ADHD Insights: Let’s Change The Rules

ADHD Insights: Copper Brain Origins
October 24, 2012
ADHD Insights: D2 Receptors and Executive Function
October 26, 2012

New Rules ArriveNew ADHD Medication Rules Make A Difference!

The best news for an author? When the Advanced Review Copies [ARCs] arrive from the publisher for final review just before printing. New ADHD Medication Rules arrived in the office mail yesterday, and is looking exceedingly good!

With this Review step soon completed New Rules will be sent from these digital bookstores before the coming Holiday Season – at a discount paperback price below the cost of my original New Rules eBook! 😉

For a quick review of 12 specific excerpts and a link to the new Kindle version now available: visit the New Rules site:

But A Key Question Remains: Why Read New Rules?

Consider: These 10 Serious ADHD Medication Problems:

  1. ADHD is the most commonly misdiagnosed and mismanaged psychiatric condition on the planet. Current ADHD prevalence numbers are inaccurate based on failure to understand functional brain diagnosis. Questions and questionnaires don’t address the patient’s real executive function challenges.
  2. ADHD diagnosis remains remarkably incorrect as ADHD diagnosis is based upon appearances – not on well know brain function measures.
  3. Even excellent psychological testing misses brain science as it often targets superficial symptoms sets from the current diagnostic manual – outdated by at least 20 years.
  4. Many write for stimulant medications capriciously, not only with vague treatment targets, but also without instructions regarding medication expectations and metabolic characteristics of the meds. Imprecision abounds – New Rules corrects imprecision.
  5. ADHD stimulant medications, Class II Controlled Substances, are some of the most highly controlled medications for good reason, but are often written almost whimsically, without understanding the biology of how they work.
  6. ADHD occurs in specific life contexts, specific realities, not only as a 24X7 presentation. Overlooked deterioration in specific complex circumstances creates lifetimes of apparently permanent pain.
  7. Comorbid conditions, other medical conditions occurring associated with ADHD, are more common than appreciated and create unpredictability with medication management. Missed depression can create suicidal thinking when using stimulant meds.
  8. Adult ADHD presents as quite different from most childhood ADHD, and is frequently missed due to failure of understanding of brain function and life context. “Hyperactivity” is less than 10% of ADHD challenges.
  9. Almost the entire psychiatric diagnostic manual focuses on feelings – affect, with almost no attention to thinking and cognition. Many aren’t thinking about the thinking process across the USA, but continue to treat thinking without thinking. The essential ADHD oversight: missing metacognition – outlined in this brief report.
  10. Drug interactions with antidepressants remain pervasively overlooked –and provide a source of dangerous concern. Some antidepressants cause long-term accumulation of stimulants – information easily available since ’96.

Simplify: The Three Biggest ADHD Med Problems Summarized

  1. ADHD diagnosis is outdated and inaccurate – creating vague treatment targets, based on appearances, not on brain function.
  2. Medications must pass through the body to get to the mind – a common sense observation pervasively denied and disregarded, and dramatically relevant for all psych medication effectiveness.
  3. Overlooking the biology, the science of mind and body interactions, repeatedly contributes to years of pain and suffering yet downstream medical inaccuracy remains both denied and pervasively disregarded.

Do connect on New Rules, and let's get into more conversations about correcting the current ADHD medication madness. Become a part of the solution! – please pass this note on to your team so we can all make a difference.

Drop me a note below, and, FYI, check out the excellent testimonials and reviews here at the Amazon Kindle Store:


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  8. Anonymous says:

    Hello Dr Parker. I’d like to ask a few questions because I have no idea what to do. I’ve been diagnosed with ADD. I haven’t been diagnosed with GAD or any other anxiety disorder but I can be very anxious. I live in Sweden and you can’t get amphetamine-based medication before trying out Concerta, Ritalin and Strattera. I’ve heard that methylphenidate-based medication are more likely to cause anxiety but since I didn’t have any choice I went with it. My doctor prescribed me Concerta (18 mg) and Ritalin (10 mg). He basically told me just to titrate (without specific instructions) it until I felt I was on a comfortably dose.

    I took a 18 mg Concerta and then a 10 mg Ritalin the first day and didn’t feel a lot of difference. The next day I took 2 18 mg Concerta and a 10 mg Ritalin and it felt ok I guess. It didn’t feel like it helped that much. I then took 3 18 mg Concerta and a 10 mg Ritalin the next day. When I took the Concerta I was feeling ok. When I got tired I took a Ritalin and then I had a horrible anxiety attack out of nowhere. I just wanted to spend time in my room and waited for the feelings of anxiousness and headache to go away. The next day I only took 2 18 mg Concerta but I still felt horrible and anxious. After this I completely stopped taking both of them and I had horrible feelings of anxiety the next couple of days even though I didn’t take any. I was shaking and I thought it was game over, it was really terrifying.

    I told all of this to my doctor and he told me this was really weird and that it usually never happens. I eventually calmed down and after that he prescribed me Strattera. I’ve been on 40 mg per day for about 1,5 week and I don’t feel it has helped me a lot. I still can’t pay attention to anyone and it’s almost like I feel more sluggish than usual. I don’t think it has helped with my anxiety as well. I feel tired and I feel like I’m not getting the sleep I need. I sleep 7 hours but I don’t feel rested. I think my doctor is going to recommend upping the dosage to 80 mg but I can’t help but feel it’s not going to help since 40 mg feels pretty musch useless.

    So it seems that Concerta, Ritalin and strattera doesn’t work. What do I do now? I have ADD and have few issues with anxiety, but not enough to warrant a diagnosis (according to the psychologist and I agree with her). I feel I have a lot of the symptoms with sluggish cognitive tempo that Russell Barkley has used. There are so many medication choices that I don’t know what to use. There is Adderall Vyvanse, dexedrine. I’ve also heard that intuniv by itself and together with for example adderall help a lot. I don’t know what to do and I feel like my doctors don’t have the knowledge they need to effectively treat me. What would you recommend?

    • Anon,
      You significantly overdosed on too rapid a titration strategy, simply because your doc didn’t know what to tell you. Your example is precisely why I wrote New ADHD Medication Rules… by the way this is the link, will add to this post in a min, where you can download the Kindle version right now:

      MPH products often do help with anxiety and one can have a difficult, counterproductive reaction to either AMP or MPH products if increased too quickly. You simply went out the top of the Therapeutic Window described in detail in various postings here, also in the book.

      Sluggish is also overdose. Over here many call it “stoned.” Just too much.
      With your doc consider starting over, go more slowly find the exact DOE and never increase faster than every 4 days. If you fail MPH products, which may happen anyway, then try a careful slow start with AMP watching carefully the DOE. Strattera only works for about 5% of the population that completely fails everything else – not my go-to drug, but rather last place on my list.

      Hope this helps!

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