RealityReality Changes The Changes The ADHD RulesADHD Rules

New ADHD Medication Rules New ADHD Medication Rules Brain Science & Common SenseBrain Science & Common Sense

http://adhdmedicationrules.comhttp://adhdmedicationrules.com

Dr Charles Dr Charles ParkerParker

1. 1. WhyWhy RealityReality For ADHD Meds For ADHD Meds

2. 2. HowHow To Rethink Standards To Rethink Standards

3. 3. WhatWhat Specifics Need Change Specifics Need Change

Overview: Overview: Let’s Take a Moment Let’s Take a Moment To Consider:To Consider:

WhyWhy Think…Think…

About New About New ADHD Med ADHD Med Rules?Rules?

Take This Home!Take This Home!

……Serious problems Serious problems regularly do occur with regularly do occur with ADHD Meds.ADHD Meds.

……That Everything is That Everything is OK in ADHD LandOK in ADHD Land

Office Tragedy EverydayOffice Tragedy Everyday- Heartbreak - Heartbreak

- Anger - Anger

- Overwhelming Side Effects- Overwhelming Side Effects

- Treatment Failures Abound- Treatment Failures Abound

Too Many Wasted Too Many Wasted LifetimesLifetimes

The Current Standard The Current Standard of Care – Think About of Care – Think About It -It -

Almost Completely Almost Completely Ignores Ignores Biologic Biologic

RealityReality

Globally,Globally, Too Often: Too Often:Both Public and Both Public and ProfessionalsProfessionals Are Are DisillusionedDisillusioned With ADHD With ADHD Treatment OutcomesTreatment Outcomes

------------------New Objective: New Objective: No No Illusions In the First Illusions In the First Place Place

So, What So, What isis the Problem?the Problem?

RealityReality Remains Remains

Dynamic - and Dynamic - and Changes:Changes:

You can’t stick your You can’t stick your foot in the same river foot in the same river twice.twice.

Heraclitus 500 BCHeraclitus 500 BC

On the other hand…On the other hand…

DreamsDreams and and FantasiesFantasies Occur Occur in the in the DarknessDarkness

DreamsDreams and and FantasiesFantasies Often Often Create ConfusionCreate Confusion

The The Biggest Biggest

Problem Problem with with

ADHD Treatment?ADHD Treatment?

> > Ambiguity…Ambiguity…DenialDenial Of The Of The DarknessDarkness

Just How Much Just How Much Inattention is Inattention is Inattention?Inattention?

How Much How Much Hyperactivity is Hyperactivity is Hyperactive?Hyperactive?

WheWherere AreAreWe We Going?Going?

How Often Do We How Often Do We Treat Treat Appearance Appearance CriteriaCriteriaNot People?Not People?

Two Two ProfoundProfound DeficitsDeficits Exist with Exist with AttentionAttention DeficitDeficit::

1. Diagnostic Specificity1. Diagnostic Specificity&&

2. Treatment Precision2. Treatment Precision

Outcome… Outcome… GuessworkGuesswork

MedsMedsWrittenWrittenWithout Without Clear MapsClear Maps

Remember…Remember…

GalileoGalileo

MeasureMeasure what is what is measurable, and measurable, and make make measurablemeasurable what is not what is not so.so. Galileo Galilei Galileo Galilei

~ 1615~ 1615

HowHowReality Does Reality Does MatterMatter

Overlooked in ADHD:Overlooked in ADHD:

BiologicalBiological Realities Do ApplyRealities Do ApplyFor Medical For Medical DiagnosisDiagnosis1.1.Brain:Brain: FunctionalFunctional Reality Reality

2.2.Body:Body: BiomedicalBiomedical Reality Reality

ADHD ADHD Realities Realities OverlookedOverlooked

In Routine TreatmentIn Routine Treatment1.1.Measurable:Measurable: Medication Duration Medication Duration2.2.Measurable:Measurable: Therapeutic Window  Therapeutic Window 3.3.Measurable:Measurable: Drug InteractionsDrug Interactions4.4.Measurable:Measurable: Medication Seesaw - Medication Seesaw - Antidepressants and StimulantsAntidepressants and Stimulants

Start: The Start: The Diagnostic Diagnostic RealityReality OfOf

Brain FunctionBrain Function

HowHow We We DenyDeny The The Reality of Reality of Brain FunctionBrain Function

How We HandleHow We Handle

Changing RealityChanging Reality

Brain Function: Brain Function: Is Based On Is Based On Changing RealityChanging Reality

Working Memory Working Memory ManagesManages

ChangingChanging RealityReality

Changing Changing Reality Reality

AmplifiesAmplifies ADHDADHD

Labels Don’t Labels Don’t Consider Consider ContextContext or or - - Changing RealityChanging Reality

What setsWhat sets

our our BrainsBrainsapart from cats,apart from cats,

cows and elephants? cows and elephants?

