ADHD & Ritalin

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  • #26
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What you are describing is my child's worst version of OCD. The non-medical name is Brain Lock. I believe that is the name of a book written on the subject. Try Amazon. It is more severe than ADD mind drift. The drug that helps stop it for her is Atavan an anti anxiety med. My child takes it as needed. You have a neurological disorder in the high end of anxiety specterum as was described to my child. Not many Psych MD's are familiar with this disorder. If by chance your live in Mass., McClane's Hospital/Clinic is the ONLY center that specializes in this BUT you have to commit 3 months living there for the residential treatment. My child could not give up college and life so has to work with the therapist who was trained there. Too many psychs relegate this to the realm of psychotic disorders and try to treat it that way which is to me malpractice. It is not psychosis and antipsychotics don't help so be careful. The resident psych who just weighed in? What do they teach in med school about OCD 'brain lock'.
 
  • #27
alxm
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Sure I've got first hand experience. Lifelong sufferer, but only diagnosed at 24.

I've had good use of both Ritalin (both as such and Concerta) as well as amphetamines. I'm currently on the latter, because I seems I've got a relatively high tolerance for the former, which meant that the dosages I was taking was raising my blood pressure too much. (not to dangerous levels, but enough that I could feel it)

I really can't tell much of a difference when I've taken the drugs. Really, no mood-altering effect at all. And for the gazillionth time, it's nowhere near the levels which would cause addiction. (and research doesn't substantiate that fear either) What I use in a month or two wouldn't last a speed-freak a weekend. I have never ever felt any withdrawal of any kind. Going a day without coffee is much much worse - at least I notice it!

The difference, being with concentration and so on, is instead rather subtle. Basically I mainly notice the difference in that days when I've taken the drug are days when I un-coincidentally get a lot of work done. It's not entirely as good an effect as I once hoped for, but it's still a lot better than the alternative.

I think it's awful that the subject has been highjacked by pseudoscience, alternative-medicine snake-oil peddlers, and well-meaning but misguided parent-activists. I mean, hello? There are lots of us adults with ADD/ADHD out there and we're completely capable of speaking for ourselves!

Finally, to express a somewhat radical position myself: I don't believe over-prescription or over-diagnosis is a problem compared to the alternative. Because there's no evidence these drugs are harmful at the levels given, and I simply don't believe people will continue to take a drug if they aren't feeling they get a benefit from it.

I view the 'false negative' scenario as far worse: A kid growing up and being constantly told by parents, teachers and others that he's 'stupid', 'lazy' or 'undiciplined' for behavior he or she is simply not capable of controlling. That's simply child abuse. (And parents are victims in that scenario as well, being constantly told by others that their 'failures' as a parent are to blame)


Anyway.. To the OP: Difficult question. Lack of concentration can be caused by depression, but ADHD is also known to cause depressions. (and has in me, repeatedly) And various antidepressants interact with ADHD medication differently. (SSRIs vs Bupropion for instance) If you're not already I'd suggest talking to a neuropsychiatrist with ADD/ADHD as a speciality.

I agree with RonL here, I couldn't say 'when symptoms appear'. Other than that some times are worse than others, some situations are worse than others and naturally, some tasks require more concentration than others. I'd describe it similarily. We're all constantly barraged with a load of impulses compelling us to do something other than what we're doing.. "Check your email", "Look out the window", "Come to think of it..". ** The difference is, normal folks can choose to ignore these impulses. But in my brain, they're 'louder'. I just follow them (without thought or consideration of course, that's what makes it an impulse') For instance where I left the two asterisks (**) I actually got up and took a few steps around the room, and got back in my chair and continued writing. I can't say why I did that. Just a spontaneous restless impulse.

So my train of thought gets derailed very easily.. But just as the 'derailment' is involuntary, I can't often get back on the right track through conscious effort either. If I can't concentrate, I just can't.

Through good fortune (and/or genes) I managed in school, thanks to good intelligence and a very good memory. (i.e. didn't pay attention much in class but remembered more of the parts I did pay attention to) But you still get stuck with some social issues. It's really hard for some people to understand/accept, for instance, that if I'm not listening to you, it has nothing to do with what you're talking about. If I can't pay attention, that's just it. But people instinctively assume they're boring you, which sucks.
(Making matters worse; the hyperactivity typically makes you an avid talker. What a great social combination.. Big talker, bad listener.)

