CorePsych Services

by Dr Charles Parker on February 12, 2009 · 145 comments

5029 Corporate Woods Dr, Ste 250

Sarah Cella
Patient Care Coordinator
+1.757.473.3770 Ext. 203
Fax: +1.757.473.3768
Email For Sarah

—— Phone/Skype Protocol – Download Please! => Phone Consult Protocol.

—– Va Beach Office
5029 Corporate Woods Dr, Suite 250
Va. Beach, VA, 23462, USA
+1.757.473.3770 Ext 203

Map Link Here =>: Second Building on Right After the Left on Corporate Woods At CorePsych, Parking also in back, Second Floor, Suite 250.

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CoreBrain Store Patient Sign Up/Order Supplements:
CoreBrain Wellness Link- First create a profile and then you will receive your password and login to use the store. Drop an email to Sarah above if confused.

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CorePsych News - Please Do Sign Up Here for Updates: to keep you posted on the happenings at CorePsych – first name only, thanks…

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Administrative Tips
If Sarah is on the phone or away from her desk, please leave a voice message. and also leave a message if the Tyson’s office is busy or unattended.
Sarah manages all routine matters, appointments, scheduling with other providers, supplements and test kits as indicated – Sarah is familiar with all of the CorePsych protocols.

Urgent Matters
- Urgent, needing attention in 24 hr such as a med reaction
- Emergency, needing immediate attention, life or death

If you need Dr Parker for an Urgent matter/Emergency, please first call 757.473.3770 and speak to someone at our other front desk [option 1 on the phone tree, not CorePsych, not option 2], and tell that desk your priority.

———- Administrative Protocols and Intake Forms —————–

New Patients
- CorePsych Evaluations & Services: Choice of Options from in-office to SPECT imaging options [Download PDF: CorePsych Services]
- Female Hormone Intake Questionnaire: [Download PDF: Female Hormone Evaluation]
- Telemedicine Agreement for those consulting with CorePsych: [Download PDF: Telemedicine Agreement]
- Note to your local Doctor about working with CorePsych as an outside consultant: [Download PDF: Letter to Your Local Doctor]

SPECT Evaluations
- PROCESS and FEE DETAILS for SPECT imaging: [Download PDF: SPECT Scan Process]
– Frequently Asked Questions about SPECT; [Download PDF: SPECT FAQ]
– Comprehensive Article with References: Why SPECT? [Download PDF: Why SPECT? Article]

NeuroScience Testing
– Reference page with references and discussion of best practice.
– Neurotransmitter Precursor Test: 12 Neurotransmitters – [Download PDF: Neurotransmitter Test Info]
– NeuroEndocrine Test: 12 Neurotransmitters, 4 cortisols, & 6 sex hormones – [Download PDF: NeuroEndocrine Test Info]
– Food Sensitivity Tests: Immune Testing for up to 110 Food Sensitivities – [Download PDF: Food Sensitivity Testing]

Immune Testing
- See Peer Reviewed References at Useful References Here

Hormone Testing
- Saliva Testing to Evaluate Hormones: DHEA, Testosterone, Progesterone, Estrogen, Cortisolx4 -[Download PDF: Sputum Process]
- NeuroScience Testing for Hormones: Download: NeuroEndocrine Test Info
- Saliva vs plasma measurement controversy: [Download PDF: Saliva vs. Serum Article]

Psych Meds: Time, Titration and Tachyphylaxis (corepsychblog.com)

Digitally available now at Nook, Kindle, Barnes and Noble.
ADHD Medication Rules – PDF For Your Desktop
ADHD Medication Rules | Paying Attention To The Meds For Paying Attention – Kindle Version

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gary

Dr. Parker, I can not thank you enough. I talked with you several times on the phone. You gave me hope and fantastic guidance. Yesterday was the best I felt in years. Maybe 20 years or more. I just listened to your cinch about the person whose body is toxic so the meds made him crazy. I was in the same situation. With your help I have done the allergy testing. I am taking shots for the environment and foods. I am staying away from the trifecta especially.