Yes - Working Yes - Working MemoryMemory

Working Memory Working Memory Timed Timed Sequence: Sequence: 1. 1. ThinkingThinking About About RealityReality

2. 2. Acting Acting Upon that Upon that RealityReality

3. 3. CarryingCarrying RealityReality Results Results to the next dayto the next day

TimingTiming is is Everything…Everything…

Working Working Memory Memory Must Be, Must Be, Timed, Timed, Synchronized… Synchronized… - In Sequence- In Sequence

FrozenFrozen Working Memory Working Memory Is Is DesynchronizedDesynchronized by:by:- - Increased VariablesIncreased Variables- - Decreased StructureDecreased Structure- - No Stimulating FocusNo Stimulating Focus

The PFC Brain The PFC Brain Desynched = yes - Desynched = yes - ADHDADHD

Desynchronized ADHD:Desynchronized ADHD:

Acting ADHD Acting ADHD 1. 1. Acting without Acting without Thinking Thinking - more explicit - more explicit than “Hyperactive” and can be than “Hyperactive” and can be placed in each Reality Contextplaced in each Reality Context

Thinking ADHDThinking ADHD2. 2. Thinking without Thinking without ActingActing, , - The Most Commonly Overlooked- The Most Commonly Overlooked

- “Cognitive Anxiety” - “Cognitive Anxiety”

- Often without Anxious Feelings - Often without Anxious Feelings

- Video: - Video: www.bit.ly/adhdanxwww.bit.ly/adhdanx

Avoidant ADHD Avoidant ADHD 3. 3. Not Thinking & Not Not Thinking & Not Acting Acting - - See YouTube ‘Avoidant’ VideoSee YouTube ‘Avoidant’ Video-Biologically correctableBiologically correctable-Social Anxiety, Intimacy, ProcrastinationSocial Anxiety, Intimacy, Procrastination

- Avoidance of specific - Avoidance of specific RealitiesRealities

Thinking, Acting and Thinking, Acting and Remembering, Remembering, Working Memory Working Memory MattersMatters----------------

But, Last Time I But, Last Time I Checked Checked The Mind Was The Mind Was Connected To BodyConnected To Body

Technology Technology Denial:Denial: Functional Functional

Body Body Reality Reality

Are You Are You

PrePre-Technology -Technology

StuckStuck or… or…

PostPost-Technology -Technology Connected?Connected?

Let’s Build Let’s Build Mind-Body Mind-Body New Roads TogetherNew Roads Together

BodyBody Diagnosis: Diagnosis: Measurable Body Measurable Body Biomedical Data = Biomedical Data = MeasureableMeasureable Impediments Impediments

Medical Biomarkers Medical Biomarkers ((Just As Cholesterol or CRProtein, Just As Cholesterol or CRProtein, Are Are NotNot CategoricallyCategorically CorrectCorrect, e.g.:), e.g.:)

-SPECTSPECT-NeurotransmittersNeurotransmitters-Immunity - IgGImmunity - IgG-Trace Elements, Heavy MetalsTrace Elements, Heavy Metals-Genetics: D2 Receptor, CYP 450 Genetics: D2 Receptor, CYP 450

Biomedical Data:Biomedical Data:Neurotransmitters - Neurotransmitters - NT NT -Measure With UrineMeasure With Urine-Without them Meds Don’t WorkWithout them Meds Don’t Work-Meds Collect NT ChickensMeds Collect NT Chickens

Biomedical DataBiomedical Data: : ImmuneImmune System Challenges System Challenges

IgIgGG:: The The GhostGhost Immunoglobulin Immunoglobulin [[7-10 Days]7-10 Days]

IgIgEE: : The The EmergencyEmergency Immunoglobulin: Immunoglobulin: [24-48 Hrs.][24-48 Hrs.]

Biomedical DataBiomedical DataHormonesHormones-Adrenal Function - DHEAAdrenal Function - DHEA-ThyroidThyroid-Estrogen [Dominance]Estrogen [Dominance]-TestosteroneTestosterone

Biomedical DataBiomedical DataTrace ElementsTrace Elements-Tissue Mineral Analysis – Drug TestTissue Mineral Analysis – Drug Test-Deficiency = NT DeficiencyDeficiency = NT Deficiency-Excess = Toxicity e.g Cu, CheerleaderExcess = Toxicity e.g Cu, Cheerleader-Effect Autonomic Nervous System = Effect Autonomic Nervous System = PNS and SNSPNS and SNS-Heavy Metals Block NT Activity - NEJMHeavy Metals Block NT Activity - NEJM

Biomedical DataBiomedical DataGenetic Testing Genetic Testing For For PolymorphismsPolymorphisms-CYP 450 2D6 – 4 Different PipesCYP 450 2D6 – 4 Different Pipes-D2 Receptor Changes – D2 Receptor Changes – Reward Reward Deficiency SyndromeDeficiency Syndrome – Food, Substance – Food, Substance Abuse, Addictions, ADHD Meds Don’t Abuse, Addictions, ADHD Meds Don’t Work – Ken Blum PhDWork – Ken Blum PhD

The The MeasurableMeasurable RealityReality Of Of

Medical Medical TreatmentTreatment

WhatWhat To DoTo Do

“Pills have to pass Pills have to pass through through your your bodybody before they before they reach your reach your brain”brain”..

