Don’t Overcomplicate Role of Medication

Don’t Overcomplicate Role of Medication

Dr. Hallowell recently started sharing content on TikTok and his video, “Don’t Overcomplicate Role of Medication” left users wanting to know more. So in this mini ep, Dr. H answers a few of the questions that came up like, “How does a stimulant help a hyperactive brain?” and “Do I have to be on medication for life?”

Check out all of the #NedTalks on TikTok! @drhallowell

Dr. Hallowell’s new book, ADHD 2.0, comes out January 12th. Pre-order Now!  Click here to pre-order your copy of ADHD 2.0.

Thanks to our sponsor, OmegaBrite Wellness! Dr. H takes OmegaBrite supplements every day and that’s why he invited them to sponsor his podcast. SAVE 20% on your first order at OmegaBriteWellness.com with the promo code: Podcast2020.

Click HERE to learn more about our sponsor, Landmark College, in Putney, Vermont. It’s the college of choice for students who learn differently. Dr. H has an honorary degree from Landmark!

Do you have a question or guest suggestion? Send an email with your thoughts to [email protected].

Distraction is created by Sounds Great Media. Our producer is Sarah Guertin and our recording engineer/editor is Scott Persson.

Check out this episode!

A transcript of this episode is below.


Dr. Ned Hallowell:
This episode is made possible by our sponsor, OmegaBrite Wellness. I’ve taken their Omega-3 supplements for many years, and so has my wife, and that’s why I invited them to sponsor my podcast. I’m proud to have them. You can find all of their products online at omegabritewellness.com and brite is intentionally misspelled B-R-I-T-E. Omegabritewellness.com. This episode is also sponsored by Landmark College, another institution that I have warm personal relationship with, in Putney, Vermont. It’s the college of choice for students who learn differently. Learn more at lcdistraction.org.

Dr. Ned Hallowell:
Hello. This is Dr. Ned Hallowell with a mini episode of Distraction. Today I’m going to answer a question that came up through my TikTok platform. I’ve recently started posting 60 second videos on TikTok, and they’re under the label #NedTalks on TikTok. They’re not TedTalks, but NedTalks. It’s about neural developmental experience discussed. NED. Neural developmental experience. Neurodiverse experience discussed. I’m sorry. Neurodiverse, N, Experienced, E-D discussed. NedTalks. Not TedTalks, but Ned talks. Oh, you get me going the bouncing around with words, which is what I love to do. Anyway, one of the NedTalks was about medication in treating ADHD, and the question came up. Can you explain how a stimulant helps someone who’s already stimulated? Namely someone who has ADHD. The explanation is simple, but I should add, it’s why categorizing these medications is so misleading.

Dr. Ned Hallowell:
The fact that it’s called a stimulant does not mean that it juices you up. They’re given a name… They’re anti-seizure medications that are good mood stabilizers, and so if you’re taking an anti-seizure medication, that doesn’t mean you have a seizure disorder. These meds are given labels, but their application may have nothing to do with the label. Now the fact is, a good way for you to understand why a stimulant helps someone with ADHD, who’s already very stimulated.

Dr. Ned Hallowell:
Think of my model for ADHD, which is you have a race car brain with bicycle brakes. You’ve got a powerful brain. Powerful, powerful brain. Active imagination, ideas flowing all the time, popping up all over the place, but you have weak brakes. You have bicycle brakes. Brakes that aren’t strong enough to control the awesome power of your brain. Well, stimulant medication like Adderall and Ritalin stimulate the brakes. They stimulate the inhibitory circuits in the brain that allow you to control the power of your brain. That’s how they work. They stimulate the brakes. Now, it happens that they produce the… You end up with more dopamine. We can get into all the neurotransmitters, but the basic sort of model that you can remember is, stimulant medication stimulates your brakes, thereby giving you more control.