That's in a way the real curse of ADD/ADHD. It's a 'hidden disorder'. Unlike say, OCD. I don't do anything 'abnormal', like switching the lights on five times in a row. People see that and they recognize that it's involuntary. But those of us with ADD/ADHD.. We don't do anything 'normal' people don't do. Ordinary folks can talk a lot, be bad listeners, get restless, etc.. But we do these things for different reasons. My behavior constantly gets misinterpreted.

To me, (since I can handle the learning and such) that's really the worst, or one of the worst aspects. And not one you hear about a lot, actually.
 
  • #28
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What you are describing is my child's worst version of OCD. The non-medical name is Brain Lock. I believe that is the name of a book written on the subject. Try Amazon. It is more severe than ADD mind drift. The drug that helps stop it for her is Atavan an anti anxiety med. My child takes it as needed. You have a neurological disorder in the high end of anxiety specterum as was described to my child. Not many Psych MD's are familiar with this disorder. If by chance your live in Mass., McClane's Hospital/Clinic is the ONLY center that specializes in this BUT you have to commit 3 months living there for the residential treatment. My child could not give up college and life so has to work with the therapist who was trained there. Too many psychs relegate this to the realm of psychotic disorders and try to treat it that way which is to me malpractice. It is not psychosis and antipsychotics don't help so be careful. The resident psych who just weighed in? What do they teach in med school about OCD 'brain lock'.

Too many psychs relegate this to the realm of psychotic disorders
Boy that seems strange--I don't know a single psychiatrist trained in the past 25 years who would confuse OCD and psychosis. Now there are some strange disorders such as Body dysmorphic disorder, some types of delusional disorders, and somatoform/hypochondriacal type of disorders that take on psychotic proportions and are occasionally helped with anti-psychotic medications--most often in conjunction with an antidepressant or benzodiazapene. Many of the antidepressant meds have anti-OCD effects and because they seem to relieve the symptoms and not wear off, and are not associated with abuse/dependence issues like Ativan, etc, are the pharmacologic treatment of choice. Brain lock was not a term I am familier with, but found it on Amazon https://www.amazon.com/dp/0060987111/?tag=pfamazon01-20

Cognitive therapy of which this appears to be a form is the non-pharmacologic treatment of choice. Of all the disorders I have seen, OCD must be the most miserable to suffer from.

OCD, btw is completely different from ADHD, though there is a clustering seen with the two and Tourette's. This has to be among the most difficult illnesses to treat as stimulants such as Concerta/ritalin will likely exacerbate the OCD and Tourette's if present.
 
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  • #29
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Thank you for your quick relpy. I hope it is helping here. My child is on an antidepressant that works. And has the Ativan as needed when the 'brain lock' symptom becomes overwhelming. She has been incorrectly diagnosed as psychotic by two Psych MDs twice overdosed on a psych med and had to be taken to ER later with dystonia symtoms. Latest incorrect hospitalization, the psych MD ignored her, was a natriopath and stood behind her to feel her chakra. There are some real ignorant dangerous jerks out there practicing medicine. I am only telling the fellow here to be very careful and research as much as he can on legit websites about his condition. Perhaps you can direct him as a MD? My child now finally is being seen by the best psychpharmacologist who teaches at local med college.
 
  • #30
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Thank you for your quick relpy. I hope it is helping here. My child is on an antidepressant that works. And has the Ativan as needed when the 'brain lock' symptom becomes overwhelming. She has been incorrectly diagnosed as psychotic by two Psych MDs twice overdosed on a psych med and had to be taken to ER later with dystonia symtoms. Latest incorrect hospitalization, the psych MD ignored her, was a natriopath and stood behind her to feel her chakra. There are some real ignorant dangerous jerks out there practicing medicine. I am only telling the fellow here to be very careful and research as much as he can on legit websites about his condition. Perhaps you can direct him as a MD? My child now finally is being seen by the best psychpharmacologist who teaches at local med college.


I am sorry to hear of your daughters poor experience at the hands of this quack. It is unfortunate indeed that the specialty continues to attract more than its share of kooks and fruits. I hope I didn't come across as some pompous ***--but the kinds of mistakes you're talking about are malpractice.

