I just passed the one-year anniversary of my accident (fell, landed on my head). I have been through intensive cognitive therapy for several months with a team of specialists in TBI.

Prior to this therapy, I had a wide range of symptoms including speech impairment, loss of reading comprehension, short-term memory loss, headaches, vertigo, and attention deficits.

The therapy has greatly improved most symptoms, but my attention deficits still get in the way of employment, driving, and participating in activities that I enjoy. Attention and periodic vertigo are the main symptoms I have right now with occasional pounding headaches.

My doctor just proscribed Vyvanse, which is used to treat ADHD, and I am wondering if anyone has had experience with this medication for treating attention deficits due to mTBI.

I have been working at improving attention through therapy and have been trying to stay away from heavy medications, but after a year I am looking at other options. I would really appreciate some input from anyone with experience with this or similar medication.

Thank you in advance for your help.

Gil

I am wondering the same thing. I have heard of ritalin and adderall being prescribed for fatigue, and for concentration. But I haven't heard much about success (some anecdotal) or whether long-term use is required.

From what I understand, stimulants help while you take them but do not cause improvements in brain function. They can cause a chemical fatigue when the brain just can't keep up with them anymore. My doctor read me the riot act about using any form of stimulant.

Is your therapist teaching you to quiet your environment so you can maintain better focus? The brain is not designed to function at a high level in an environment with too much of any kind stimuli.

The neuropsychologist is working with me on developing my divided attention, sustained attention, alternating attention in different ways. After three months of intensive therapy (12-16 hours per week with a team of therapists working together) and a year after the injury I have noticed marked improvement, but I still don’t function well outside of the house and the controlled environment of the clinic.

I have have problems switching between tasks. For example, I will walk away from the stove if the phone rings, and I will forget to return to it.

I have problems doing more than one thing at a time. For example, I have a hard time taking notes while someone is speaking.

While riding in a car, if I see that the traffic light is green, I don’t register at the same time that there is still someone in the crosswalk.

So, where I appreciate what you are saying about controlling the environment (and I have found that to be a big help) I am to a point where I need to be functioning in the real world where I can’t control the distractions. I want to be able to drive a car and to hold a job where there are other people working. More than any other factor, the deficits in attention are preventing that.

I guess my concern is that the medication would delay actual improvements in brain function by substituting chemical manipulation for re-training the brain. But mainly, I don’t know anything about it and I appreciate the discussion on this and other factors involved in use of ADHD medication.

Gil

This prior post from a year ago here on NT may provide some helpful input for you to consider: http://neurotalk.psychcentral.com/ar.../t-161501.html.

While my own experience with being Rxd generic Adderall and generic provigil last year proved 'beneficial' for me in the short term, in the long term I believe that it led to me push myself to achieve more than I was actually capable of sans a setback --- which for me was a horrible major long term relapse and loss of all that I had recovered/healed.

It was for me as I look back upon it now, an artificial sense of energy/capacity/wellness that did allow me to do/achieve a great deal; yet the end-cost was far greater than whatever it allowed me temporarily. In truth, I believe that I got myself into 'adrenal burnout'. The price/time I paid in recovery was unbelievable, now looking back.

I myself would not recommend the course of ADD/ADHD type of meds for tender post-concussive condition. It's simply not worth the cost of the benefit, in the end analysis, in my own experience.

All the best to you,

Theta Z.

Gillian-Gillian,

I wonder if such intense therapy may be counter to your brain recovering further. That is quite a stress load.

I have many of the same problems, especially with driving.

Are they working with you to learn work-arounds or just trying to strengthen brain functions? Some of your lost functions may need work-arounds rather that being able to strengthen weak or lost functions. The biggest problem I have is the ability to rely on those functions. Driving and the kitchen are where these issues are critical.

In the kitchen, I use a timer any time I use the stove. I set it for 5 minutes and repeat it until I turn the stove off. If I walk away from the stove, I know the alarm will call me back within 5 minutes.

