Borderline ADHD-PI symptoms due to possible ASD. Which meds

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Well, would you believe that I think the subject line is too short to put the entire subject in.......

So, as my signature suggests, I effectively have such distraction symptoms "ooh, a bird" "ooh, a crisp packet"

Of course, some would say this is beneficial to a degree and better than someone walking into a brick wall etc. (OF course, my alertness did not stop me from walking into a lampost once but that's another story)

So, I thought I would get a trial of ADHD meds, just to see if my attention span would be a bit more positive but the ADHD specialist said "I think you are borderline ADHD and I think that the ADHD meds would perhaps make you a little bit much over focused on analytical issues etc, ie maybe like obsessive even more?

I can reduce everything to a debate....a long debate, subject to my limits.
What really frustrates me is that I never did well at school because when I tried to work, it was just too much effort. My reports were always easily distracted, talks too much, could do better, etc etc.

Of course, I appreciate that back in my primary school days (1980-1986) everything was more relaxed in the United kingdom and perhaps teachers were being polite so as not to make the reports too negative or even too glossed over.

On the many questionnaires I did (about 500 questions + more at the 3 hour meeting) I got nearly always enough inattentiveness for adhd-pi.
I have anxieties and self conscious issues as well, ie, I don't really like to hear my voice in public most times...

So, I really wonder, if I tried an anti anxiety or dopaminergic, even tiniest doses, would this help me perhaps, or would the side effects not be worth it.

Currently I've been a total underachiever and avoided college for social and "learn in my own time" reasons.

I hate deadlines and stress crumbles me (if most would call it stress)

So, what drugs "might" help me, based on your experiences?

Meds can work very differently for different people. Work with a psychiatrist to find the right ones for yourself. I take Concerta and love it. It helps my ADHD without any noticable side effects. One of my son's can't take anything for his ADHD because it causes a lot of problems with his mood issues, but he takes other things for mood. Concerta works well for me, but for another of my son's it is horrible. He feels like a zombie. For him Adderall works like a charm.

If you work with a Dr you should be able to find the best solution for yourself.

You say your symptoms are mild; have you tried caffeine? It seems to work for some people with mild ADHD. Caffeine is addictive and a systemic stimulant; so it's not necessarily the best choice; but it's available over-the-counter in many delicious varieties, and is very safe as far as drugs go (so much so that it's given to preemies with apnea of prematurity to prevent them sleeping too deeply and forgetting to breathe!). Yes, you can OD on caffeine; but you'd have to try ridiculously hard.

I have heard of people with ADHD and autism combinations getting good results from just about every stimulant on the market, and equally, heard of them having annoying side effects or just not being helped at all. So, your best bet is to try them until you find one that works.

You're lucky in one respect: Stimulant medications, if they work, will work fairly quickly. You usually begin to notice better focus as soon as your body absorbs the substance. If it's not going to work, or if you get unpleasant side effects, you'll know and you can try something else.

However, there's one specific issue with autism, and that's the higher proportion of us who tend to be very sensitive to psychotropic meds. If you are one of these--and you mightn't know until you tried--you might get bad side effects from a normal dose, but be helped by a dose so small the pills are usually only given to toddlers. If you are medication-sensitive, as I tend to be, then you will want to get the doctor to start you on a very low dose and work up if necessary.

The medication that finally gave me some help was Adderall; and I started out at the smallest dose of Adderall available. I lost my appetite for a week; but eventually I got used to it and the dose was increased to one and a half times that much. I had been given an adult's starting dose of Ritalin before; and the medication hit so hard that I found myself sitting and staring at the wall, unable to initiate any actions. Extended-release and low dosage corrected that problem.

I did not get any benefit from Strattera, which is a non-stimulant ADHD medication. Others have benefited, though. The drawback with Strattera is that it takes a while to take effect, because it works more like an antidepressant than a stimulant, so you won't know right away whether or not it does you any good.

I need to note, though, that medication is only a tool that works as much as you're able to make use of it. It may allow you to concentrate better; but if you don't set out to learn the skills that make use of that concentration, then you won't get any benefit. If you have a counselor, talk to them about it; if not, talk to the doctor you're talking to about your medication if you don't have a counselor, and see about getting one. Make sure they know you're asking for support with learning things that will help you compensate for disorganization and poor concentration, rather than wanting to talk about emotional issues.

