ADHD medication – can you take it long term? What are the risks and do benefits continue?
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Attention deficit hyperactivity disorder (ADHD) is a condition that can affect all stages of life. Medication is not the only treatment, but it is often the treatment that can make the most obvious difference to a person who has difficulties focusing attention, sitting still or not acting on impulse.
But what happens once you’ve found the medication that works for you or your child? Do you just keep taking it forever? Here’s what to consider.
What are ADHD medications?
The mainstay of medication for ADHD is stimulants. These include methylphenidate (with brand names Ritalin, Concerta) and dexamfetamine. There is also lisdexamfetamine (branded Vyvanse), a “prodrug” of dexamfetamine (it has a protein molecule attached, which is removed in the body to release dexamfetamine).
There are also non-stimulants, in particular atomoxetine and guanfacine, which are used less often but can also be highly effective. Non-stimulants can be prescribed by GPs but this may not always be covered by the Pharmaceutical Benefits Scheme and could cost more.
How stimulants work
Some stimulants prescribed for ADHD are “short acting”. This means the effect comes on after around 20 minutes and lasts around four hours.
Longer-acting stimulants give a longer-lasting effect, usually by releasing medication more slowly. The choice between the two will be guided by whether the person wants to take medication once a day or prefers to target the medication effect to specific times or tasks.
For the stimulants (with the possible exception of lisdexamfetamine) there is very little carry-over effect to the next day. This means the symptoms of ADHD may be very obvious until the first dose of the morning takes effect.
One of the main aims of treatment is the person with ADHD should live their best life and achieve their goals. In young children it is the parents who have to consider the risks and benefits on behalf of the child. As children mature, their role in decision making increases.
What about side effects?
The most consistent side effects of the stimulants are they suppress appetite, resulting in weight loss. In children this is associated with temporary slowing of the growth rate and perhaps a slight delay in pubertal development. They can also increase the heart rate and may cause a rise in blood pressure. Stimulants often cause insomnia.
These changes are largely reversible on stopping medication. However, there is concern the small rises in blood pressure could accelerate the rate of heart disease, so people who take medication over a number of years might have heart attacks or strokes slightly sooner than would have happened otherwise.
This does not mean older adults should not have their ADHD treated. Rather, they should be aware of the potential risks so they can make an informed decision. They should also make sure high blood pressure and attacks of chest pain are taken seriously.
Stimulants can be associated with stomach ache or headache. These effects may lessen over time or with a reduction in dose. While there have been reports about stimulants being misused by students, research on the risks of long-term prescription stimulant dependence is lacking.
Will medication be needed long term?
Although ADHD can affect a person’s functioning at all stages of their life, most people stop medication within the first two years.
People may stop taking it because they don’t like the way it makes them feel, or don’t like taking medication at all. Their short period on medication may have helped them develop a better understanding of themselves and how best to manage their ADHD.
In teenagers the medication may lose its effectiveness as they outgrow their dose and so they stop taking it. But this should be differentiated from tolerance, when the dose becomes less effective and there are only temporary improvements with dose increases.
Tolerance may be managed by taking short breaks from medication, switching from one stimulant to another or using a non-stimulant.
Ground Picture/Shutterstock
Too many prescriptions?
ADHD is becoming increasingly recognised, with more people – 2–5% of adults and 5–10% of children – being diagnosed. In Australia stimulants are highly regulated and mainly prescribed by specialists (paediatricians or psychiatrists), though this differs from state to state. As case loads grow for this lifelong diagnosis, there just aren’t enough specialists to fit everyone in.
In November, a Senate inquiry report into ADHD assessment and support services highlighted the desperation experienced by people seeking treatment.
There have already been changes to the legislation in New South Wales that may lead to more GPs being able to treat ADHD. Further training could help GPs feel more confident to manage ADHD. This could be in a shared-care arrangement or independent management of ADHD by GPs like a model being piloted at Nepean Blue Mountains Local Health District, with GPs training within an ADHD clinic (where I am a specialist clinician).
Not every person with ADHD will need or want to take medication. However, it should be more easily available for those who could find it helpful.
