Saturday, May 16, 2009

Why the Menstrual Cycle may affect ADHD Medication Dosing Levels

Do hormonal fluctuations result in variable ADHD medication dosage levels across the menstrual cycle?

We have investigated the impact of gender on ADHD in a number of earlier posts. We have covered topics such as:


Clearly, there are a number of boy/girl differences in the root causes, diagnoses and treatment methods for the disorder.

However, we need to investigate whether intra-individual differences are also an important factor, especially where medication treatment and medication dosing levels are concerned. Based on a number of studies, it appears that women may actually require different medication dosing levels depending on where they are in their menstrual cycle. Additionally, post-menopausal drugs such as estradiol patches may also alter the drug effects of certain ADHD medications such as amphetamines. The main culprits are most likely fluctuating levels of estrogen and progesterone.

Here are brief summaries on some of the relevant studies and their findings. Wherever possible, I will include a link to the original studies:
  • The link between Estradiol treatment and amphetamine medications: This study focused on whether pretreatment with estradiol played any role in the reaction to amphetamines. The drug used in this study was D-Amphetamine, which would correspond to the medication Dexedrine, however, this is also the predominantly active compound in medications such as Adderall or Vyvanse (once this "pro-drug" is metabolized). It is unclear at the moment whether chemical "cousins" to amphetamines, such as methylphenidate (Ritalin, Concerta, Daytrana, Metadate), also exhibit these fluctuations when combined with estradiol-releasing drugs.

    The study found that for females who took estradiol-supplementing treatments during the early follicular phase (pre-ovulation) of the menstrual cycle experienced an overall greater "stimulating" effect of the amphetamine medication (taken as 10 mg of amphetamine). This may suggest that a slightly lower dosage during this stage of the menstrual cycle might be warranted, and (as this blogger's personal hypothesis) may actually affect the addiction potential of ADHD stimulant drugs such as amphetamines.

  • Another study by the same group found that estrogen may be responsible for some of the heightened euphoric effect felt from amphetamine-based drugs. However, the hormone progesterone may actually counteract some of this euphoria. During the luteal phase of the menstrual cycle (after ovulation), high levels of both estrogen and progesterone are seen (although levels of both of these taper off going into menstruation), so the effects of estrogen may be curbed. During the late follicular phase, where progesterone levels are low and estrogen levels begin to spike, the "high" may be at its peak, especially if stimulants are involved.

  • A case study found that an increase in inattentive symptoms coincided cyclically with the menstrual cycle for a patient who was undergoing treatment for newly-diagnosed ADHD with a twice-daily dosing regimen of the stimulant medication Concerta.

  • The findings from these two studies suggest the possibility that a slightly smaller dosing schedule with amphetamine-based ADHD medications (such as Adderall, Vyvanse or Dexedrine) may be warranted during the follicular phase. However, during the luteal phase, when progesterone levels are higher, the amphetamine-based effects are less pronounced. This may correlate to a slightly higher dosing regimen for amphetamine-based treatment for ADHD and related disorders.

  • While there is a relatively good theoretical basis for this assertion above, practical consideration measures must also be considered. Based on the relative scarcity of studies (besides the 2 mentioned above) on the amphetamine-menstrual cycle interactions, it is unclear as to how pronounced the medication change should be.

    For instance, should someone taking 10 mg of Adderall during the follicular phase boost up to 15 mg for the luteal phase? 20 mg? 30 mg? Additionally, hormonal fluctuations vary during the phases themselves, such as the estrogen spike during the late follicular phase. Questions abound, especially when dealing with the brief ovulatory phase as well.

This blog post hopefully introduces what may be a new consideration to women who have ADHD and are currently taking stimulant-based medication treatments. Perhaps this posting simply confirms what you have already experienced.

Nevertheless, given the fact that administering variable levels of medication based on cyclical patterns such as time of day (like ramping up methylphenidate concentrations via controlled release formulations to offset "acute tolerance" based effects), and the fact that individuals with ADHD may experience seasonal variations in symptoms, at least suggests, that variable dosing of medications across the near-monthly period of the menstrual cycle may prove to be beneficial treatment strategy for females with ADHD.

Add to Technorati Favorites

18 comments:

citrate sildenafil said...

It is certain that the main culprits are most likely to fluctuating levels of estrogen and progesterone. So this is what we should focus

acomplia buy said...

I heard what amphetamine is very dangerous for life is it true?

retirement homes in costa rica said...

thanks for the info, is very good!
retirement homes in costa rica

Handwriting analysis said...

