ADD Really is NOT the Same as ADHD

Posted by sleepyguy in Prescription Sleep Medicine on March 19th, 2011

Inattentive ADD is one of the three subtypes of Attention Deficit Hyperactivity Disorder (ADHD)but it really is very different from ADHD.

The confusion lies in the labeling of this disorder. Inattentive ADD is sometimes called ADHD which is a shortened version of Attention Deficit Hyperactivity Disorder. This subtype of ADHD is oft times also called ADHD predominantly inattentive, ADHD-I, and ADHD-PI but no matter what you call it, the signs and symptoms of ADD are simply different from the signs and symptoms of ADHD.

How is it different? ADD is different from the other two subtypes in various ways. The most seen symptoms of the inattentive subtype are inattention, easy distractibility, disorganization, procrastination and forgetfulness.

Almost a third of individuals with the Inattentive subtype also have concurring lethargy and fatigue and individuals with this variant of ADD are said to have Sluggish Cognitive Tempo or SCT.

People with ADD and Sluggish Cognitive Tempo have less or no symptoms of hyperactivity or impulsiveness and they are much less likely to have a co-existent diagnosis of Oppositional Defiance Disorder or Conduct disorder. Hyperactivity and Impulsiveness are symptoms that are characteristic of the other two variants of ADHD, the Combined type of ADHD referred to as ADHD-C, and the Hyperactive/Impulsive subtype of ADHD which is referred to as ADHD-HI.

Persons with Predominantly Inattentive ADHD have been shown in research studies to do more poorly in school than people with the other variants of ADHD but they are significantly less likely to suffer the adverse life outcomes that the other types have such as substance abuse disorder or law enforcement troubles. These issues are seen more commonly in people with the other two subtypes of ADHD.

The causes of ADHD-PI are unknown but genetic influences are thought to play a major role. Phsysicians think that up to 70% of persons with Inattentive ADD have a relative with the Inattentive subtype of ADD. Other factors that may play a role in ADD and SCT include:

Dietary Allergies. It is speculated that some people can have an increase of ADHD-PI symptoms after consuming possible allergen containing foods or food dyes and preservatives.
Damagecaused environmental factors and toxins can bring about ADHD like symptoms. Pesticides and lead have both been implicated in increasing ADHD.
Mother and child factors such as prematurity and maternal smoking can result in an increase chance of being diagnosed with ADHD. Traumatic head injuries may be associated with an increased risk of symptoms of ADD. Social Influences such as maternal separation and other social elements are being studied to determine their role in acquiring this diagnosis.

Testing:

ADHD questionnaires are most commonly given to make a diagnosis of this disorder. These written tests include a series of symptom questions where the parent and the teacher score the severity of symptoms and the experienced degree of disability caused by each symptom.

Other diagnostic methods include online and computer programs that measure inattention, activity and impulsive conduct. The online and computer test may give a more unbiased view of symptoms which is indispensable because parent and teacher questionnaire responses may vary a lot and oftentimes don’t agree on the severity or on the disabling characteristic of the ADHD symptoms.

Treatment:

The appropriate dose of medication, which is useful in the treatment of ADD can be lower in the case of treating Inattentive ADD than it’s for the treatment of the other subgroups of ADHD.

The following is a list of medications utilized to treat Inattention:

Dextroamphetamine (Adderall, Dexedrine,Vyvanse) - The medicinemost usually used as stimulant treatment (along with methylphenidate) for all subtypes of this condition. Most patients with ADD will get the best response for this type of medicine

Methylphenidate (Ritalin, Concerta, Focalin, Daytrana,Metadate) - A lot of individuals may have a genetic basis for NOT responding to methylphenidate. This type of medicine can cause more negative symptoms in individuals with ADD. The explanation for this is uncertain

Atomexitine (Strattera) is a non-stimulant pharmaceutical treatement. This medication at times performs well for persons with Inattentive ADHD.

Alpha-2A-Adrenoceptor Agonist (Intuniv, Clonidine) - Especially utile for combined ADHD and Tourette’s syndrome. These medicines may also treat the symptoms of ADHD-PI. This type of medicine is very useful for the treatment of sleeping problems that can co-exist all types of ADHD.

Selective Serotonin Re-uptake Inhibitors (Paxil, Zoloft, Prozac) are useful for the treatment of co-morbid depression or as another line of medicine for ADHD-PI when stimulants do not work.

Tri-Cyclic Antidepressants (Norparmine,Tofranil) - Also employed for treating co-existent depression but the Tri-cyclics may have unpleasing side effects and should be utilized with extreme caution in children.

Bupropion (Wellbutrin) - Wellbutrin is a norepinephrine and dopamine reuptake inhibitor and is another second line medicine for the Inattentive subtype of ADD.

Behavioral therapy is useful as stand alone treatment or combined with medication to better treat issues associated to motivation, persistence, school problems and social skill difficulties. Behavioral therapy may be more useful for ADHD-PI than it is for the other subtypes.

Lifestyle treatments generally strive to address life style issues like diet, physical exercise and life stress reduction that may worsen the symptoms of ADHD-I.

