Diagnosed w/ADHD, afraid to take Ritalin bc my brother is schizophrenic
December 8, 2014 12:18 PM   Subscribe

For as long as I can remember, I've experienced anxiety, depression, and concentration problems. After finally going to a therapist/psychiatrist for these, they think I have ADHD and want me to start on Ritalin. Problem is, my brother has schizophrenia, and I'm right in the target age range for it to hit me as well. Stimulants can trigger this. Thoughts?

I've spoken with my therapist and psychiatrist multiple times, and they've both told me I have nothing to worry about, and that I'm past the age range to become schizophrenic (not true: I'm 27, which is the median age for women to develop the disease.) One of my biggest fears is becoming schizophrenic, and obviously I have a ton of anxiety around this. I have a higher chance than the general population (10% vs. 1%) of developing schizophrenia because my brother has it, but I would desperately like to resolve these problems that I've had to manage my entire life.

MeFi ADHD'ers, what are your thoughts? If you were in my shoes, would you at least try Ritalin to see if it helped your situation? My psychiatrist doesn't think there seems to be a problem at all, but I'm not sure if she's super knowledgeable about schizophrenia.

posted by shotinthedark to Health & Fitness (16 answers total)
There's some research suggesting that buproprion (sold was Wellbutrin) also helps with ADHD to some extent, being a milder stimulant than Ritalin. Also, as a non-SSRI antidepressant, it's less likely to screw over your sex drive if that matters to you.

If your current doctors don't take your concerns about schizophrenia seriously, you have every right to find doctors who will. You don't owe them loyalty. Put yourself and your own health and peace of mind first.
posted by starbreaker at 12:24 PM on December 8, 2014 [3 favorites]

There are non-stimulant meds for ADD, which ironically I cannot remember the name of because I forgot to take my adderall this morning, but anyway my uncle takes it and has had excellent results.
posted by poffin boffin at 12:27 PM on December 8, 2014 [1 favorite]

oh but my point is if I were you I would try a non-stimulant option first.
posted by poffin boffin at 12:27 PM on December 8, 2014

As someone who started treatment for ADHD at your age, I'd say try it. It made such a big difference for me right away that if I was you, I'd at least want to see what a difference it makes.
posted by Oktober at 12:30 PM on December 8, 2014

There are non-stimulant meds for ADD, which ironically I cannot remember the name of because I forgot to take my adderall this morning, but anyway my uncle takes it and has had excellent results.

posted by winna at 12:35 PM on December 8, 2014

I say try it.
My understanding of schizophrenia, based on recent research, is that it's genetic. So if you're going to get it, you're going to get it. Ritalin may bring it to the surface faster or more intensely than would have otherwise happened, but it won't cause it. True schizophrenia is not the same as the stimulant-caused psychosis that happens in a very tiny minority of stimulant users. And the studies that associate stimulant use with schizophrenia are based on prolonged use during childhood, not adulthood toward the end of the target age range for symptoms to appear.

If there's a good chance it will help your life, take it.
posted by trivia genius at 12:38 PM on December 8, 2014 [2 favorites]

"The study, led by University of Melbourne researcher Rob Hester and his colleagues at the Queensland Brain Institute, investigated how the brain monitors ongoing behavior for performance errors—specifically failures of impulse control." Source
Stimulant meds aren't going to speed up any mental illness that may lurk in your genetic code. Try the Rx, see how you feel. Adderall changed my life for the better.
posted by Ideefixe at 12:45 PM on December 8, 2014 [1 favorite]

Response by poster: Dang, you guys are fast! Thanks for the speedy response. Trivia genius: this is partially true--yes, it's genetic, but not completely. Scientists are still trying to determine the environmental factors which can come into play to trigger it. If one identical twin, for example, is schizophrenic, the other twin only faces a 50% chance of getting it.

One of the main triggers frequently discussed is drug use and abuse. Cannabis-induced psychosis, in those predisposed to schizophrenia, may trigger the disease when it may otherwise have remained dormant. I've read the same of stimulants, and traumatic events (which makes sense with my brother; he was DX'd at 18, his freshman year in college, after suffering the death of my mother.)

Anyway. The dose I'm prescribed is pretty light (10mg/day), so I think I'll give it a try just to see what it does. I tried Zoloft a few weeks ago and had a horrible reaction to it (anxiety through the roof), so here's to hoping it helps. Will keep reading responses, thanks guys!
posted by shotinthedark at 12:57 PM on December 8, 2014 [2 favorites]

As someone who has two uncles with the disease I completely understand what you are going through. Watching what happens to someone you know when they come into the grips of this disease...watching them over time turn into someone....somthing...else. It's something that cannot be described. Only experienced.

You ARE passed the age of developing the disease. 27 is the Median age for DIAGNOSIS which is entirely different than the age for the onset of the disease. Most schizophrenics become diagnosed years after they first start developing the symptoms. At first they tend to keep the symptoms to themselves because they can. They usually start out in the late teens and early 20's and no one else notices something is wrong because the symptoms tend to occur far apart enough and the victim is afraid to share the weird things he/she experiences. By the time the symptoms get to the point where others start noticing there is an issue, the disease has gripped them to the point where medications may not work as well anymore. It doesn't always work this way. Sometimes it just takes a trigger to go into an all out attack, but usually this isn't how it works. Either way- medication works very well when the disease is caught early. If it isn't (and it very often isn't for the reasons mentioned) It doesn't tend to work as well. If you haven't had symptoms at this point your chances of developing it is almost none. Plus there's the fact that you are female and for reasons still unknown females have lesser chance of getting it as well. You are worrying over nothing. You will be fine. I realize that accepting this can be easier said than done.

