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Dear Dr. Wong: I am worried about my father. When we were growing up, he was very angry at home and every little thing could upset him, he would yell at us all the time. It was much worse when he drank, especially on weekends. He was probably a weekend alcoholic. My mother tried very hard to keep the house calm and peaceful. He quit school early, but he was very smart.
He ran a successful business, but his employees were scared of him because of his temper. He had a heart attack at 55 and has slowed down since. Because of his temper, my mother got him to see a counsellor. After several sessions, she suggested that he should see a psychologist. After some tests, the psychologist diagnosed him with ADHD. He was referred to a psychiatrist who confirmed the diagnosis and started him on Vyvanse. He has been more mellowed since, and has quit drinking. He can even tolerate our two rather active boys without getting frustrated. However, I am worried that the medicine he is taking may not be safe for him at his age.
Answer: If the psychologist and psychiatrist are correct, which I think they are, Vyvanse is a good choice for your father, even at his age. Let me explain.
From your description, it is possible that your father has attention deficit hyperactivity disorder (ADHD) since childhood. Children with ADHD have difficulty paying attention, especially in academic subjects, even though many of them are extremely bright. They often drop out of school at an early age.
If they are fortunate enough to work on things that interest them or fit their temperament, they can be very successful. This is especially true if they can delegate tedious and boring work to others, like their employees. However, many adults with ADHD have low tolerance for frustration. They like to argue and get angry easily and their temper can be explosive. This can get them into trouble with confrontations, fights, and assaults, and hurt others physically or emotionally. Homelife can be traumatic for their spouses and children.
It is very common for adults with ADHD to drink alcohol and use other drugs. These chemicals can calm their brains, ever so briefly. Their brains are very busy and they have many random and worrying thoughts all the time. Alcohol and drugs can give them temporary reprieve and unfortunately, that reprieve can often lead to addiction. Their temper gets worse with drinking and they take their anger out on their family and those who love them most.
You are very lucky that your mother tried to keep the peace at home, although at great cost to everyone, especially as you grew-up. Many with ADHD also lead an unhealthy lifestyle; they are busy but they don’t exercise. It is hard to eat healthy while drinking or using drugs. They often have high blood pressure, diabetes, heart disease, and stroke. These are complications of ADHD that many don’t realize. People with ADHD are always stressed; they have high stress hormones and adrenaline in their body.
Once properly diagnosed, adults with ADHD can benefit from stimulant medications like Vyvanse. Although Vyvanse can increase his heart rate and blood pressure a little bit, it will be more than compensated by the reduction of stress hormone and adrenaline in his system. You can give him a present: a home blood pressure machine so that he can self-monitor. He also needs to increase daily exercise as well as eat healthy.
Both of your parents will have a better quality of life because of his medicine.
Dr. David Wong is a retired pediatrician in Summerside and recipient of the 2012 Distinguished Community Paediatrician Award of Canadian Paediatric Society. His columns will appear in the Guardian on the last Tuesday of every month. For a collection of his previous columns, go to askdrwong.ca. Email questions for Dr. Wong to Prince County Hospital, 65 Roy Boates Ave., Summerside, P.E.I. C1N2A9.