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Bob, you know how I hate to disagree with you, so I'll keep it short and hope you'll forgive me one of these days. ;)

I can't say enough to describe the difference in my life that Wellbutrin has made in the last couple of months. It's like someone dug into my brain and flicked the 'concentration, motivation and self control' switch. Now I'll grant you that my dose of Wellbutrin is ludicrously high, and it is augmented with Adderall, but I simply can't get over the difference it's made, I'm not the same person.

That said, I don't expect it will work for everyone, I simply feel that it's an option that shouldn't be entirely ignored. The fact that it treats the same neurotransmitters as the stimulants, in my mind, makes it a better option than Strattera, which does only half the job. I can't speak to anxiety, it's generally not part of my symptom set, and as such I may be overlooking it.

Interesting side note, if you think getting Dexedrine is hard, you wouldn't believe the stories I've read of people trying to get their hands on Desoxyn, a med that is actually methamphetamine, approved in the US for treatment of ADHD, yet virtually impossible to get a scrip or find a pharmacy for. Sadly it's full on illegal in Canada.


Sunsetnan, I'm sorry to hear your husband's story, I know well the pain of trying to find the right med. While you developed the impression that your doctor was simply spinning the medication wheel and hoping for the best, he was doing the right thing. Finding the right med for an individual can be a long and difficult process, and the only way to tell how someone is going to respond to a med is to try them on it and watch. It's taken me more than two full years (27 months) to find the right combination at the right dose, but the difference is simply outstanding (I'm trying to think of superlatives to describe it, but I'm falling short). Less than three months ago, I was convinced that I was somehow broken in a way that couldn't be fixed, and was pretty much ready to give up. I've tried every legal treatment in Canada except one at several different doses. I've mixed different meds, I've tried taking my meds at different times of the day, nothing worked consistently until my latest scrip. I'm looking forward to seeing my psychiatrist in a month to tell him how great things are going, we finally found the right combination.

Don't get me wrong, if you and your husband feel that Strattera is the right med, then stick with it; no one save your husband and you can tell you which medication is the right one, it's all about what works for you. But if you find that you're hoping for something better down the road, don't be afraid to find a doctor that's willing to experiment, you may find that it's worth the time.

Best of luck!
Thu,

You should disagree with me. Wellbutrin has helped many with ADHD.

I opinioned that ST22 wouldn't do well on wellbutrin.

I'm working on a summary to help myself account for the differences in our ADHD group. I do better on Dexedrine. You do better on Adderall. Why?

I'm attacking it from the cognition side. Conversion is simple. Neurotransmitters are the mechanics of cognition.

I start with simplified definitions of the (brain) modules affecting attention. The "where is the bug" questions I ask next I can't answer. Each of us has the same subset of attention problems. If the cause is the same, we have the same extended symptom cluster and we respond to the same meds. Otherwise, we don't.

Think of it as my hypothesis to explain the differences within our ADHD group. You are forgiven in advance if you disagree. I'll hate you if you disagree and don't disagree. I'll never learn a damn thing.

Ready? Here goes:

Working memory refers to the capacity to hold information “on-line” in mind for manipulation not passive maintenance. Working memory "inherits" three major memory modules. Audio, Visual-Spatial, and Integration/Sequencing. Working memory doesn't do any work. It is where the work is done.

Central Executive controls working memory IO (Input Output) . Input comes through all 5 senses. Eyeballs convert light into electrical impulses that the brain interprets as vision. Central Executive determines the "visual objects" that go to working memory. Central Executive determines what to load from long term and other internal memory types.

Central Executive performs attention functions on the various "file types" loaded into working memory.
* binding information from a number of sources into coherent episodes
* shifting between tasks or retrieval strategies
* selective attention and inhibition

Central Executive inherits many function modules, one of which the inhibition controller.

If all goes well, and it certainly doesn't with me, Central Executive works over the data in working memory and outputs solved problems, action plans, behavior, social interaction, and what comes out of my mouth that I wished hadn't.

