CorePsychPodcast

Welcome to CorePsychPodcast

For a free article on:  The 10 Biggest Problems with ADD/ADHD Medications - and Their Solutions, sign up today for Publication Notification on my New ADD Book. [No obligation to purchase] and also Sign up for CorePsychBlog Email Updates over here> 

Click here for a Brief Personal Message updated 9-21-08:  only 1.5 min
Thanks, cp

 

CorePsychPodcast Molts: New Skin Coming Soon

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CorePsychPodcast Will Dramatically Change, Tell Your Friends:     

1. Soon will be changing to a WordPress Skin, with more clarity, less busyness, and better navigation,
2. This year will be becoming more active with podcasting video blogs also linked to You Tube on hot topics for every day use  in the office - from ADHD to Brain Injury. These will be short videos filmed  here at my office in Va Beach.

Working to get all this done ASAP,

Please stay tuned for the next iteration,
cp

ADD, ADHD Stimulant Medication Dosage: The 'Bottom Bewitching Hours'

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Target the Entire PM for Adequate Dosing

Often ADD/ADHD medications aren't targeted, or dialed carefully in, for the Entire Day, but rather set for an inadequate objective to just "get through work or school." This problem has been with us since much before the 1960s - is paleolithic - and simply does not address the 'bewitching hours' of 4-8 PM. The 'Therapeutic Window' is often simply not reviewed.

New meds can cover the entire day, school and work alone are no longer the only objectives. Family life, the evening, and overall cognitive management throughout the day, have become important treatment objectives with the new medication alternatives. This article discusses some of those new options for stimulant medication titration - and thereby adjusting the dosage correctly.

7 Tips to Find and Correct Insufficient Duration Through the Day

1. Look for that longer objective: It may sound simple, but with the new drugs we can significantly change our PM objectives. The new drugs such as Vyvanse and Daytrana will last 13-14 hrs easily, but just take some time to ask the questions carefully and then adjust the dosage.
2. DOE, 'Duration of Effectiveness,' evaluation must come up at every medication check. If your doctor dosen't ask about it, you must think about it anyway to encourage the discussion. It is time consuming, but if you are prepared you will make the medical job easier. One of the main reasons it is time consuming is because with the new stimulant medications it is more difficult to assess.
3. Know The Characteristic Subsets of the PM Drop: - These will be carefully outlined in another full article, but suffice it to say that with the longer duration medications it is much harder to recognize. Look for any change in focus, appetite, inattention, even a vague feeling of decreased motivation can signal the end of the DOE.
4. How Vyvanse will cover 12-14 hr: Increased carefully with 10 mg increase in the AM will add about 2-4 hrs on the the PM bewitching hours. Studies show even in children that an object of 13-14 hr is reasonable, but don't, repeat that, don't try to do it all at once. Give the person time to assimilate, to get used to, the medication, even this excellent product can be overdosed by starting too high. Give the person about 1-2 weeks with each dosage so they can find and report the DOE at that specific dose, then the team will be on target. Adjusting to aggressively, too quickly, will bring more side effects.
5. How Daytrana can cover 12- 14 hr: I like both of these medications because compliance goes up with less afternoon dosing, and there is no need to remember that PM dose. The company does not recommend cutting the patch, but the patch can easily be cut to target a specific clinical effectiveness through the day. Keep the patches in the refrigerator, cut them to increase or decrease the dose, and don't forget that you can leave them on longer in the PM to cover evening work. Each person is different, and using PPT 'Post Patch Time' [should be 3-4hr] will tell you if the daytime dose is effective. If only 1 hr PPT, the dose is insufficient.
6. Adderall XR, Concerta, Focalin XR, Metadate CR Durations: Of the collection of stimulant medications it is my experience that Adderall XR is easier to adjust for about 10 hr, sometimes 12, but the others routinely fall short. With all of these medications including Vyvanse and Daytrana: Too little: it isn't covering the PM, too much it is interfering with sleep.
7. Teach the children at the outset: It is harder for them to know what to look for setting these PM treatment objectives. Spending just a little time at the front end will help them feel like part of the team.