Classroom treatment methods can\may include; classroom management, parent assistancet training and classroom changesthat improve the symptoms of Inattentive ADHD.

Other useful treatment methods include;
Vitamin supplementation - To address potential deficits in Omega-3 fatty acids, iron, magnesium, or zinc. Behavioral interventions and Coaching. Psychotherapy (to treat the troubles that may co-occur with Inattentive ADHD like anxiety, depression and social phobias). Cognitive-behavioral therapy (CBT) , to address common areas of cognitive weaknesses such as automatic negative thinking or other deleterious mind processes, and lastly social skills training to make less severe the problems that take place socially from the inattentive symptoms of ADHD-PI.

The symptoms and treatment for Inattentive ADHD are different from the signs and symptoms of the other variants of ADHD. Persons with Inattentive ADHD and parents of children with ADHD should ensure that an appropriate diagnosis of ADHD is made in order that this variant of ADHD is certain to be well managed.

The short answer to the question whether ADHD medications with less side effects is a mirage has a very short answer with only three letters. Yes ! Let us face it - any medicine of the allopathic or chemical kind, the staple of Western medicine, is going to have side effects. I have just been given an antibiotic for a ‘flu virus and reading all about them has done nothing to hasten my recovery!

The problem with ADHD medications with less side effects is that many parents try desperately to find the right medication for their child because each child is unique and reacts in a different way to the meds. There is a lot of talk on the ADHD forums about ‘tweaking’ the meds as regards dosages and when they should be taken. Parents and doctors are stuck inside the box and rarely bother to look outside where they could actually find herbal and homeopathic ADHD medications without side effects !

There are a whole range of alternative treatments for ADHD which range from homeopathy, behavior modification techniques, dietary supplements, family counselling, herbal medicine, and even equine therapy. ADHD meds can be effective in reducing some of the ADHD symptoms such as inattention and hyperactivity and seem to work with about 75% of children. What the drug companies forget to tell you is that after three years of being on drugs like Ritalin and Vyvanse and Adderall (all amphetamines), children are unlikely to show any permanent change in their behavior ! This study was done a few years ago and goes on to state that the best treatment seems to be behavior modification with or without medication.

Are stimulants better than non-stimulants, some parents ask. Maybe one of these types of ADHD medications with less side effects might suit their child. There is confusion about the long term implications and side effects can be alarming. Choose a stimulant like Concerta or Ritalin and your child might have to cope with racing heart, dizziness, insomnia and loss of appetite. Add to those the long term concerns about heart health, potential for abuse and paranoia, aggression and depression.

Choose a non-stimulant like Strattera and does the picture change ? Well, some of the reactions are similar to the stimulants but there may also be headaches, nausea and the most alarming one is that may be a risk of increasing suicidal thoughts, especially if the child is already depressed!

Now you can see why some parents have looked outside the box and moved away from ADHD meds without side effects which are inexistent and actually choose ADHD homeopathic remedies which really do NOT have any side effects and there are actually no long term health risks at all. The other great things about these remedies is that no one will seek to buy your kids’ meds on the school parking lot and they come a lot cheaper !

Have you ever had a look at the major websites for prescription medicine for ADHD medicine? If you do, you will be struck by the very upbeat tone of their information, their flashy widgets and also, of course, a whole range of experts who will advise on any aspect of ADHD from lack of attention, problems with homework and ways to cope with hyperactivity. It is, quite frankly difficult to find any disadvantages with taking these ADHD drugs. What is the problem? The problem is that these sites are sponsored by the pharmaceutical companies making these drugs so their information is not complete and is at best biased.

Did you know that some of the companies have put their profiles on Facebook and other social networking sites and have thousands and thousands of followers? They offer advice to parents and teachers of ADHD children. They have a massive presence on the Internet.

A few facts will suffice to realize that all is not well in the ADHD drugs market. The first problem is that the prescription medicine for ADHD, if given to a child over a number of years, will not cure the child. The child is still left struggling and may be at risk of drug abuse and he will also be pestered by schoolmates to sell his drugs on the school parking lot. These drugs merely relieve symptoms of ADHD (inattention, fidgeting, lack of concentration and so on) and there is a lot of doubt in some medical circles about the long term effects of these medicines on the child’s brain.

When we talk about ADHD we are merely describing a chemical imbalance in the brain and that the neurotransmitters are not sending out the right signals for the child to perform fairly elementary tasks like focusing. Ask an adult with ADHD and the most frequent problem is lack of ability to stay on task and to finish projects and meet deadlines. The prescription medicine for ADHD may affect the child’s mental development and also physical growth.

Prescription medicine for ADHD is a powerful lobby and its tentacles have penetrated the medical profession from researchers, lecturers, care providers, paediatricians and doctors. There is a wall of censorship about the long term effects of this type of medication and the lobby has made sure that only certain information is getting through from clinical trials.

ADHD natural remedies such as herbal and homeopathic treatment is hardly mentioned but parents are becoming more savvy. They know now that these natural ADHD cures are much safer, have no side effects and there are no risks at all in the long term. Compare the effects of the prescription medicine for ADHD which can play havoc with a child’s appetite, sleep and growth. Wiser parents are looking further than the first page on Google and are being rewarded.


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