Primarily Inattentive ADD

Drug or non-drug ADHD Treatment, What is Best?

2012-01-30T09:38:00.000-05:00

Drug or non-drug ADHD Treatment, What is Best?

Many people in the ADHD community insist that non-Drug ADHD Treatments simply do not work. When a study is published indicating a positive effect from taking Zinc or from computerized working memory training, most ADHD authorities insist that the study was small, or poorly done, or that it did not have a good control group. These concerns are all valid but they apply to the research performed on drug treatment as well.

The U.S. Department for Health and Human Services Agency for Healthcare Research and Quality (AHRQ) set out to critically review all the studies that had been performed, from 1980 to 2010, on the benefits of behavioral therapy and stimulant ADHD treatment.

AHRQ is this country's healthcare watch dog agency and they have been asked to look at diseases and their treatments to determine what interventions really work. As the amount of money spent on health care increases, questions such as, “What ADHD treatment really works?”, become critically important.

According to the AHRQ webpage, their mission is to improve the quality, safety, efficiency, and effectiveness of health care for all American by generating the knowledge and tools required to improve the quality of life, save lives, and gain value for the health care dollars that we spend.

When the AHRQ looked at 30 years worth of ADHD research, what they found was pretty amazing. The agency published their findings in an October of 2011 report. Their report states that many of the studies performed over the last 30 years did not meet the criteria necessary to deem them 'good' studies, (for all the same reasons that I mention above regarding the non-drug treatment studies), but from the few good studies that were performed, there were only able to conclude that, in terms of long term benefits for ADHD symptoms:

1. Parent training worked well for diminishing the ADHD behaviors of preschoolers

2. Primary school age boys with ADHD combined type, showed improvements in behavior when they were treated with methylphenidate (Ritalin) or Atomoxetine (Strattera).

That’s it! Those were the only two conclusions that they were able to make.

Studies haves shown that 50% of adults and children prescribed a stimulant for ADHD will discontinue the medication within 12 months. The reasons for discontinuation are varied and include side effects, unmet expectations or simply a discomfort with taking a controlled substance.

When stimulant medication is stopped, parents of children with ADHD and adults with ADHD symptoms may look to alternatives only to be told by their health care provider that the benefits of these therapies are questionable or short lived.

Given the findings of Agency for Healthcare Research and Quality it appears that, unless you are a preschooler or a 10 year old boy with combined type ADHD, the same can be said for drug therapy.

So the next time you question your health care provider about the merits of a non-drug therapy and they report that therapies such as working memory training, social skills training or fish oil supplements do not work, you should mention the above study and remind our learned ADHD specialist that apparently, for most people with ADHD, not much does.

Attention Deficit Hyperactivity Disorder: Effectiveness of Treatment in At-Risk Preschoolers; Long-Term Effectiveness in All Ages; and Variability in Prevalence, Diagnosis, and Treatment [Internet].
Charach A, Dashti B, Carson P, Booker L, Lim CG, Lillie E, Yeung E, Ma J, Raina P, Schachar R.
Rockville (MD): Agency for Healthcare Research and Quality (US); 2011 Oct. Report No.: 12-EHC003-E
AHRQ Comparative Effectiveness Reviews.

A Western Diet Can Worsens ADHD

2012-01-22T09:23:00.000-05:00

A Western Diet Can Worsens ADHD

Some patients do not respond to ADHD Inattentive medication and in some patients ADHD medication is not indicated because of co-occurring conditions such as Tourette’s Syndrome, Anxiety or other side effects. In patients with Sluggish Cognitive Tempo and Inattentive ADHD treatment failures may be more common. Pyschiatrist and mental health specialist are coming around to believing that for a certain subgroup of patients with ADHD symptoms, dietary changes may be the answer.

According to J. Gordon Millichap, MD, and Michelle M. Yee, CPNP, of Children's Memorial Hospital in Chicago, a great alternative to traditional treatment is an ADHD diet treatment regimen. They report that diet treatment is especially helpful for:

Parents of children that do not respond to medications
Parents that want an alternative to medications
Children that may have dietary vitamin or mineral deficiencies.

