Primarily innattentive type ADD (4-19-07) edit

You wrote on the discussion page

I would like to know if the different medications are prescribed based on the three different types of ADHD. These types are: Primarily Inattentive, Primarily Hyperactive/Impulsive, and Combined Type. I am diagnosed with Primarily Inattentive [commonly referred to as ADD] and have been prescribed Concerta, then Adderall XR, and now Daytrana; none of these have produced any effect whatsoever. If anyone has any information on a) if different types of meds are prescribed for the different types of ADHD and b) information on treatment of ADHD/preferrably treatment of Primarily Inattentive/ADD type. And c) any explanation as to why the medication does not work? I have an idea that I am willing to go into depth about if you ask. I have read about people claiming the medications are simply placebos in the sense that the meth/amphetamines do not affect concentration. Is there truth to these statements? MattTheMan 01:39, 19 April 2007 (UTC)

I am going to try to answer your questions but I am not a doctor so I might be a little off. Most of my information is coming out the very great book "Delivered from Distraction" by Hallowell and Ratey. (Worth a good read) I have inattentive type myself. From what I have read about the stimulant based medications like Adderal XR and Daytrana, they seem to work right away unlike some medications like antidepressants where they must build up over time to a useful concentration. I don't know about non stimulants like Strattera. I believe different medications may be recommended for different types of ADHD, and yours seem typical for inattentive. Any given medication might not work for 10 to 20 percent of people (according to book I listed above), but you have had three so far. So I don't know what to say.
The medications certainly aren't placebos. FDA studies show they definitely work and from personal experience I can easily apart tell the days when I forgot to take mine and when I did but forgot that I had. What the medications should do is (quote from book above) "improve mental focus and bolster executive functions (e.g., planning prioritizing, organizing)." They don't prevent you from getting distracted through. There are plenty of times were I have gotten concentrated on something that I shouldn't have been doing. It just happens less often that when I am not on the medication. One cause may be that your dose is just not high enough, **Not medical advice because I am not a professional** You may ask your doctor about the possibility of increasing your dose. But read what I have to say next.
VERY IMPORTANT: Sometimes ADD comes with comorbid disorders or other disorders have symptoms similar to ADD that your current medication cannot treat. Carefully consider the areas of your life that your ADD affects. Is is just when you have to read a lot of stuff or listen to people? Does the concentration problem come and go or is it all the time? How did your doctor diagnose your ADD? Did he/she look for other possibilities, and did you take lots of different tests or meet with him more than once? These are very important questions to ask. Learning disorders, dyslexia, auditory processing disorders, depression, bipolar, or something else all together: these many cause symptoms similar to ADD but may require a different treatment. The lack of concentration may have a different underlying issue. Sometimes doctors just don't go into depth enough and may misdiagnose or overlook other issues. Read some articles about cases where a simple diagnosis is not enough or doesn't catch the whole issue. (the magazine ADDitude had one about this a while back called "How not to be diagnosed" or something like that) If you think it is relevant, consider checking with your doctor or a specialist about other causes and be sure to be very specific when describing how your concentration falters.
Based on the book I mentioned above, there are other things you can be doing that may help. Diet, exercise, behavioral exercises (hopefully these will be discussed in the article sometime soon.) This book talks about them. It's a great read.Sifaka talk 20:56, 19 April 2007 (UTC)Reply

Another response edit

Haha I'm also responding to your question on the ADD/ADHD page:

I am currently a 4th year pharmacy student, about to go on clinical rotations in a year so I suppose I can offer some insight into the kinds of things we've been taught. The most effective medications for ADD/ADHD are the stimulants (which I see you've tried) and Strattera, which works differently - more like antidepressants. The only differences among the stimulants, like Ritalin and Adderall and all of those is how long they stay in your body for the most part. Drugs like Concerta are extended release, while Ritalin is immediately released, and has to be taken more often throughout the day. Less commonly, doctors may prescribe things like tricyclic antidepressants or clonidine (but the side effects are horrific so these are definitely not first choices), or selective serotonin reuptake inhibitors, like Prozac, although results from these generally aren't as good. Buproprion (Wellbutrin) has also been used. We haven't been taught that there's a distinct difference in treating the different types of this disorder - this may be something I pick up from practice. As for why the medication doesn't work, the way the medication works is as follows: ADD/ADHD may be caused by a decrease of dopamine in the brain. Because of this, the patient has an imbalance of the other neurotransmitters, like serotonin or norepinephrine and all of these have to do with normal functioning. The stimulant medications cause more dopamine to be released, regulating the balance in the brain. If you do not, in fact, have a deficit of dopamine, the medications would not work. Either that or your body isn't able to make more dopamine, even in the presence of these medications? I'm not sure what you're trying to say with the placebo idea, but there is most definitely a stimulant medication contained in these pills! If you give Adderall to a person that doesn't need it (ie, they don't have ADD/ADHD), you will see an overactive response. Could this be what is happening? Meligan

