High-Dose Stimulants in Adult ADHD: Efficacy and Safety Considerations
Introduction:
At Philadelphia Integrative Psychiatry, we treat all severities of ADHD with a keen focus on the upper limit of FDA-recommended stimulant doses. We prioritize holistic care, viewing our patients as individuals with unique needs, and integrate research-driven methods to optimize treatment while being mindful of potential side effects at higher doses.
We enjoyed reading a study by Grady, PharmD, BCPS, BCPP, and collaborators that offered an in-depth exploration of high-dose stimulants in treating adult ADHD. Their study examines the balance between efficacy and safety in using elevated doses of stimulants, providing critical insights for healthcare professionals.
Study Summary and Insights:
The research assesses the use of high stimulant doses for managing adult ADHD, considering both the therapeutic benefits and risks.
ADHD affects about 4.4% of adults, with methylphenidate or amphetamine-based stimulants as first-line treatment options.
Both stimulant classes have comparable efficacy, but amphetamines are more potent and typically started at lower doses.
Methylphenidate products come in immediate-release and extended-release formulations, while amphetamine products offer similar options, including extended durations of up to 16 hours.
After bariatric surgery, concerns about medication absorption arise, but stimulants are generally well absorbed. Liquid formulations or transdermal patches can be effective alternatives.
Case Study - Ms. Helen:
A 30-year-old woman with ADHD, depression and anxiety, and a history of Roux-en-Y gastric bypass surgery, faced challenges with attention and task completion.
Ms. H was on high-dose dextroamphetamine/amphetamine and other medications.
Due to potential rapid metabolism post-surgery, a transdermal patch was considered for better efficacy and reduced risk.
Ms. H experienced an improvement in ADHD symptoms without adverse effects after switching to a 30 mg/d methylphenidate transdermal patch.
Conclusion:
At Philadelphia Integrative Psychiatry, we are adept at managing complex ADHD cases, carefully considering each patient's specific circumstances and medical history. We strive to balance effective treatment with minimal risk, especially when higher doses of stimulants are involved.
To explore personalized ADHD treatment options, visit www.phillyintegrative.com or call 610-999-6414. We offer comprehensive care that unites holistic and research-based approaches, aiming for the betterment of our patients' overall well-being.
