'I discovered 'combination therapy' by accident. The term refers to using a stimulant and a non-stimulant to reduce ADHD symptoms. There were no lectures in medical school on this therapy and no studies of it yet, in 2000, when I started my ADHD practice.'
). The results were mind-boggling. Patients who completed the study had remission-level responses— of more than 90 percent. Dr. Wilens’s patients weren’t just a bit better; their ADHD symptoms were gone and their attention was normal.
, which showed what most subsequent studies have shown — side effect rates were the same for combination therapy and monotherapy.Most adult patients in my practice who take extended-release stimulants need average to high dosages to achieve optimal symptom reduction. They typically report eight to 10 hours of medication benefit, and most require short-acting supplements to treat their evening symptoms.
At Heidi’s next six-month visit, she reported that her symptom reduction was very good in the evening. Stimulant effects declined much more gradually, and she couldn’t pinpoint when they wore off. Her ADHD-RS score was 10, and her SSR 80 percent. Her supervisor had noted several improvements on her latest performance review at work. Family life was better when she got home from work, although still a challenge. Heidi has taken that combination for several years without loss of effectiveness.
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