With these tips you will be better able to make essential PM adjustments with ADD/ADHD stimulant medications to cover the most often overlooked part of the day, without creating sleep disturbances.

Bottom Line By following simple guidelines and the metaphor of the 'Therapeutic Window' you will be more able to adjust dosing correctly, and effectively - so you and yours don't feel like treatment failures. I invite you to sign up now for my new book "Fixing the ADD Madness: A Patient's Guide to Stimulant Medication Details," at the top of this page - And enjoy the bonus gifts on the thank you page for signing up early.

See the complete series of these articles on dosing stimulant medications at EzineArticles here.

Russell Jaffe MD: Commenting on Brain, Body and Foxhounds

Welcome back to CorePsychPodcast with this program, the first of a series on brain and body medicine with esteemed colleague Russell Jaffe MD, PhD.

Dr Jaffe will keep you interested with anecdotes that sound at first like you are "down home," but then you realize who you're talking to. His broad experience, remarkably simple and applicable clinical tools will definitely keep your interest.

Fasten your seatbelt and listen up... he thinks in paragraphs, but punctuates every conversation with warm good humor, and personal tidbits that give you the feeling that you know him a lot better than you actually do!

See what you think about foxhounds, psychoneuroimmunology, depression and neurotransmitters on platelets... and the evolution of medicine. He reports on discussions with Lewis Thomas MD, author of The Youngest Science: Notes of a Medicine Watcher, and former President of Sloane-Kettering in NYC.

He is a great person, a remarkable professional, and I very much look forward to his interest in chatting with out CorePsychPodcast community.

This brief introduction will give you a brief [13.5m] review of Dr Jaffe's take on the state of current medical practice.

Good listening!

Listen to Amen on PBS: The Visionary Finds His Larger Audience

Brain Function, SPECT Imaging, evolved Psychiatric Treatment goes Public

No matter how you slice the SPECT landscape tomographically, Daniel Amen is the primary person who began the leap from brain evidence to application using isotopes in brain imaging. Even now at large national meetings in the imaging industry the imaging folks are still far away from discussing the clinical applications. They simply don't have the experience/numbers! And they didn't have the psychiatric background to ask the right questions.

So it's fun for me to see my past mentor achieve the victory that any pioneer longs for in the context of repeated professional retributions and "quacklike" criticism.

Let's face it, he has been beat up for years on these matters, and still walks out with a smile, great brain information, and provocative true stories. He is in that phase of science [see Thomas Kuhn The Structure of Scientific Revolutions] wherein many are claiming it was their idea, ...they figured it out at the same time.

If you haven't heard the Master speak, he is one of the absolutely best medical speakers on any level, and fun, entertaining, with great stories, and .... remarkable science.

These are the links for your review as soon as possible: Change Your Brain, Change Your Life on PBS

http://amenclinics.com/server1
Intro by his friend Bill Cosby : 7 Principles to Change your Brain

http://amenclinics.com/server2
Less Emotional Instability and Secrets to Deal with Difficult People

http://amenclinics.com/server3
Healthy Brain Prescriptions for a Lifetime

If you like brain science, you will enjoy Amen.

Gluten/Casein Sensitivity: Brain Function Deterioration

Brain Function problems show on SPECT imaging downstream from gluten/casein sensitivity. Some can appear psychotic, as we have witness in our CorePsych office -and as reported in the Annals of Internal Medicine in that previous post.

This interview, over from YouTube, is my first attempt at transfer of interesting video documentation. I have two more short celiac instructional videos from YouTube in my Celiac/Casein Playlist there and will be sending you personal vlogs [video logs] on my own review of brain and body functional matters soon.

And, by the way, you can drag your cursor across the bottom of the screen while the video is on, and click on either of the other two short videos on my Gluten/Casein list. While just sitting on this page you can see all three:

1. this first video,
2. -then another: a woman from Australia talking about her celiac condition,
3. -and then: a more specific medical review of the pathology so you can see what happens directly to the gut.

This should be interesting!

Only 7 min, see what you think about this info and don't hesitate to comment below,