I did neurotransmitter testing. I found extremely low levels in many areas. Not enough chickens as you say. I also did testing to find that my digestive, adrenal,liver, system was massively toxic. I am now taking many supplements and it’s working. I am also following the Buhner protocol for Lyme’s. I found out that I have chronic neuro-lyme’s. I have had it for many years without knowing.

I found out the my body has been toxic for many years. I wish that more people would understand what is going on with them. It is not easy. It takes a lot of will power and changing habits. That is in the past. I am enjoying the moment of life. What a great feeling. I have found the answers. I am not crazy. I can not thank you enough. Keep up the great work!!!!!!!!!!!!

http://www.corepsychblog.com Dr Charles Parker

Gary,
Sincere thanks, you made my day! I hope others read this and better understand/appreciate what it takes to move your progress forward. Happy Holidays!
cp

Kimhayes

Dr. Parker — Just want to say I love your website, and it’s been a godsend in helping me sort through the problems with ADHD meds with anti-anxiety, anti-depressant meds. I hope you have a few minutes to read this, and help me figure out how to talk to the docs. My 16 year old son is diagnosed with ADHD, GAD, OCD, and Depression. Took forever to find something long-acting to help with anxiety symptoms but FINALLY we did, in Cymbalta. However, it didn’t work well with the ADHD med, which is Vyvanse. What to do? Well, we went back to Celexa, which he’d been on before, but with that we’re not getting benefit of anxiety symptoms controlled.
I really liked the way Effexor XR sounded, but it is not approved to treat children. I looked up Pristiq as well, and it is not. The doc said that Zoloft would only treat anxiety, not depression, in my son. I know this is a lot of info, but could you answer a question? Are there cases where a teenager could be treated with one of these for both depression and anxiety? I’m just about at the end of my rope with these psychiatrists, who don’t really listen to my concerns when I sit in their offices and try to tell them about my son’s actions which he is either not aware of or doesn’t remember. His perceptions of reality are many times VERY distorted, he’s confused, has short term memory loss, and I really believe it has to do with these meds and the way they have been interacting, particularly the Vyvanse and Cymbalta, which he was on for 2 months. Am I completely off base here?Our latest regimen is: Morning Vyvanse 60mg, Celexa 40mg, Abilify 5mg, Xanax XR 1mg —- Afternoon Dexedrine 10mg —– evening Trazodone 100mg (or he can’t sleep).Before that, it was: Morning Vyvanse 60mg, Cymbalta 30mg —— Afternoon Dexedrine 10mg ——- Evening Seroquel 200mg (he slept great but gained 30 lbs in 2 months)I think we’re almost there, it’s like we’re circling the bullseye but haven’t hit the mark. I saw that you’re in VA Beach, which isn’t terribly far from me, as I’m near Raleigh, NC. Would you be willing to see us to provide a second opinion or something? I would gladly take a day and come up there, if for nothing else but to have a little peace of mind. Please let me know if this is a possibility, and if so, who to contact. In any case, thanks so much for taking the time to read my post, and again your site is truly amazing, it has helped me to understand so much more than I ever did about these meds.

http://www.corepsychblog.com drcharlesparker

Kim,
I can tell you my off-the-cuff, with no clinical exam, shoot-from-the-hip observation: Your guy does need a full on metabolic testing, and we do provide that in our office. We see plenty of folks from that part of NC, and the good news is that we can do follow up on Skype or FaceTime, no problem.

Each of these specific symptom subsets, and you are chasing symptoms [not the underlying cause], is related to one or more neurotransmitters out of balance. I just don’t guess as to which ones when I have such excellent testing at our fingertips.

We do consults all over the country, are accustomed to working with local docs after we figure out the details, so if travel is a prob we can work abound that detail as well.

Sarah is your contact on the Nav Bar here – and on this page at CorePsych Services – she’s up there on top.

