I was doing some research last week for a talk I gave at theannual conference
of the Brain Injury Association of Massachusetts (thanks to the survivors, family members, and clinicians who attended!). Thought I'd share with you something I found regarding efficacy of stimulant medications with brain injury survivors.
While use of these agents is a fairly common practice with both adult and pediatric TBI patients, these "ADHD medications" have not been FDA approved for this use, and clinical implementation relies heavily on anecdotal data.
I had a great conversation at a recent ADHDworkshop
about the role of frontal synaptic dopamine transmission on the one hand and subcortical dopaminergic function on the other. (...and why should you care about any of this? scroll down to the last paragraph...)
I was makingsome point
about about the role of the basal ganglia in the dopaminergic pathway, and an attendee (hi, Barry!) noted that his understanding was that stimulant medications (which increase available dopamine) have their mechanism of action at the level of the synapse, and in the prefrontal cortex (where we believe planning and sequencing and inhibiting take place).
, brain science
, executive functioning
Earlier this week I blogged about a practical alternative
which I regularly offer to individuals and families who have questions about ADHD and related disorders, but aren't sure they're ready to spring for a full neuropsychological evaluation. The next post here at this blog was a consideration ofhow to determine when such evaluation
is in fact right for you or your family member.
So what happens after a neuropsychological evaluation? After all the testing and scoring and writing up the results.
Hey I want to let you in on something I'm excited about! HypnotherapistDan Candell
and I, along with mytireless staff
(hi Vivian and Susan!) are putting together a resource for parents and partners of individuals living with the frustrations and challenges of ADHD.
This audio/workbook product is a resource for clinicians and teachers who want to know more about supports for folks with ADHD, and it's a great jumping-off point for newly diagnosed teens and adults themselves.
The Kit provides a brief overview of the clinical work of a neuropsychologist and a hypnotherapist and what these specialties bring to the table in terms of ADHD support.
Aftermy recent posting
at Psychology Today, I got the following great question from a reader. I'm offering my response to that question here because this is the kind of concern that comes up frequently at workshops and in the clinical setting.
Q: Why is it that a people with a certain title are more qualified to say i'm doing "good enough"? if i could benefit from medication why is it their right to say i won't benefit enough to get it?
A: This is a great comment and hits on a couple of things that clinicians as well as clients might consider.
a link toan article
in the American Journal of Psychiatry suggesting there are specific brain changes in individuals with ADHD who have history of stimulant medication use.
The tweet bounced to myFacebook page
where a reader (hi, Lindsey!) asked:
Okay David, I took a look at the article... I'm wondering if you could explain what was said in layman's terms?
Sure - quite simply: It's an exciting time to be doing this work! Now, a somewhat longer explanation follows.