[Crescent Moon]

I have a question I need to ask the community about stimulants and depression/apathy.

My son was diagnosed ADD in 1st grade. Took ritalin, I think, and school got better. By 5th/6th grade he was taking Adderall XR.. and then in by 8th/9th grade he was taking Vyvanse.

He's been suffering from depression/anxiety since 5th/6th grade. Since there were very stressful life circumstances going on at the time, it wasn't hard to see why. Persistent low-level depression and apathy, or lack of motivation, has plagued him.

Now he's 20, and he decided to stop taking the Vyvanse. He just *knew* it was somehow related. Sure enough, his silly, effervescent, comical, talkative personality came out. He was just fun! He wasn't happy about feeling like he couldn't follow anything through, but he was definitely happy that he felt like he was alive.

So Pdoc suggested he try Concerta - two 36mg. He did that for the first time today, and although he said he doesn't feel especially depressed, he feels very unmotivated. His happy grin disappeared. His lively silliness is gone. He did say, though, that he does feel like he can handle more complex thoughts than he can handle when he's not had anything.

I don't get it! I thought stimulants increased motivation - not decreased it!

Any ideas? Any suggestions of what he might try?

Thanks

No, the stimulants increase focus ability and attention for ADHDers. My son does notice a difference in his perkiness on or off vyvanse, but he also realizes that being perky doesn't necessarily equate to being able to focus and follow through. Motivation is more intrensic than focus and attention. I don't think it comes in pill form unfortunately.

If he's only taken the concerta once, it's a bit soon to really know how it will work for him yet. It may take a few weeks for it to settle in and for him to really know the end result.

[equive]

I've had boyfriends who have taken medication for ADHD. I've worked with kids who have taken it as well. One thing that some of them did was take a "medication vacation" once a week - usually they'd skip their meds on Sundays. But then during the week, they were able to focus better and get things done. Maybe you/he could speak to his doctor regarding taking the medications PRN.

Another thing that helped the people I knew was creating structures and routines and sticking with them. The more chaotic a person's environment is when they have ADHD, the more symptoms they will have. It's a bit easier if things are organized and the expectations are clear. Maybe he could see a therapist to see if any lifestyle changes could be made to help him feel better.

There is a non-stimulant medication - Strattera - that is approved by the FDA to treat ADHD.

[-jimi-]

Why did he get off ritalin?

[vvector0000]

From personal experience, with Ritalin, when it is a little above its ideal dosage, it can cause what I call 'hyperfocus' which makes the brain sort of slow thinking. It becomes hard to task-switch or do complicated things.

This definitely manifests as apathy, mild dysphoria at times, and lack of motivation. Reducing the dosage would be #1, but if he doesn't want to take it.. it is his decision..

[novelagent]

your son was on too high of a dose, causing an increase in catelcolamines (sp) and this increases cortisol and causes hyperfocus/blunted affect/apathy. He would do well trying just 36mg of Concerta, or a lower dose of Vyvanse. There's a happy medium here, and he's looking for an all-or-nothing solution.