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Combining ADHD Medications

Main Chapters: 00:00 Intro - Combining ADHD Medications 00:20 Take home message 02:24 Why Combine ADHD Medications? 08:01 Prevalence of Combining ADHD Medications 12:20 Potential Benefits of Combining ADHD Medications 15:46 Combining Medications for Comorbid Conditions with ADHD 17:58 Clinical Experience with Combining Medications for ADHD 19:24 How and When to Combine ADHD Medications The medications that the FDA has sanctioned for treating ADHD have all been approved as stand-alone agents only. But we know that combination medication therapy is widespread in the treatment of ADHD. Aren't stimulants powerful and dangerous enough alone? Why add on something else? Despite the powerful ability of stimulants to reduce ADHD symptoms, for many, residual symptoms persist. Others can't tolerate stimulates, or have side effects (like insomnia) worsened by the drugs. Co-morbid conditions like depression, PTSD, anxiety, and OCD are common with ADHD, which also often prompts the use of combination therapy. Most of the research on combination therapy for ADHD is descriptive - how often does it occur, with which medications, and for what subpopulations. But some experimental research indicates that two combinations: atomoxetine + stimulants and guanfacine + stimulants can lead to improved outcomes and does not increase the risk of serious side effects. When combining medications, one should have clear treatment goals in mind, monitor responses closely, and start low, particularly with agents that may have overlapping modes of action. ----- Follow   / dockruse   on Medium for hundreds of full length articles on this subject and more! Access to full articles requires paid membership. ----- References: Combined Stimulant and Guanfacine Administration in Attention-Deficit/Hyperactivity Disorder: A Controlled, Comparative Study (2016) https://www.jaacap.org/article/S0890-... A Systematic Review of Combination Therapy with Stimulants and Atomoxetine for Attention-Deficit/Hyperactivity Disorder, Including Patient Characteristics, Treatment Strategies, Effectiveness, and Tolerability (2013) https://pmc.ncbi.nlm.nih.gov/articles... A retrospective claims analysis of combination therapy in the treatment of adult attention-deficit/hyperactivity disorder (ADHD) (2009) https://pmc.ncbi.nlm.nih.gov/articles... Combination pharmacotherapy for adult ADHD (2006) https://pubmed.ncbi.nlm.nih.gov/16968... Natural Product-Derived Treatments for Attention-Deficit/Hyperactivity Disorder: Safety, Efficacy, and Therapeutic Potential of Combination Therapy (2016) https://onlinelibrary.wiley.com/doi/1... Full Chapter list: 00:00 Intro - Combining ADHD Medications 00:20 Take home message 02:24 Why Combine ADHD Medications? 02:35 Greater Symptomatic Relief 04:47 Adapting to Different Forms of Stimulants 05:53 Tolerating Bigger Doses and Side Effects 07:34 Treating Comorbidities 08:01 Prevalence of Combining ADHD Medications 08:11 2009 Study 09:19 2015 Study 11:43 2021 Study 12:20 Potential Benefits of Combining ADHD Medications 12:30 Combining Stimulants and Atomoxetine (Strattera) 13:33 Combining Stimulants and Guanfacine 14:50 Combining Stimulants and Supplements 15:46 Combining Medications for Comorbid Conditions with ADHD 16:02 ADHD and Comorbid Depression 17:04 ADHD and Comorbid Anxiety / OCD / Tic Disorders 17:58 Clinical Experience with Combining Medications for ADHD 19:24 How and When to Combine ADHD Medications 22:06 Specific Instances of Combining Medications 23:40 Outro ------------------------- Psychiatrist, neuroscientist, and author John Kruse, MD, PhD presents practical, actionable, well-researched information about treatment options that scientists and clinicians recommend for adult ADHD and other mental health conditions. Subscribe if you're curious about how neuro-atypical brains can optimize their functioning in our shared, and somewhat strange, world. Dr. Kruse has posted talks in both the "live" and the "video" sections of this channel. Thumbnails on ADHD topics have a pink background, and those on more general mental health topics have a purple background. A small collection of ADHD-Trump videos have an orange background. You're welcome to email him with topics you want discussed or people you think he should interview. [email protected] #health #mentalhealth #adhd #medication