Expert: Layla Yeganeh - 9/22/2007

Question
i am a 30 year old male with a rather severe case of ADHD.  I have tried all the meds like ritalin, aderall, concerta, etc. they worked but i don't like pills and for six months or so last year i didnt take any meds at all for ADHD.  then my psychiatrist told me about daytrana and i thought it would be great because its a  patch not  a pill.  So i have been on daytrana for about three months now and i'm happy with it except for one thing....the doaage i take is the highest dosage and it doesn't work as well as the pills in terms of helping me focus on my work  without losing focus and going to something else.  I mentioned something to my psychiatrist about it, but she kinda just said its the highest milligram and there's nothing u can do.
 my question is....what do u think i could do ?  i was the first person she prescribed it to, so i think she just doesn't know.   Would it be bad to take off one patch after four hours and put on  a new one?  i am frustrated because i work full time and i'm finishing my degree at night and its hindering me in both respects.

Answer
It is the maxium dosage, it would not be wise to take more than what is the MAX.

Do not put on an extra patch, that will only temp, solve your problems.

Stimulant medications for ADHD, only work for some period of time, before they actually start to hinder preformance, in higher doses. The dopamine receptors in the brain, suffer from an inability to relpenish themselves, this can have the reverse effect, actually making concentration worse.

I would talk to you doctor about adding in an SSRI, that will work on serotonin, suck as Luvox, prozac, or zoloft, in a low dose. Serotonin, can help add emensly, espically the inattentive type. It can help people to listen better and help with restlessness, and improve patients.
That is required for long periods of listening to lecutres and concentrating on reading and studying. I reccomend adding in an ssri.

This is just my opinion, please talk to you doctors. It sounds like just the stiumlants arent doing much for you anymore, and the rule is if something is not working then you change, you dont keep doing the same thing,,,dont you think?

Thanks