It really is a legitimate branch of medicine--mostly. I say that cuz there are some pretty weird therapies that even today receive mainstream support,and IMHO for which double blinded clinical evidence is lacking. But the important thing is that there are knowledgeable practitioners and reasonably efficacious medications as your daughter's case shows. Only forty years ago schiophrenia was being blamed on bad parenting.
 
  • #31
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thank you- but getting back to the fellow who needs help here, can you direct him to legitimate web sites where he can research his condition? AND did they teach you anything about the 'brainlock' part of OCD in med school? 3 previous Psych MD's my child saw thought this was 'psychosis'. This person asking for help here may be misdiagnosed as such.

As per the malpractice part of my child's treatment, it was enough to talk to and complain to the head of the psych dept in the hospital to let him know of our displeasure and while in the E.R demand to know how to proceed with the dystonia. And with the help of my own Psych MD and the local university Psych Dept found adequate providers. No reason to pursue the bad providers.
 
  • #32
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thank you- but getting back to the fellow who needs help here, can you direct him to legitimate web sites where he can research his condition? AND did they teach you anything about the 'brainlock' part of OCD in med school? 3 previous Psych MD's my child saw thought this was 'psychosis'. This person asking for help here may be misdiagnosed as such.

As per the malpractice part of my child's treatment, it was enough to talk to and complain to the head of the psych dept in the hospital to let him know of our displeasure and while in the E.R demand to know how to proceed with the dystonia. And with the help of my own Psych MD and the local university Psych Dept found adequate providers. No reason to pursue the bad providers.

Jim,

I will PM you re some of what you ask.

As to brain lock, afaik the term was coined somewhat recently and . I am still not sumay not be in the general lexicon of shrinkspeak. I am not sureexactly what it means as my search results were much like those DaveC mentions--mostly the work of the two who wrote the book I found available at amazon. Maybe you could tell me your understanding. Often self help and/or commercial programs generate their own jargon.

Not to make light of the situation, but many of my students complain of brain lock or freeze during exams. As they have no history of other OCD spectrum stymptoms, I always considered this more as a form of performance anxiety/stress. Constant and repetitive ruminatations is more along what I was taught as being an OCD symprom. It may well be that OCD sufferers, obviously having a severe anxiety disorder, are also more prone to suffer from other anxiety symptoms. And no I wasn't suggesting you take action, only that based on what you said of the situation, it is certainly an egregious error. To the best of my knowledge, an acute dystonic reaction like you mention is w/o any long term consequence, is easily antidoted, but horribly, horribly distressing while it lasts. It would be difficult to claim damages in such a case, but obviously I'm not a lawyer.
 
  • #33
15
0
Dave C described it well. Constant and repetitive disturbing ruminatations like a computer loop. In my child's case it is a compulsive need to keep doing mathmatical calculations or keep saying the lyrics of a song, also my child is an artist so suddenly the need to 'draw' in the air anything seen and fingers start moving involuntarily as though they were drawing. The symptom feeds on itself and produces killer anxiety and fear and mental stress. And like I said Ativan stops it w/in minutes. The brain gets ' locked ' into a repetitive thought loop.
 
  • #34
961
0
Oh, ok. We are talking about some of the hallmarks of the disease. As a kid I would count a lot--like the seconds between a search light sweep, and perform calculations like the powers of 2 before I knew what they were. I see some of the same behaviors in my daughter. Doubtless there is a good chunk of genetic influence. At one time it was associated with childhood measles--not sure if that association still holds. Hard to say in the USA with the MMR vaccine.

For the most part I outgrew them and never had the type of repetitive, intrusive thought that plagues many sufferers of OCD, that of comitting some violent act. In the most classic cases, the compulsion (behavior) relieves the anxiety generated by the obsession. But only for seconds, minutes or hours before the anxiety builds up again, generating the need to self-sooth thru the compusion, ad infinitum. Since reality testing is undisturbed, ie NOT a psychotic disorder, cognitive therapy is often very helpful in recognizing and redirecting the thoughts over time. Ativan is a powerful and fast acting antianxiety agent which is often helpful on an as needed basis as your daughter's success shows. But more unbelievable still is that at least where I trained, Freudian psychoanalysis was still being used--on kids no less.

One other interesting factoid about OCD is it is is the only mental illness to my knowledge fo which a "lobotomy" is still indicated.
 
