When I talk about “optimizing medication” in my presentations on Adult ADHD, some faces in the audience look puzzled. That’s not surprising, given the stories I’ve heard for years of careless prescribing patterns that result not only in unnecesary side effects but also sub-sub-optimal positive effects. Often, I’d vent my frustration via e-mail to Dr. Charles Parker.
Now, I can’t take credit for Dr. Parker deciding to produce a long-awaited comprehensive guide, ADHD Medication Rules: The Meds For Paying Attention, but no one is more thrilled than I am to have this as a resource. (It’s an e-book, complete with hyperlinks and search function. Very handy!) Readers of his Corepsychblog have long appreciated his breadth and depth of knowledge (in posts as well as video and audio and podcasts), and now they can benefit from his comprehensive strategy for the medical treatment of ADHD.
I found Dr. Parker years ago, in searching for a medical source for my book who could explain the differences between the two classes of stimulants (AMP and MPH), especially in their immediate release forms; this is an important distinction often overlooked by physicians.
At the same time, I sought a physician who had a broad-but-detailed knowledge of all the myriad factors affecting health, especially brain health, such as food sensitivities, amino acids, thyroid function, hormones, and other metabolic issues. (So many of the people I meet with late-diagnosis ADHD have complex cases, often accompanied by co-existing psychiatric diagnoses and physical health challenges.) With Dr. Parker, I found all that plus high-level expertise in SPECT brain-imaging technology (in fact, he opened and formerly ran an Amen Clinic on the East Coast). His is indeed a rare set of skills.
Look for more details about the book here soon–and perhaps an excerpt. In the meantime, the book’s price is discounted until July 11, so I wanted to get the word out now. Please help to spread the word, especially to clinicians, but to anyone affected by ADHD. Click here to purchase the book from Dr. Parker’s CorePsych website. And, click here to read the press release, which is excerpted below:
ADHD treatment targets are superficial and almost entirely descriptive, ignoring brain function, and, by default, leave both doctors and patients to conjecture about clear treatment objectives. “Hyperactive, Inattentive and Combined” not only provide vague, superficial targets, but also fail to address important variables of context, feelings, and thinking. Current diagnostic targets almost always overlook the personal experience of those suffering with ADHD.
Not only are we not paying attention to paying attention, we aren’t thinking about thinking!
The truth is, current stimulant treatment strategies typically make little operational sense to patients and many professionals. Translating ADHD medication theory into effective what-you-do-in-the-office step-by-step guidelines has been challenging – and we are the purported thought leaders in the world! Even the expert observer recognizes that no basic rulebook exists that sets clear treatment options, clear objectives.
No wonder the ADHD treatment process appears unscientific – it is!
Great post, Gina. It’s astonishing how meds, whether for ADHD or not, are prescribed using only the most basic guidelines. For physicians, it typically boils down to selecting from one of three dosages (yup, that’s usually the number), and determining the frequency based on the patient’s weight and MAYBE their age and/or race.
Very little titration typically gets done, and that’s a terrible failure, ’cause it may easily lead to the patient dropping treatment because the dose is effectively too high for them due to genetic variation, thus preventing them from benefiting from a drug that otherwise could have been effective for them. This is a tragedy when one considers how few drugs we have in the first place — losing one for such a bone-headed reason is a big deal…
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