DEAR DR. DONOHUE: Can you tell me if the new medicine Strattera, for attention-deficit disorder, works in adults as well as children? What kind of side effects does it have? Is it a stimulant? I have the disorder, and the older medicines do not help me. – B.

ANSWER: Attention-deficit hyperactivity disorder (ADHD) is not just a childhood problem. Many adults suffer from it. Experts estimate that 30 percent to 50 percent of children with the disorder will continue to have it in adult life.

ADHD makes it nearly impossible for people – adults or children – to pay attention to details. They find it difficult to concentrate on a task and often fail to complete assignments. Children fidget more than adult patients. They cannot sit still for any prolonged period of time, and they are constantly in motion. Both children and adults often act impulsively. Affected adults frequently change jobs without solid reasons for doing so.

Ritalin and Dexedrine are two medicines that have been used for many years to treat the disorder. Both are stimulants. They activate brain centers that control hyperactivity.

Strattera is a new medicine that is not a stimulant. It works by increasing norepinephrine, a brain messenger chemical. Increased levels of it have a calming effect.

Strattera is for adults as well as children. Side effects are the kind similar to many other medicines: a loss of appetite, dizziness and sleepiness. A few users develop a dry mouth, and even fewer experience a diminution of the sex drive.

Don’t be swayed entirely by the medicine treatment of ADHD. A counselor versed in treating the disorder is as important as medicine is.

DEAR DR. DONOHUE: May I offer an alternative answer to the question of sleeping in being a cause for migraine headaches? I wonder if the person was a regular caffeine consumer.

A caffeine withdrawal headache could be the reason why the letter writer developed headaches on the mornings he or she slept in. I experienced them, and only a dose of caffeine alleviated the headache. – V.V.

ANSWER:
You and many others wrote suggesting the connection – that not having caffeine at the usual time could bring on a headache. You are quite right. The body becomes so used to having a jolt from caffeine that depriving it of caffeine at its usual time, even for an hour or so, can bring on a headache.

Thank you all for writing me about this.

We still cannot abandon the possibility that too much sleep brings on a migraine. It does, as does too little sleep.

Headaches account for an inordinate loss of productive time for so many. The headache pamphlet contains a longer discussion of all headaches and how they are treated.

Readers can order a copy by writing: Dr. Donohue – No. 901, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. along with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: Will you kindly comment on that horrible, unbearably itchy, contagious condition called scabies?

From where does it come? How is it transmitted? What is the preferred method of treatment?

My wife and I picked up this scourge, which the doctor originally thought was an allergic reaction. I got it first. When my wife got it, a dermatologist changed the diagnosis to scabies. With treatment, we are pretty much back to normal. I wouldn’t wish this experience on my worst enemy. – J.H.

ANSWER:
Scabies is a mite, and the mite is usually passed from person to person via skin contact with people who happen to be hosting the mite on their skin. Much less frequently, bedding, clothing or furniture on which the mite has landed can be a source of infection.

Permethrin cream is the standard treatment for scabies. Ivermectin, an oral medicine, can also evict the mite from skin, but it does not have Food and Drug Administration approval for this use at present.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.


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