Rethinking ADHD Treatment: The Power of Non-Stimulant Medication

Explore ADHD treatment beyond stimulants with Dr. Tracey Marks. Dive into the world of non-stimulant medications like Qelbree, and their potential to improve executive function and work productivity in adults with ADHD. Uncover the impact of executive dysfunction and discover strategies to enhance focus and manage symptoms effectively.

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Video references
Price MZ, Price RL. Extended-Release Viloxazine Compared with Atomoxetine for Attention Deficit Hyperactivity Disorder. CNS Drugs. 2023;37(7):655-660. doi:10.1007/s40263-023-01023-6

Faraone SV, Gomeni R, Hull JT, et al. Executive Function Outcome of Treatment with Viloxazine Extended-Release Capsules in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder: A Post-Hoc Analysis of Four Randomized Clinical Trials. Paediatr Drugs. 2021;23(6):583-589. doi:10.1007/s40272-021-00470-2

Disclaimer: All of the information on this channel is for educational purposes and not intended to be specific/personal medical advice from me to you. Watching the videos or getting answers to comments/question, does not establish a doctor-patient relationship. If you have your own doctor, perhaps these videos can help prepare you for your discussion with your doctor.

[phail_trail]

"...that 15 minute quick call can ruin your productivity for the rest of the day..."

I screamed YES at the top of my lungs when I heard this! OMG WTF?! I totally thought I was alone but this is a thing?! Thank you thank you thank you!!!

[incorrigiblycuriousD]

Wow, you just described my whole life. So you mean I'm not insolent, lazy, disrespectful, inattentive, rude, uncooperative, unproductive, won't pay attention and refuse to follow instructions or transition from one task to another? I was taught that I was just incorrigible and spent the first 40 years of my life fawning or disassociating to cope.

[tayzonday]

What about bupropion? It is not a stimulant and approved for ADHD. I need Auvelity (mainly the Bupropion part) to address executive dysfunction, or amphetamines like Vyvanse are counterproductive. With no other medication alongside stimulants, I will hyperfocus on harmful/useless things, spending hours down the wrong rabbit holes.

[nicolebea]

Thank you! I have significant difficulty set shifting. Neurotypical people do tend to think it’s “dramatic” and such. I currently work at a company that encourages constant disruptions and they don’t understand how that throws me off. They can’t fathom how your whole day gets ruined by that. Fortunately, I have a few interviews elsewhere lined up. I’m tired of fighting for accommodations and being told, “This is just company culture.” 😕

[AnnaLilySnapeoo]

I had no idea set shifting was the term for it! I always described it as “I can’t easily start or finish tasks, but I’m great in the middle of them! And if you disturb me, it’s the same thing over again.” Now I don’t need to use that long description! 😂

[Kknderbueno]

Wait what? Stimulants aren’t very useful for executive dysfunction? NO WONDER I felt like they were useless to me. I struggle way more with executive dysfunction than with hyperactivity or attention. Omg I can’t wait to ask my doctor about this.

[vanessac]

Untreated trauma and a frozen nervous system causes problems with focus and organization, no one is treating this, it's getting designated to the adhd basket. We're also judging productivity by very recent environmental demands in a post industrial setting.

[kenhaze]

I think the phone call scenario is a perfect example. For me, there's also a risk that the hyperfocus will switch TO the phone call, and then, whatever I'm doing falls to the wayside. Incidentally, the time in my life where I had to focus the most was writing my dissertation on brain dynamics and phase transitions in brain states... albeit in ASD, but the general principle applies to to all brains. ADHD brain wants to latch on when it DOES get something engaging, and it's hard to break that, but when it is, the hyperfocus is reoriented towards whatever broke it.

THEN getting BACK to writing, or whatever work, is extremely hard once again. It's fatiguing.

[BigIndianBindi-jycz]

my mind didn't get quiet and the intrusive thoughts didn't stop until I got real stimulants. Vyvanse was my first one i tried. I have control over thinking. Nothing pops in on its own and repeats/loops, being all annoying. What do I want to think about? I can choose. So I choose not to think about stuff that bothers me. BTW, I'm almost 40, and this is the first time I got to see what it's like to have control over thoughts. This is a big deal, because my mood is greatly affected by my thoughts.

