Posts tagged as:

Therapeutic Window

Large image of telephone switchboard. Photogra...

Connections Matter Wikipedia

Intuniv, Glutamate and ADHD Symptoms
Thanks to Intuniv we have a new neurotransmitter to consider – and it must be considered in the context, as with any other ADHD med, of the Therapeutic Window. Glutamate, as you will soon see in these pages, as well as several others [PEA, Dopamine, Norepinephrine, and indeed Serotonin] can all make a difference as we regularly address the specifics of ADHD neurotransmitter corrections. For this post: specific glutamate considerations.

For The Record
These are previous CorePsych Blog posts on Intuniv:

Details About Glutamate
Amy Arnsten, PhD at Yale: See this summary page for details of this interesting ADHD science. This paragraph is from that page:

Goldman-Rakic used a spatial working memory paradigm to uncover the neural basis of working memory abilities, and found that representational knowledge is encoded by networks of prefrontal cortical (PFC) pyramidal cells with shared stimulus properties, engaged in recurrent excitation. [ed note: good working memory diminishes the possibility of ADHD.]

These recurrent excitatory connections depend on glutamate actions at NMDA receptors. Spatial tuning is heightened through GABAergic, inhibitory connections between networks with dissimilar spatial properties (e.g. Rao et al, J. Neurosci 20: 485, 2000). The working memory abilities of the PFC are also highly dependent on the neuromodulatory environment, whereby loss of catecholamines in PFC is as detrimental as destruction of the PFC itself (Brozoski et al, Science 205: 929 1979).

Another reference:
Russell VA, Wiggins TM, Increased Glutamate-Stimulated Norepinephrine Release from Prefrontal Cortex Slices of Spontaneously Hypertensive Rats Metabolic Brain Disease 25: 297, 2010

Bottom line in the office:
1. Excess glutamate alone presents as ADHD with hyperactive and significant ODD symptoms.
2. Diminished glutamate often presents as inattentive, and may be associated with ODD symptoms, but less overt anger.
3. Excess glutamate with both excess dopamine and norepinephrine appears as untreatable with any ADHD meds, even though symptomatically presenting as ADHD. The characteristic refractory, paradoxical response to stimulant meds, and  to Intuniv often leads to the diagnosis of bipolar – but the dysregulation is in the neurotransmitters, not the appearances.
4. Number 3 is always associated with other biomedical issues including food sensitivities measured, e.g., by IgG – such as gluten sensitivity.
5. Measure when in question. Why spend more time guessing?

Still don’t get the relevance? Take a look at this video on Dopamine and Glutamate-
Remember, this video is a patent oversimplification – dopamine does modulate glutamate, as does norepinephrine, but the interplay with many other neurotransmitters is not addressed in this short clip.

Stay tuned for more on the ADHD Neurotransmitter details – and sign up for email notifications for CorePsych Blog in the upper right hand corner of this post.
cp

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


Bookmark and Share

{ 2 comments }

ADHD Medication Rules: Affiliate Details

by Dr Charles Parker on July 9, 2010 · 7 comments

Tired of Watching The ADHD Medication Mess Escalate?

Start With Rules

This note will be short and sweet – it’s about an opportunity to actually work together to change the current muddle, the morass so present in ADHD treatment strategies. Let’s review the game Rules.

We both know many are seriously frustrated -
Just take a look at the hundreds [now nearly 2000] of comments here and elsewhere that highlight the challenges with dialing in ADHD medications for effective treatment. No, I am not asserting it’s all a mess – many do well and have no problems – but it is quite true that the challenges out there are not rare, but rather commonplace, – way too commonplace.

Rules Speaks Directly To Those Specific Issues in Detail
To Order Rules: ADHD Rules

Rules Table of Contents
ADHD Medication Rules is organized into the following sections and chapters:
Section I: First Things First
Beginning Treatment, First Identify Target Objectives

Chapters
1. Right Drugs For The Right Diagnosis – Beyond appearance diagnosis
2. How to Get Past Outward Appearances – In to functional office diagnosis
3. Acting ADHD: Acting Without Thinking – Impulsivity redefined
4. Thinking ADHD: Thinking Without Acting – Beyond OCD
5. Avoiding ADHD: Not Thinking And Not Acting – Avoidance and procrastination
6. Measure Metabolism: The Burn Rate – Understanding metabolism: essential rules
7. Depression And Anxiety: ADHD Confusion – Suicide is a possibility if you miss this one
8. Furious Minds: Bipolar And ADHD – Predict medication rages
9. Unpredictable: Brain Injury And ADHD – The mystery ADHD, so commonly misssed

Section II: Monitoring Medication Progress
Improved Structural Grids for Medication Management

Chapters
10. Shoot For Your Therapeutic Window – Basic office how-to for everyone
11. Breakfast Matters – This detail can sink the ship
12. Sleep For Brain Defrag – If your hard drive is fragged you will remain ADHD
13. Managing With Your Medical Team – Teamwork is the ticket

Download this Rules Affiliate pdf Instruction Paper for more details.

