Discontinuation of ADHD Stimulants in Adults

[FunnyCurrent]

What is the typical clinical/treatment course for patients with Adult ADHD treated with stimulants?

• Discontinuation of medication with the resolution of symptoms
• Discontinuation of medication without resolution of symptoms but without significant distress from symptoms (ie. pt lost to f/u)
• Discontinuation of stimulants and replacement by non-stimulant
• Continuation of stimulant medication until contraindicated new disease process
• Continuation of stimulant medication until death
• New diagnosis

Thoughts?

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[vistaril]

What is the typical clinical/treatment course for patients with Adult ADHD treated with stimulants?

• Discontinuation of medication with the resolution of symptoms
• Discontinuation of medication without resolution of symptoms but without significant distress from symptoms (ie. pt lost to f/u)
• Discontinuation of stimulants and replacement by non-stimulant
• Continuation of stimulant medication until contraindicated new disease process
• Continuation of stimulant medication until death
• New diagnosis

Thoughts?

continuation of medication for as long as patient wants as long as they have money for appts or copay(if they have insurance). +/- addition of a benzo to 'take the edge off' the stimulant in 1/2 of cases.

 

[combatwombat]

continuation of medication for as long as patient wants as long as they have money for appts or copay(if they have insurance). +/- addition of a benzo to 'take the edge off' the stimulant in 1/2 of cases.

Aren't we just putting them into an upper-downer cycle then? I'm not sure how I'd feel about putting someone on an addictive med on another addictive med, especially when there are alternatives (clonidine? ramelteon? or just switch their stimulant to guaifenecin?)

 

[Barley426]

or just switch their stimulant to guaifenecin?)

Isn't that an OTC expectorant? I think you meant Guanfacine?

 

[vistaril]

Aren't we just putting them into an upper-downer cycle then? I'm not sure how I'd feel about putting someone on an addictive med on another addictive med, especially when there are alternatives (clonidine? ramelteon? or just switch their stimulant to guaifenecin?)

I wasn't rationalizing or justifying the practice. The OP simply asked what is typical...not what is best practice.

 

[markglt]