Michele Campione, M.D.
I specialize in the treatment of Attention Deficit Hyperactivity Disorder (ADHD).
ADHD is characterized by distractibility, impulsivity and restlessness or hyperactivity. These symptoms are present from childhood on, and with a much greater intensity than in the everyday person so that they interfere with everyday functioning.
Diagnosis is made primarily by reviewing one’s history; there is no foolproof “test” for ADHD. There are no blood tests, brain scans or paper exams to prove that one has ADHD. The following list may give you an idea if an evaluation for ADHD is appropriate.
If you have exhibited at least twelve of the following behaviors since childhood, consider an evaluation for ADHD.
• Often has trouble waiting for one’s turn.
• Difficulty getting organized.
• Chronic procrastination or trouble getting started.
• Many projects going on simultaneously; trouble with follow through or completion of tasks.
• A tendency to say what comes to mind without necessarily considering the timing or appropriateness of the remark.
• A frequent search for high stimulation.
• An intolerance of boredom.
• Easy distractibility; trouble focusing attention, tendency to tune out or drift away in the middle of a page or conversation, often coupled with an inability to focus at times.
• Often creative, intuitive, highly intelligent.
• Trouble in going through established channels and following “proper” procedure.
• Impatient; low tolerance of frustration.
• Impulsive, either verbally or in action, as an impulsive spending of money.
• Changing plans, enacting new schemes or career plans; hot-tempered.
• A tendency to worry needlessly, endlessly; a tendency to scan the horizon looking for something to worry about, alternating with attention to or disregard for actual dangers.
• Often does not give close attention to details or makes careless mistakes in schoolwork, work or other activities.
• Often has trouble keeping attention on tasks or play activities.
• Physical or cognitive restlessness.
• A tendency toward addictive behaviors.
• Often does not follow through on instructions and fails to finish schoolwork or duties in the workplace
• Often loses things needed for tasks and activities.
• Often gets up from the seat when remaining in seat is expected.
• Is often “on the go” or often acts as if “’driven by a motor”.
• Often blurts out answers before questions have been finished.
• Often talks excessively.
• Often interrupts or intrudes on others e.g. butts into conversations.
TREATMENT FOR ADHD
Most symptoms of ADHD improve safely, quickly and effectively with medications. When clients experience the positive effects of medication for the first time they feel profound relief. The effect can be so sudden and dramatic that it is frequently compared to the effect of putting on eyeglasses and seeing clearly for the first time. Stimulants are believed to enhance the availability of the brain’s chemical messengers dopamine and norepinephrine. These messengers play a role in behaviors like attention and movement. The stimulants include medications like Ritalin, Adderall, Adderall XR, Vyvanse, Concerta, Focalin, and others. As long as stimulant medications are used as prescribed they can alleviate symptoms safely.
In determining the best initial dose, it is best to start at a low dose and make increases gradually until:
1—symptoms are under control, or 2—side effects develop. Research indicates that more rapid increases in initial dose are associated with greater side effects and a higher likelihood of stopping the medication before it has had a chance to work.
Although used primarily as a treatment for ADHD, stimulant medications have also shown some early success in the treatment of certain eating disorders. A recent paper in JAMA PSYCHIATRY described success treating Binge Eating Disorder (BED) with Vyvanse.