Talk soon!
cp
http://www.corepsychblog.com drcharlesparker

Found the reply! -> Don’t know where my reply went with this Disqus software, bottom line is that we certainly can see him, see many from that part of NC, and all you have to do is call Sarah up at the top of the page here on Services.
cp

don’t know anymore

hi Dr

I’m a 32 yr old female juggling parenting an ADHD child, a toddler, husband and fulltime online student. I have been on 20 mg Adderall for chronic fatigue and 30 mg of Celexa for mild to moderate depression and 15 mg of Amdien because the Celexa doesn’t let me sleep at night. The fatigue has started coming back and I don’t think the Celexa is really helping but this is my third switch in depression meds and I’m tired of trying something new. But I also hate that I can’t seem to control my emotions. I cry for anything, a sad commercial a song that has a memory attached to it. Sometimes its just weeping while other times I have to hide in the bathroom to get the relief of the emotions pent up inside me. I can’t focus on my school work and even with a 3.0 GPA I still don’t feel like I”m good enough. I have constant fears/anxiety that I won’t be able to do the job I’m going to school for once I do graduate or why am I even trying. And people tell me I’m doing good I tell myself that they are just being “nice”. I think a lot about actually talking to a prof about my issues, but often I hold a conversation in head and never actually act on it. I do see a physiologist but we just seem to talk about “how are you doing with the meds” and I often reply “ok” and that seems to be the end of the visit. I find it so hard to speak up to others but with in my own family I can talk freely and am even bossy.

http://www.corepsychblog.com drcharlesparker

Don’t know..
You do have several issues, not the least of which, in fact the main one, is the use of stim meds to fix exhaustion. The work for cognitive issues like ADHD, can cover exhaustion for a while, but exhaustion always wins because it arises from other issues not treated by ADHD meds – like adrenal fatigue, IgG issues, thyroid etc. To find a local person who is deeply into those details: attend your local CHADD chapter, no cost, and ask.

If you want a long distance consult we do them successfully all the time. Schedule an hour and we can chat, and order the testing for what is clinically indicated on that meeting. We can’t treat across state lines, but we certainly can investigate and recommend considerations for your med team.
cp

http://www.corepsychblog.com drcharlesparker

T Weaver,
Absolutely consider that he has comorbid depression and check out my video on Anxiety, OCD and ADHD near the end talking about serotonin and dopamine… I think the dopamine add on it down-regulating his serotonin and thereby contributing to his depression. This is covered in great detail in Rules, my book on ADHD meds.
cp
http://www.corepsychblog.com drcharlesparker

Taylor,
Many questions: you need a brief tutorial on the meds so go the nav bar here, get a cup of Starbucks and watch the videos on that post.

These need to be checked with your doc:
- Sounds like you have a bit of depression lingering in the background and would likely profit from a small dose of antidepressant [Not Prozac, Not Paxil].
- Sound like you went up too fast, and need to retrace your steps, as you are a guy who has been struggling for along time and are, quite likely, one of those folks we so often see who just wants to make up for those many years of frustration all at once. Easy translation: try with your docs approval: 50 mg
- Specifically Search for ADHD and Depression on this Blog and you will get better details than i have time for right here, and don’t miss my frequent remarks on Clint Eastwood.
cp
Tweaver

I have a 14 year old son that has ADD. We tried Concerta and I immediately took him off of it because when I picked him up from school he looked and acted like he was on major drugs. We then tried Vyvance 40 mg. We had success for awhile but he started having very aggressive behavior, easily angered. So he stopped taking Vyvance. Things are much happier around our house except my sons grades are terrible. I am thinking of putting him back on Vyvance but also adding Intuniv. My son also wanted to stop taking Vyvance because he said it made him week at football practice. PLEASE give me your thoughts.
Taylor H

I am so in need of feedback relating to my inconsistent results of Vyvanse!

I’m a 19 year old male. My weight fluctuates
between 140 and 135lbs rather constantly. I started Vyvanse on a 20mg dosage a
month ago (September 30th 2011), quickly being upped to 40mg. While
on the 40mgs I experienced great results. Those being: extremely motivated to
get what’s needed to be done, done. Focused,
alert, confident, in a really great mood. I had the feeling to “want” to learn
more, for example I had completed my college classes for the day and wished I had
more to attend. I’ve failed a math course in college and I’m retaking it, I’ve
had real low self-esteem in relation to math and would dread doing it. But when
I was getting great results on Vyvanse, I would study it for hours teaching
myself how to do stuff I never understood. First test this year I aced with a
103%. At home my parents told me that dinner was ready, yet I continued to do
math exercises (that weren’t even required).
While in class I would be rather hyper, but it would be a “hyper-ness”
in which I could harness and direct to the professor lecturing. I would be so
fixed on what was going on and being explained, it was great. It was as if the windshield
wipers were on and I could see and understand everything so clearly. Unfortunately,
the 40mgs lost their effectiveness and I was upped to 60mgs. The first day I took
them I felt just as I had with the 40mgs at their working peak. I took it on a Saturday
so no class, however If I were engaged in a conversation, I would be extremely
interested and delve deeper into what’s being said, I would also be very
talkative. I was in a great mood and outgoing to everyone I saw that day. I was
motivated at work and running around doing everything that needed to be done.
Now it’s the second day of the 60mgs and I feel exactly how I did with the
40mgs when they lost their effectiveness. Am I expecting too much from this
medication? Are the effects I’ve experience not what’s supposed to happen?

