HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

Suggest Medication To Help With Attention Deficit Disorder

Posted on Mon, 20 Oct 2014

Question: Hi

I have ADD and have trouble paying attention and focusing on task that require thinking and are not to my liking like writing essays. I tried ritalin which worked for a few months then stopped working and I don't have access to Adderal. I am currently taking Modafinil which gives me some extra energy but doesn't help with paying attention and focus. I tried many supplements which claim to increase focus but with no result. Is there anything that can help me with this problem.

Answered by Dr. Vipul Prajapati (7 hours later)

Brief Answer:
Detail required

Detailed Answer:
Hi dear,

Thank you for your query.

First of all I would like to know since when you are suffering from ADHD and on treatment?

As you described you improved with methyl phenindate but in what dose?

As you tried many medication but what was the dose and for what was the duration?

I would like to know all this because improvement depends on dose and duration of treatment.

You can also get benefit by psychotherapy particularly attention oriented therapy.

Awaiting your response.
Thank you

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Vipul Prajapati (7 hours later)

I have been suffering from this condition all my life but I would characterize my condition as ADD not ADHD as I am otherwise a calm person just have trouble with focusing on tasks that don't interest me and are time consuming and the doctors and psychiatrists that I visited seemed to agree with me. I can focus on tasks that require a lot of thinking and time like solving mathematical problems because I like math but as I said before I have real difficulties focusing on writing. Even writing this reply for me was a challenge. The dosage of ritalin that worked for me was 20 to 30 mg taken two or three times a day but when it stopped working, I experimented with different dosage for as low as 5mg to as high as 40 mg for about six months but all it did was making me sleepy which is not a typical side effect of this drug. All also tried different dosage of all the other medication that I mentioned in my previous post but with very little result. The only thing which is helping me little bit is modafinil. I am currently taking 100mg modafinil in the morning. The other strange thing about this drug is that if I don't take with butter, it causes headache and if I eat egg yolk with it, it slightly helps with focus. I also tried psychotherapy but with no results.

Thanks

Answered by Dr. Vipul Prajapati (1 hour later)

Brief Answer:
Need to increase the dose of modafinil

Detailed Answer:
Hi dear,

Methyl phenindate is the medication which is used in ADD but it has more effect on hyperactivity.
You also might have learning and writing disabilities and so you need to work on those skills with the help of expert.
if you are having improvement with modafinil then increase dose up to 300 mg a day.
You have to do concentration exercise as much as possible.

Also You can try Fluoxetine as it also works for lack of concentration .
Discuss with your treating doctor.

Thank you
Thank you

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Vipul Prajapati (2 hours later)

I don't know what you mean by learning and writing disability. I have an advanced degree in Mathematics and learned three foreign languages with ease. As I explained, I have difficulty concentrating on a task I find boring and time consuming. When ritalin was working for me I had no trouble writing long essays and journals. Also,everyday I read dozens of articles on line about science, economics and current affairs, again things that I am interested in. As to your suggestion for increasing the dose of Modafinil, I have already done that. I am taking this drug on and off about a year and half and at one point increased the dose to 400mg with no improvement in its effect. What I like about this drug is that unlike ritalin there are very few withdrawals symptoms when I stop taking it. I was wondering if it is safe to combine low doses of ritalin like 10mg with modafinil?

I have also tried fluoxetine but it made me so sleepy that I couldn't get out of the house. All I wanted to do was sleep no matter how much caffeine I drunk.

Answered by Dr. Vipul Prajapati (7 hours later)

Brief Answer:
Yes you can combine the medication

Detailed Answer:
Hi dear,

you can combine the medication modafinil with methyl phenindate and also if not improved we can add atomoxetine for better improvement.

With this combination you have not major side effects.

As you have improvement with methyl phenindate first take it with modafinil.

Normally fluoxetine dose not lead to sleep but insomnia occurs with it.

Thank you

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Vipul Prajapati (16 hours later)

Are there any good supplements that I can take with Modafinil. I am a bit worried about combining two stimulant drugs. I read about Modafinil's side effects and in rare cases, it can trigger XXXXXXX XXXXXXX Syndrome which is very scary. I tried combining choline, citicholine and alpha brain supplements with Modafinil but I didn't gain anything from it. There are so many glowing reviews about these supplements on line but they just made me a bit dizzy and certainly no improvement in focus and concentration. The newest one of these so called brain enhancing supplements is Nitrovit which is supposedly as good as Adderal. Do you know anything about Nitrovit and can it be combined with Modafinil?

Also, about 9 years ago, I tried Atomoxetine (Stratera) for a whole year from low to high doses but it did not help me at all. At that time, this pill came new to the market and I spent a lot of money on it because I was looking for anything that was not a stimulant and was prescribed for ADD/ADHD but it was a big disappointment.

Answered by Dr. Vipul Prajapati (10 hours later)

Brief Answer:
Not much effective.

Detailed Answer:
Hi dear,

Nitrovit can be taken with a modafinil as a supplement but its effect on ADD is not that much, but you can try it as it may help you and also it is also safe.
Normally it is used in Mental retardation for cognitive enhancement.
You can get benefit by new method called Deep Brain Stimulation, which has now a days very good effect.

You can go for that because in this method direct stimulation of brain given.

Though in past you did not improve with atomoxetine, you combine it with modafinil or methyl phenindate, which might give you a good response. Discuss all about aforementioned suggestions with your doctor.

Thank you

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Vipul Prajapati (38 hours later)

Are you familiar with a new device called (Upgraded Focused Brain Trainer). It is available from XXXXXXX Ausprey's website called ( The Bulletproof Executive). It cost about 900 dollars and is supposedly working like weight lifting for the brain and improves focus. I was wondering if I should buy that device but if doesn't work then 900 dollars is a lot of money to waist.

Thanks

Answered by Dr. Vipul Prajapati (19 hours later)

Brief Answer:
Not having any idea

Detailed Answer:
Hi dear,

I am not familiar with the device called upgraded focused trainer so I would not recommend you about that.
It is very costly so first confirm it and then buy.
But what I suggest you is deep brain stimulation about which I aware.

Wish you healthy health.

Thank you.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Vipul Prajapati (25 hours later)

I read about deep brain simulation and this procedure is use for very serious conditions such as parkinson disease. Are you sure, it can be used for ADD/ADHD? In any case, I don't think my doctor would agree to it.

Also, when I was taking Atomoxetine, I combined it with methyl phenidate for six months in various doses but it didn't do anything for me. All it did was to make very anxious and nervous. I desperately need help with ADD but I haven't been able to find anything yet.

Answered by Dr. Vipul Prajapati (9 hours later)

Brief Answer:
May be effective in your case

Detailed Answer:
Hi dear,

Deep brain stimulation works in some cases so it may possible that works in your case.

Discuss with your treating doctor about it.

There are other medication which might help you like guanfacine, Clonidine, Bupropion so you may also try with help of your treating doctor.

Behavior therapy also has very good result in adult ADD.

Thank you

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Yogesh D