stimulant meds and aspergers

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Hi everyone, I also posted this over on addforums, but thought I'd get input over here too, plus I've been meaning to create an account here, so this was a good excuse to do so.

I?m a 29 year old woman currently in the process of being diagnosed with ADHD, my psychiatrist says that she would have diagnosed me on the spot but it?s policy to also get interviewed by a psychologist, take the TOVA and MMPI tests (I go to a large academic institution, so stimulant drug seeking is common), so I?m currently waiting to do all that fun stuff.

One unexpected thing that came up was that she also thinks that I may have Asperger?s, which I wasn?t expecting at all. Since then I took the aspie quiz and got a 146 on the aspie side, 94 NT. With the Ritvo test, I met the threshold for a possible Aspergers diagnosis?with some areas being comfortably in the aspergers domain and some being lower but still above threshold, and with the Baron Cohen AQ test, I did not meet the threshold of 32? I hovered around 24-26 (I took it a few times), which is still higher than average NT scores?.I seem to be in a no man?s land between Aspie and NT.

Most people?s scores I?ve seen online seem to have a good correlation between all three tests. The thing is, there are certain things about Asperger?s I definitely can identify with. Like coming to the realization that I do work off of a script when I interact with people?a script mostly learned from trial and error and watching TV, also having obsessions with things?when younger it was things like Garfield books, dog breeds, and TV shows, when I hit the teenage years I would have secret obsessions on guys, which I occasionally still have but I try to suppress it because it?s just plain makes me feel icky. But other things I do not identify with at all?like not being able to understand sarcasm, which I can understand quite well, or being obsessed with small details?I?m a big picture type of gal.

My psychiatrist wants to see how I do on stimulants. If Asperger?s encompasses all symptoms of ADHD as I?ve read, why aren?t people with just Asperger?s taking stimulants? If I do have Asperger?s and ADHD would stimulants exacerbate the symptoms of the Asperger?s? Do people diagnosed with both usually take stimulants?

Asperger and ADHD can often have a lot of overlaying traits. The problem with ASD is that it can't be medicated away. It used to be thought that people on the spectrum couldn't even have any other mental health problems, yet they were given all of this medicine (often for ADHD) and it didn't help with some of the more difficult behaviors associated with autism.

Now research is showing that ASD can be comorbid with a lot of things, one of which is ADHD. If you feel like stimulants help you, then it makes sense you should be treated with them. A lot of us on the spectrum at least have SOME traits of ADHD and it might be beneficial to try stimulants if it's bad enough. If you can't even do chores, stay hygienic, do school work, or drive because of severe focusing problems and becoming distracted, it probably wouldn't hurt to try them.

I'm diagnosed with ASD but I was also diagnosed with ADHD at 16 and the person who evaluated me for ASD told me to look into mood disorders and ADHD also. It was fairly obvious to him that I was describing Bipolar and ADHD, and my focusing problems were SO obvious that during my ADOS test he could tell I had ADHD after 30 minutes. Stimulants did indeed help me, but I know I will have trouble going back on them because of college students abusing them.

I think it's good news they are testing you. That way, you have solid evidence behind the decision to put you on a stimulant. A warning: Different stimulants often will react differently. Even generic can have a different effect due to the inactive ingredients used. I do know that some people here (like myself) seem to have extreme sensitivities to medicines. On stimulants, however, I did completely fine. It even made me sleepy when I was supposed to sleep (I have insomnia). I was on Adderal XR 20mg twice per day. Looking back, that was probably overkill. Once per day is usually enough for the XR.

If you feel like you come down from stimulants all jittery and nervous, you may have to try another kind or adjust the dosage. It's important to tell your doctor about any adverse reactions so he/she can help determine the best dosage.

By the way, all of us aren't put on stimulants because all of us don't have ADHD. While we can have similar issues to ADHD, they have different causes within the brain. Sometimes the causes overlap but you still don't have ADHD. A lot of us have sensory problems that mimic ADHD but have nothing to do with it. Also, stimulants don't even work for everyone with ADHD. No medicine works 100% of the time, unfortunately.

Strattera worked for me

It doesn't work for a lot of people with ADHD, but when it does work, I've heard it's VERY effective. So if stimulants don't work for you, it is worth a shot to try that, too!

Thanks for the input everyone. Yeah you're definitely right in that the two conditions are acting on different parts of the brain but may produce the same symptoms...I guess I wouldn't be surprised that many people initially suspected with ADHD may actually in fact just have Aspergers...in that way, taking the TOVA test is a good thing...I'd assume people with just Aspergers would "pass" (ie not get distracted), or even if they didn't pass, they wouldn't do well on stimulants.

Speaking of stimulants, my psychiatrist lead me to believe that she would only be trying Ritalin or Adderal (those were the only two info sheets she gave me), with Strattera not even being brought up, but I'll be sure to ask her about it.

