35 replies to this topic

[fast turtle]

IMO there's enough evidence to suggest that SSRIs will work within the first week or two of administration and there's no reason to go beyond that if nothing happens. Personally I think they're crappity crap for treating ADD/ADHD.

[doug123]

Ok guys so heres my update for strattera. I am still taking it at 80mg a day. I believe i may drop it sometime in the near future. Not sure yet. I did drop the lexapro. I dont need it any longer since i am back on adderall. I now take adderall 15mg twice daily and three times on days i need extra time for studying. Yeah i know what you all are thinking adderall why am i taking that. Well my doctor wouldnt allow me to take provigil. He is an old crusty fart and set in his ways and theres no way to get him to change his mind. He told me that since the FDA didnt pass provigil as a treatment for ADHD then he would be holding himself liable in the event of a problem if something happened to my health and we went to court he thinks he would get screwed. Anyways so after he told me this when i was at his office he then proceeded to call and make sure with this guy he talks to about his practice. He asked him about provigil and whether he was allowed to prescribe it for ADHD, apprently the guy told him no. Then he asked this guy whether strattera and provigil would be acceptable to combined and he got a no for this as well. He told me that he has never had someone combine strattera and provigil and that he would be "really putting his neck out on the line" if he prescribed both to someone. Anyhow so he put me back on what i was taking 7 months ago (Adderall). So am back to where i was before. I do get benefit from Adderall but dont like the side effects -increased agression, up and down feeling. So where do i go from here? I guess i will have to find another MD to go to. Whats everyone think about this matter?

I should really be getting ready for bed as it's way past my bedtime, but...without affirming your ad hominem on your doctor, I'll start by posting this quick abstract:

In this case -- no offense to your doctor -- but I can tell in this case that he is simply not up to date. I believe you said your doctor actually had to call someone else to find out whether or not he can prescribe a medicine. That is really not a good sign of competence in his field; or that he is not up to date.

Medicine -- like any other field of science is based on [url="http://en.wikipedia.org/wiki/Scientific_evidence"">

scientific evidence[/url]

The scientific method is the best way yet discovered for winnowing the truth from lies and delusion. The simple version looks something like this:

    * 1. Observe some aspect of the universe.
    * 2. Invent a tentative description, called a hypothesis, that is consistent with what you have observed.
    * 3. Use the hypothesis to make predictions.
    * 4. Test those predictions by experiments or further observations and modify the hypothesis in the light of your results.
    * 5. Repeat steps 3 and 4 until there are no discrepancies between theory and experiment and/or observation.

When consistency is obtained the hypothesis becomes a theory and provides a coherent set of propositions which explain a class of phenomena. A theory is then a framework within which observations are explained and predictions are made.

Science is best defined as a careful, disciplined, logical search for knowledge about any and all aspects of the universe, obtained by examination of the best available evidence and always subject to correction and improvement upon discovery of better evidence. What's left is magic. And it doesn't work. -- James Randi

There are is a substantial amount of peer reviewed literature that might suggest that Provigil (modafinil) may be effective to treat ADD/ADHD.

An example:

modafinil[/u], venlafaxine, tricyclic antidepressants, and guanfacine. Psychotherapy is shown to help control impulsiveness, form more satisfactory relationships, rear children more effectively, and improve organizational and problem-solving skills.
PMID: 12238735 [PubMed - indexed for MEDLINE]

Anyways, to answer your question about combinations of particular drugs, such as Provigil + Strattera...which I take myself (only when I am competing in school) -- I've had three [3] different psychiatrists prescribe me this combination. All I had to do is submit to the MD the evidence -- a good way to do this is bring in print outs of the abstracts.

Sure, there is always a possibility that a court case could arise as a result of a doctor/patient relationship -- but in this case, I think your doctor isn't as up to date as he could be with respect to attention related medicine; or he might not feel comfortable with you as a patient. Every doctor is different. I've had doctors that wrote me prescriptions for everything I requested only after the third or fourth visit because he or she had to take the time to understand my story and particular case. Doctors are expensive, as you might know, and if you see him or her rarely, he or she might feel less inclined to give you something they might be unfamiliar with.

One of my psychiatrists oversaw a clinical trials unit for several years and was principal investigator for several major studies --- some funded by NIH and others privately funded by major pharmaceutical companies. However, I was the first person to ever request Strattera and he looked at me like I was a crazy person! I had to print out the titration schedule for him and everything! Then on my next visit he called Strattera an SSRI, when it is really an SNRI. So you can't expect every doctor to know everything...however, if you have an attention related disorder, I'd strongly suggest working with a Doctor who either specializes in attention related disorders or one that is a jack of all trades -- kind of like my current doctor. These days, most doctors have all this information built into their palm pilots, so I think you should be a smart ass and tell your doctor on the next visit that you heard your friend say that his doctor has a program on his palm pilot with all the info he had to call someone else to find out...

More on this later...I need to get to bed...

[cmorera]

Hi Adam!

[doug123]

Hey Christian! Is your car ready yet? Still in the shop?

[salesman]

Yeah i defiantely agree with you on this. Hes old and getting towards the end of his practice. I can see why he wouldnt care us much as the young bucks do. That was a real good indicator that he didnt know his info when he had to call someone and find out on the phone. Its sad because i feel like i know about what to take then my MD does. To top it off my doctor does specialize in attention medicine. I need to find a different MD. Whats a good way to do this? Just look them up and call and find out what they specialize in?

[doug123]

I need to find a different MD. Whats a good way to do this? Just look them up and call and find out what they specialize in?

If you are currently insured, your medical insurance company should be able to provide you with a list of physicians in your local vicinity that accept your insurance.

If you don't have insurance (or pay out of pocket), this can often present a big problem because MDs charge lower rates to insurance companies than to individuals...paying out of pocket can get really expensive.

If you aren't currently insured, I can probably print out a list of doctors for you that accept my insurance plan depending on where you live -- you can call these doctors and ask them their billing procedures. PM me with your City and State and I will see what I can do...you don't really need a doctor who necessarily only does attention medicine...just one that is familiar with the literature...and I'd suggest leaving a message with prospective doctors telling them a little bit about your case and try to get them on the phone first to see if he or she is open minded at prescribing you what you want. Just keep calm and don't be overly aggressive. Show sincerity in your voice and tell them what you need help with and they should help out. Most MDs have to have good ethical records if they are allowed to practice medicine.

Here's a good trick to assess the integrity an MD:

Go to Google and enter in your state name (for example, California) and -- in quotes -- "medical board." Run the name of your doctor through and you can see exactly how long he or she has been practicing medicine and also if he or she has ever been convicted of any wrongdoing. One of my former doctors was fined by the California State Medical board for questionable billing practices...what might send up a red flag would be a malpractice suit or something....