[tomaszfalkowski]

My experience with Vyvanse has been relatively positive, I have been taking it for over a year. I was diagnosed with attention deficit disorder (ADD), but the non-hyperactive version. I tend to have a low energy drive, which makes me procrastinate and overthink, and I have low self-esteem, and I often keep to myself. But when I started taking Vyvanse 40mg, I actually became more energetic, and I no longer procrastinate. I also noticed that my self-esteem improved, and I am more willing to engage in conversations with people. I think it's safe to say that Vyvanse helps me break out of my shell.

[TheGrimmy]

I never knew set shifting was a think and nearly cried once you described it. I have SO much trouble doing that that if people disrupt anything I'm doing it sends me into an anxious spiral. So I will definitely ask my doctor about Qelbree!

[Astronaut]

At 31 I actually got diagnosed with ADHD this year and got prescribed Strattera and it’s been working well for me. Started at 25mg and could immediately notice a difference in my attentiveness and ability to organize thoughts better(I like to say that it kept my cats all into one space).

After 6 months I actually asked for a higher dosage(40mg) and it has been wonderful. Immediately felt like I could maintain focus on my many tasks all day and my coworkers have noticed that I don’t “buffer” nearly as often while I’m trying to think of the word or thing I was about to say.

[PrimroseFrost]

Thank you for giving me a name for my struggles! I have such a hard time with set shifting, and no one seems to understand how difficult it is for me to switch between tasks, especially if it's unexpected. Just like you said, it can absolutely mess up the rest of my day, but it feels like even people who should know better write me off as exaggerating. It is so helpful to hear someone validate that yes, it CAN be that bad, and I'm not just being dramatic!

[benf]

Set shifting... good term. When I'm pulled away from a task I always feel like I need to reconstruct my entire thought process to pick up where I left off. It's like all the thoughts I had vaporize into nothingness and I need to go find them again.
This video is a very well organized and articulated. And whoever edits your videos is pretty good too!

[guildedbutterfly]

Thank you Thank you Dr Tracey. I'm 53 now and received a diagnosis as a fluke when visiting my Dr a few times and having breakdowns. Between the ADHD and set shifting and now menopause, I am so exhausted. My son is 13 now and has been diagnosed with ADHD and Autism.

I wish I had known all of this when I was growing up. It explains lots of poor, impulsive decisions over the years. But I thank you for helping me understand all of this so I can get a hold of my own mind to help my son. Thank you😢

[vaingirls]

Thank you for talking about set shifting. I hadn't heard the term before, but I instantly recognize it as one of my MAJOR symptoms.

[stargazer]

Set shifting.... I have tried to explain this to people my whole life and no one has seemed to ever understand! Thank you for giving me the words to explain myself to others!

[zipbangcrash]

I just started crying when you gave that example of the 15 minute thing. It's so real.

[maryblue]

I never heard of set shift.

Some time ago, before i started concerta i was telling my relative therapist, that things are so difficult that between any task i had to take my phone, scroll, and then when i felt better, could continue the task t hand.
This meant, i always, always, sat in the car for 15‘ doing nothing, to be able to continue that.
I lost so many hours!!!
But now its all in the past! Its a miracle.
I started concerta & tyrosine, which totally breaks the cycle of endless background thinking and feeling, it makes the brain go silent!
The tyrosine i mean.
It has to be taken in 2x doses to hve effect all day -7am and 13:00 … i only need 10% of the 500mg pill at every dose.
Be aware, dosage and timing is everything.
Also, tyrosine completely erased the 17:00-19:00 crash and end of day emotional depressive vulcano .

The concerta on its own did not help with the hyperactive thinking feeling sadness.

It helped me be functional physically, but it did not help in the inner/thinking part of the functioning.
Tyrosine is like a body double, this is how i would compare it.
The equivalent of your best friend shadowing you and where your brain knows it does not need to worry because your are taken cared ..!
After 4 months i still cant beleive this endless torturous burden was lifted just like that.
Still, i myself dont beleive it.

[the.modern.cookie]

What I'm finding is that it doesn't matter how much education we have on ADHD. No doctor wants to treat it or even talk about it.