Medpedia

The content on or accessible through Medpedia.com is for informational purposes only. Medpedia is not a substitute for professional advice or expert medical services from a qualified health professional. Read more

Medpedia Answers

(Other)

Medpedia Answers is a platform for asking and answering questions about health and medicine. Read more.

ADHD Medication and Writing

Since I've been on medication for adhd my writing has changed completely. It looks nothing like it used to. I used to have kind of small, straight or slightly left-slanting chicken-scratches that most people couldn't read, even myself, sometimes...lol. Now my writing is a bit larger, slightly right-slanting and actually legible. It's really quite odd. I really have no idea what to make of this. Why would this happen?

Thank You.
41 yr old, Female
41 yr old, Female
asked Mar 07, 2010 at 06:00PM in Other
5 Answers
4 Following
↓ answer this question
Sort By Date Votes
  • 2
    Votes
    answered Mar 08, 2010 at 06:16PM
    Best Answer
    First, congratulations for learning about Adult ADHD and thank you for raising this important question on Medpedia. This phenomenon is more common than most people (including medical experts) would guess.

    The connection between certain handwriting difficulties (called "dysgraphia") and untreated ADHD is familiar to top ADHD experts and knowledgeable observers.

    Sometimes a child will be diagnosed with dysgraphia by an educational specialist but the ADHD will be missed entirely - and thus a potential treatment for the dysgraphia (as well as primary ADHD symptoms). Such are the gaps in cross-disciplinary knowledge and cooperation among specialties.

    To put it simply, neurostimulants such as methylphenidate (generic form of Ritalin) boost the supply of the brain chemical called dopamine, thus improving message transmission to/from/within the brain. In general, this can help with ADHD's core symptoms of impulsivity, distractibility, and inattention, giving the person more control over thoughts and actions.

    Here is an in-depth discussion on ADHD-associated writing challenges: http://www.behavioralandbrainfunctions.com/content/2/1/33
    Please note this important conclusion:
    "These are significant findings as children with motor problems are at risk for learning problems and poorer psychological adjustment. Because motor clumsiness is not a diagnostic criteria in DSM-IV, it is often not assessed when ADHD is diagnosed and the child may go without intervention."

    Here are two studies on ADHD and writing difficulties:

    1.
    http://www.ncbi.nlm.nih.gov/pubmed/16483390
    Fine motor skills and effects of methylphenidate in children with attention-deficit-hyperactivity disorder and developmental coordination disorder.
    Excerpt:
    "Results demonstrated that children with ADHD-DCD performed more poorly on the manual dexterity subtests, had poorer quality of handwriting, and drew more rapidly, more fluently, but less accurately than controls on the graphomotor task. On methylphenidate, manual dexterity and quality of handwriting improved, and strokes on the graphomotor task became less fluent but more accurate. ...Up to 50% of children with ADHD also have motor coordination problems that are severe enough to meet criteria for DCD.”

    2.
    http://www.ncbi.nlm.nih.gov/pubmed/17710822
    ADHD and dysgraphia: underlying mechanisms
    Excerpt:
    "Multiple complaints in the domain of writing are common among children with Attention Deficit Hyperactivity Disorder (ADHD)... Recommendations for remediation include educational interventions, use of word processing and judicious use of psychostimulants."
  • 0
    Votes
    answered Mar 09, 2010 at 09:05AM
    Gina,
    May I chime in? I have also seen patients properly treated, who's hand writing got worse. Improvement is the most common senario along with improved thought process.

    Gerry
  • 1
    Votes
    answered Mar 09, 2010 at 10:03AM
    Absolutely, Gerry. When it comes to ADHD, there are no one-size fits all answers, as I'm sure you well know. We humans are such variable creatures. ;-)

    Some thoughts:
    1. One of the trickiest aspects of ADHD to treat is maladaptive coping strategies. For example, if a child (or adult) has learned to write very fast in order to keep up with rapid-fire thoughts, it might require some assistance to adjust writing technique. It can also take some psycho-education for the person to learn to deal with a more tempered cognitive pace. They might have become accustomed to the flood of thoughts.