Their findings, just published in the Online version of the journal Pediatrics concluded that a diet that was low in saturated fats, high in fruits, vegetables and grains was one of the very best alternatives to drug therapy. The also noted that Omega-3 and omega-6 fatty acid supplements had been shown, in well performed controlled studies, to help with ADHD symptoms.

Millichap and Yee did a literature review of 70 trials that used diet as a medical intervention for the treatment of ADHD symptoms and found the following:

Diet was an intervention that was easy for parents to implement.
The symptoms of ADHD were significantly associated with "Western" diets.
Children with allergies have improved ADHD symptoms when foods that contain colorings, preservatives, and allergens such a wheat, dairy, nuts and citrus are restricted.
Zinc and iron deficiency may cause symptoms in a small group of patients with ADHD and confirmed deficiencies should receive supplements or appropriate dietary adjustments.
The best trial performed to date on the Omega-3 and Omega-6 fatty acids confirmed that these supplements are helpful for the treatment of ADHD symptoms.

Regarding fatty acid supplementation, Yee and Millichap reported that other trials that have failed to confirm benefits may have failed to do so because the researchers of those trials used too many different methodologies to come to any firm conclusions. They also report that they, themselves, now recommend these supplements to their patients but not as a sole treatment for ADHD symptoms or Inattentive ADHD symptoms.

The researchers are quoted as saying the following: "Supplemental diet therapy is simple, relatively inexpensive, and more acceptable to patient and parent,"

Millichap and Yee concluded. "Public education regarding a healthy diet pattern and lifestyle to prevent or control ADHD may have greater long-term success."

Inattentive ADD, ADHD and the DSM V

2012-01-16T20:00:00.000-05:00

Inattentive ADD, ADHD and the DSM V

I have not posted in a long time about the proposed changes to the Psychiatric Diagnostic Manual, the DSM, which is used to diagnose all mental impairments including ADHD. The reason for this is not neglect but rather there has not been much new to say.

What is new now is the fact that there appears to be so little clarification to the question of what will happen to the ADHD subtypes even though the deadline for the proposed new edition is just 12 months away.

The manual, that last had a major revision 1994, is called the DSM IV. It is the fourth edition of the diagnostic manual but now almost 20 years latter, a new manual is necessary. Much has changed in psychiatry and psychiatrists have been working on the revised version of the manual, the DSM V for over two years.

The new manual was supposed to sort out, among other things, whether there was value in dividing ADHD into three subtypes. The subtypes were developed for the DSM-IV but they have been found to be both helpful and problematic.

The subtypes are helpful because they establish and recognize that there is a subgroup of people with attention deficits that are not inattentive because of hyperactivity and impulsive behavior. The subtypes however are confusing because calling something without hyperactivity, Attention Deficit Hyperactivity Disorder, makes no sense. It is also confusing because the grouping has had the affect, in my opinion, of having psychiatrist treat ADHD, regardless of subtype, much the same.

The two conditions both have Executive Function problems but the problems that they have are not the same. People with Inattentive ADHD do not have the debilitating emotional control and impulse problems of the Combined type though they do have in common much of the organization, time management, motivation and perseverance problems.

There are many conditions in the DSM-IV that also have executive function issues and they are not all lumped into one diagnostic pile. People with Post Traumatic Stress Disorder, Depression and schizophrenia all have executive function problems but they are not all lumped into the same DSM category.

The American Psychiatric Association (APA) was hoping to have some empirical data (research findings, scholarly analysis, etc) to inform them of how to best sort out the entire subtype dilemma by February of 2013 and they still may make their deadline.

Functional MRI studies are shedding light on the ways that the brains of the Inattentive and the Sluggish are different from the brains of the impulsive and the hyperactive and there are some extremely brilliant people working this out. Hopefully they will come to a conclusion that improves recognition, diagnosis and treatment of all the subtypes of ADHD as that, after all, is the goal.