New Rules New Rules Outlines Outlines Exactly What Works Exactly What Works Most OftenMost Often

- Almost - Almost every problem every problem with ADHD medication is with ADHD medication is directly relateddirectly related to to realreal, , measureablemeasureable, , body body metabolic challengesmetabolic challenges..

- Body - Body MetabolismMetabolism Directly Directly Effects Effects Mind FunctionMind Function

In the FogIn the FogWithout Without LandmarksLandmarks……

Any Any Markers Markers MatterMatter

MeasurableMeasurable Medication Medication DDuration uration OOf f EEffectiveness: ffectiveness: RealityReality IsIs Built Into Each Built Into Each Med = Med = DOEDOEShort Acting – e.g. Ritalin IR 4hrShort Acting – e.g. Ritalin IR 4hrLong Acting Long Acting – e.g. Adderall XR 8-10hr– e.g. Adderall XR 8-10hrVyvanse – 10hr Kids, 12hr adults. Vyvanse – 10hr Kids, 12hr adults. Daytrana 12hr, - Strattera 10hrDaytrana 12hr, - Strattera 10hr

Measureable Sweet SpotMeasureable Sweet Spot

Therapeutic Therapeutic WindowWindowSides = Sides = DDuration uration OOf f EEffectiveness: ffectiveness: DOEDOETop = Too MuchTop = Too MuchBottom = Too LittleBottom = Too Little

ADHD ADHD MedicationMedication IntroIntro Tutorial Tutorial::- These 8 Videos Describe - These 8 Videos Describe HowHow To Work With ADHD To Work With ADHD MedsMeds

http://bit.ly/medstutorialhttp://bit.ly/medstutorial

ADHD ADHD MedicationMedication DosageDosage TutorialTutorial:: - 9 Short Explanatory - 9 Short Explanatory Videos on Videos on HowHow Dosage Dosage StrategiesStrategieshttp://bit.ly/dosevidshttp://bit.ly/dosevids

Dark Circles Dark Circles Encourage Encourage Precise Precise QuestionsQuestions

1. 1. Measurements Measurements Matter : Matter : IgGIgG

IgG

ADHD, ADHD, Immunity Immunity Mind & Gut Mind & Gut TutorialTutorial:: - 8 Short Videos on - 8 Short Videos on YouTube | IgG ExplainedYouTube | IgG Explainedhttp://bit.ly/mindguthttp://bit.ly/mindgut

Predictable Predictable

Drug InteractionsDrug Interactions2D62D6 Makes A Difference Makes A Difference

- Video: - Video: Prozac & Paxil Prozac & Paxil - - NotNot With StimulantsWith Stimulantshttp://bit.ly/prozacadhdhttp://bit.ly/prozacadhd

2. Measurements 2. Measurements Matter : Matter : Trace Trace Elements - Elements - TMATMA

TMATissue Mineral Analysis

3. Measurements 3. Measurements Matter : Matter : NeurotransmittersNeurotransmitters

NeurotransmitterNeurotransmitters s

Depression & Depression & ADHD ADHD Serotonin/Dopamine Serotonin/Dopamine Seesaw Seesaw – See Video– See Videohttp://bit.ly/2diagnosehttp://bit.ly/2diagnose

Coaching & CorePsych Coaching & CorePsych UpdatesUpdates: : Treatment Options: Treatment Options: CorePsych.com/servicesCorePsych.com/services400+ Articles400+ Articles: : CorePsych.comCorePsych.comCoach Partners: Coach Partners: CoreBrain.org/coachesCoreBrain.org/coaches

ReviewsReviews & & New Rules New Rules Excerpts:Excerpts: http://adhdmedicationrules.comhttp://adhdmedicationrules.com

Free White PaperFree White Paper: Predictable Solutions: Predictable Solutions::http://corepsych.com/adhdbookhttp://corepsych.com/adhdbook

HOWHOWThree Important Three Important Complimentary Complimentary How To ADHD Medication How To ADHD Medication YouTube Tutorial Playlists at: YouTube Tutorial Playlists at:

www.youtube.com/ www.youtube.com/ drcharlesparkerdrcharlesparker

Learn More About Learn More About Reality for ADHD Reality for ADHD Medications Medications – – Webinar Details At:Webinar Details At:

http://corebrain.org/http://corebrain.org/realityreality

Many Many ThankThank

s! s! cpcp