I guess I also want to figure out more of how ADHD layered on top of Aspergers would present. And some of the things mentioned earlier..not being able to do chores, being lax in the hygiene dept (don't worry, I still shower, but I just don't care much about "looking good"...never really have), or severe focusing issues on things that I don't find interesting...definitely resonate with me, and all these traits are definitely being exacerbated by the fact that I'm currently in a demanding professional program. But yeah, just how there are some things with Asperger's I don't relate to, there are certain things about ADHD I don't relate to as well, for instance, I've always done very well in school (even if during the actual class I doodled all over my notebook, but I only did it because it helped me concentrate on what the teacher was saying), and I don't necessarily jump from interest to interest quickly, I have quite a few long term interests that I still pursue.

I'm wondering if I don't have ADHD, should I pursue a possible look into an Asperger's diagnosis? I don't know how much it will help me, I'm also wondering if it could be PDD-NOS

Your psychiatrist is actually practicing evidence-based medicine. Stimulants are the first line of treatment for ADHD. Only if those don't work or have major side effects should someone consider something like Strattera. That medicine can have horrible side effects (very big risk of suicidal ideation with it).

I don't think the PDD-NOS diagnosis is valid anymore. I think it was removed from the newest DSM (V). Regardless, it's probably helpful to look into both for you. The only way to know if a stimulant will work is if you try. If a stimulant does work and takes away your behaviors that "seem" autistic, I would argue that maybe you aren't autistic after all. The behaviors that remain would be good indicators as to what is also going on. But yes, ADHD and ASD can be confused and misdiagnosed.

I was diagnosed with ADHD when I was 16, but not ASD until a few months ago (I'm 23). I'm also female, so neither ADHD nor autism was really considered based on my gender. I have pretty obvious traits of both. I would say for me, there isn't a clear cut line where ASD ends and ADHD begins. I do know that stimulants worked for me, but I still had my autistic behaviors. I will make a short list of what changed when I took a stimulant:

1. My mind slowed down. Usually, it's going at this very fast pace ALL of the time.
2. I was able to focus on one thing instead of my mind being on autopilot and switching to different tasks every few seconds
3. I was able to do some chores without prompting.
4. I was able to receive directions somewhat easier, but I still had problems with taking things too literally (autism).
5. I didn't stop (literally) bouncing off of the walls, but I felt less like a speed racer
6. I talked a lot less, with less interrupting, and didn't change topics dozens of times within a short period
7. It actually made me sleepy when it wore off. I felt like someone gave me a nice hot cup of tea and I was just a lot calmer
8. The most important change is I was able to read words without having to reread the passage at least 6 times before I understood it. My eyes weren't darting around, and the words didn't feel like they were jumping off of a page.

It's important to remember it didn't make my life perfect. The changes were somewhat subtle because I didn't have other coping skills like a supportive environment, I was on other medications that weren't good at the time, and I didn't really understand how I could help my ADHD without medicines. I just thought ADHD was another diagnosis I was given, and didn't pay attention to it.

However, the stimulant worked so well that I felt like the edge of my freakishly "always running" brain was toned down. That allowed me to finally do things I wasn't able to do before. Here are some things I still had trouble with (my autism):

1. Social skills
2. Eye contact
3. Trouble with talking in "odd" ways
4. Meltdowns
5. Special Interests
6. Extreme clumsiness
7. Always analyzing situations (all day long, over and over)
8. Not liking change
9. Very detailed routines



I hope this helps you. By the way, a lot of us have different traits of autism. I don't think ANYONE fits every single trait that can be listed. If you're talking about the specific criteria, the DSM V will tell you what is needed for a diagnosis. We all vary in regards to level of functioning, IQ, special interests, and more. Some of us don't even have special interests, and instead have routines or motor repetitions.

Not all with Aspergers have ADHD, not all with ADHD have Aspergers, but you can have both apparently. Or so I'm told. I have Aspergers, and I also am diagnosed ADHD so I take focalin (not adderall because of my tics) and it helps.

Well, I had my neuro-psychological appointment the other day and learned that I'm just a "nerd with ADHD" (at least that's what the psychologist said, not kidding haha...don't worry he appeared to be a nerd too, so it was ok). So it looks like no Asperger's here. My psychiatrist mostly was suspecting asperger's because I have a hard time making friends (though now that I think about it I do have many acquaintances...but not very many on a close friend level). Hopefully with adderall (or whichever med I start on) and some talk therapy, I can start perhaps getting more confident in social settings.

hiya ZB welcome to the club

it's quite an interesting club. Nerd + ADHD = you want to study and over-achieve Lisa Simpson-style, but you're constantly fighting your inner Bart Simpson and are easily distracted by shiny objects...so I always thought I was just a fraudulent nerd....it's nice to have some confirmation of the truth though!

I am constantly fighting my inner HOMER simpson.