Alison Poulton, Senior Lecturer, Brain Mind Centre Nepean, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Going for a bushwalk? 3 handy foods to have in your backpack (including muesli bars)
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This time of year, many of us love to get out and spend time in nature. This may include hiking through Australia’s many beautiful national parks.
Walking in nature is a wonderful activity, supporting both physical and mental health. But there can be risks and it’s important to be prepared.
You may have read the news about hiker, Hadi Nazari, who was recently found alive after spending 13 days lost in Kosciuszko National Park.
He reportedly survived for almost two weeks in the Snowy Mountains region of New South Wales by drinking fresh water from creeks, and eating foraged berries and two muesli bars.
So next time you’re heading out for a day of hiking, what foods should you pack?
Here are my three top foods to carry on a bushwalk that are dense in nutrients and energy, lightweight and available from the local grocery store.
Leah-Anne Thompson/Shutterstock 1. Muesli bars
Nazari reportedly ate two muesli bars he found in a mountain hut. Whoever left the muesli bars there made a great choice.
Muesli bars come individually wrapped, which helps them last longer and makes them easy to transport.
They are also a good source of energy. Muesli bars typically contain about 1,500–1,900 kilojoules per 100 grams. The average energy content for a 35g bar is about 614kJ.
This may be a fraction of what you’d usually need in a day. However, the energy from muesli bars is released at a slow to moderate pace, which will help keep you going for longer.
Muesli bars are also packed with nutrients. They contain all three macronutrients (carbohydrate, protein and fat) that our body needs to function. They’re a good source of carbohydrates, in particular, which are a key energy source. An average Australian muesli bar contains 14g of whole grains, which provide carbohydrates and dietary fibre for long-lasting energy.
Muesli bars that contain nuts are typically higher in fat (19.9g per 100g) and protein (9.4g per 100g) than those without.
Fat and protein are helpful for slowing down the release of energy from foods and the protein will help keep you feeling full for longer.
There are many different types of muesli bars to choose from. I recommend looking for those with whole grains, higher dietary fibre and higher protein content.
2. Nuts
Nuts are nature’s savoury snack and are also a great source of energy. Cashews, pistachios and peanuts contain about 2,300-2,400kJ per 100g while Brazil nuts, pecans and macadamias contain about 2,700-3,000kJ per 100g. So a 30g serving of nuts will provide about 700-900kJ depending on the type of nut.
Just like muesli bars, the energy from nuts is released slowly. So even a relatively small quantity will keep you powering on.
Nuts are also full of nutrients, such as protein, fat and fibre, which will help to stave off hunger and keep you moving for longer.
When choosing which nuts to pack, almost any type of nut is going to be great.
Peanuts are often the best value for money, or go for something like walnuts that are high in omega-3 fatty acids, or a nut mix.
Whichever nut you choose, go for the unsalted natural or roasted varieties. Salted nuts will make you thirsty.
Nut bars are also a great option and have the added benefit of coming in pre-packed serves (although nuts can also be easily packed into re-usable containers).
If you’re allergic to nuts, roasted chickpeas are another option. Just try to avoid those with added salt.
Nuts are nature’s savoury snack and are also a great source of energy. Eakrat/Shutterstock 3. Dried fruit
If nuts are nature’s savoury snack, fruit is nature’s candy. Fresh fruits (such as grapes, frozen in advance) are wonderfully refreshing and perfect as an everyday snack, although can add a bit of weight to your hiking pack.
So if you’re looking to reduce the weight you’re carrying, go for dried fruit. It’s lighter and will withstand various conditions better than fresh fruit, so is less likely to spoil or bruise on the journey.
There are lots of varieties of dried fruits, such as sultanas, dried mango, dried apricots and dried apple slices.
These are good sources of sugar for energy, fibre for fullness and healthy digestion, and contain lots of vitamins and minerals. So choose one (or a combination) that works for you.
Don’t forget water
Next time you head out hiking for the day, you’re all set with these easily available, lightweight, energy- and nutrient-dense snacks.
