ADHD Medication Outcomes: Medical Teamwork & Consistency – CorePsych Radio

by Dr Charles Parker on May 18, 2009 · 5 comments

2082681947 d858e698a9 m ADHD Medication Outcomes: Medical Teamwork & Consistency CorePsych Radio
Image by mikebaird via Flickr

Regarding ADHD Medications: Medical interventions always work most successfully with team play – but first a few game rules…

Best to start early with specific rules of engagement and some clear expectations – without them it’s like running around the basketball court without two hoops.

This is last of 10 1 hr Radio Programs on ADHD Medication Details at CorePsych Radio.

This program brings together in one place perhaps the most important aspect of medication management, setting your team in the first place, then working through challenges with clear parameters. As you know, lines on the mysterious playing field of ADHD treatment can become quite vague.

Program outline in PDF download at CorePsych Radio with the Internet link – The program airs at our usual times at 4 EDT and 1 PDT

See ya there!

cp

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ADHD Medication Outcomes: Medical Teamwork & Consistency CorePsych Radio

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Tagged as: ADD and ADHD, Attention-deficit hyperactivity disorder, Child and Adolescent, Health, Mental health, Neurodevelopmental, Pharmaceutical drug, SPECT Brain Function Imaging, Stimulant medications

  • http://www.google.com Kelly Brown

    Hi, very nice post. I have been wonder’n bout this issue,so thanks for posting

  • Jackie

    Dr. Parker,
    Thanks so much for your reply. In fact, her doctor has begun Lamictal (as of today she titrates to 100mg) — because there appears to be a mild/soft cyclothymic quality to her underlying mood, and he felt this might be a more prudent route than going directly to an SSRI (though that may at some point prove necessary). Any perspective on the LTG/LDX combo, either in practice or theory?
    BTW, I would also be very interested in purchasing your radio programs (without the other Expert site services) — so please let us all know when/how we can do that!
    Jackie

    • http://www.CorePsychBlog.com Dr Charles Parker

      Thanks Jackie,
      LTG/LDX not an interaction problem, could be quite helpful, reasonable intervention with good possibility of helping with the depression, just watch that depressive piece and then consider with your doc dialing in the LDX more precisely for the PM.
      Will keep every one posted thru the blog when we get those programs produced… am in the process now. thanks. Best to sign up for the ADD book list as that crew will get specific emails.
      Have a great weekend, hope she feels better-
      cp

  • Jackie

    Dr. Parker,
    I’m really enjoying these radio programs and handouts!
    Earlier today I emailed you this “Confusing Question About Vyvanse” via facebook:
    My teen daughter has significant adhd with some emotional dysregulation. In the past we have been frustrated by what seems to be both high sensitivity to med SEs and shorter duration of effects than would be expected. For a month now she has been on Vyvanse 30mg at 8am, which helps her all morning but then two things happen: between 1-3pm she becomes angry, hostile and antisocial; then by early evening the mood lifts but she is once again impulsive and distracted. Adding 5mg Dex IR at 6pm has allowed her to get through homework, etc. however, the mid afternoon mood and aggression persist. We were about to lower the Vyvanse dose to 20mg because we were interpreting the early afternoon problem as toxicity (getting hyperfocused in negative place) — but do you think it’s possible that she is experiencing a crash and actually needs more Vyvanse?! Thanks for all your awesome work and help on this! Lattegirl NYC

    • http://www.CorePsychBlog.com Dr Charles Parker

      Jackie,
      Sorry about not getting back on facebook, I am so busy with everything else it falls near the end of my list even tho I appreciate those connections.

      Thanks for your kind remarks, the Radio Program does take considerable extra time, I am really pleased it is helping out – long distance!

      The specific reactions you describe are often seen [and not seeing her to detail leaves me at a significant clinical disadvantage], with comorbid depression. A link for comments regarding comorbid depression is at this Dec 06 CorePsych posting. To briefly summarize: Dopamine down regulates an already diminished serotonin aggravating a comorbid pre-existing depression. I have seen this phenomena thousands of time over the years, but it is surprisingly under appreciated at this late date. Cognitive depression [apathy, indifference and Clint Eastwood overtones] often will become affective depression when adding a stimulant med.

      See these links and submit these ideas to your doc there – I have met some really strong docs in NYC over the years with several Manhattan presentations – including a fun lunch presentation in Spanish Harlem – he/she will likely consider an antidepressant for the moods, and then the Vyvanse after mood regulation will likely need increase as the DOE is insufficient according to your report here. First one move, then the other with your docs approval of course.

      I always try to consider/separate affect from cognition, sounds like an affective regression on top of a cognitive rebound – they can occur simultaneously when stimulants drop off in the PM.
      cp

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