Combining ADHD Medications
Dr. John Kruse
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Combining ADHD Medications
6 055 просмотров · 1 год назад
Dr. John Kruse
18 тыс. подписчиков
6 055 просмотров · 1 год назад
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.
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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
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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.
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