Psychiatric Medications Online Conference Transcript - All about Psychiatric Medications

Written by Guest: Dr. Lorraine Roth

wishing_A: Do you know of any medications that could be tried on a child of 12 that has been diagnosed with ADHD (Attention Deficit Hyperactivity Disorder), Intermittent Explosive Disorder, and Disruptive Behavior Disorder?

Dr. Roth: I generally treat adults, but I'm aware of many meds which we have which would be appropriate for a trial in such a child. Many of them are the same medications used for adults but in smaller dosages.

iglootoo1: My 16 year old son takes 30 mg a day of Adderall for ADHD (Attention Deficit Hyperactivity Disorder) Inattentive. He feels better able to focus, but still claims he "cannot" remember to write things down to keep track of assignments, etc. Is this "learned helplessness" or a short-term memory problem that won't be helped with medication? He sounds so sincere when he says he can't, I don't know what to believe and want to understand.

Dr. Roth: I doubt that it is a short-term memory problem. I also would not attribute it to learned helplessness. Some people are naturally "absentminded" and this may be the problem. Be Positive! He sounds like he's doing well.

David: Now here's an adult ADD (adult Attention Deficit Disorder) question, Dr. Roth:

Richardsbb: What medications would you recommend for an adult diagnosed with ADD (Attention Deficit Disorder), Inattentive type?

Dr. Roth: If ADD is the correct diagnosis, then one should prescribe the same meds that would be prescribe for a child with that diagnosis.

David: And those would be?

Dr. Roth: The stimulants, like Ritalin, and the antidepressants. For "inattentiveness" one would want to be certain they are not dealing with a petit-mal type of seizure disorder.

tracy565: Have you heard of the new drug, Pagoclone, and does it seem to have positive results with panic disorder?

Dr. Roth: I have not heard of that drug. I'm not sure that you have spelled it right.

cd: I was on Effexor (Venlafaxine) for about six weeks, then went off after hearing about withdrawal. I have been having weird brain jumbling. Why is this? I called my doctor and he said Effexor is one of the safest anti-depressants. Is it really, and what is this brain scrambling stuff?

Dr. Roth: You might have been talking Paroxetine. One should never go off meds quickly and that may be a withdrawal response. I have not heard of such a symptom but no meds should be stopped abruptly.

David: What are the consequences of sudden withdrawal from some of these medications?

Dr. Roth: It can be different depending on the medication. Anti-anxiety medications are the most dangerous to stop abruptly. Discontinuation of anti-depressants may cause a relapse of depression. Likewise, stopping lithium may cause a manic relapse.

David: Why are anti-anxiety medications the most dangerous and what can happen?

Dr. Roth: Stopping a moderately high dose too fast for some time can cause a seizure.

Serena32: Is there danger in taking more than one antidepressant at a time or being on too many psychotropics at the same time.

Dr. Roth: Certain anti-depressants should never be combined. These are primarily MAO inhibitors. One also has to avoid certain foods while on these MAO inhibitors.

David: And that's something you can get from your doctor or pharmacist.

lilly2: Is it necessary to take medications to recover from eating disorders such as anorexia and bulimia?

Dr. Roth: Medications can be helpful with those disorders. But they can be helped a great deal with psychotherapy also.

insight: Can you please comment on the relation between root causes of illness and psychiatric medications. There is concern that although medications can aid healing, and/or control symptoms, it can also interfere with healing - again depending on the root cause and the psychiatric illness involved. Your response to this would be appreciated.

Dr. Roth: You can't always wait to learn the root cause of an illness before prescribing medications. If a person is suffering from severe symptoms, such as sleeplessness or more severe symptoms of depression, then meds can relieve these symptoms so a person can concentrate and make therapy work for them. They can't use therapy if they can't think clearly.

David: What do you think about alternative medications or herbs for some of these disorders, i.e. St. Johns Wort, etc.

Dr. Roth: St. Johns Wort is one of the most widely prescribed meds in Europe. If someone wants to try it, they should try it, but you need to make sure that over-the-counter medications are not interfering with your prescription medication.

anonymous1: A friend of mine started on an antidepressant for the first time ever at three pills a day as prescribed by her doctor, only to go into seizures. Is this sort of thing common? Would this still have happened if the pills had been introduced more slowly to her system?

Dr. Roth: That depends on the dose of each pill, but it is very uncommon. I have never had a patient go into a seizure from medications. I wonder if she has an underlying seizure disorder?

David: Interesting you say that Dr., that you've never had a patient go into a seizure from medications because I'm getting a lot of questions about that and comments on experiencing that.