Two other proposed ideas for the new DSM had to do with the age of diagnosis and the number of symptoms that had to be present to determine if there was a 'true' ADHD diagnosis. Currently the DSM-IV states that for you to be diagnosed with ADHD, you have to have had symptoms before the age of seven and that you have to have 'X' number of these symptoms or 'X' number of that symptom.

The symptom number is an issue because as people age, their hyperactivity symptoms can improve or they may control their impulses better than they did when they were six, but they are still impaired despite not having the exact number of symptoms needed for a diagnosis. The age of onset stipulation is also problematic and especially detrimental to those with Inattentive ADHD because Inattentive ADHD kids can sit in a classroom until middle school without anyone noticing that they are not focused on school.

These latter two issues will likely be clarified in the new DSM-V but only time will tell if the APA is able to sort out the subtype issues before the February 2013 deadline for the publication of the new edition.

Inattentive ADHD, Baby Boomers and the Aging Brain's Default Mode

2012-01-09T11:33:00.000-05:00

The world works in mysterious ways. People with Inattentive ADHD and Sluggish Cognitive Tempo (SCT) may finally get more scientific insight into what is causing their symptoms thanks to Baby Boomers and a new discovery called the Brain's Default Mode.

As the cohort of Baby Boomers age, this huge demographic is driving research into what happens to our aging brains that make us forgetful, mentally slower, unfocused and unable to tune out irrelevant distractions.

I have just finished a book called The Secret Life of the Grown Up Brain by Barbara Strauch and I was struck by how the aging brain resembles the brain of people with Inattentive ADHD. Researchers are now, with Pet Scans and other diagnostic tools, able to see a decrease in brain cell communication in the aging brain, they are able to actually see the brain daydreaming and they have just discovered a brand new brain state which they have called the Brain's Default Mode.

This default mode is described by researchers as a brain mode where the brain is distracted by silent but continuous chatter. This is the part of the brain that when you are doing nothing starts thinking thoughts like, 'Boy, that cobweb on the wall has an interesting pattern and maybe I will make a design on my notebook with that pattern..."

Apparently, as the brain ages, it's ability to switch off the default mode starts to become less efficient and scientist are now seeing that older individuals have poorer memories, slower processing speeds and are less focused because, during problem solving, they use their prefrontal cortex less and the default mode of their brain more.

Using scanners, neuroscientist at the University of California at Berkeley have been able to see the aging brain struggle to maintain focus. The researchers did a study where they showed older adults faces and scenes and told them to concentrate on the faces. The older adults were able to focus but it took them longer, their processing speeds were slower, because they were less able to filter out the distractions of the scenes that accompanied the faces.

Does this not sound familiar? Inattentive ADHD (ADHD-PI)could be the results of our brains being stuck in default mode. It not only explains our problems with working memory and focus, it also explains why some of us have Sluggish Cognitive Tempo. The great news is that Baby Boomers are also driving research into the interventions that will keep us from getting stuck in the brain's default mode.

The aging brain does not look as much like the Combined type or the Hyperactive type of ADHD but it does look an awful lot like Inattentive ADHD and Sluggish Cognitive Tempo. Hopefully all this new research on the aging brain will, inadvertently, turn out to bring more insight into what is going on in the brains of people with ADHD-PI and SCT.

Inattentive ADHD Scholarships

2012-01-04T11:26:00.001-05:00

Happy New Year!! I am finally getting back in gear after a wonderful family vacation in Florida and I wanted to let you know about a scholarship opportunity. Shire the pharmaceutical company behind Vyvanse, Intuniv, Adderal XR and the Daytrana Patch has a program for college bound kids with ADHD and ADHD Inattentive type. The award not only includes $2000 in cash but also offers youngsters a year's worth of ADHD Inattentive counselling.

Last year Shire had a few hundred applications for 50 spots. I think that it is well worth applying because given that Inattentive type ADHD is generally under represented in any ADHD group, your chances of having your child selected may be even better than if you have a kid applying that had a diagnosis of Combined type or hyperactive type ADHD.

