ADHD - To Medicate Or Not Medicate - That Is the Question

People with ADHD can have a combination of symptoms that can include inattention, hyperactivity, and impulsive behavior. Psychiatrists recognize three sub-types of ADHD. The Hyperactive subtype, the Inattentive subtype and the Combined subtype. The necessity to use medication to treat ADHD symptoms may have a lot to do with these subtypes of ADHD and with the presence or absence of impulsive behavior symptoms

Russell Barkley, PhD, one of the most respected authorities on ADHD has been recently lecturing on the importance of emotion in understanding and managing ADHD and on the role of the anterior cingulate on impulse control in ADHD. Studies have shown that in people with Impulsive symptoms of ADHD, the anterior cingulate fails to control emotions as it does in non-impulsive ADHD controls. This lack of activity in this part of the brain can lead to aggression, increased displays of anger and frustration, excitability and impatience. Many of the poor outcomes associated with ADHD which include substance abuse, difficulty in maintaining relationships, social difficulties, and conduct disorders may be attributed to this biological inability to control or inhibit emotions.

The ability to succeed at work, at home and in social relationships involves the ability to control your emotions. A lack of emotional control can cause total havoc in the lives of people with ADHD but stimulant therapy with methylphenidate (Ritalin) or amphetamines (Adderall) has been shown to be very effective in controlling the impulsive symptoms that are sometimes associated with ADHD.

A recent Consumer Report article stated that while most parents of children with ADHD noticed an improvement in ADHD symptoms when their children were on medication, only slightly more than 50% were happy with the treatment. There are many reasons for parents to feel ambivalent about medicating their children but sometimes it is an absolute necessity to medicate and the decision to medicate or not medicate may boil down to one simple question, does the ADHD diagnosis includes impulsive behavior or not?

Animal models have shown that Ritalin positively engages the anterior cingulate and promotes impulse control. People with Predominantly Inattentive ADHD (ADHD-PI) often have fewer problems with impulse control. A Developmental Psychopathology study published in 2009 describes people with ADHD-PI as being, with respect to reflexively controlled inhibition (impulse control), considerably less impaired. Stimulant therapy for people with ADHD-PI and no impulsiveness may be less necessary than stimulant therapy for ADHD with impulsiveness.

Dr. Ari Tuckman, another well known ADHD authority has proposed an integrative approach to ADHD therapy, an approach which includes Behavioral Therapy and ADHD coaching as well as medication and psychotherapy. For people with ADHD without behavioral impulsiveness, Cognitive Behavioral Therapy, ADHD Coaching interventions, and psychotherapy may successfully treat the symptoms of ADHD without the need for stimulant therapy. For people with ADHD and behavioral impulsiveness, stimulant therapy in combination with these other forms of treatment may offer the best control of their ADHD symptoms and, more importantly, the best opportunity for a successful adult life.

For more information on Primarily Inattentive ADHD please visit Tess Messer at http://www.primarilyinattentiveadd.com/2010/02/why-blog.html. There you will find information on ADHD symptoms, ADHD treatment, alternatives to medications, Information on ADHD vitamins and supplements and much more. Looking forward to meeting you there!!