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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 2 of 2. This is the beginning of the thread.
Posted by Philidor on August 27, 2004, at 12:33:41
I know I've posted this link before, but there's a reason I'm doing it again (besides the fact that it offers a fascinating, non-technical intro. to the subject.)
Dr. Patrick Cosgrove, a psychiatrist, has treated many people for many years, esp. children, with ADHD, using stimulants like Ritalin. And his opinions, along with his blunt criticism of his collegues, have made him controversial to say the least. But one point in particular intrigues me:
"Ritalin and Dexamphetamine tablets take too long to get from the mouth to the brain to make anyone addicted to them....
"Tolerance is when a person on Ritalin or Dexamphetamine needs progressively increasing numbers of tablets to keep the beneficial effect of the treatment the same. This happens because the enzymes in the liver and in the gut inactivate a greater and greater percentage of what you swallow over the weeks and months. It's the body's defence against foreign chemicals taken by mouth.
"Psychiatrists get confused between addiction and tolerance. When a patient is tolerating Ritalin or Dexamphetamine, they think he or she is getting more and more addicted....
"Q. Well, that's not too difficult! You need an increasing dose over time to stay where you are! And this is not addiction.' Does this go on for ever and ever so you end up shovelling tablets into you mouth?
"A. No! This tolerance, this inactivation of the tablets swallowed has a ceiling. There comes a point where the gut and the liver stop trying to compete with the doctor, and the tolerance stops. The tolerance is capped!
"Q. It's what?
"A. It's capped! The tolerance is capped i.e. it has a ceiling so you never get anywhere near having to shovel tablets in."
http://www.adders.org/info28.htm
Now, I have never heard this before. Has anybody seen any evidence that just raising the dose will defeat tolerance and allow you to stabilize your dosage?
Phil
Posted by TheOutsider on August 27, 2004, at 14:02:54
In reply to Tolerance vs. Addiction, posted by Philidor on August 27, 2004, at 12:33:41
Dr Cosgrove was my doctor, he was a very nice guy, although I don't really know what he was like as a doctor, I wasn't with him for long enough.
I will say that he was far more open to knew ideas than the average p*ss poor uk Pdocs!He was forced to retire, because (i think) he disagreed with UK policy so much. :>(
Regarding his theories on tolerance and addiction I'm not sure whether its right or not.
He prescribed me dexedrine at a final dose of 30mgs a day.
I didn't get addicted, but I think I did build up tolerances.
This is the end of the thread.
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