This is not the time to be overly concerned about limiting your sugar or fat intake. Hiking, particularly in rough terrain, places demands on your body and energy needs. For instance, an adult hiking in rough terrain can burn upwards of about 2,000kJ per hour.
And of course, don’t forget to take plenty of water.
Having access to even limited food, and plenty of fresh water, will not only make your hike more pleasurable, it can save your life.
Margaret Murray, Senior Lecturer, Nutrition, Swinburne University of Technology
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Nasal Hair; How Far To Go?
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t’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝As a man in his sixties I find I need to trim my nasal hair quite frequently, otherwise it sticks out in an unsightly manner. But I’m never sure how severely I should cut the hairs back, or even how best to do it. Please advise.❞
As you might know, those hairs are really important for our health, so let’s start by mentioning that yes, trimming is the way, not plucking!
In an ideal world, we’d not trim them further back than the entrance to our nostrils, but given the constant nature of hair-growing, that could become a Sisyphean task.
A good compromise, if you’re not up for trimming when you get up and having visible hairs by evening, is to put the scissors away (if you haven’t already) and use a nasal hair trimmer; these are good at a) trimming nasal hairs b) abstaining from trimming them too far back.
By all means shop around, but here’s an example product on Amazon, for your convenience!
- Note 1: despite the product description, please do not stick this in your ear (or any other orifice that’s not your nose, for the love of all that is holey)
- Note 2: we chose that one for a reason; the shape of the head prevents overtrimming.
- In contrast, we do not recommend this cheaper one that has a different shape head for a closer trim, which in this case, is not what we want.
Enjoy!
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How anti-vaccine figures abuse data to trick you
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The anti-vaccine movement is nearly as old as vaccines themselves. For as long as humans have sought to harness our immune system’s incredible ability to recognize and fight infectious invaders, critics and conspiracy theorists have opposed these efforts.
Anti-vaccine tactics have advanced since the early days of protesting “unnatural” smallpox inoculation, and the rampant abuse of scientific data may be the most effective strategy yet.
Here’s how vaccine opponents misuse data to deceive people, plus how you can avoid being manipulated.
Misappropriating raw and unverified safety data
Perhaps the oldest and most well-established anti-vaccine tactic is the abuse of data from the federal Vaccine Adverse Event Reporting System, or VAERS. The Centers for Disease Control and Prevention and the Food and Drug Administration maintain VAERS as a tool for researchers to detect early warning signs of potential vaccine side effects.
Anyone can submit a VAERS report about any symptom experienced at any point after vaccination. That does not mean that these symptoms are vaccine side effects.
VAERS was not designed to determine if a specific vaccine caused a specific adverse event. But for decades, vaccine opponents have misinterpreted, misrepresented, and manipulated VAERS data to convince people that vaccines are dangerous.
Anyone relying on VAERS to draw conclusions about vaccine safety is probably trying to trick you. It isn’t possible to determine from VAERS data alone if a vaccine caused a specific health condition.
VAERS isn’t the only federal data that vaccine opponents abuse. Originally created for COVID-19 vaccines, V-safe is a vaccine safety monitoring system that allows users to report—via text message surveys—how they feel and any health issues they experience up to a year after vaccination. Anti-vaccine groups have misrepresented data in the system, which tracks all health experiences, whether or not they are vaccine-related.
The U.S. Department of Defense’s Defense Medical Epidemiology Database (DMED) has also become a target of anti-vaccine misinformation. Vaccine opponents have falsely claimed that DMED data reveals massive spikes in strokes, heart attacks, HIV, cancer, and blood clots among military service members since the COVID-19 vaccine rollout. The spike was due to an updated policy that corrected underreporting in the previous years
Misrepresenting legitimate studies
A common tactic vaccine opponents use is misrepresenting data from legitimate sources such as national health databases and peer-reviewed studies. For example, COVID-19 vaccines have repeatedly been blamed for rising cancer and heart attack rates, based on data that predates the pandemic by decades.
A prime example of this strategy is a preliminary FDA study that detected a slight increase in stroke risk in older adults after a high-dose flu vaccine alone or in combination with the bivalent COVID-19 vaccine. The study found no “increased risk of stroke following administration of the COVID-19 bivalent vaccines.”
