr. Phil learned a lot from Oprah in terms of preparing that gravy train for later profit.

Rhapsody in Blue, it's absolutely abhorrent that your Doc didn't warn you of the risk of benzo oaddiction. It's even plastered all over the patient handouts here in the States. From medscape re: klonipin (the link is below):

The manufacturer states that the recommended dosage of 1 mg daily is based on the results of a fixed-dose study in which the optimal therapeutic effect was seen at this dosage. In this study, higher dosages of 2, 3, and 4 mg daily were found to be less effective than the 1 mg daily dosage and more commonly associated with adverse effects. In an open study in which patients with panic disorder were treated with clonazepam over a 2-year period, clonazepam produced and maintained a therapeutic benefit without evidence of tolerance development (as manifested by dosage escalation or worsening of clinical status). The manufacturer states that there is insufficient experience concerning how long patients with panic disorder who are treated with clonazepam should remain on the drug. However, some clinicians state that panic disorder is a chronic condition; therefore, it may be reasonable to continue therapy in responding patients. If clonazepam is used for extended periods, the need for continued therapy with the drug should be reassessed periodically. When clonazepam therapy is to be discontinued in patients with panic disorder, the manufacturer states that therapy should be gradually discontinued by decreasing the dosage by 0.125 mg twice daily every 3 days until the drug is completely withdrawn.

http://www.medscape.com/druginfo/monograph?cid=med&drugid=14403&drugname=Clonazepam+Oral&monotype=monograph
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Old 03-04-05, 01:36 PM
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For sure,

And I really should mention that the fact that I've used 'medical research' as my example, is just because I am a medical researcher.
In no way was my example a dig at the medical research fraternity :-)

The point that I guess I am badly trying to beat a path to, is that the way that we behave is defined by the logic of our experiences.
But that this logic is a composite of blocks of logic which vary from the fairly objective .. right down to the highly subjective.

As we learn more, listen more and communicate more, we can either hold on to what we believe or choose to incorporate new ideas into our view on reality. It's hard though to reshape one's models of reality-- because a fixed perspective on life is more comfortable than a fluid, but expanding understanding of the world in which we live.

The more deeply ingrained, the harder to excise and remodel.

As I entered the conversation that I allude to above, my contribution was from a perspective of medical research could conquer all unpleasant aspects of the human condition, and that I could make the world a better place.

My (now) friend's views were so challenging that it would have been easier to discount his words and to have continued on, in my own way, rather than to attempt to dig sufficiently deep within myself to determine whether his ideas were true.

When one feels one's foundations shake, just like a building, one worries about the whole thing crashing down.

But in this case, the tremors were signs of firstly, a renovation and then a strengthening of the building's foundations allowing an extra floor or two to be built up on top.

Or shifting the metaphor, I felt as though I had achieved a small step closer towards an understanding of the world in which I inhabited.

I cannot say that I have waved goodbye to using the 'rigid models' which define our behaviour. Just maybe that through this conversation, a very rigid model or two that were fundamental to me were reshaped.

I am still a medical researcher. And I might still try and convince people to follow me into this field.

But my previously blind zeal is now more balanced.

:-)

SB.
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