  • #35
52
1
my children took it in H.S and it helped them focus and graduate. on your OCD problem, one of my children now 25 has this serious disorder which includes a syptom called Brain Lock {look it up} She is under treatment with a Psych MD and psychologist who specializes in this. Cognitive therapy is helpful but also therapy developed ny Japanese psychiatrist named Morita. It is a neurological brain disorder of communication pathway disruptions. There IS an antidepressant that also works on OCD -ask your MD Psych. Morita focused on diversion. When symptoms appear start doing something physical that you really HATE doing like cleaning the house and keep doing it focusing intensely on the cleaning- whatever it is that you HATE doing. It refocuses the brain off the OCD. Good luck.


Morita's approach sounds like it might be useful for the behavioral aspects of disorders, but his approach of "accept your feelings" is just incorrect (for people with serious psychiatric disorders). In some cases what he is advising is not possible.
 
  • #36
52
1
Oh, ok. We are talking about some of the hallmarks of the disease. As a kid I would count a lot--like the seconds between a search light sweep, and perform calculations like the powers of 2 before I knew what they were. I see some of the same behaviors in my daughter. Doubtless there is a good chunk of genetic influence. At one time it was associated with childhood measles--not sure if that association still holds. Hard to say in the USA with the MMR vaccine.

For the most part I outgrew them and never had the type of repetitive, intrusive thought that plagues many sufferers of OCD, that of comitting some violent act. In the most classic cases, the compulsion (behavior) relieves the anxiety generated by the obsession. But only for seconds, minutes or hours before the anxiety builds up again, generating the need to self-sooth thru the compusion, ad infinitum. Since reality testing is undisturbed, ie NOT a psychotic disorder, cognitive therapy is often very helpful in recognizing and redirecting the thoughts over time. Ativan is a powerful and fast acting antianxiety agent which is often helpful on an as needed basis as your daughter's success shows. But more unbelievable still is that at least where I trained, Freudian psychoanalysis was still being used--on kids no less.

One other interesting factoid about OCD is it is is the only mental illness to my knowledge fo which a "lobotomy" is still indicated.

By who? Dr. Wacky?
 
  • #37
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By who? Dr. Wacky?

No. :surprised It is an accepted procedure, albeit of last resort, for severe and intractable OCD. Known as an anterior cingulotomy, is severs one of the tracts thought to be responsible for the disorder.
 
  • #38
15
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my child had ECT years ago for intractible depression and that also helped stop the OCD for a while. But Labotomy- Yikes- barbaric. So much else is damaged in the process. Look at President Kennedy's sister. And I can't believe that there is only ONE center in the N.E. that specializes in this- McClanes in Mass. So many people suffer from this disorder. I live near a Medical College- you would think the dummies there would have know how to treat my child! They were treating it as psychosis.
 
  • #39
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my child had ECT years ago for intractible depression and that also helped stop the OCD for a while. But Labotomy- Yikes- barbaric. So much else is damaged in the process. Look at President Kennedy's sister. And I can't believe that there is only ONE center in the N.E. that specializes in this- McClanes in Mass. So many people suffer from this disorder. I live near a Medical College- you would think the dummies there would have know how to treat my child! They were treating it as psychosis.

Hey I am no advocate for the procedure, though in fairness we should look at some outcome studies. The most respected general psych. journal published in the USA had the following article:
OBJECTIVE: Long-term outcome associated with cingulotomy for obsessive-compulsive disorder (OCD) was prospectively assessed. Findings are reported for 18 patients previously described in 1995 and for 26 new patients. METHOD: An open preoperative and follow-up assessment was conducted at multiple time points for 44 patients undergoing one or more cingulotomies for treatment-refractory OCD. The patients were assessed by using the Structured Clinical Interview for DSM-III-R preoperatively and with the Yale-Brown Obsessive Compulsive Scale, the Beck Depression Inventory, and the Sickness Impact Profile both preoperatively and at all follow-up assessments. The patients completed clinical global improvement scales at all follow-up assessments. RESULTS: At mean follow-up of 32 months after one or more cingulotomies, 14 patients (32%) met criteria for treatment response and six others (14%) were partial responders. Thus, 20 patients (45%) were at least partial responders at long-term follow-up after one or more cingulotomies. Few adverse effects were reported. CONCLUSIONS: Thirty-two percent to 45% of patients previously unresponsive to medication and behavioral treatments for OCD were at least partly improved after cingulotomy. Cingulotomy remains a viable treatment option for patients with severe treatment-refractory OCD

The article in its entirety can be found here: http://ajp.psychiatryonline.org/cgi/content/full/159/2/269


I think much as the case with ECT there is much misunderstanding and prejudice re these forms of intervention. Modern "lobotomy" bears little relation to the primitive methods of yore which were aimed at controlling behavior, and little else. Just saying.
 