This is only the second year that Shire will award the fifty scholarships to college bound folks with ADHD and the deadline for application for these scholarships is 3/30/2012 for the 2012-2013 school year. Scholarships will be awarded by June of 2012. The press release with the web link to the Edge Foundation, the organization managing the awards, and to the Shire scholarship site is below.

Philadelphia, PA, US – October 20, 2011 – Shire, a global specialty biopharmaceutical company, has expanded its ADHD Scholarship Program. The program is for individuals in the United States diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) who are pursuing higher education at a college, vocational school or technical school. Fifty winners will be selected in 2012, twice as many as in the first year.

The Shire ADHD Scholarship includes a $2,000 monetary award and offers a prepaid year of ADHD coaching services provided by the Edge Foundation to assist with the transition to higher education. Fifty one-time scholarships will be awarded on June 12, 2012. The deadline to apply is March 30, 2012. For information, including eligibility requirements and scholarship application, visit www.ShireADHDScholarship.com.

“The response to the Shire ADHD Scholarship Program in 2011 was tremendous, with hundreds of applications from inspiring students across the nation,” said Michael Yasick, Senior Vice President of Shire’s ADHD business. “There are thousands of high school seniors, college students, and adults going on to higher education who suffer from ADHD. We want to recognize the brave individuals who work hard to overcome the challenges of this life-altering condition, and help them continue their educational pursuits.”

Award recipients will be offered ADHD coaching from the Edge Foundation, which includes weekly sessions with specially trained ADHD coaches. The students set weekly goals and action plans to meet those goals and have e-mail and phone support from their coaches to help keep them on track. This support may be important for students transitioning to the higher education environment because they have more free time and less adult supervision.

The Edge Foundation is a Seattle-based nonprofit organization that offers support for students with ADHD. The Edge Foundation’s primary mission is to provide access to qualified, professional coaches for students with ADHD as part of their multi-modal treatment program. For more information on the Edge Foundation, please visit the company’s website: Hwww.edgefoundation.orgH.

Shire’s ADHD Scholarship Program is part of Shire’s patient centric approach that offers support to patients, parents, advocates and others while providing care for people diagnosed with ADHD.

Comprehensive Evaluation and Treatment for ADD and ADHD is Required

2011-12-19T20:50:00.000-05:00

Why Not Comprehensive Treatment for ADD

“The doctor came in the room pulled out a questionnaire and asked me to fill it in. I answered the questions as best I could and less than five minutes later I had a prescription for Adderall, a diagnois of ADHD and the doctor had left the room.”

Musings of a bewildered ADHD Patient

The above scenario sounds preposterous, right? It may be a bit of an exaggeration but the experience of this bemused ADHD patient happens every days and is not all that dissimilar to the experience that many families and patients have when they first go to see a physician with ADHD like symptoms.

Though ADHD is a chronic condition that affects billions of adults and children worldwide; most parents and patients are barely evaluated when they are given a diagnosis of ADHD. A teacher or educator has probably been the driver of the doctor's referral and the diagnosis is often a given before the patient has even entered the clinician's office.

Under many circumstances, the health care provider performs a short and inadequate examination, does not explain in any detail the course or scope of ADHD symptoms to the parent or patient, he/she does not discuss medication alternatives, side effects or contraindication and most patients are rarely made aware of anything but the pharmaceutical treatments available for this problem. This is simply not right!

I have said many times on this blog that I am not anti-medication, I believe that treating ADHD, like treating any medical problem involves a comprehensive approach that includes appropriate diagnosis, education, a review of all available interventions and continuing evaluation regarding the success or failure of any treatment plan.

The Herman Miller Healthcare plan has reported the following regarding chronic illness. “In order to effectively and efficiently treat chronic diseases, there needs to be a continuum of cooperation, from doctor to home, from specialist to patient and from intervention to prevention." but this philosophy appears to be non-existent and a non-starter in the ADHD healthcare community. Comprehensive evaluation, education and intervention rarely, if ever, happens.

