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Understanding ADD/ADHD Medications: Pay Attention to the Details

Posted Jul 21 2008 10:11am

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 -Addadhdfrust_2with disastrous long term consequences. Problems arise much too often. And they are correctable!

Hey, this is not hype - we see these challenges everyday in my office and have for many years! I have seen literally several thousand second ADD/ADHD opinions, heard responses from dinner meetings with hundreds of medical folk, and find that some things just are not done in the offices they way they should be.

And the Paradox is Simple: We're treating Attention Deficit Disorderwithout Paying Attention!

Getting the meds right takes some forethought, careful planning and ongoing operational guidelines. I've been discussing this ADD/ADHD Medication subject since thefirst post here at CorePsychBlogback in '06, and really haven't changed my tune.

We shouldnotfind ourselves asking the patients what to do next, we should beteaching everyone what to look for, what the targets are, and evaluating progress byspecific measurements- instead of simply "Is it working?"

And I am certainly not blaming anyone, any docs, any academics. We simply don't have a book, a reference, a set of guidelines currently available that provides a simple structure for medication management. My simple take on it: we are so research driven that too few are actually developing feedback loops with the patients in the offices.

Providers themselves are vertically challenged! Just see what myold friend Dr Edward de Bonosays about the changes in management systems:

"TELESCOPE TO KALEIDOSCOPE: The management metaphor has moved from telescope to kaleidoscope. Where once top managers could focus on their own concerns, with little need for peripheral vision, they now view a constantly changing pattern of shapes, sizes and colours, from which they must try to make sense. It sounds like an awesome task. It would have been impossible save for the advances in IT, which animates and accelerates the agile corporation, setting it free to move from control to coordination of collaborative effort, from the status quo to the future." FromThinking

Sound familiar? Medicine for my entire [almost] 40 years in practice has been delivered vertically, from the top down - with a cross between a microscope and a telescope, both of which miss the ADD/ADHD kaleidoscope. It's now time to provide a more inclusive, more horizontal operational grid withspecific measurement systems

Your heard it first here: yes,feedback loops[Jack Welch on feedback here] with specificparameters.

 I've been talking about these issues for months now, and to make this discussion more convenient for you, I will link some of my previous posts on some of the important ADD medication management topics, and will tell you quickly about this new project in just a moment. Here are just few of the many topics I have been writing about:

  1. Onmetabolic problems with ADD: Specifically gluten sensitivity
  2. Oninternists using SPECT imaging for diagnostic evaluationsshowing PFC evidence
  3. On thecontroversy regarding the use of SPECT imagingfor psychiatric diagnosis
  4. Onimmune testing as it relates to ADD symptomsand obvious immune dysregulation
  5. On usingprecise guidelines with the "Therapeutic Window"
  6. On the importance of breakfast multiple posts, withthis one on school breakfasts

So what is the point?

Very simply, I am in the process of writing a book-map to help us out of this confusion - and I want you, my trusted readers, to be the first to know. The book I'm writing:

Understanding ADD/ADHD Medications: Paying Attention to the Details

  • I have changed the audio here to tell folks about this new book, and have created a special gift
  • I have added an opt-in box over there just below the email update box to go after that gift
  • The deal is simply this: you sign up now, just to let me know you are interested in the book
  • And on theThank You Pagefor signing up you will find a checklist: a pdf file outliningThe 10 Biggest Problems with ADD/ADHD Medicationswith some brief notes on basic solutions.
  • There is no obligation to buy the book when it is published, this simply gives you a big bonus benefit: a preliminary look at the contents, and a significant discount when the book comes out near the end of August
  • Also, special savings/benefits on forthcoming teleconference training regarding *The Details* because you expressed that early interest

So sign up for the discount and goodies if you haven't already.

If you have and didn't get the bonus, just let me know, I will get you the checklist. Then think of two or three people who would like the checklist who are troubled by their progress [this will likely be easy] and send them the CorePsychBlog link so they can get into this offer. Time is short, so get it done now.

Hope you enjoy the checklist and this summary - please let me know what you think in the comments below-

Have a great week!


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