Yet vaccine opponents used the study to falsely claim that COVID-19 vaccines were uniquely harmful, despite the data indicating that the increased risk was almost certainly driven by the high-dose flu vaccine. The final peer-reviewed study confirmed that there was no elevated stroke risk following COVID-19 vaccination. But the false narrative that COVID-19 vaccines cause strokes persists.
Similarly, the largest COVID-19 vaccine safety study to date confirmed the extreme rarity of a few previously identified risks. For weeks, vaccine opponents overstated these rare risks and falsely claimed that the study proves that COVID-19 vaccines are unsafe.
Citing preprint and retracted studies
When a study has been retracted, it is no longer considered a credible source. A study’s retraction doesn’t deter vaccine opponents from promoting it—it may even be an incentive because retracted papers can be held up as examples of the medical establishment censoring so-called “truthtellers.” For example, anti-vaccine groups still herald Andrew Wakefield nearly 15 years after his study falsely linking the measles, mumps, and rubella (MMR) vaccine to autism was retracted for data fraud.
The COVID-19 pandemic brought the lasting impact of retracted studies into sharp focus. The rush to understand a novel disease that was infecting millions brought a wave of scientific publications, some more legitimate than others.
Over time, the weaker studies were reassessed and retracted, but their damage lingers. A 2023 study found that retracted and withdrawn COVID-19 studies were cited significantly more frequently than valid published COVID-19 studies in the same journals.
In one example, a widely cited abstract that found that ivermectin—an antiparasitic drug proven to not treat COVID-19—dramatically reduced mortality in COVID-19 patients exemplifies this phenomenon. The abstract, which was never peer reviewed, was retracted at the request of its authors, who felt the study’s evidence was weak and was being misrepresented.
Despite this, the study—along with the many other retracted ivermectin studies—remains a touchstone for proponents of the drug that has shown no effectiveness against COVID-19.
In a more recent example, a group of COVID-19 vaccine opponents uploaded a paper to The Lancet’s preprint server, a repository for papers that have not yet been peer reviewed or published by the prestigious journal. The paper claimed to have analyzed 325 deaths after COVID-19 vaccination, finding COVID-19 vaccines were linked to 74 percent of the deaths.
The paper was promptly removed because its conclusions were unsupported, leading vaccine opponents to cry censorship.
Applying animal research to humans
Animals are vital to medical research, allowing scientists to better understand diseases that affect humans and develop and screen potential treatments before they are tested in humans. Animal research is a starting point that should never be generalized to humans, but vaccine opponents do just that.
Several animal studies are frequently cited to support the claim that mRNA COVID-19 vaccines are dangerous during pregnancy. These studies found that pregnant rats had adverse reactions to the COVID-19 vaccines. The results are unsurprising given that they were injected with doses equal to or many times larger than the dose given to humans rather than a dose that is proportional to the animal’s size.
Similarly, a German study on rat heart cells found abnormalities after exposure to mRNA COVID-19 vaccines. Vaccine opponents falsely insinuated that this study proves COVID-19 vaccines cause heart damage in humans and was so universally misrepresented that the study’s author felt compelled to dispute the claims.
The author noted that the study used vaccine doses significantly higher than those administered to humans and was conducted in cultured rat cells, a dramatically different environment than a functioning human heart.
How to avoid being misled
The internet has empowered vaccine opponents to spread false information with an efficiency and expediency that was previously impossible. Anti-vaccine narratives have advanced rapidly due to the rampant exploitation of valid sources and the promotion of unvetted, non-credible sources.
You can avoid being tricked by using multiple trusted sources to verify claims that you encounter online. Some examples of credible sources are reputable public health entities like the CDC and World Health Organization, personal health care providers, and peer-reviewed research from experts in fields relevant to COVID-19 and the pandemic.
Read more about anti-vaccine tactics:
- How vaccine opponents spread misinformation
- How misinformation tricks our brains
- How vaccine opponents use kids to spread misinformation
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Mastering Gut Health for Women – by Karín Feltman
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The author, a registered nurse, has a focus on holistic health, and in this book it’s all about wellness from the inside out.