So far, I managed to go though only some of the posts you have here, but I find them very interesting and informative. Just want say thank you for the information you have shared.

www.camobel.org said...

It can't really have effect, I think this way.

Anonymous said...

I'm a woman in my 30's, finally diagnosed with ADD. Medication helped so radically - doctor and therapist were very pleased.

But I kept having to change the meds every month (Adderall) because of fluctuating response. Doctor became wary of me. I became wary of me - what if I'm an addict?! 5mg went to 10, then 20. I was too high on the 20, so I'd skip. Other times, it wasn't enough.

Eventually, the doctor's and pharmacist's suspicious questions became embarrassing and I quit getting meds.

I'm managing by not eating gluten, corn syrup, or other processed foods. Life is better. But only 2 1/2 weeks of every month: 3-4 days before menstruation, through 3-4 days after ovulation, I feel great, energized, organized, human. Thereafter, I lose motivation, feel socially awkward, can't finish tasks, etc.

Repeat. Repeat. Repeat.

I will continue doing my own research on alternative options for the weeks my progesterone is higher. I know it's hormonal, but I can't put off my clients by telling them that!

Also, yr captcha words are nearly unidentifiable... pick a slightly-less secure setting?

Anonymous said...

I have been using ProGest, a progesterone cream, to counteract severe chronic pain caused by PCOS and estrogen dominance. In the several months I have been using progesterone, my ADHD seems to have gone away, and I use no other medications or treatments. I am now able to add up in my head long strings of numbers, concentrate better at work, remember things better, and I have lost those ADHD traits that are so maddening. I am wondering if I ever really had ADHD or actually had a progesterone deficiency and was mis diagnosed? It feels so good to be clear headed!

Anonymous said...

I've had the exact opposite affect to my stimulant meds as this study reported. I am currently taking Vyvanse and love it. I was taking Tri-sprintec where the progestrogen levels stay consistent and the estrogen level increase weekly. The first week I was great, second I was okay and by the third I was a complete scatter brain again and couldn't even tell I took my ADHD meds. I've recently switched to a very low estrogen pill that stays consistent all month and it feels like the Vyvanse works a hundred times better and stay consistent from the beginning to the end of the month.

GAILNY said...

I have known this for years and I didn't need a "study" to tell me. I have been adjusting my meds accordingly as a result but unfortunately there isn't an amount of adderal high enough to work around the problem without side affects that outweigh any benefit. It's a lost cause sometimes

Amy said...

Thank you for this info. Never Thought about this connection. But it sounds so obvious now after I read your article.

Akami Ayurveda said...

I came across through your blog. I found the valuable information from your blog.
spondylitis ayurvedic treatment

Joseph said...

Your blog post are really impressive and interesting. Thanks for sharing the valuable information.
Ayurvedic Treatment in Kerala

aliwazir said...

Very deep Information of Menstrual Cycle Phases and women's period so must read it in detail.

Emily Williams said...

For ADHD Medication Online, click these below links.

Buy Adderall Online
Buy Adderall 10mg Online
Buy Adderall 12.5mg Online
Buy Adderall 15mg Online
Buy Adderall 20mg Online
Buy Adderall 30mg Online
Buy Adderall 5mg Online
Buy Adderall 7.5mg Online

Tasha Moore said...