  • #40
52
1
Hey I am no advocate for the procedure, though in fairness we should look at some outcome studies. The most respected general psych. journal published in the USA had the following article:


The article in its entirety can be found here: http://ajp.psychiatryonline.org/cgi/content/full/159/2/269


I think much as the case with ECT there is much misunderstanding and prejudice re these forms of intervention. Modern "lobotomy" bears little relation to the primitive methods of yore which were aimed at controlling behavior, and little else. Just saying.

Fair enough, although anything that has disorientation as an immediate effect is likely to produce a bump in the BDI.
 
  • #41
15
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I think if my child's mind was 24/7 like it is during the episodes, I would do anything to stop the suffering. I am not familiar with the new way they proceed but I am sure it is not an ice pick through the eye socket and then wiggle it around like was once done.

I think our focus should go back to the person who is doing this forum and their suffering. I hope we are giving them enough information to demostrate that it is not ust ADHD that is causing the mental OCD.
 
  • #42
Since you also have depression I'd recommend also incorporating omega 3's into your diet if you don't already
 
  • #43
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Can Ritalin cause a brain lock?
 
  • #44
DaveC426913
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Can Ritalin cause a brain lock?

You might want to elaborate if you want useful answers.
 
  • #45
15
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luvok (sp?) helped my child with the OCD
 
  • #46
20
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hmmm well i've heard alot of hearsay about ritalin, and its positive and negative effects.
but what i know as a fact is, that concerta and ritalin are basically the same thing. they are both the same drug just under different brand names.... Hmmmm.
and it is commonly used to treat ADD and ADHD.

Side effects you should be warned of before taking:
Brain/CNS/Mental- Hyperactivity, insomnia, restlessness, talkativeness, dizziness, drowsiness, toxic psychosis (http://medical-dictionary.thefreedictionary.com/toxic+psychosis,) headaches, and seizures.

CV - Bp Changes

Endo -Growth retardation.

GI -nausea, anorexia, dry mouth, weight loss, abdominal pain.

Blood/Hema -Leukopenia, anemia.

Misc. Fever, Hair Loss.

you should not use if you have high blood pressure. or gilles de la tourettes syndrome.

precautions: depression, seizures, lactation, drug abuse.

p.s. probably best if you don't over caffeinate.

i did research on ritalin vs. adderall for my girlfriend a few months ago. we decided on adderall.

unfortunately i can't find the paper with the adderall stuff that i wrote down. it should have been in the same area... but its not lol.
sooo when i find it i'll post it. ummm btw i'm not urging you to fight against your psych's prescription. just offering information on the topic.
 
  • #47
DaveC426913
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p.s. probably best if you don't over caffeinate.
Interestingly, caffeine is often suggested for ADHDs to calm them and help them concentrate.
 
  • #48
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Interestingly, caffeine is often suggested for ADHDs to calm them and help them concentrate.

let me clarify
while on methylphenidate (ritalin/concerta,) its it very important not to over caffeinate.
 
  • #49
DaveC426913
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let me clarify
while on methylphenidate (ritalin/concerta,) its it very important not to over caffeinate.

Not sure how that's clarifying it; you merely restated it. I ambiguity lies in what you mean by over-caffeinating. Do you mean that, while on these drugs it is still all right to take caffeine, however it is particularly risky if the dose of caffeine is excessive?
 
  • #50
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Not sure how that's clarifying it; you merely restated it. I ambiguity lies in what you mean by over-caffeinating. Do you mean that, while on these drugs it is still all right to take caffeine, however it is particularly risky if the dose of caffeine is excessive?

it is still alright to have some caffeine while on methylphenidate, yes. but having an excess amount of caffeine while on methylphenidate can be risky/dangerous yes.

i'd be curious if the over caffeination is related to what you mentioned before, about caffeination being used to help people with adhd concentrate and calm down.
 

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