In addition, when I don’t get the positive effects
of the medication, I’m not motivated to do work or study, I don’t feel alert or
things aren’t as “clear” like when I have the good results. I get pretty irritable,
easily set off over little things, which is NOT my normal self. I am such a
passive guy. Very optimistic, I was once told that I’m a “ray of sunshine”. So
being easily set of over the smallest of things is a clear indicator it’s the medicine.
When I don’t get the desired results and I’m irritable, I distance myself from
everyone and just keep to myself, Whereas when I WAS getting the desired
results, I would be happy and enthusiastic about everything which is normal for
me. But I don’t think I should feel irritable and be distant when I don’t get
the desired results.

So to sum everything up to make it
easier, Are the positive effects I’ve mention supposed to happen? Or am I expecting
too much from this medication? Positive effects being: Extremely motivated (desire
to learn). Focused, Energetic, happy, alert .

And if I don’t get the positive
effects, is it normal to be irritable, and to distant yourself from everyone? (My
parents told me I’m not the same, That I don’t Joke around, sing or just be
loud and silly as I used to be)

This is my first ADD medication for
I was just recently diagnosed with it a month ago, So im really lost in the
dark on what to expect and ANY feedback would be so so so greatly appreciated.
I’ve struggled my whole life in school and to finally get a little taste of achieving
academic success has honestly been the best feeling in the world.
Sincerely , Taylor H.
OCD trials

Thoughts of a patient tormented by untreated OCD (comorbid with ADHD, but ADHD is treated)
maybe a realization?

“So there are no answers and there is no one who can help me any more than they already have. There is nothing left for me to learn that could help this problem. I am left to solely relying on the Faith and nothing else. I believe wholeheartedly in the Faith and God’s Providence, but does that really mean I rely on nothing else? That I just stop all other attempts? That seems despairing to me and is not my aim. Perhaps I am wrong about that. Can it be that that is what I rather must do?? And if so, how? God grant me the grace to know what to do, the strength and means to do it, and the courage and trust to do it alone.”

http://www.corepsychblog.com drcharlesparker

OCD,
My understanding: OCD is treated from the ADHD perspective, but not treated from the affective/depressive side of the equation or from the immune system dysregulation side of the equation. OCD by itself, if refractory to care is more complex in this presentation and requires more investigation. More information makes it more treatable.
cp

OCD trials

My thoughts were in all sincerity and truly not despairing, but really wondering. I have this insatiable need to understand any particular thing to the ultimate degree and so since being diagnosed with adhd and having many things get much easier, I have stopped at nothing to understand the complexities…when in reality, perhaps what I need to do is it just to wait – without the one answer (which doesn’t exist) or proof. I know it’s not that black and white. I know that just because a couple of SSRIs increased my anxiety through the roof, doesn’t mean effexor won’t be effective….and that just because I responded totally differently between the extended release tablets (pharmacy filled incorrectly) and now the capsules, also doesn’t mean it won’t be effective. Oy. I need to stop now…

http://www.corepsychblog.com drcharlesparker

OCD,
Those thots are all valid, and run through my mind in an effort to connect with the details in every med check. Information does provide better possible outcomes… so just watch to see what your outcome is and work with your doc to make the adjustments.
cp

http://www.corepsychblog.com drcharlesparker

Jade,
Thanks for your kind comments about Rules, it’s great to hear that others are finding the info useful.