Driving is another issue all together. Driving needs to most skills and attention at the most dangerous time. I have had too many close calls. I know that I do worst in a comfortable car with power steering with no feedback and insulation that limits the amount of outside sounds and vibrations felt in the drivers seat. I also struggle in congested traffic, especially where I have to watch traffic from two or more directions.

I only drive when I am alone in the car. I do not want the responsibility of another life or the possibility a passenger can be a distraction. I rarely drive faster than 35 to 40 mph. If I need to drive a highway, it can not be during heavy traffic times. I have an automatic transmission SUV that I have disconnected the electronic shifting system so I have to shift it manually. It helps but I still know that I need to be on top of my game before I get behind the wheel.

The worst scenario for me is to have to live the rest of my life knowing I hurt or killed someone because of my driving skills.

My wife will ask if it is a "driving day." This is our term for whether I should be driving or using power saws or taking other risks.

I hope somebody is helping you with ideas about what you want to do versus what you can do reliably. Car pooling to a job is a consideration. You may need a quiet work station to be successful. Or, very supportive people around you. Never give up trying to reinvent yourself and your skills.

I know how tough it is. I had to curtail my driving 8 years ago. I have driven about 8000 miles since. I went for a year and a half without driving at all. I cut a finger off with a saw and realized I needed to re-evaluate how I judged my capabilities.

I wish you the best as you struggle with these critical issues.

i have been on vyvanse 30 mg for about four months. i am a 19 year old college student who has suffered 9 concussions in a span of 5 years. i can't say for sure what they will do for me in the future, but right now i have never been more focused in school. last semester i got 3 D's, 1 C, and a B and this semester while taking vyvanse my grades are 1 A, 2 B+, C+. i have been able to concentrate on school for more than just ten minutes at a time and actually retain the information. I don't normally take the medication on the weekends to give me brain a break, i find the medication to be more effective this way. i'm a huge fan of it, but everyone is different. if you think it might be helpful then i think it's worth a try.

Thanks for posting the link to a previous discussion. I did a search before starting a new thread, but could not find anything.

Just a note on driving. Even if there is no one else in your car, there are other people on and near the road. My biggest concern with driving is not whether or not I can operate a vehicle, but if I will be able to respond appropriately to another driver's mistakes. I think having someone else in the car or having the radio on can be a distraction and should be avoided if distractions are a concern, but please don't forget about other people who are at risk every time you take the wheel. Driving a car is operating heavy machinery. Think about it.

Again, thanks for your replies.

The worst scenario for me is to have to live the rest of my life knowing I hurt or killed someone because of my driving skills.

Driving needs very careful consideration.

I was in a unknown state of my condition of memory loss while in school and could not focus so I told my primary physician I was having major problems and they gave me adderall....

Unlike you I did not know what was going on with me and never thought I had PCS in accident....the hospital said soft tissue...after I told them I thought I hit my head because I had no idea how I got to shoulder of rode and was sick while waiting for highway patrol.

The adderall had me doing great in school and focused, motivated, I was showing great improvements in school but as time passed my behavior changed and headaches were often but still did good in school.

I started to turn to more symptoms with speech and my thought process and now over a year from accident I found out I have PCS with mild dementia, balance issues and a list of every cognitive impairments...

I will be starting neurocognitive therapy hopefully soon plus 4 others. I had to withdraw from school to prepare myself for therapy.

I don't know if my symptoms got worse because I did not know what was wrong with me for over a year of concussion or it was because I was on adderall.

They said three months after I start neurocognitive therapy I will need to get help getting off my med's because I am on a speed ball!

I have a adderall to control some symptoms and xanax to control others...

I am on the opposite end of your situation....I wonder if the adderall made mine worse over time and if I am going to be able to get over the impairments?

If you could let me know how the therapy is so I know what I am facing!I would greatly appreciate it

Best of Luck to you!