Posts tagged as:

methylphenidate

ADHD: Vyvanse and Duration – DOE Simplified

by Dr Charles Parker on June 9, 2009 · 13 comments

Thanks for your continued interest in evolving mind/body science! Stay tuned for more details on how neurotransmitters, immune system challenges and hormones create problems with mind-balance.

DOE = Duration of Effectiveness An Essential Tool
This brief video requires your immediate attention: The ADHD medication mess can be significantly corrected by regularly paying attention to the specifics of each individual DOE, – is it too much, or too little? Basic!

Do we really have to pay attention to treating paying attention? Oh yeah…

DOE is the acronym that absolutely should be on every medication progress note with every stimulant medication, period. Why am I so dogmatic? Take a look at this video and see what you think about the value of this kind of precise thinking.

DOE would cut out all this flap about what’s wrong about psych meds and much of the noise about side effects. It’s a simple matter of respecting, paying attention to the basic science of:

The medication delivery process [how it is made by the company to be released in the body] will set the hours of DOE for each product if the dosage is adjusted for best DOE effect [less is too little, more is too much]

Immediate Release [IR], [Ritalin IR-4Hr, Dexedrine IR-5Hr, Adderall IR-6Hr]
Extended Release [Adderall-XR -10/12hr, Ritalin LA -8Hr, Concerta 8-10Hr, , Metadate CD -8Hr],
Daytrana Patch 10-12 Hr, or
[in a separate DOE league]: Vyvanse – the benefit: 12-14 Hr, by peer-reviewed findings and in my office.

2. The metabolic individuality of that specific person will set the individuality of that metabolic process-

Determined by genetics [CYP 450], CYP 2D6 has multiple genetic variations see this CorePsych post – 4 most measurable
liver function and adhd-medications-ssri-amphetamine-interactions-cause-serious-problems/”>drug interactions – see this previous CorePsych post,
inflammation
nutrition
bowel function [fast or slow transit],
metabolic disorders,
immune dysregulation

Each one of these variables can effect DOE, and the more challenged the liver, the more metabolic problems, the narrower the window, the greater the difficulty finding the right dose. I will send out a specific video on the Narrow Therapeutic Window soon – stay tuned. [You can subscribe to my YouTube Channel [to stay informed via email.]

Or sign up for the blog email updates here if not already hooked up.

Drop a comment to let me know if this DOE video note is useful for you and yours.

Think DOE!

Why the Menstrual Cycle may affect ADHD Medication Dosing Levels (adhd-treatment-options.blogspot.com)
Daytrana Absorption and Metabolism Patterns Compared to Ritalin and Concerta (adhd-treatment-options.blogspot.com)

Make sure you take a look at these pages!
ADHD Medication Rules Purchase
“Rules” Affiliate Link
Neuroscience Details

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Tagged as: ADD and ADHD, Attention-deficit hyperactivity disorder, Concerta, Daytrana, Disorders, Health, Mental health, methylphenidate, Psychiatric Medications, Stimulant medications

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ADHD Medications with Depression: Seven Significant Problems

by Dr Charles Parker on March 30, 2009 · 5 comments

: Image via Wikipedia

Depression and ADHD: Often Confusing – Listen on CorePsych Radio [handout for the program at this link]

Advancing Technology: The laboratory findings have changed so dramatically that the new information seems unreal. I was at a meeting recently with molecular and cellular physiologists arguing “old news” about how the intergenomic cross talk occurs between a nucleus of a cell in communication with that cell’s mitochondria. These systems can significantly effect neurotransmission.
SPECT and other brain imaging systems can actually see where specific neurotransmitters, such as dopamine, become active in the brain.
Antidepressant medications have become increasingly more effective and more widely used for treating more than depression.
We know much more about the CYP 450 metabolic pathways, and how they can, and do, interfere with certain medications causing drug-drug interactions.
The world of stimulant medications has changed even more profoundly in moving from first and second generation stimulants to now a third generation stimulant. [First Generation: immediate release such as Ritalin or Dexedrine; Second Generation: extended release such as Concerta, Adderall XR; Third Generation: prodrug – Vyvanse with a different time release process unaffected by acid-base balance or transit time] Many do not appreciate these differences.
The trend to using antipsychotics and mood stabilizers [e.g. Risperdal and Lithium] for ‘impulsivity’ that doesn’t appear to fall under the label of ‘hyperactivity’ appears in increasing frequency with diminished awareness of the complexity of ADHD comorbidity. These are seen on the rise with multiple second opinions in my office - resistance and confusion about ADHD diagnosis.
We can be much more confident regarding side effects and medication predictability than we were even 5 years ago, leading to a false sense of security with partial ADHD diagnosis – if a little ADHD then they must be all ADHD. In psychoanalysis, we called that process ‘the incomplete interpretation.’

Please join me as we take a full hour to look at the many angles on depression and ADHD challenges. And check out the links below for more info.

See ya there,

Understanding ADD/ADHD Medications: Pay Attention to the Details

July 20, 2008 Beyond ADHD

ADD/ADHD medications at first seems simple – if you have ADD, “Here’s the script.” Yes, I am suggesting we modify our scripting process. The truth is that ADD/ADHD medications do require specific, precise thinking with clear guidelines – or the entire process of medication management can become dangerous, frustrating, or disappointingly ineffective – with disastrous long term consequences. Problems arise much too often. And they are correctable!

19 comments Read the full article here →

ADD/ADHD Treatments: Tips for Vyvanse

August 29, 2007 Beyond ADHD

You already know our regular CorePsych theme with ADD/ADHD and emerging brain science: the more we know the more we can have a positive impact. Vyvanse is a surprisingly forgiving stimulant medication.

151 comments Read the full article here →

Notes On ADD: CorePsychPodcast

February 4, 2007 Beyond ADHD

Heads up! Some of you may not be tuned into my audio site over at CorePsychPodcast, so just to let you know today I sent over an audio MP3 file, downloadable from iTunes, and playable on your machine. Today, Episode 3: The Wrong Meds – Why they don’t work In previous programs: Episode 1: Diagnosis [...]

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ADD 2: The Media, the Meds and the Madness

January 27, 2007 Beyond ADHD

ADD 2: New podcast up on how to make the meds work better for ADD. Over at CorePsychPodcast Seems like so many of the basics are so often overlooked. Why a stimulant in the first place? They do work best if used correctly, listen to the how. What do they actually do in layman’s terms? [...]

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Problems with ADD: Stimulants2

December 8, 2006 Beyond ADHD

Correct dosing strategies: now two additional sides of the therapeutic box – from titration using duration of effectiveness with stimulants on a daily basis [those two sides], to adjusting the dose [titration] over time. These two additional problems we often find overlooked with titration: the top and the bottom of the therapeutic window: for more [...]

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