Archive for the tag: ADHD

How ADHD medicine works

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The drugs usually work by boosting levels of certain neurotransmitters in the brain.

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ADHD Medication

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ADHD Medication

Attention-Deficit/Hyperactivity Disorder (#ADHD) affects people’s ability to concentrate and organize their lives. Medication combined with CBT and parental coaching can help those with ADHD.

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How stimulants work in Adult ADHD: Most people know that the stimulant medications can be of great help in Adult ADHD, but most people think it just boosts concentration. They can be wonderfully helpful and I’ve witnessed many people who have found them to be transformative. But there’s no free lunch and it can be helpful to understand what some of the downsides are and how you can mitigate them.

The stimulants (dexamphetaine/Adderall, ritalin/concerta/methylphenidate) have many effects on the brain/body. Many of these aren’t well know to people, or even to their doctors, so we’ll unpack the 10 secrets of stimulant medications:
Secret 1: Stimulants can inhibit natural distractibility
Secret 2: Stimulants can reduce spontaneity, creativity and playfulness
Secret 3: Stimulants can worsen sleep, anxiety, panic and anger
Secret 4: Stimulants can sometimes reduce anger and anxiety
Secret 5: Stimulants stimulate positive emotion with can sometime lead to addiction
Secret 6: Stimulants can increase physical performance, blood pressure and heart rate
Secret 7: Rebound effects are the opposite of the stimulant effects
Secret 8: Sometimes the “crash” can help with sleep
Secret 9: Tolerance can happen over time, that lead to dose creep
Secret 10: Tolerance/dose creep can be mitigated by regular (weekly) breaks from them

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How ADHD Medication Works – Chapter 41

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The following is taken from ADHD Medication: Straight Answers to Big Questions.

Coach Laurie Dupar: I talk about stimulant medications because what they’re stimulating is they’re stimulating that dopamine in our brain. So I actually called them dopamine boosters.

Dr. Stephanie Sarkis: So there are four neurotransmitters in the brain, there’s serotonin, dopamine, norepinephrine, and GABA, and those neurotransmitters, depending on the level of those neurotransmitters in your brain, that affects ADHD behavior, depression, anxiety, schizophrenia, any
kind of brain issue can be related to how much dopamine you have or how much norepinephrine, depending on the disorder that you have between the synapses of neurons in your brain.

Rick Green (Comedian with a degree in Science) neurotransmitter, neuro from the Latin or is it Greek something for brain and transmitter from the English for transmitting. How does it work? Well I don’t want to get all scientific and talk about how the action potential travels from the presynaptic cell down the axon towards the postsynaptic cell which is separated by the synaptic cleft and so the synaptic vesicles that contain the neurotransmitter which has been synthesized from enzymes and then stored in the vesicles until the action potential causes the vesicles to fuse with the presynaptic membrane and release their neurotransmitters into the synaptic gap or cleft and then you know the neurotransmitters flow across and bind with the postsynaptic receptors and
the neurotransmitters in the cleft are deactivated by reuptake or enzymatic degradation leaving the synapse free to transmit the next action potential.

So instead here’s the town of incoming and this is the town of destination and they’re separated by the synapse River and a delivery truck carrying a message comes along and the message is loaded from the delivery truck onto a ferryboat.

The ferry boat crosses the river and the message is unloaded and put on to another delivery truck and the ferry is either taken out of service or it melts and sinks into the river all gone and that ferry is the ship dopamine.

The problem with ADHD is that this dopamine doesn’t stay around long enough, our bodies are recycling it too quickly before it’s had time to make a connection and transmit the information across. It’s (Woosh) gone too soon.

By slowing down this flushing away or recycling or re-uptake of the dopamine the medications allow more dopamine to be available to form the connection and transmit the message.

Dr. Steven Kurtz: you know the medicines that people take correct the amount of dopamine available in these little synapses. These are minute changes it’s not like the presence of dopamine or the absence of dopamine.

So those minute changes account for a lot of difference in outcome.

Rick Green: it’s like I say if the ferry crosses the half-mile-wide river but falls just 30 feet short or doesn’t stay long enough for you to get your car unloaded from the ferry nothing arrives.

Laurie Dupar: and what the medications do is they actually help to, I call re-balance some of those neurotransmitters

Rick Green: well whoa not so fast we’re still using that dopamine to get the signal across. That’s what’s happening.

Laurie Dupar: so it’s like they’re boosting that dopamine in your brain and it can be incredibly effective.

Rick Green: Now unlike a ferry the dopamine is used and removed it’s recycled so that the next signal can appear there’s another gap. They call it re uptake, they take it back up your body re-uptakes it.

If we can slow that down so it stays there a little longer if we can inhibit the re-uptake we have a
re uptake inhibitor. So the stimulant isn’t stimulating your whole body the way music does.

So when you get upset with yourself, I can’t remember where I put my keys, consider that you can’t remember a memory that you never made in the first place.

Dr. Margaret Weiss: The objective of treatment is to optimize the response of the individual.

Why Stimulants Help ADHD

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It seems like stimulants and hyperactivity shouldn’t mix, so why are they so often prescribed to treat ADHD?

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Image Sources:
https://commons.wikimedia.org/wiki/File:Amphetamine.svg
https://en.wikipedia.org/wiki/Methylphenidate#/media/File:Methylphenidate-2D-skeletal.svg