Send us Fan MailDoes our brain adapt to stimulant medication over time, develop tolerance, so that we require higher doses to achieve the same effect?When patients tell us their stimulant doesn't seem as helpful (after working well for a while), could this be tolerance? ... or could it be something else? To answer these questions, Dr. Elise Fallucco chats with Dr. James Waxmonsky, co-PI for NIMH-funded study: Examining Tolerance to CNS Stimulants in ADHD. 00:00 Introduction of Dr. James Waxmonsky01:26 What Is Tolerance?02:10 Clinical Evidence for Tolerance02:57 Longer-term Tolerance to stimulants03:40 "The Brain Moves Its Targets"04:16 Clinical Considerations in evaluating when "meds not as helpful": Changing Life Demands or true tolerance?06:30 Management of Stimulant Tolerance06:56 Clinical Pearl: Ask about increases in executive functioning and life demands07:40 Taking a break from stimulant medication08:14 Waxmonsky Longitudinal Study09:00 Weekend Holiday Design09:32 Recap - Do weekend holidays matter and reduce the need for higher doses?11:46 Quicker dose escalation in continuous vs. holiday groups14:00 Weekend Dosing Tradeoffs15:45 Growth vs Dose Myth and Mg/Kg Dosing17:35 Recap of how to Manage Tolerance17:57 Toolbox for Recapturing Effect18:37 Closing Thoughts19:04 Final RecapDr. James Waxmonsky is the Division Chief of Child Adolescent Psychiatry at the Hershey Medical Center, the University Chair in Child Psychiatry at Penn State and a Professor of Psychiatry at the Penn State College of Medicine. He serves as Co-PI for an NIMH-funded study, Examining Tolerance to ADHD Stimulants. Check out our website PsychEd4Peds.com for more resources!Follow us on Instagram @psyched4peds

Ask this episode

“What did the council decide on item 42?” — answered with the speaker and the moment.

Transcript

Related