Quick How To

Special Thanks To These Thought Leaders
Thanks Gina Pera for your excellent endorsement over at your ADHD Roller Coaster!
Thanks Roger Parker [no relation] for your kind remarks over at your Published and Profitable!
Thanks Bryan Hutchinson for your thoughtful remarks over at Adder World!
Thanks Keath Low for your thoughtful remarks over at ADD.about.com
Thanks Terry Matlen for your kind remarks over at MomsWithADD
Thanks Jennifer Koretsky for your excellent review over at ADD Management.
Thanks Tara McGillicuddy for your kind support over at My ADD/ADHD Blog.

Affiliate Registration Open Right Now
If you are a coach, counselor, advisor, family member or friend of someone downstream from this pervasive confusion – help them purchase Rules, and share in the experience with me through your own Affiliate link, available here.

Remember: Your don’t have to have a website to become an affiliate, all you have to do is share your specific affiliate link to set up the payment process through the shopping cart. See below for several suggestions on exactly where to put your link, and how to set it, even with a business card or a simple one page handout.

Review the Affiliate Details
This weekend the game changes for us at CorePsych – the price goes up and the Affiliate network becomes operational at the new price for rules – 37$. See the comments on why that price here on this page with the rest of the Affiliate details.

So what’s the Affiliate Deal?
Simple: I get paid for each book, – and through the miracles of modern computer connections, I pay you for your help with helping get this important Rules message in the hands of the folks that need it in Alaska, South Africa, or right down there in Possum Hollow, TN. Look forward to working together – register now, and I will send you your Affiliate link this weekend when the launch is almost over.
Let’s make it happen!
cp

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


Bookmark and Share

{ 7 comments }

ADHD Medication Rules: Why not use the science?

July 4, 2010 Beyond ADHD

ADHD Medication Rules: Paying Attention To The Meds For Paying Attention is hot off the press – and is available July 4 -> July 11 at the promised early bird discount.

20 comments Read the full article here →

Intuniv for ADHD: Metabolic Challenges

February 1, 2010 Autism Spectrum

This post is the fifth, with four others, documenting Intuniv Overview, Dosing Details, Drug Interactions and Addiction Indications. Please review all of these posts for more informed use of Intuniv

57 comments Read the full article here →

Holistic Reviews At CorePsych

January 24, 2010 Autism Spectrum

Do consider attending the Holistic Health Virtual Conference, – I look forward to presenting there on Wednesday Jan 27, and am sending out this unique offer for folks who attend.

5 comments Read the full article here →

Intuniv For ADHD: Dosing Details

November 28, 2009 Autism Spectrum

Intuniv For ADHD Is Guanfacine, But Better and Easier – ADHD treatment evolves: This will be a short note to quickly address the growing comments here at CorePsych Blog on the previous Intuniv post.

152 comments Read the full article here →

Vyvanse diminishes Memory? Watch The Top of The Therapeutic Window

November 14, 2009 Beyond ADHD

Vyvanse can create memory problems and there are several likely explanations, so let’s review. Most importantly, remember these small Vyvanse
challenges do teach us – they point the way to the next logical intervention for the most effective medication dosage strategies.

21 comments Read the full article here →

Impulsivity Translated for Street Applications: The Impulsive Brain

September 13, 2009 Beyond ADHD

Impulsivity is, without doubt, the most frequent challenge in our daily lives – for mental health professionals, teachers, HR professionals, physicians, and anyone working with administrative challenges. Let’s call it a problem instead of rationalizing the behavior-

0 comments Read the full article here →

ADHD and Anxiety: ADHD Looks Like OCD

May 31, 2009 Beyond ADHD

As you will see in this video, ‘anxiety’ can take on many different faces – and cognitive anxiety, you heard it first here, is simply not in the books yet – strange, but true. If we don’t look for it we just can’t see it – and so much of ADHD symptoms are associated with anxiety.

6 comments Read the full article here →

ADHD: The Therapeutic Window via Indiana and NYC

April 26, 2009 Beyond ADHD

Monday I recorded the CorePsych Radio Therapeutic Window Piece, – all set for playing 4PM Thursday afternoon, whilst I was on a plane headed to Fort Wayne, IN. Fri I gave a full day presentation on brain and body evidence, diagnosis and the new medications, for Park Center – the recording didn’t make it due to a server crash.

0 comments Read the full article here →