ADHD has reached epidemic proportions in this country. Estimates have reported that almost 10% of children and over 4% of adults have a current diagnosis of ADHD. We need to consider ADHD as a chronic condition that requires both a comprehensive approach to diagnosis, and a treatment plan that is also comprehensive and includes other interventions in addition to and besides medication. The treatment of ADHD must include education regarding diagnosis, prevention, lifestyle interventions, behavioral therapy and other potential treatment options.

I hope to in future post address where we stand today with regards to new, old and controversial treatments for ADHD. I believe that treating ADHD with a full court press, no holds barred, “pull out all the stops”, diagnosis and treatment plan will make a difference in the lives of millions of people diagnosed with this condition.

Parents, educators, physicians and individuals with a diagnosis of ADHD must know what is involved in a ‘kitchen sink’ approach to ADHD Treatment. Only with this type of information can parents and the medical community move ADHD diagnosis and treatment to a more thorough, complete, safer and more effective level.

Glycemic Index, ADHD Inattentive and Sluggish Cognitive Tempo (SCT)

2011-12-12T12:01:00.000-05:00

Glycemic Index, Inattentive ADHD and SCT

Inattentive ADHD and Sluggish Cognitive Tempo symptoms may be affected by breakfast meals or so reports a new study out of Britain. The British are way ahead of us when it comes to trying to figure out how our diets affect our health.

A new study published in the British Journal of Nutrition last month looked at how kids learned and retained information after eating different breakfast foods. What they discovered was that the kids that ate foods with a high glycemic load but a low glycemic index, learned better.

The difference between glycemic load and glycemic index is important because of the way these indices affect our insulin levels. Insulin levels are important because sugar is the primary energy source of our cells and too much or to little insulin affect the amount of sugar we have circulating in our bodies. This in turn affects our brain functioning as well as other hormone levels that play a role in our mental health. The correct amount of sugar is necessary for our brain cells and other bodily cells to work properly.

The whole glycemic load/glycemic index calculation is not important here. You can Google these terms if you want to know more about them. What is important is that the researchers of this study have proved what nutritionists have been saying for a very long time, “You are what you eat”. The study findings showed that high glycemic load meals caused kids to feel more confident and less sluggish or hungry and low glycemic index meals caused the kids to do better on tests of verbal memory and vigilance.

So, high glycemic load meals with low glycemic index numbers are what we need to be feeding ourselves and our children. What does a high GL/Low GI breakfast look like? I thought you might ask. The following foods are fairly high in glycemic load but fairly low on the glycemic index.

Steel cut Oatmeal, bananas, sweet potatoes, melon, pineapple, apple, peanut butter, multigrain toast, multigrain pasta, and brown rice, Multigrain Cheerios with milk or Wheaties cereal with milk. An older study from Lund University in Sweden found that eating a low glycemic but filling “good carbohydrate” breakfast with these foods improved mental focus for 10 hours.

This new study also measured cortisol, a hormone that is increased when the body is stressed, and found that the high glycemic meals increased cortisol levels . Higher cortisol levels are never a good thing, especially for folks with ADHD, Sluggish Cognitive Tempo or Inattentive ADHD (ADHD-PI). You can read more about Inattentive ADD and cortisol in this other post.

I think that it would be a pretty good idea to think about glycemic index and glycemic load when preparing all of our meals. Also remember that as we enter the holiday season, we will be under lots of stress, both good and bad and it is especially important to remember that what we eat will affect our mental health and the mental health of our children.

British Journal of Nutrition. 2011 Nov;106(10):1552-61. Epub 2011 Jun 8.
Glycaemic index and glycaemic load of breakfast predict cognitive function and mood in school children: a randomized controlled trial.