Dr. Ned Hallowell:
Along with that question came the question, how long can these meds be taken? They can be taken for as long as they’re helpful. There’s no limit to how long. You can take them for decades, as long as they don’t cause side effects, and as long as they’re effective. Now, you don’t develop tolerance, so you don’t have to increase the dose over and over. I have people who are on the same dose of Adderall for 10 years. They didn’t change it at all. Once in a while, the meds will cease to be effective. Instead of increasing the dose, what you ought to do is just stop the meds for a few days, and then start them up again at the same dose. Often, they’ll kick back in. Why that works, I don’t know. Maybe it gives you… The neurotransmitter’s a rest. That makes no sense neurologically, but it makes sense intuitively.

Dr. Ned Hallowell:
Whatever. I’ve just found over my many years, that if you simply stop the stimulants for a few days, and start them up at the same level, they kick back in and are effective. This medication… By the way, these medications are not based on how big you are, or how old you are. Most medications in the world are based on milligrams per kilogram. The dose is based on how big you are. Not so with these. Some little people need a lot, and some big people need only a little. It’s a matter of trial and error, but once you find the right dose, you can stick with that for many, many years. People asked, “How long do I have to take it?” You don’t have to take it at all. ADHD is not a life-threatening condition. It’s not like insulin for a diabetic. You never have to take these meds.

Dr. Ned Hallowell:
You see, the ADHD is not going to kill you, but it can impair your life significantly, so you may find that you want to take it. Untreated ADHD can… Russell Barkley has shown this over a lifetime, reduce your life expectancy because of all the mishaps that can accompany untreated ADHD, but you don’t ever have to take the medication. Now, if you find a dose of a medication that you like, that helps you, that doesn’t cause side effects, chances are you will want to take it indefinitely for as long as it continues to be effective, and not cause the side effects. It’s really straightforward that way.

Dr. Ned Hallowell:
Then, what kind of doctors should you see? Again, I did another mini episode on this, but any doctor who has experience in prescribing. It’s got to be an MD, or a nurse practitioner, or a physician’s assistant who works with an MD. Anyone who has medical training can prescribe stimulant medication. That means psychologists can’t, social workers can’t, but psychologists and social workers almost always work with someone who has an MD, so they can refer you to their… What’s called medical backup, or whatever term they want to use for it, but someone who works with them, and can prescribe. You need to have somebody who has a medical degree, an MD, overseeing the prescribing of the medication. You’d never want to take these meds without careful supervision.

Dr. Ned Hallowell:
While they are very safe and effective, they can be dangerous if you are not… If you don’t know what you’re doing. If you do know what you’re doing, or working with a professional who knows what he or she is doing, then they are indeed among the safest meds we’ve got, as long as they’re used properly. They are controlled substances, so you have to take them again, with respect and with caution.

Dr. Ned Hallowell:
You never want to give these medicines away, you never want to sell them, you never want to… If somebody says, “Could I borrow one of your Adderall? I have a test.” You have to say, no, you can’t, and please don’t ask me again because it’s illegal. You need to be careful. In any case, medication is a powerful tool in the toolbox. Just work with a doctor who has plenty of experience in prescribing. Well, that’s it for me for this mini episode of Distraction.

Dr. Ned Hallowell:
Thanks to our sponsor OmegaBrite Wellness. Save 20% on your first order at omegabritewellness.com with the promo code Podcast2020. Please reach out to us with your questions, and comments by emailing [email protected] If you’re on TikTok, you can find me there with the username @drhallowell. I’ve posted lots of videos about common ADHD issues, each one only 60 seconds. Take a look, and let me know what you think.

Dr. Ned Hallowell:
Distraction is created by Sounds Great Media. Our recording engineer and editor is the wonderful Scott Persson, and our producer is the also wonderful Sarah Guertin. I am Dr. Ned Hallowell, until next time when I will still be Dr. Ned Hallowell.

Dr. Ned Hallowell:
The episode you just heard was made possible by my good friends at OmegaBrite Wellness. I take their supplements every day, and that’s why I invited them to sponsor my podcast. Shop online at OmegaBrite, and that’s B-R-I-T-E wellness.com.

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