<donning pharmacologist hat>
Now, before I say any of this-- I'm not for even an instant suggesting that it is wrong to medicate persons with ADHD/ADD so that they can function more normally-- they really help some people, and I understand that. I just think they are perhaps not sufficiently respected by clinicians as the potent drugs that they are. This should never be a casual decision, IMO.
It is also posited by some (mostly those without background in the molecular side of this) that ADHD subjects may not respond to the drugs in the same way that neurotypical persons do (meaning that the two factors I mention are thought to be untrue for them)-- but from a molecular/neurochemical standpoint, that seems farfetched to me.
Nik, I really urge you to speak to someone with genuine expertise in neuropharmacology and cardiac pharmacology who knows your family's medical history. A genetic quirk at the receptor level might lead to dangerous idiosyncratic responses to stimulant drugs that a neuropharmacologist might not consider. (I only mention that because I have some background in BOTH of the subdisciplines involved-- and cross-training, particularly in physicians in these disciplines, is unusual.)
One thing to bear in mind with psychotropic drugs in this class (that is, SSRI's and stimulants that are intended to operate in the biogenic amine system) is that they alter the kinetics of the neurotransmitter system.
There are two important sequelae of that fact clinically:
a) these drugs as a class may produce potentiation with habituation-- that is, the system responds in an exaggerated manner to additional doses of the drug once it has been withdrawn for a period of time. (This is a contributing factor in cardiac fatalities that are so well-known in stimulant-addicted persons who fall off the wagon after detoxing-- they are sensitized to the effects of the drug and a previously safe dose results in an overdose-- this is most frequently seen with the tropanes like cocaine, but I don't know whether it has been sufficiently investigated with the amphetamine or SSRI class.)
b) because they alter the baseline kinetics of neurotransmitter signalling, (reducing post-synaptic clearance times), use may result in INCREASED clearances when unmedicated, relative to naive control subjects. In other words, while drugs in this class do not induce "physical dependence" the way opiates do, it is extremely clear that neuropharmacologically, there is most certainly dependence.
This alteration is apparently permanent, incidentally, which is why I am often horrified at how cavalierly clinicians offer to "try" these drugs as a means of differential diagnosis in children or adults suspected of 'maybe' being depressed.
The latter is why I think that probably "occasional" use of ADHD meds could just make 'unmedicated' periods worse than before, and the former would lead me to have very serious concerns in someone who had underlying cardiac risk factors.
HTH. Of course, this isn't medical advice-- I'm pointing out why I'd want input from someone with expertise in cardiac pharmaclogy before going that route.
<taking off pharmacologist hat>
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It's also interesting to me to note that my DD's problem is writing (or doing anything else) without a deadline. Maybe that says something about underlying causation, and maybe it doesn't mean a thing. But it is a remarkable contrast.