Your problem is more complex than simple adjustments, as you so correctly point out. You are very likely suffering from an immune condition which predated the trials of Concerta. Your therapeutic window is too small, too tight/narrrow, a challenge always seen with underlying metabolic issues, often brought on by reactions to food. You are already estrogen dominant, very likely have a transit time longer than 24 hrs for years [do measure it] and a good run at specific food evaluations thru IgG would be likely very informative.

Without clear maps you could be messing around with all of this for years. Take a look at the Testing Options Page here for more info there on the nav bar.
cp
http://www.corepsychblog.com drcharlesparker

Raymer,
Easy and quick: the dose is too much – see this article: http://bit.ly/lpfXPh The psych just got too excited, as I have about the projected possible reaction to Vyvanse based upon the Concerta dosage, but just went over the top from the outset. See if these titration suggestions help on the linked post.

I would start all over with 1/2 of 40 mg and slowly work up to cover the day… 1.5 hr onset is always too much.
cp

Montessori

Dr. P,
you say it’s too much, but according to other things you’ve written, it could be too little…since the top and the bottom often look alike. long onset and short duration (9 hours in this case) combined with a steady benefit (not flip-flopping back and forth throughout the day) indicates too little.

My question for the parent would be, did she have these mood issues and agitation before starting the medication?
***If she did, it could be that the dose is too low or it could be the result of some other condition.

***If she did not, I would agree with the parent’s interpretation that she simply does not tolerate stimulants well…since she experienced the same thing with the other class of stimulants.

Another question I have would be this: at what time in the evening does she take the intuniv? In other words, how long before she has to go to bed does she take it?
And my last question for Raymer — was she tired because she was experiencing insomnia or was she tired because the intuniv makes her sleepy? If it makes her sleepy, maybe move the dose earlier in the evening. if it gives her insomnia, take it in the morning.

I’m a teacher of students up to 4th grade and Ive been recently diagnosed with adhd and ocd myself. Ive read a lot myself, experienced a lot myself, and witnessed first hand the experience of many students on various medications; Intuniv, vyvanse, prozac, abilify, concerta, clozepam, adderall, metadate/ritalin, allergy meds, among them. And of these, only one of my students was referred by me because I hate labeling kids and do everything to modify my teaching and the environment to their needs. I also have these students for 3 years (montessori).

http://www.corepsychblog.com drcharlesparker

Montessori,
Great job thinking through the important details… I wish everyone thot like you! You are so right, could go either way, thus my hesitancy often to render an opinion… the variables are simply too complex, and do require more thinking. I join you in watching carefully for cookie cutter solutions – you, my fair teacher, are right on in your thinking.
cp

Jadeoboe

Hi Dr Parker, I’ve just downloaded your ebook on ADHD meds and it has made me realise what has gone wrong with my own treatment. I am in the UK and was diagnosed ADD by a psychiatrist (actually I diagnosed myself and he agreed after looking it up on the internet!!) – yes we are so backward in this country but that’s another story. So basically my doctor will do whatever I tell him to regarding dosage as he hasn’t got a clue either.

I was wondering if you would be so kind as to offer me some advice – after having not much luck on generic methylphenidate (ups and downs, felt depressed etc) I started on 36mg Concerta. The first day I took it, it was like someone had turned the light on, albeit in a very subtle way. I felt more ‘normal’ than I have for many many years; head was clearer, no longer angry, more awareness etc. But the next day, nothing. Day 3, the same thing happened, but then for the next 4 weeks it was like I was taking a sugar pill. The dose was increased to 54mg which made me severely depressed and my husband ordered me to reduce the dose after a big argument. Now I’m back at 36mg and nothing.

However, ever since I started Concerta I have been constipated and in fact didn’t ‘go’ for about a month. I have PCOS but that is being treated with metformin, also low aldosterone treated with fludrocortisone. So yes I do have metabolic issues and even before Concerta had bowel issues, especially before each period.

After reading your book I have now realised that I am taking too much Concerta for my current metabolic rate, but here is my dilemma – a side effect of Concerta for me is constipation, but when bowel transit time slows down, this makes the Concerta dose toxic. As the first dose I took had an effect, and actually made me feel relaxed, doesn’t that show that this was probably the correct dose for me? Do I come off Concerta altogether until I get these issues sorted out or just take a lower dose – I’m so confused and depressed by it all, I would be so greatful for any input.