Micha R, Rogers PJ, Nelson M.
Source

Nutritional Sciences Research Division, King's College London, 150 Stamford Street, London SE1 9NH, UK.
Abstract

The macronutrient composition of a breakfast that could facilitate performance after an overnight fast remains unclear. As glucose is the brain's major energy source, the interest is in investigating meals differing in their blood glucose-raising potential. Findings vary due to unaccounted differences in glucoregulation, arousal and cortisol secretion. We investigated the effects of meals differing in glycaemic index (GI) and glycaemic load (GL) on cognition and mood in school children. A total of seventy-four school children were matched and randomly allocated either to the high-GL or low-GL group. Within each GL group, children received high-GI and low-GI breakfasts. Cognitive function (CF) and mood were measured 95-140 min after breakfast. Blood glucose and salivary cortisol were measured at baseline, before and after the CF tests. Repeated-measures ANOVA were used to identify differences in CF, mood, glucose and cortisol levels between the breakfasts. Low-GI meals predicted feeling more alert and happy, and less nervous and thirsty (P < 0·05 for each); high-GL meals predicted feeling more confident, and less sluggish, hungry and thirsty (P < 0·05 for each). High-GL (P < 0·001) and high-GI (P = 0·05) meals increased glucose levels 90 min after breakfast, and high-GI meals increased cortisol levels (P < 0·01). When baseline mood, glucose and cortisol levels were considered, low-GI meals predicted better declarative-verbal memory (P = 0·03), and high-GI meals better vigilance (P < 0·03); observed GI effects were valid across GL groups. GI effects on cognition appear to be domain specific. On balance, it would appear that the low-GI high-GL breakfast may help to improve learning, and of potential value in informing government education policies relating to dietary recommendations and implementation concerning breakfast.

Inattentive ADD and a Do it Yourself, Cheaper Learning Rx

2011-12-05T12:41:00.000-05:00

Do it Yourself, Cheaper Learning Rx

I wanted to follow up on some questions and comments that I received regarding the last post on executive functions and ADD and ADHD Inattentive. Some readers wanted to know what Learning Rx did, if there was a "cheaper Learning RX out there, and if Learning Rx was different from tutoring or classroom help.

Learning Rx is not tutoring or classroom work. This program uses a teaching model that support the concept that the brain can be trained to think better. Using the science of brain plasticity (an emerging field of study that has shown that you can improve brain functioning with practice), Learning Rx works with adults and kids on a one and one basis to work on eight areas:

Working Memory
Long Term Memory
Processing Speed
Attention
Auditory Processing
Visual Processing
Reading Skills
Logic

The child or adult is first tested to determine areas of weakness and then a program is devised to address these specific areas. The program is unique in that the child or adult works very closely with the trainer and is not left on their own to complete a computer program. A metronome is used to give the participant a sense of timing and a time goal to conquer.

Regular readers of this blog will see that all eight areas that Learning Rx focuses on, coupled with the metronome component that specifically acts as an "anti-sluggishness" trainer, addresses all the areas of possible weakness of people with Inattentive ADD.

The program, as I mentioned, is quite expensive but it is effective. The one of one experience of someone other than the parent that is working closely with the child is invaluable and apparently powerful. I wanted to share with you a letter from one of my blog readers. I found the letter so informative that I asked her if she would allowed me to post this letter about the experience that her son has had at Learning Rx.

Hi Tess,

Just wanted to give you some feedback regarding our experience with Learning Rx. It is as you say quite pricey, however, it is also one on one training and not typical tutoring but brain exerciese that are really kid friendly and fun. Our son always looked forward to his sessions. Also it is definitely a commitment, 2 or 3 times a week for 1 or 1 1/2 hours, which can sometimes be challenging in the midst of after school activities, homework, sports etc. We are 1 session away from completing his program, at which point he will will be retested and they will do a comparison of his beginning testing to his end testing to show the improvement in areas such as Executive Functioning, Long Term and Short Term Memory, Processing Speed etc.

