ADHD Problems: The Cause For ADHD Symptoms – More Than Simple Dopamine Deficiency
With just a little more investigation we can see what we intuitively already know well: Those excellent ADHD meds simply not only don’t work for everyone – they can become quite unpredictable if we aren’t careful. This post both lists the reasons for ADHD medication challenges and provides some easy links for chasing down more details.
ADHD biological complexity with multiple contributory imbalances will spoil good, insightful medical intervention if not better appreciated and investigated. See this CorePsych Blog post for 171 medical conditions which look like ADHD.
First Layer: Neurotransmitter Imbalance Unrecognized
– Dopamine Elevation: If dopamine is already elevated then stimulants will almost always make the patient’s ADHD symptoms significantly worse – with anger, feeling stoned, inappropriate impulsive behaviors. Switching stimulants doesn’t work as both AMP and MPH are dopamine re-uptake blockers causing more accumulation at the synapse.
- Norepinephrine Elevation: If norepinephrine is already elevated for other reasons, Strattera and Adderall [XR or IR] both with noradrenergic effects causing more accumulation at the already norepinephrine-loaded synapse. When norepinephrine is too high the ADHD symptoms of feeling internally anxious, with inability to sort thoughts in a timely manner can become overwhelming. You can feel, in a word, completely crazy.
- Glutamate Elevation: With all of the posts on Intuniv, now more than eight here at CorePsych Blog, we see considerable promise with new science regarding glutamate neurotransmitters at play. But just like dopamine and norepinephrine, glutamate can be elevated for a number of reasons, resulting again in a poor response to well-intentioned, carefully adjusted ADHD meds.
- Elevation of Other ADHD Neurotransmitters: From PEA [phenylethylamine], to epinephrine, to histamine [all excitatory neurotransmitters] – if any or all of these are elevated the outcome, once again, the overall neurotransmitter balance can become overstimulated with those otherwise useful stimulant medications.
First balance the underlying imbalance, and then the meds work quite predictably! Procedures for laboratory assessment and discussion here on this CorePsych Blog Neuroscience page.
Second Layer: Endocrine Imbalance Unrecognized
- Endocrine challenges: From hypothyroid to insufficient adrenal function to estrogen dominance – if not evaluated can significantly contribute to ADHD symptoms. Endocrine messages can significantly destabilize neurotransmitters, and endocrine levels are easily measured with a number of easily available laboratory tests.
Third Layer: The Foundation Layer | Immune Systems Challenges Unrecognized
Immune system dysregulation: Caused by under-recognized and under-appreciated antigen invaders such gluten, casein, other foods, parasites, bacteria [PANDAS], viruses, will send cytokine messengers up to muck up balanced neurotransmission – and will always create a significant problem with stimulant meds or with neurotransmitters supplements used to turn around neurotransmitters imbalances.
Neuro-Endo-Immune Challenges
These measurable biological, neurophysiological imbalances all conspire to create significant problems with ADHD meds. And if we don’t start looking more carefully at these imbalances, and indeed measuring them to see them, we will continue to see those troubled with ADHD feel like medication guinea pigs. Without science, without an operational grid, without evidence, there are simply no targets other than appearances, and ADHD medication adjustments will remain an unpredictable mystery, patients will feel like failures, drug companies will be blamed for problems they didn’t cause, and the medical profession continues to look like they don’t know what they are doing with ADHD treatments.
Don’t Forget
These challenges will be part of that all day presentation out in San Francisco on April 30. See the Events Calendar here for details. Translation from the laboratory bench to the office trench for these next steps in the treatment of ADHD is imperative, it’s possible, and, yes, it’s sometimes imperfect, – but it works. Biomarkers are real, not imaginary, and they are useful clinically.
If you can’t show up in San Francisco, do sign up on this CoreBrain Training list for specific updates on other upcoming presentations – Thanks, hope to see you there in San Fran,
cp
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