Where is the bug(s)? Is it in working memory? Is it one of the major memory modules? Is is leaky? Does it flush too quickly or persist too long. Or is the bug in one of the many Central Executive function modules? Do I have an out of control inhibition controller? Or is it in a module outside Central Executive such as our Sensory Interface module. Is a visual or auditory processing disorder feeding garbage in to CE? Garbage in. Garbage out.

We read with our eyes. Is Auditory or Visual memory used? The language symbols on the page are converted into language sounds in our head that are processed in working memory's auditory module.

If you have trouble reading but have less trouble listening, where is the bug? Can't be auditory memory? Not necessarily. Reading with comprehension requires larger blocks of working memory for longer periods of time. Reading could exceed an auditory memory deficit whereas less intensive listening does not.

I used layman's terms in a few cases to make it easier for me to understand. The summary is from 5 scholarly type documents. I eliminated most of the information and reduced the rest. I use analogous computer terms because the authors did. They drew from volumes of research that convinced me that terms such as "working memory" conceptually describe how the brain works. Our brains our highly layed where top level functions inherit many layers of functions and properties. Brains epitomize OOP - Object Oriented Programming. Our brains epitomize OOPS. That's no acronym.

Time for sleepy.

Bob
Wow, that's a handful. You've delved deeper into the problem than my current understanding of the issue can handle. It's probably going to take me a day or two to manage a cogent reply, so I'll just throw in a random thought or two.

My understanding of ADHD is that there's a neurotransmitter shortage. In simple terms, my concept of what's going on is something along these lines. For whatever reason, many ADHD sufferers find themselves short on PEA. PEA is short for Phenethylamine, which apparently works as a neuromodulator within the central nervous system, acting to release dopamine and norepinephrine. In this way, its effects are very similar to our friend amphetamine. This shortage of PEA likewise leads to a shortage of those neurotransmitters that are controlled by it. Several studies have shown that PEA from outside sources can have the effect of dramatically improving ADHD symptoms. This would lead one to believe that PEA is the holy grail of ADHD medication, and many companies are trying to capitalize on that impression. The problem is that PEA is very rapidly metabolized by MAO B within both the digestive and nervous systems, making it virtually impossible to get into the brain without practically injecting it directly or taking MAO inhibitors, neither of which is ideal in a real world setting. As a result, we're stuck with a more stable analogue, amphetamine.

Wow, a bit of a digression there . . . anyway, we all may or may not know that messages within the brain and CNS are transmitted by a hybrid electrical and chemical system. Simply, as I understand it, messages, once generated or passed on from the nucleus of a neuron, travel down the axon as an electric impulse. Because these messages cannot travel electrically across a synapse to another neuron, however, they are translated into a chemical signal, expressed as a release of neurotransmitters across the synapse, which are then received by the next neuron in the chain, which either acts on the message or passes it on. In this system, not enough neurotransmitters means messages die in the synapses, never reaching their ultimate destination. The end result of this situation means that a well meaning higher brain might have trouble providing guidance to a more primal lower brain, leading to a higher likelyhood to act on impulse, or to have difficulty deciding which stimulus requires attention at any given time.

Obviously, this is probably massively oversimplified and half wrong, but this is how I've come to understand the disorder. The lack of neurotransmitters leads to spotty communication between the higher and lower brains, so the executive functions that the higher brain is responsible for, self control, motivation, attention suffer to one degree or another, depending on the severity of the shortage. To state a poor analogy: the head office is having trouble coordinating the guys in the field because there aren't enough cell towers for all the boys to get a dependable signal. Supplementation of our neurotransmitter pool, as provided by amphetamine or other similar chemicals, provides us the ability to have our brains better communicate internally and to the CNS.

So there, it doesn't speak specifically to your post, but that's my random 40 minute thought. I really should have gone to bed instead of getting off on another tangent. ;)





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