In our continual quest to explore every opportunity available to help our child with his focus we enrolled him in Learning Rx. Our son is ADHD Primarily Inattentive type, his grades have always been A/B and he has only the normal childhood social challenges. That said, we have personally not noticed any glaring improvement on a day to day basis from his brain training program. HOWEVER, his teachers certainly have, they say he has become increasingly more confident in how he expresses himself at school and stays on task more easily. Also, the difference between this year's and last year's state standardized testing was off the chart. He had been on the lower end of "Proficient" for his grade level each year, this past year his Language Art and Math scores increased by a phenomenal 39 points. He is now on the high end of "Proficient" in Language Arts and "AdvanceProficient" in Math. From what we have been told, since the annual standardized tests are grade level appropriate, most kids from as young as 3rd grade (when testing starts) through 12th grade fluctuate within the same 10 point spread from year to year. To increase almost 40 points is exceptional and not the norm. I can also report that his IQ testing shows a 2 point increase - I am not a believer in IQ as an indicator of long-term life success however, I have to assume that the increase is related to his Learning Rx training.

The one thing I have resolved myself to that there is no one secret wepon to 'fix' ADHD. We continue to use a variety of strategies for homework, like diet, exercise, vitamins, timers, and organizers. Executive Functioning training is for us another strategy which has given him success. At some point maybe medication will work best for him, but like everything else we do it will just be another option to explore for our child's continual success. I'm now investigating Laser Therapy - if anyone has any info on that I would appreciate it.

Thanks for all you do to keep everyone informed

I was asked my several readers if there was a cheaper way to duplicate what learning RX is doing. The answer is probably. To get started I think that you would need:

An assessment of working memory, processing speed, reading skills, auditory and visual processing so that you had an idea what areas to concentrate on.
A metronome to time and improve the time that activities took.
A motivated one on one coach
A series of brain games such as the ones that you can buy at Luminosity for less than $7.00 a month
Some non-computer games such as this free Stroop game, this game called Set, and a game like Blink as well as some connect the dot games and card memory/matching games that you could get anywhere.
A book giving you some background on the Learning Rx method like this Unlocking the Einstein book (this is a book that has some real valuable information about how the program works but it also has a lot of Learning Rx propaganda).

A properly trained high school or college student with an interest in education or psychology would probably love to do a program like this for about $10.00 per hour. I am guessing that you could buy the books and the games and be up and running for less than $50.00 and then the coach could cost as little as $30.00 a week. You could try it for 12 weeks at a cost of about $400.00.

This amount is far less than the thousands of dollars that you would pay for the real program. Granted, all of this would probably not be as polished or well done as what you would get at Learning Rx but it would cost you a lot less.

Its the Executive Functioning, not the ADHD

2011-11-30T16:40:00.001-05:00

Not too surprisingly, a new study has found that our level of Executive Functioning will determine how successful we are at school and at work. The study just published in the Journal of Abnormal Child Psychology reported that higher Executive Function levels correlated with higher academic and professional achievement.

What this means from a practical standpoint (to me anyway) is that it is not the ADHD diagnosis that is the problem but it is our level of Executive Function problems that determine how well we will do in life. Drug therapy can help working memory and some of the other factors of Executive functioning (maybe... some researchers are less convinced than others) but studies have shown that there are other treatments that work even better than drug therapy to improve Executive Functioning.

Adele Diamond published an article in the journal Science in August where she stated that "Diverse activities have been shown to improve children's executive functions: computerized training, noncomputerized games, aerobics, martial arts, yoga, mindfulness, and school curricula. All successful programs involve repeated practice and progressively increase the challenge to executive functions. Children with worse executive functions benefit most from these activities."

You may remember that Dr. Adele Diamond is the Canadian PhD who authored the article on Inattentive ADHD that appears on the left hand side of this blog when you click the link labeled "Research References". She has been busy, in her lab in Vancouver, investigating methods of approving executive functioning and much of her recent published work has been on research related to these efforts.

I have written about exercise, yoga and meditation for ADHD and have also mentioned the benefits of computerized programs that help improve Executive Functioning but there are now several companies that provide training programs that include computer training and non-computer skills training for adults and children with ADHD.