Scopes edit

There are some general rules when picking a scope, which most people seem to ignore. Always, always, always start with the intended use, and work out the minimum requirements, then find the scope that best meets those minimums, and costs as much as you can afford. Bells and whistles that you don't need add cost, and if, like most people, you have a budget to work with, those bells and whistles merely serve to lower the quality and capabilities of the scope you can afford. In other words, if you need a 4x scope for shooting in daylight and have a $400 budget, then by the best fixed power 4x scope with a small objective lens you can find for under $400, not a $400 4x-16x variable with a 50mm objective. You will get a much lighter, more compact, and far more reliable offering with the small fixed power scope, because that $400 all goes into the highest quality components and workmanship, not into more moving parts and bigger optics that you don't need. Many people go way overboard in terms of magnification; this is bad. Pick the minimum you need, and don't get more than that. Every bit of magnification you add cuts down on your field of view; unless you're shooting varmints or bullseye competitions where 1/10th of an inch at 100 yards matters, and the targets don't move, then stay away from the high power magnifications, because any advantage you might gain will probably be more than offset by the loss of field of view.

 
Shooting with both eyes open, the 5 MOA Tasco ProPoint II on the rifle at bottom will let me shoot a nickel sized group at 25 yards, a distance where the dot is 1.25" in diameter

Since you're looking at red dots, and quote a review on an airsoft page, I'll assume for a minute you're looking for a sight for something like a BB gun, airsoft gun or paintball marker. Forget magnification, it's not worth what you trade off to get it. None of these are going to give you the accuracy to require any magnification; I know BB guns and airsoft guns generally give me about a 2 inch group at 20 feet, and my limited experience with paintball markers showed much more variation than that. So even the biggest, fattest, dot I've seen, 20 MOA, is only going to cover about an inch and a third at that range.

With magnification you also loose the primary advantage, in my experience, of the dot sight, which is the effectively unlimited field of view. Shooting with both eyes open, the brain just blocks out the view of the scope, and all you see is the dot. Since the scope does not produce a virtual image of the target, just the dot, and since that image is not distorted measurably by the optics, then you just raise the gun, put the dot on the target, and shoot. Red dots are used by top bullseye pistol shooters, as well as IPSC shooters, because they provide as much precision as is needed to shoot a perfect round in bullseye (and mind you, that is hard enough that NO ONE has EVER shot a perfect 2700 point match), yet they are the fastest type of sight to use in competitions where every millisecond counts. If you're looking for an optical sight for anything but long range rifle shooting, I think the red dot provides the best solution, be it a handgun, carbine, or shotgun.

Next is the issue of tube vs. tubeless designs. They both work the same way, with a curved piece of constant thickness glass treated to reflect certain wavelengths, typically red, of light. Since the glass does not vary in thickness, it does not act as a lens to the light passing through, but the curved surface makes it into a mirrored lens to the reticle image. The tubeless designs are lighter, but despite their claims, do not really offer any wider field of view than a tube scope with the same sized objective. While it is true you can see through an tubeless sight at, say, a 45 degree angle, you can't see the reticle, so the fact that you can still see the target is moot. A tube design actually provides, in my experience, a slightly faster acquisition because you can use the body of the tube as a rough sighting guide, which gets you close enough to the correct alignment that you can then pick out the dot. Tubeless sights seem to be more prone to "hunting" for the dot. Now, if you're a professional shooter, that's not an issue; you could look at the target, close your eyes, draw the gun, and be right on target just from kinesthetics; ditto long guns where you have a stock to provide a reference point. So, if you are sure you can reliably get close enough to get the reticle in the window every time, then a tubeless sight may be the way to go, to save weight, but if you're not sure of your ability to find the reticle the first time every time, a tube may help you out.

One more thing that tube sights have over tubeless is the ability to attach things to them. The ProPoint II, for example (my favorite, I have one in 5 MOA and 10 MOA dot size), comes with:

  • A set of amber lens covers, which serve to both increase contrast on many targets and keep the optics clean
  • A ocular side extension, which is textured and painted matte black on the inside, which serves to kill reflections off the optics when the sun is at your back
  • An objective side extention, also textured and matte black inside, which prevents excess light from washing out the image when the sun near the target
  • A cross-polarizing filter that lets you block out glare, and up to 95% (at a guess) of the light coming into the scope. This lets you dim the image of a very bright target without dimming the reticle brightness--this is effective enough I can literally aim at the sun and still make out the dot.

The picture of the 10/22 shows the scope with everything but the amber cover on it; with the extensions and polarizing filter off, it cuts about 1/3 off the overall length. For paintball and airsoft, I'd say one major plus of the tube design is the ability to put a set of see-through lens covers on it. In addition to the ability to the amber or yellow filter (which helps increase your eye's ability to pick up low contrast changes in green and red objects) it adds a level of protection to the scope, so that if it is hit by a pellet or paintball, the cover will absorb much of the force of impact, not the scope. An important consideration if someone takes a shot at you with one of those ceramic .29 gram pellets. scot (talk) 14:44, 1 May 2008 (UTC)Reply