UN-INDEXED QUESTIONS, VARIOUS SUBJECTS When to use SSRI's Tuesday, April 7th From: Dr. Chirs Landon When would you use SSRI's in ADHD? What about in Autism? They do NOT help ADHD sx.  In fact you have to watch to make sure kids dont get MORE hyper on them.   What about methamphetamine and ADHD? Tuesday, April 7th From: Dr. Chirs Landon In methamphetamine use what do you do about their ADHD? Do you want a bottle of Adderall in the house? i dont Rx stimulants if there is active or recent meth use.  If people have been clean over a year I MIGHT consider it. I try Strattera and Wellbutrin first. How high to take the stimulants. Tuesday, April 7th From: Dr. Chirs Landon When would you use high dose stimulants? Does it require caution? I don’t feel comfortable pushing the dose. For y'alls purposes I would say the following guidelines: Ritalin up to 30 mg tid, Focalin XR up to 30 mg 1-2 times a day, Concerta up to 104 mg per day or 72 mg bid , Adderall Xr up to 60 mg per day, and Daytrana up to 40 mg per day. First stimulant working? Tuesday, April 7th From: Dr. Chirs Landon What percent of the time does the first stimulant work? 10%, 25%, 50%? I generally find the first stimulant works and is well tolerated 50% of the time. Stimulant Metabolism. Tuesday, April 7th From: Dr. Chirs Landon Is there different metabolism of stimulants? The PDR does not cover this. Which kind would you use? ??? Stimulant time. Tuesday, April 7th From: Dr. Thurber How long doe different stimulants last? Ritalin last only for a few hours, while Focalin XR is now the 'long lasting' choice, working for 4-8 hours. How to progress through stimulant use. Tuesday, April 7th From: Dr. Thurber How should I use stimualnts. Should I start full force with a full routine and full dose? It is best to start with a few doses and work your way up to a full routine. How does Concerta work? Tuesday, April 7th From: Dr. Thurber How well does Concerta work? How long does it last? How much should be used? Concerta lasts up to 12 hours and is often taken 3 times a day. Does can be up to 108 mg. Daytrona. Tuesday, April 7th From: Dr. Thurber What about daytrona? Daytrona is a useful stimulant patch. It lasts about 12 hours, including time after remoing the patch itself. Possible problems are getting them to keep it on and the possibility of skin irritation. How will they react? Tuesday, April 7th From: Dr. Thurber How can you know how a child will react to any given stimulant? You really can't. There is no way to predict how a child will react to different stimulants, so it is important to take it slow. What about Adderall? Tuesday, April 7th From: Dr. Thurber How well does Adderall work? Adderall lasts 4 or 5 hours. However, Adderall XR is the same in pretty much as respects, except that it lasts as much as 12 hours, making regular Adderall more or less obsolete. What ever happend to Strattera? Tuesday, April 7th From: Dr. Thurber I heard Strattera was supposed to be 'the perfect stimulant alterative', what happend to it? At first, Strattera was hyped as and seemed like the perfect alterative, but in the end it had its own share of issues and so it was as perfect as was thought. How should Strattera be used? Tuesday, April 7th From: Dr. Thurber What is the best method for using Straterra? Unlike regular stimulants, the maximum dose which should be used of Strattera depends on the patient's weight. You should start off low and then work you way up to a final level, depending on their weight. Short acting stimulants? Tuesday, April 7th From: Dr. Thurber Is it better to start with short acting stimulants, so that if there are problems they will ware off quickly? ??? How about Tenex and Clonidine? Tuesday, April 7th From: Dr. Thurber How do the enex and Clonidine stimulants work? They both have a positive effect on the patient's temper, appetite and sleeping habits, but they don't do much for their attention span. Help with skin irritation. Tuesday, April 7th From: Dr. Thurber What do you use to help with skin irritation from stimulant patches? ??? Stimulants for pre-schoolers? Tuesday, April 7th From: Dr. Thurber What stimulants should be used with pre-schoolers? What side effects are more common? There is not much difference in what stimulants should be used, although lower doses are best. Certain drugs are known to cause tactile hallucinations in younger patients. PTST or ADHD? Tuesday, April 7th From: Dr. Thurber Is it possible for PTST to appear similar to ADHD? Yes, it is possible for PTST to seem similar to ADHD. Time for Tenex? Tuesday, April 7th From: Dr. Thurber What is the best time to give Tenex? Tenex should not be given after 5 pm, as it often causes nightmares. Avoid using it before bed time. Maximum amounts? Tuesday, April 7th From: Dr. Thurber What is the maximum amount different stimulants should be used each day? ??? Ticks? Tuesday, April 7th From: Dr. Thurber What do you do about Ticks? If Ticks are coming from an overall condition of ADHD, it is important to treat ADHD as a whole, not just the Ticks. For Tick specifically, it is best to use lower doses of medications. What does to start at?. Tuesday, April 7th From: Dr. Thurber What dose size do you start at for stimulants? Always start with the lowest dose and work your way up. Liquid stimualnts?. Tuesday, April 7th From: Dr. Thurber Which stimulants come in liquid form? ??? PCIT?. Tuesday, April 7th From: Dr. Thurber What is PCIT? "Parent Child Interactive Therapy". It works well with young children, coaching parents by having them receive instructions through an ear phone. TAY?. Tuesday, April 7th From: Dr. Thurber What is TAY? Transitional Age Youth Center. Run by the tharapists Omar and Cookie, it is a center for 18+ children. It is required the child calls them selves in, not their parents. They are based in Oxnard but can provide transportation fro other areas. Suggested Books? Tuesday, April 7th From: Dr. Thurber Which books would you suggest to help with parenting skills? 1, 2, 3 Magic! is a good book when dealing with younger children, and Out of Sync Child is another good choice. The Explosive Child, by Ross Green, is good for children with temper and aggression issues. Websites? Tuesday, April 7th From: Dr. Thurber What are some good websites for information? www.aacap.org provides many facts for families. It has 1-2 page information sheets in multiple languages with help for parent and general family problems. www.chadd.org is a good source for information on ADHD.