As for Ritalin: I would try other things first besides that. I'm not too keen on the whole ADD thing and find that it is way overdiagnosed anyway. I'm of the belief that a real illness is something that hinders your ability to function well in ALL environments. Such as Schizophrenia for example. It doesn't matter what environment you put an unmedicated schizophrenic in; they are always going to be suffering, will always have trouble functioning in daily life and there will always be danger. But someone with ADD only suffers and has trouble in certain environments. In environments that are more open to creative solutions and flexible scheduling ADDers tend to do BETTER than their non-ADD counterparts. So is it really an illness? Or is it merely a social construct derived from the fact that over the past 40 years (when ADD first became a diagnosis) society's schools and professions have become less accepting towards creative solutions and flexible scheduling. In today's world finding a good paying job that is NOT 9-5, Monday-Friday, sitting at the same cubicle, doing the same thing, year after year can actually be difficult. Thereby making it seem like people who are not wired for this new societal norm have something "wrong" with them. I would suggest that you try to take Fish Oil tablets with a higher EPA than DHA 2-3 a day. I got this tip from a book called "The Depression Cure" and it really helps a lot. Takes about 3 weeks to kick in. If after a month of trying natural remedies you still feel you need something more re-consider the Ritalin only then.
posted by rancher at 1:20 PM on December 8, 2014 [1 favorite]

There's no conclusive proof any drug use is causal for manifesting schizophrenia that I know of, but many citing precipitation due to prolonged stress and trauma.

If anything, the ability to focus could immediately deal with all three of your main concerns. Not being able to think clearly can cause many people anxiety, long term anxiety leading to depression, depression causing more anxiety and unclear thinking, etc.

If anything, try something cleaner than Ritalin, like Adderall. It's not something that needs to build up in your body, you will know if it is effective in half an hour. What you should do is see a therapist for adult ADD, because not having the capacity to develop and exercise long term thinking and executive function tends to be the big issues with adults with undiagnosed ADHD. If anything, a lot of people who have issues that interfere with daily living mostly have problems related to ADHD such as a lack of long term thinking and impulsivity, such as with anxiety and depression where this moment's negative emotion seems like everything forever when it will pass. Once one is past a moment, the world is a lot bigger and more interesting because your ability to appreciate it is.
posted by provoliminal at 2:33 PM on December 8, 2014 [1 favorite]

My understanding of schizophrenia, based on recent research, is that it's genetic. So if you're going to get it, you're going to get it.

I don't think this is the full picture, even though there is a strong genetic component. Not all identical twins come down equally with schizophrenia. I believe it's still not totally clear why one person with the genetic potential for schizophrenia expresses the disease and another person doesn't. My understanding as a layperson is that there is an interaction of genetic and environmental factors, and so someone who suspects they have the gene is smart to weigh environmental risks. This is not advice about ADD meds ...just FWIW.
posted by third rail at 2:41 PM on December 8, 2014

Missed OPs update. Seconding that.
posted by third rail at 3:09 PM on December 8, 2014

But someone with ADD only suffers and has trouble in certain environments.

This is not true. ADHD affects a person's entire life.
posted by ocherdraco at 3:15 PM on December 8, 2014 [8 favorites]

Best answer: I think the thing you need the most is a doctor/therapist who listens to you - and who knows plenty about schizophrenia if your brother has it.

I'm sorry, but I just can't fathom a therapist prescribing a stimulant to you without 1) having a thorough knowledge himself of all the drugs for ADHD and their side effects, including the potential to trigger other illnesses, and 2) taking the time and energy to sit down with you and address your very legitimate questions in detail, considering all the factors involved - including your fears and anxiety about the schizophrenia and your reaction to the Zoloft, as well as your need for medication for the ADHD.

Obviously, I don't know the whole story, but it sounds like you know more about schizophrenia than your doctor and probably more than some of the commenters here, myself included, which I don't doubt; my sister had severe grand-mal epilepsy and our entire family learned everything there was to know about epilepsy at that time - that's what you do when you love someone who has such an illness.

Wishing you the best, whatever decision you make. Just remember that you are entitled to a doctor who knows his business, knows how to juggle all the factors involved, and works with you carefully.
posted by aryma at 10:26 PM on December 8, 2014 [1 favorite]

"But someone with ADD only suffers and has trouble in certain environments.

This is not true. ADHD affects a person's entire life."

This is an extremely vague statement. I never said it didn't effect a person's entire life. I said that they only suffer in certain environments. If you're entire life consists of a particular environment that is unsuited to ADD (as is the case with most people) then of coarse it will affect your entire life. When you change an ADHD'ers environment to something more suited to them for the most part they tend to excel... not even average but EXCEL. That is not an illness. That's like putting a math genius in a school full of talented visual artists and then prescribing him medicine because he can't paint a gorgeous landscape; thereby there is obviously something terribly wrong with him. Put him in a school where the curriculim is mostly math and then see if he still needs a prescription to succeed. Now I realize that in today's world it's not always possible to change one's environment so you need to make due with literally changing the brain chemistry with drugs instead, but this does not mean that the person is truly "ill". At least not in my book.
posted by rancher at 9:29 PM on December 16, 2014

I said that they only suffer in certain environments

This is an incorrect statement, much like the one to which ocherdraco is responding.
posted by poffin boffin at 7:37 AM on December 17, 2014 [2 favorites]

« Older What city in Southwest Florida is the best place...   |   Outside the circle of fire. Newer »
This thread is closed to new comments.