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Intuniv Answers: ADHD & Addiction Indication

by Dr Charles Parker on December 15, 2009 · 0 comments

Intunive: Not a Stimulant

Intuniv For ADHD & Substance Abuse
As we move down the early ADHD road of experience with Intuniv some interesting additional likely indications appear. Remember: Intuniv is not a stimulant, not a controlled substance, not abusable, and is approved by the FDA for ADHD.

The indication suggested in this post is not FDA approved, but simply makes street sense. This Intuniv comment/question regarding addiction indications recently arrived in this CorePsych Blog comments:

Question
I have a 19 yr old son, he’s still trying to finding the right medication [for ADHD], period. Doctors don’t want to put him on a stimulant because of his age and possible addiction. He has tried Strattera, that didn’t seem to work well [my observation, repeatedly], he seemed to be moody.

We are trying Intuniv tomorrow, at first because of his age I wasn’t sure, age says from 6 to 17, but I am trusting the doctors, are there any studys of young adults who have taken it, I know its new. I am also going to start a protein shake of 8oz of coffee and 20g of protein powder with it, so hopefully it will work.

My Reply
You are on the right path. Intuniv is clearly indicated with folks who have some measure of medical concern about abuse… it just isn’t abusable, period. A likely indication, not mentioned in this post, are those in recovery from substance abuse, e.g. medical professionals in programs who suffer with ADHD and are standing before licensing boards, and pilots?

As you point out adults don’t have a specifically approved indication through the FDA, but the safety with children does encourage an Intuniv intervention if any abuse concern does exist. Older adults on antihypertensive meds, with blood pressure problems or any specific cardiac conditions need a medical review – in spite of the fact that in the ‘flexible-dose’ titration study [customized for the person based upon symptom resolution, rather than the 2 'forced-dose' titration studies] the hypotensive side effect was nearly the level of placebo.

On the other hand, it is my frequent concern that still too few docs understand the diminished abuse potential of Vyvanse, documented throughout CorePsych Blog posts and elsewhere, including this abuse study from Shire. Yes, Vyvanse is an amphetamine, but is the only full-on stimulant with peer reviewed studies in the package insert regarding diminished abuse potential. Nothing is perfect, but anecdotally Vyvanse has proven useful with its prodrug release for use with recovering individuals with ADHD.

Stay with the protein, well done, and very likely you will have a positive outcome. It’s never to late to treat ADHD, and with more treatment options Intuniv might prove quite helpful for these other indications. Always remember that substance abuse folks frequently show diminished neurotransmitter biomarkers, and often prove refractory to psychotropic medications of any sort.
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—>Tweet this post below! For ADHD Medications: Download complimentary white paper Precise Solutions now, – and get ready for the complete version of ‘The Patient’s Guide’ details to follow. Get Neurotransmitter Details Here

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Lady in Red

Image by Kopfjäger via Flickr

Make your reservation now!

School has started, the Fall is upon us, we are back at work with questions about just what to do with Impulsivity.

Impulsivity is, without doubt, the most frequent challenge in our daily lives – for mental health professionals, teachers, HR professionals, physicians, and anyone working with administrative challenges. Impulsivity works against administration, works against group order, works against progress – and can be downright embarrassing.

Want a recent example of Impulsivity? Lay your politics aside for a moment, and simply ask yourself this question – was it a productive contribution when Rep Joe Wilson shouted out “You lie!” at Obama’s Joint Session of Congress? No matter what you think of national health care take a look at this guy, and see which side you are on regarding good order.

Affect mismanagement, emotional dysregulation – loosing it - creates havoc in families, work sites and the world, locally and internationally. Someone’s impulsivity has impacted your life. Impulsivity, from anger to suicide, destroys both the self and relationships. Impulsivity is the hallmark of poor management and atypical of balanced leadership – just ask Jack Welch,  or read his book on Leadership.

Was Wilson’s outburst ‘just a quirk?’ Who knows… Was it a problem, you bet! – And no, I will not conjecture about his prefrontal cortex.

Wilson’s interruption, his inappropriate shout during a presidential speech,  is but a small example of a seriously overlooked problem we see everyday in any group setting. So often we write impulsivity off as ‘character,’ or ‘passion,’ or ‘immaturity,’ even with adults!