Thank you,

Jade
Raymer

I am so confused as to what is best practice for my child with ADHD. First she was on concerta. It was helping but not quite doing the job. Dr. kept putting up dosage. Defiant behaviors began to appear. Told pediatrician. pediatrician sent us o psychiatrist. Then my daughter was put on Vyvanse 40 mg. Seemed somewhat better but classroom observation showed she was still fidgeting and was only at rest 9 seconds out of 15 min sample. Then psychiatrist upped vyvanse to 50 mg. She became very agitated. So much so she kicked our dog so hard that he bite her. She was extremely moody. Took her back down to 40 mg Vyvanse. and added Intuniv 1mg at night time. Fidgeting has mostly stopped but mood is often present. I am thinking she doesn’t tolerate stimulants very well. I would like to slowly drop her dosage and get her off Vyvanse and just use Intuniv. The Vyvanse she takes at 7 am. It starts working at 8:30. It lasts till 4 and night time homework is painful at best. Focus is then so difficult. Increase in Intuniv made her like an angry bear in the morning she was so tired. Do you know of any Dr. in the Pittsburgh area that can help me. When a child is in an agitated state with all these med changes it is difficult to handle alone. I need a Dr. that will work with us to solve this med problem so my child’s high average intelligence shines through. Please help.
Lisa Forman

Hi, .

Sorry I tent to just go in circles, really stuck in the past and now fearful of my future.

I will look at the tutorials, which I think I have seen before. I’ve been on ADHD meds, anti depressents, and mood stabilizers and am highly anxious (controlling and never got the tools to calm myself down when i was young). now i work myself up.

Now with the possible metabolic issues the behaviors are worse. and cause I am not working and have lost all interested in anything, I am not doing anything. I do try to volunteer but the pain is debilitating and my mind is ruminating at my fears of the future. I’ve lost all inspiration. Not in the present at all

Really haven’t had a life, isoloated, PSTD (sex abuse and no love from family, ostracized by peers), no close relationships, no sex except abuse, used to have a false sense of bravado. Now I am weak and needy without any support from family. Cannot sleep. Been off meds 4 years on SSDI. Trying to go natural, energy work, after pushing myself and really have ever been able to relax. Dont do anything and am having major irritability,rage (angry all my life) and anxiety at a drop of a hat( maybe be related to immune/metabolic issues)

This is not new but was numbed by meds all my life. Been angry and easily frustrated since I was young. To top it all off after waking up from my unconscious negative thoughts and past memories 4 yrs ago, its like I opened pandoras box. My brain locks onto my thoughts/frustrations and increases my all ready existing pain and I get really rageful, and have to take tranquillizers to break out of it which just give me anxiety the next day. Bad and addictive

I have never release my anger, as numbered my family, drugs and meds. Done energy work, but part of my brain thinks I am evil and bad and i am very self-abusive. I get triggered by everything so quickly and my body seizes ip. Now my emotional area all over the place and my thoughts are like the past and fear of the future repeating in my brain. I don’t enjoy anything and cannot stay present, even volunteering. I used by able to go to the store but now I just whole up in my house.

After being able to some how survive, even though not being able to keep jobs for long, I am now on SSDI. I am really scared of my future and have lost all inspiration due to my pain (horrible musculear contracions – adrenal pain, that spasms in my neck and sides of back every five minutes and doesn’st release) that is consistent, lack of support (i’m alone) and self care. Just in my head.

I am afraid to go back on meds cause of the emotional numbing and since I hyperfocus on the negative, I question going back on ADHD meds. I need to change my perspective, but am stuck and have been all my life. Everybody says that I need to heal myself. I’ave been to so many healers and doctors. i cannot leave my my apt that I cannot afford cause of my limited ability to move (pain) and don’t have any schedule and what is planning? I am scared that I will loose my saving as i have made no forward motion my whole life. Actually I am 47, no connection to my femine (yin imbalance and liver/spleen deficiency -accupunturists, but emotionally 6. Not in my heart only in my head.