To effect this, she lays out a 12-week program of transformations:
- Week 1: transform your knowledge
- Week 2: transform your brain
- Week 3: transform your digestion
- Week 4: transform your immunity
- Week 5: transform your emotions
- Week 6: transform your sleep
- Week 7: transform your energy/vitality
- Week 8: transform your activity
- Week 9: transform your hormones
- Week 10: transform your diet
- Week 11: transform your weight
- Week 12: transform your habits
Which all adds up to quite a comprehensive overall transformation!
Of course, it’s possible you might want to implement everything at once; an exciting prospect for sure, but oftentimes it really is best to just change one thing at once before moving on; that way it’s a lot more likely to stick, and that’s why she presents it in this format.
On the other hand, maybe you might want to take longer than the 12 weeks, if for example it takes you more than a week to do a certain part. That’s fine too, though for most people without serious constraints (or suffering some unexpected major interruption to your usual life), the 12-week program should be quite doable as-is.
The style is personable and friendly, albeit with frequent references to science and appropriate citations.
Bottom line: the title centers gut health, and so does the book itself, but this is truly a holistic approach that goes far beyond the gut, which makes it even more worthwhile.
Click here to check out Mastering Gut Health For Women, and master gut health for yourself!
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Do CBD Gummies Work?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝I take CBD gummies. I don’t know if they are worth buying. Can you find a study on the effectiveness of gummies❞
If you take them, and you’re not sure whether they’re worth it, then it sounds like you’re not getting any observable benefit from them?
If so, that would seem to answer your question, since presumably the reason that you are taking them is for relaxation and/or pain relief, so if you’re not getting the results you want, then no, they are not worth it.
However! CBD gummies are an incredibly diverse and not-well-studied product, so far, given the relative novelty of their legality. By diverse we mean, they’re not well-standardized.
In other words: the CBD gummies you get could be completely unlike CBD gummies from a different source.
CBD itself (i.e. in forms other than just gummies, and mostly as oil) has been studied somewhat better, and we did a main feature on it here:
And while we’re at it:
Cannabis Myths vs Reality ← This one is about cannabis products in general, and includes discussion of THC content and effects, which might not be so relevant to you, but may to some readers.
Companies selling CBD and CBD gummies may make bold claims that are not yet backed by science, so if you are buying them for those reasons, you might want to be aware:
Selling cannabidiol products in Canada: a framing analysis of advertising claims by online retailers
One thing that we would add is that even though CBD is generally recognized as safe, it is possible to overdose on CBD gummies, so do watch your limits:
A Case of Toxicity from Cannabidiol Gummy Ingestion
Take care!
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Carrots vs Broccoli – Which is Healthier?
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Our Verdict
When comparing carrots to broccoli, we picked the broccoli.
Why?
These are both excellent candidates that should be in everyone’s diet, but there’s a clear winner:
In terms of macros, carrots have 50% more carbs for the same fiber (giving carrots the relatively higher glycemic index, though really, nobody is getting metabolic disease from eating carrots, which are a low-GI food already), while broccoli has more protein. By the numbers, it’s a nominal win for broccoli here, but really, both are great.
In the category of vitamins, carrots have more of vitamins A and B3, while broccoli has more of vitamins B1, B2, B5, B6, B7, B9, C, E, K, and choline. An easy win for broccoli. We’d like to emphasize, though, that this doesn’t mean carrots don’t have lots of vitamins—they do—it’s just that broccoli has even more!
When it comes to minerals, carrots are genuinely great, and/but not higher in any minerals than broccoli, while broccoli has more calcium, copper, iron, magnesium, manganese, phosphorus, selenium, and zinc. So again, a clear win for broccoli, despite carrots’ fortitude.
All in all, an overwhelming win for broccoli, though once again, enjoy either or both; diversity is good!
Want to learn more?
You might like to read:
What Do The Different Kinds Of Fiber Do? 30 Foods That Rank Highest
Enjoy!
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