I am bold enough among many others to state that there is now a potent cure to this sickness but many are unaware of it. I discovered that I was infected with the virus 3 months ago, after a medical check-up. My doctor told me and I was shocked, confused and felt like my world had crumbled. I was dying slowly due to the announcement of my medical practitioner but he assured me that I could leave a normal life if I took my medications (as there was no medically known cure to Herpes). I went from churches to churches but soon found that my case needed urgent attention as I was growing lean due to fear of dying anytime soon. In a bid to look for a lasting solution to my predicament, I sought for solutions from the herbal world. I went online and searched for every powerful trado-medical practitioner that I could severe, cos I heard that the African Herbs had a cure for Herpes syndrome. It was after a little time searching the web that I came across one Dr Itua(A powerful African Herbal Doctor), who offered to help me at a monetary fee. I had to comply as this was my final bus-stop to receiving a perfect healing. My last resolve was to take my life by myself, should this plan fail. At last it worked out well. He gave me some steps to follow and I meticulously carried out all his instructions. Last month, to be precise, I went back to the hospital to conduct another test and to my amazement, the results showed that negative,Dr Itua Can As Well Cure The Following Desease…Cancer,Hiv,Herpes,Shingles, Hepatitis B,Liver Inflammatory,Diabetes,Fibroid,Parkinson's,Alzheimer’s disease,Bechet’s disease,Crohn’s disease,Cushing’s disease,Heart failure,Multiple Sclerosis,HypertensionFatal Familial Insomnia Factor V Leiden Mutation ,Epilepsy Dupuytren's disease,Desmoplastic small-round-cell tumor Diabetes ,Coeliac disease,Creutzfeldt–Jakob disease,Cerebral Amyloid Angiopathy, Ataxia,Arthritis,Amyotrophic Lateral Scoliosis,Autism,Fibromyalgia,Fluoroquinolone ToxicitySyndrome Fibrodysplasia Ossificans ProgresS sclerosis,Seizures,Adrenocortical carcinoma.Asthma,Allergic diseases,,Copd,Glaucoma., Cataracts,Macular degeneration,Cardiovascular disease,Lung disease.Enlarged prostate,Osteoporosis.
Dementia.,Lyme Disease,,Non Hodgkin Lymphoma,Skin Cancer,Uterine Cancer,Prostate Cancer Dercum,Lupus,Hpv,Weak Erection,Infertility,fibromyalgia,Chronic Diarrhea,Get Your Ex Back,Als,SYPHILIS,Colo-Rectal Cancer,Blood Cancer,Breast CANCER,Lung Cancer,Prostate Cancer,Autism,Brain Cancer,Genetic disease,Epilepsy, Parkinson's disease..You can free yourself of this Herpes virus by consulting this great African Herbal Doctor via this email: drituaherbalcenter@gmail.com / .  or call and whatsapp him on +2348149277967 He will help you and his herb medication is sure. he has the cure on all disease .You can talk to me on INSTAGRAM..tashamoore219.

Health and Sports said...


buy xanax online

BUY ADDERALL ONLINE

buy Klonopin online

buy-tramadol-online

**CLICK HERE TO BUY ONLINE MEDICINES IN USA**

**ORDER HERE FOR OVERNIGHT DELIVERY**

**GET INSTANT OFFER**

**GET EASILY DISCOUNT ON ALL MEDICINES**

**PLACE YOUR ORDER HERE**
$ - Buy Tramadol Online For Anxiety Disorder Get up to 55% Off - $



Jennifer Morgan said...

Hello, I want to write a little review about the good work of doctor ehiaguna, who cured me from HSV 1&2 for just 2 week with his herbal medicine, I never believe I can be cured again and have a good life like others, I always regretted the day I got diagnose with this virus, I become lost of hope when my doctor told me there is no cure for it, Well I am so grateful for my helper who get me cured with his herbal medicine, I went online in search of anything that can help me because I can’t deal with it forever so I found dr ehiaguna email drehiaguna@gmail.com on a Facebook of someone who was cured by him,of the same herpes, so I quickly contacted him for help and explained all my pains to him, he told me not to worry about it there is a cure for real, I never believe until he sent me the herbs when I ordered for it and I got it within 5 working days that is how I took the medicine for 2 weeks and the following week I went for a test just to confirm I was 100% cured from this sickness what a miracle in my life, I am so happy right now, and forever greatful, you can also get in contact with him if you have such sickness through his whatsapp +2348073908953 you can  email him:: drehiaguna@gmail.com visit his website.  https://effectiveherbalcurehome.blogspot.com/  God bless you

Dana Marris said...

I'm 28 years old female I tested genital herpes (HSV1-2) positive in 2002. I was having bad outbreaks. EXTREMELY PAINFUL. I have try different kinds of drugs and treatment by the medical doctors all to know was avail. Six months ago I was desperately online searching for a helpful remedies for genital herpes (HSV1-2) cure, which i come across some helpful remedies on how Dr ehiaguna have help so many people in curing genital herpes (HSV1-2) with the help of herbal treatment because I too believe there is someone somewhere in the world who can cure herpes completely. As of the past 2 months, however, I've been following his herpes protocol Via drehiaguna@gmail.com and it stopped all outbreaks completely! To my greatest surprise I was cured completely by following the protocol of his herbal medicine . Don't be discouraged by the medical doctors. There is a cure for HSV with the help of herbs and roots kindly contact him for more information Via drehiaguna@gmail.com or Whatsapp him on +2348073908953 you can also visit his website https://effectiveherbalcurehome.blogspot.com/ He is capable of curing HIV/AIDS, HERPES, HPV, HSV1&2, CANCER of all kinds, DIABETES and so many other infections.