I wonder if I have chronic anxiety. been medicating my pain with marijuana, but it doesn’t work anymore cause my mind gets really negative.

Any
The big issue is that I have terrible negative thoughts and low self esteem, recently noticed 4 years when I woke up, and I don’t have any coping mechanisms to calm myself down> that is not true. I know some but the fear is still there and to be honest I have been so stuck and out of balance all my life that I’m ether impulsive or do nothing. Sounds like a lot of anxiety (fear of losing control)

I really need something to calm me down, get out of my head and move on to find a job that suits me. I want work with people but I am considered controlling and difficult and don’t have communication skills outside of talking about myself.

Yes, I would like to talk to you by phone and I heard you may be in the West Coast in May. I have had tests that show high GAba, nueroepinephrine, eprinephine, low serotonin. been going to an integrative specialist.

So there is a lot to deal with. I have about 8 months of money left before I got broke.

thanks Lisa

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

Lisa,
Without asking more specific questions, just addressing the multiple issues you document here… you have way more than ADHD, and yet ADHD is likely a downstream effect of the profusion of serious metabolic issues you have on your plate. While I always shy away from specific advice with folks here on blog comments, I do feel that you need a hand with several useful general concepts, and hope these help.

1. As I have repeatedly noted here: Evidence matters. I would spend the few bucks or whatever insurance on digging first into immune dysfunction – specifically IgG testing, even if you can test only for the 22 most frequent antigen possibilities [49$ with NeuroScience].
2. After that if you have any cash invest, after taking out the offending antigens, in testing for your neurotransmitters – you are likely suffering with too few chickens in your ranch, thus the medical chicken catchers simply can’t do their job.
3. Other factors are your dissipated adrenal system, likely thyroid challenges and overall nutritional status [even though you are taking supplements] as you like have significant #2 issues with decreased bowel integrity.

These are broad strokes, but if you can do any of them you would like have some useful new info.
cp

Lisa Forman

Dr. Parker,

Can you recommend a doctor/shrink or functional specialist that can help me in the San Francisco Bay Area. My mind will not shut up and just goes thorugh all the possibilities, but like when I worked I would get stuck in a step and not move, like I am living on a harmster wheel. When I am in conversations I get the first part but then cannot follow along with the rest, middle and end. I am isolated in anxiety and not caring for myself. I am alone as I have no support and am very scared for my life.

Any recommendations are appreciated.
I am desparate. Lisa

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

Lisa,
Just don’t have a specific rec at this moment – sounds like a mix of cognitive and affective challenges best addressed by a child psychiatrist who also sees adults. The happy result of that combo: they would likely get and treat both the ADHD and the depression, and likely the associated sleep disorder, tho not mentioned. If your circumstances are limited economically i would try one of the many excellent community mental health facilities out there and get in quickly – then you can get started asap.
cp

Jonathan

Hi, Dr Parker..
I have to admit that I’m impressed by your keen ability to really examine what’s really going on what really happens with ADHD and its intertwined conditions. I’ve often come to the conclusion, after, in my opinion, being misdiagnosed by numerous doctors over the years, that if they could watch my life for a day and observe; they would throw these old theories out the window and humbly surrender. I’ve been told face to face with several doctors that its not a real condition. I still to this day don’t claim that I have it because it’s still like it almost doesn’t exist. You almost get thrown into that fad with the other label-junkies as soon as people hear about it. But when I watched your videos on how you’ve observed ADHD within patients, I knew you were speaking from a rigorous observational P.O.V. So I’d like to thank you for that.
And I was wondering if the neurotransmitter tests would be a great thing for testing that can really hold weight because I’m in school full time with very little income so I can not afford the spects even though they’re absolutely fascinating. Some people get excited with a new car – I’d rather know more on how this vehicle is designed to work.
Truly appreciative,
Jonathan

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

Jonathan -
Right on about the new car/working model concept. Scans, quite interestingly, do support a part of that working model construct, but the don’t have the real cellular punch one often needs to get the job done. I still use scans for major issues like massive denial regarding problems only scans can ID – like brain injury, Alzheimer’s, and with substance abuse interventions. The other hypometabolic and hypermetabolic states can be evaluated through neurotransmitters with the better income that immune system dysregulation consequences can be seen and directly attacked with those assessments.