- Reminds me of a person in advertising who still lives by the adage “You’re only young once, but you can be immature for a lifetime.” He manages to live up to that creed, and has torn up his family in the process. There is a price for immaturity. There is, my friends, a biology for both impulsivity and immaturity.

The Impulsive Brain – Details on exactly what it is, why it is, and how to fix it.

If you live anywhere in the Norfolk, Va Beach, DC or Richmond area, [anywhere on the East Coast] and work in the context of human services you will appreciate this opportunity at Norfolk’s Old Dominion University to look more carefully at new brain and behavioral insights into the problem of Impulsivity.

  • I will be presenting 1 full day of details there on Fri Oct 16th, just around the corner in time.
  • ODU Registration has a discounted rate for groups, and a low fee for these challenging times
  • 6 hr CEU & 6 hr CME,
  • The fix will detail the latest in diagnostic evidence regarding Impulsivity, and
  • Details about the right meds and
  • The new process of actually measuring neurotransmitters to target specific interventions
  • New advances in ADHD treatment
  • New insights into Brain Injury
  • Specific interventions for Bipolar Disorder
  • The Biologic Contributions to Addiction Recovery.
  • Without getting away from bottom line street applications.

If you can’t use it, I won’t be dwelling on it. Translation, street language and concepts are the key to informed intervention strategies.

Please forward this to your colleagues and friends and let’s make a day of it.

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—>Tweet this post below! For ADHD Medications: Download complimentary white paper Precise Solutions now, – and get ready for the complete version of ‘The Patient’s Guide’ details to follow. Get Neurotransmitter Details Here

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Vyvanse Adjustments: Start By Looking for the Exact Window

September 6, 2009 Beyond ADHD

Watch For: Top of the Therapeutic Window -This comment on Vyvanse is worth your time, and is so commonly seen in the office. Vyvanse in the PM is so forgiving – that when it finishes, it is hard to assess. Measure the DOE anyway – start with that process.

21 comments Read the full article here →

Vyvanse for ADHD: The Complete Story on CorePsych Radio

June 18, 2009 Beyond ADHD

Vyvanse Works Exceedingly Well If You Know How to Work It – Vyvanse continues to prove itself as the most effective ADHD stimulant ever – but many still simply don’t know how to use it.

6 comments Read the full article here →

Vyvanse Dosage for ADHD: Finding the Safe Top of the Window

June 17, 2009 Beyond ADHD

ADHD and Ultrarapid Metabolizers: Frustrations Facing Individualized Care with Vyvanse.
Cookie cutter medicine in psych treatment is on its way out folks – from SPECT reports to simply adjusting the dosage of medications in the office, the public knows that one size, one platitude, one description of one mood, does not fit all.

5 comments Read the full article here →

ADHD: Vyvanse – The Therapeutic Window Mystery

June 11, 2009 Beyond ADHD

Overlooked: Vyvanse has many interesting features for ADHD treatment – but this challenge is often missed. Take a quick look at this video, will only take a few minutes, – but can help find the Top of the Window with Vyvanse – the ‘forgiving amphetamine.’

30 comments Read the full article here →

ADHD Medications with Depression: Seven Significant Problems

March 30, 2009 Beyond ADHD

Depression and ADHD: Often Confusing – Listen on CorePsych Radio -handout for the program at this link, medications specifically recommended

5 comments Read the full article here →

ADD, ADHD Medication: Find The Sides of the Therapeutic Window.

November 5, 2008 Beyond ADHD

7 Essential Tips to Find Those Effective Sides of the Therapeutic Window When Treating ADD/ADHD:
The ‘Sides of the Window’ are Puzzling and Require a Few More Office Questions. The reason to ask the questions is simple: we want to know exactly how the medication is working in the context of time of day, duration of effectiveness,

6 comments Read the full article here →

Vyvanse for ADD/ADHD: The Water Titration Recipe

November 14, 2007 Beyond ADHD

Some have asked offline about clarification of the water titration strategy with Vyvanse, and this post is a brief clarification on that process.

30 comments Read the full article here →

ADD/ADHD Treatments: Tips for Vyvanse

August 29, 2007 Beyond ADHD

You already know our regular CorePsych theme with ADD/ADHD and emerging brain science: the more we know the more we can have a positive impact. Vyvanse is a surprisingly forgiving stimulant medication.

135 comments Read the full article here →