Monday, September 26, 2011

drug dosing

Determining the best dose and timing of ADHD drugs requires work.  I think the primary appeal of drugs like Concerta is that they simply it.  For myself though, I find Concerta lacking.  In adults taking Concerta, blood levels typically drop to half of the peak 9.6 hours after taking it.  So when you take it at 6:30am, the effect is disappearing around 4pm.  I want the benefit of medication from the morning as I get my kids ready for school, through the day, and the evening until my kids are in bed.

To figure out my desired dosing, I downloaded the product monograph for APO 20mg methylphenidate-SR from Health Canada.  Using the monograph, I estimated the hourly blood levels and recorded them in a spreadsheet.  With that I was able to calculate and graph the levels obtained for different drug dose timings.

Monday, September 19, 2011

drug costs

There is a wide range in price between different ADHD drugs, and even in the price for the same drug from different pharmacies.  Here are some examples:
Concerta 54mg, 30 tablets: 123.90 at Superstore pharmacy vs. $111.32 at Costco
The manufacturer is distributing co-pay benefit cards through doctors and pharmacies which covers the difference in cost between Concerta and the generic version.  For the Superstore, this difference was $36.56, bringing the price down to $87.34.
MPH-SR(generic Ritalin-SR) 20mg, 90 tablets: 37.39 at Superstore pharmacy vs. 26.42 at Costco.

Friday, September 16, 2011

drug performance testing

I have started testing my performance while taking ADHD medication.  I am doing a PASAT-2 followed by a go/no-go test every hour starting from the time I take the medication.  My first test is with 54mg Concerta, and I plan to test other medications.  In addition to attempt to quantify how effective the medication is, I am attempting to quantify it over time.  The product monograph for Concerta indicate that peak serum levels were reached in adults between 5 and 9 hours after ingestion, with a median of 6 hours.  I expect the tests to show when the peak effect occurs after ingestion.

Monday, September 12, 2011

ADHD tests

My doctor used a questionnaire in diagnosing my ADHD.
Adult ADHD Self-Report Scale
Before going to my doctor I had tried TotallyADD's virtual doctor.
Note that Dr. Russell Barkley says scoring high on hyperactivity (feeling driven like a motor) is of no diagnostic value in adults.

I have had difficulty finding objective online tests for ADHD. I've found studies showing people with ADHD perform below average on inhibition tests like go/no-go and stop signal.  Studies indicate medication improves performance on those tests, and my tests on and off medication show an improvement too.

I also perform well below average (bottom 1%) on the n-back test, though I haven't found any studies of this. Although ADHD causes problems with working memory(WM), my initial score of 7 on the reverse digit span test indicate my WM capacity is above average.  This paper concludes n-back doesn't primarily measure WM, rather it primarily measures attentional control.  In other words the attention deficit makes it more difficult to effectively use WM.  For me, medication doesn't seem to effect n-back performance.

Thursday, September 8, 2011

Purpose of this blog

I'm writing this blog to collect information about adult ADD and document some of my experience with it.
I don't want to duplicate other sites, so I'll list a few that I pay attention to.