Be really careful about caffeine pills. I used to take them, but I discovered they wrecked havoc on my blood pressure. Now, the only caffeine I get is in the form of coffee, tea, and rarely, sodas. Chocolate, too. I don't drink energy drinks, or Mountain Dews. I abstain from No Dose, too.

I messed with caffeine in massive doses from a "very little tea or coffee intake" starting point.
ie. I scaled up to 10 teaspoons nescafe in one mug, drank one at 5pm, one at 4am before bed.

Did not notice anything to be honest.


I'm not sure if caffeine has ever had an effect on my relevant symptoms but I know it stimulates other parts of the body so its not ideal.

OBviously 500mg caffeine in a drink, before bed, without any issues is rather weird I think.......especially, as I mentioned earlier, I don't even drink much caffeine, in fact I hardly "self-medicate" at all, which is what made me approach the adhd clinic with an opening statement of "I'm not really sure I have adhd at all"........

Maybe it is all anxiety, depression and thinking.......to the extreme.

Still, i'm borderline hypogonadic(undesirably low Testosterone) due to obesity it seems (22stones), as indicated by my SHBG status, so thats certainly another thing to think about. (Maybe some symptoms will be alleviated by a healthy amount of testosterone supplementation.....)
Trouble is, I look for root causes, not to treat the symptoms really....
However, sometimes, the causes are hard to treat.

Some people don't like caffeine. My mom's like that. It doesn't do so much for me nowadays, because I substituted coffee for orange juice and that works just as well. Too much caffeine is supposed to make you lethargic or drowsy, one, because it overstimulates the adrenaline gland.

Didn't notice any adrenal issues either. It's just always a blunt response.

Just to add, too much caffeine can trigger anxiety attacks.

I have ADHD-PI and ASD.

The medication has been mostly successful for me. I do get increased hunger and a bit shaky, but usually eating something small and doing something like reading or studying can stop the shakiness. I can focus better and for longer, talk more to people and I'm not as moody.

Sometimes if I take meds straight after coffee I can get a bit jittery so I wait at least an hour before taking them.

I did awful in school too. I could barely understand the work and because I talked 2% of the time I was in the classroom I wouldn't ask for help. Or perhaps it was pride? So I got bad grades, was home schooled, went back to high school, and finally completed year 10/11/12 at a college. I had the same problems in that college like I did at school.

I was nervous about the meds but I only require a small does (10mg) for sustained concentration and more energy for 6-8 hours. If I need more I take one more.

ADHD-PI isn't just about not being able to concentrate it's about low energy which is often mistaken for laziness. Usually they're not the type to talk in class. They're not picked up as often by teachers because there's no behaviour problems, but then I guess everyone can have it in different ways. You could even be combined PI and PH.

I suppose you could try the meds. They do make me more obsessional but I like it. For me the problem was mental and physical exhaustion as well as moodiness and anxiety. They do help with anxiety. I'm usually a bit paranoid about hearing and seeing things.

Good replies all. Thanks. Obviously though, I'm still looking for more so bump bump.

I should clarify that when I wrote borderline ahdh-pi, I should really have been clear that because I never needed to self medicate with alcohol or coffee, tea, cola, caffeine tabs, illegal drugs etc, I sort of believe that my "symptoms" are just a side effect of the ASD. At the end of the day, stims will help anyone who is compatible, hence why drugs like amphetamines have a nickname of speed etc, probably due to those believeing that it gave them a productivity boost.

I read that some people actually get more social on anti-psychotics/dopamine reducing drugs. This is weird, but is it a marker simply that without the beer, social stimulation, the "apparently reduced" dopamine now leads the person to more desperate measures to get that hit, even to the point that they are not putting themselves at more risk than they used to?

Here's an article which reminds me of ..........me in some ways.

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Summary a totally healthy student with healthy family background is reduced to anxiety, fear, detachment and more all by dopamine antagonistic drugs. Well, when you consider that parkinsons disease has big connections with dopamine, is it any wonder that, theoretically, a lower than functional amount of dopamine in D2 and D4 areas of the brain, leads to "some" of the symptoms, albeit far less pervasive.

I don't think it's just as simple as dopamine obviously, as from what I've read, one neurotransmitter can affect many variables.

Ahem....link..

http://www.reuniting.info/science/artic ... l_distress

Yes, I know its not statistically significant especially as its only 1 student, but the symptoms are very interesting.