What is the burn rate of a medication?
Charles Parker: The term refers to the way attention deficit hyperactivity disorder (ADD/ADHD) medications work biologically, how they "burn in your body. Burn rate is an approximate measure of how healthy or dysfunctional your metabolism is. Your metabolic state significantly changes the effective duration of ADD/ADHD meds. I had an adult patient who had been on different meds at different dosages since she was a little girl. Each medication worked for a while, then became ineffective. She thought she was untreatable. I found that she had gluten sensitivity, which affected how the meds worked. Avoiding food with gluten helped fix the problem.
Do most doctors know about burn rates?
CP: Not enough of them do. A doctor who considers burn rates when prescribing can save patients years of medication problems. Without burn-rate awareness, the meds may not work well, and you can become frustrated. Many adults simply stop treatment.
What else affects burn rate?
CP: Allergies to peanuts, soy, casein, and other foods affect burn rate, as do interactions with other drugs and genetic factors, such as the size of your metabolic pathways. Doctors should take all of this into account when prescribing medications. Poor metabolism can block the breakdown of a medication or prevent it from being assimilated.
What's a simple way to assess burn rate?
CP: I always ask every new patient, "How many times a day do you have a bowel movement? Many gut/bowel problems affect your metabolism -- and metabolism affects the dosage of the drug that is prescribed. A slow metabolism will result in a slower burning of ADD/ADHD medication, and will require a lower-than-usual dose.
Your advice to professionals?
CP: There are no cookie-cutter prescriptions, because each person has a different burn rate. Customize the prescription for every patient on the basis of his own burn rate.
More on ADD/ADHD Prescription Medications
This article appeared in the Summer 2011 issue of ADDitude. SUBSCRIBE TODAY to ensure you don't miss a single issue.