    2.
    It is so rare for ADHD medication treatment to be optimized, I would wonder if the patients had truly been properly treated. It is a very small dosing window that works best -- just a few miligrams up or down can make all the difference.

    3.
    The existing medication studies on dysgraphia and ADHD seem to have all been done using immediate-release methylphenidate, which itself is a rather problematic treatment. Rapid start and rapid wearing off can create as many problems as its solves.

    4.
    When I started typing more for my job (starting 30 years ago), I noticed that as my typing improved in accuracy and speed, my handwriting deteriorated in equal measure. So, while I can type 350 words per minute, my friends can't read my hand-written thank you notes! I could imagine that children who are used to the rapid-fire pace of video-games, texting, etc. might have a hard time adjusting to the slow pace of a pen. Maybe a good reason to strictly limit those activities in the early years.
    • Can you really type that fast. I dont even read that fast!!
      Kudos to Gina
      Gerry Lane commented Mar 09, 2010 at 10:13AM
    • It's true, Gerry! lol!
      On deadline, in a newsroom of fast typists, the clackety-clack from my keyboard sometimes made all the reporters stop and take notice.
      Gina Pera commented Mar 29, 2010 at 10:04PM
  • 0
    Votes
    answered Mar 09, 2010 at 02:09PM
    Thank you all for your input! I wasn't sure what type of responses I'd get to my question because it seemed so odd to me.

    Gina, your comment about an improvement in your typing speed, I've noticed the same thing. Although my "faster" typing speed is probably more like 350/10...lol. I've always had to look at the keyboard because if I didn't I'd hit the wrong keys (one-key-off-syndrome), but now I don't have to and I type much faster and more accurately. One of those other weird things I've noticed.

    Gerry, you made a comment about "improved thought process." I'm not exactly sure what you mean. There's something I'd like to share, and since I have no idea what it's called, I'm going to share it as a personal experience and maybe you know can identify it. Here goes...
    This is an example scenario, but the same thing happens when I'm in other such situations:
    If I'm at a really busy intersection, that has many traffic lights and signs, some pedestrians, lots of cross-streets, a ton of cars, constant noises (horns, music on in car/passenger talking to me, etc)...I'll get completely stumped. It's like my brain gets so confused or something that I'll have no idea what to do. I've driven down streets the wrong way (i.e. against traffic), turned on red lights, gone thru red lights, sat there on green lights, etc. My spouse gets scared when I drive, "No!!!! Don't turn!!! The light is red!!!" Since I've been on medication, I don't get confused in situations like that (and I haven't scared my spouse lately). It's like I can actually survey all aspects of the situation and make a decision. I really don't know how to explain it any better. But it's really a good thing, because the same thing happens when I'm at 6-Flags, casinos, etc. (Yep, a 39 year-old roller coaster junkie.)

    Thanks Again!
  • 1
    Votes
    answered Mar 09, 2010 at 09:09PM
    Hi Lisa,

    See, your question wasn't odd at all. :-)

    And neither is the one on ADHD's effect on driving. In fact, it is one of the most well-studied aspects of ADHD, including neurostimualnts' effect on mitigating ADHD-related driving deficits.

    Some ADHD experts describe ADHD's cognitive challenges by talking about "Executive Functions" in the brain. These include prioritizing, organizing, planning, etc. And these definitely all come into play with driving.

    For example, when you're at a really busy intersection, you're hit with a lot of stimuli (the traffic lights, signs, etc.) that you must quickly prioritize in order of direct relevance to you and decide how to proceed safely. Trouble is, with untreated ADHD, all the stimuli can seem equally important!

    So, your experience with medication improving your driving skills echoes that of many others - as well as the considerable research in this area.
The content on or accessible through Medpedia.com is for informational purposes only. Medpedia is not a substitute for professional advice or expert medical services from a qualified health professional. Read more
Editor Directory - browse by last initial
ABCDEFGHIJKLMNOPQRSTUVWXYZ
Professional Directory - browse by last initial
ABCDEFGHIJKLMNOPQRSTUVWXYZ
Cancel