Those tests provide more biomarker evidence to take the next steps. I use both methods often and they both have their place, often using the scans to start the discussion and Neurotransmitter, Neuroendocrine, IgG testing to get to the real underlying problem needed to direct specific treatment.
Thanks-
cp

m82

Dr Parker,
Have you had any experiences with significant differences in reactions to different generic brands? I filled my adderall IR prescription yesterday and a new one for celexa (for obessiveness, anxiety) and after I got it, I saw that the pharmacy had switched their generic from corepharma to barr. I wasn’t so happy about that especially considering we’re adding something new anyway….so now instead of one variable, there are two.

The barr is brighter blue (I take 10 mg x 2.5 for each does) and tastes sweet. I didn’t really like the sweet part. It also wasn’t effective when I expected. I started to panic, but I’m ok now I think – well, working on it anyway.

I was looking for the ingredients of each, but maybe it’s just better if I forget about it for now.

What’s your experience with these kinds of things?

Thank you.

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

m82,
Challenges with different generics are often short lived and minor. Some, as you might expect have more severe problems, as some of the meds are loaded with allergens like gluten.
cp

m82

Interesting. Well I was basically off because of it, I sort of seemed toxic. The headache and inability to do anything came on in about an hour and went away after seven. Then I took less, I did notice it take effect in the right amount of time, but felt very foggy and it only lasted for 3 1/2 hours.
Then I called my insurance company and complained, and every pharmacy in the area. I have to get a new scrip (and make sure the override on insurance goes through), but for the meantime, I was able to return the bottle to the pharmacy where I got it and they gave me what I had had before (some). I guess the reason it wasn’t filled with that to begin with is that there wasn’t enough.

it really makes you wonder what else they put in there! It was the Barr that was off, and I read somewhere that Barr and Teva brand were the same? Is that true?
I’ve got Core now and Ive been fine, but now it also makes me wonder about the other generic out there — Sandoz/Eon?

I cant find anywhere what the inactive ingredients in the Barr brand are as compared to the Core, and that should be readily available shouldnt it!!!

Thank you,
Julia

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

Julia,
You are most welcome, rest well,
cp

Lisa Forman

Hello,
I’m interested in your terms “cognitive abundance” and over-thinking, always on edge (never chill or relaxed) as I think that this sums me up and I keep going in circles. I was diagnosed hyperactive younger than 5, medicated which made me aggressive, sullen, depressed and lacking in social emotional IQ. More meds continued for over 43 yrs of my life. i am now 46, incapacitated by fibromyalgia, chronic stress/muscular tension. I have always been a highly spirited person who was unfortunately squelched by drugs and bad parenting. It feel like a prisoner

So now it is up to me, Its hard to say but I’m a non-linear triangle/rectangle located into the pattern of a square with very reserved qualities. I want to get back to my true self and try, take risks instead of being stagnant of the belief that I mess up with any decision, etc. Also, I have PTSD. All these labels..

I want to be me, have been on all kinds of meds, and behaviors that don’t serve me and a lack of social skills. I believe that I have sensory integration issues, as my overwhelm has a very quick onset.
I’m wondering if stimulants or ADHD meds will help the over-thinking/worry/talking in circles. Antidepressants which is what I’ve been on all my life have just cut my feelings and emotions to nil and I’ve missed out on a lot of life. Also, are there resources for sensory integration help.

As for my fibromyalgia, I am going to a naturopathic doc and pain doc. I’ve had the NT tests that showed my dopamine and GABA off the charts, while my epinephrine is optimal.
Any ideas?
thanks Lisa

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

Lisa,
It would be inappropriate to make a diagnosis from your brief note here – but every time I see unmanageable cognitive abundance I do consider ADHD. My very quick armchair shot is that you do quite possibly have an immune system dysregulation with the fibro, have some depression that is refractory, perhaps associated with serotonin decrease, and then could have ADHD by history. Take a look at this series of ADHD Tutorial videos and see if they ring further bells.

Many ideas, but don’t like guessing – would be happy to look at your findings, speak with you further by phone and make more precise suggestions. – Can’t write for meds unless I see you in one of my two offices.
cp