One of the best known companies providing comprehensive Executive Function training is called LearningRx. I have heard mostly good things about the results of their work but at a cost of $1500 a month, it better be good.

Luminosity has programs that help Executive functioning and their programs are cheaper but they are, unlike LearningRx, self directed and not very kid friendly. There are also universities throughout the

United States

experimenting with programs that aim to improve Executive Functions. Here you can find a list of ADHD research centers by state and it is worth a call to your nearest research campus to see if you or your child might be eligible to participate in one of these studies.

A huge thanks to those who went to Amazon through my site. I very much appreciate your support. Don't forget to visit the Primarily Inattentive ADD Forum to give whatever help you can to the folks asking questions there. Thanks!!

Science. 2011 Aug 19;333(6045):959-64.
Interventions shown to aid executive function development in children 4 to 12 years old.
Diamond A, Lee K.

Dev Psychol. 2011 Nov 21. [Epub ahead of print]
Dopamine, working memory, and training induced plasticity: Implications for developmental research.
Söderqvist S, Bergman Nutley S, Peyrard-Janvid M, Matsson H, Humphreys K, Kere J, Klingberg T.

Journal of Abnormal Child Psychology. 2011 Nov 29. [Epub ahead of print]
Childhood Executive Function Continues to Predict Outcomes in Young Adult Females with and Without Childhood-Diagnosed ADHD.
Miller M, Nevado-Montenegro AJ, Hinshaw SP.

Ningdong: Non-Drug ADHD Treatment

2011-11-21T10:57:00.000-05:00

Ningdong a Non-drug ADHD Treatment

I have been compiling a book of ADHD treatments that are not drugs. This, for me, has been a monumental effort. I tend to want to spend 45 minutes formatting a paragraph for every 10 minutes that I spend writing. I am certain that you know what I am talking about...

I am making headway and there are now about 6 chapters under my belt and I am writing the chapter that I am calling Herbal Preparations for ADHD.

Prior to starting the writing, I did some research (and a lot of paragraph formatting) and discovered this interesting review article that reported that a traditional Chinese Medicine, known as Ningdong (NDG) granules had been found, in a case control study (a study with both subjects and a control group that did not receive the treatment), to be as effective as Ritalin in treating the symptoms of ADHD. The authors concluded that this treatment was effective and safe. This same traditional medicine had been found in animal and human studies to help Tourette's syndrome, a disorder that causes tics.

NDG granules are a Chinese medicine but it is not made up of one herb. Like many traditional medicines, Ningdong is made with 4 different plant species, 3 animal substances, and human placenta. I searched high and low for the 4 plant species and the name of the three animal species but my trail ran cold.

The Chinese have been using the human placenta as a tonic for thousands of years but it is considered unsafe and potentially toxic by the United States so you will not be buying Ningdong granules here anytime soon. Canada and Great Britain also have regulations that bar the sale of products containing human placenta because of safety concerns.

The Chinese have used dried human placenta, known as "Ziheche" to treat illnesses such as infertility and impotence for thousands of years. Some people in China make a soup of the placenta after childbirth and use it to ward off post-partum depression. I have included the recipe for placenta soup below.

The review article that brought the Ningdong to my attention confirmed what I have written about before. There is good evidence that zinc, iron, Omega-3 fatty acids and Pycnogenol help reduce the symptoms of ADHD. You can find more information on any of these topics by going to the search bar in the top left hand column and typing in a search word such as "zinc".

Have a wonderful Thanksgiving; please visit the Amazon store, (also in the left hand column of this webpage), and thank you for your comments and support!!

Placenta Soup Recipe

1. Wash the placenta with water, just as if you would wash a chicken before cooking. You may
use some wheat flour to rub it for further cleansing.
2. Drain out all excess water from the placenta.
3. Put the placenta in an oven at low heat, until it's completely dried but not turning brown
(around 180F, depending on your oven). You want to dry it, not cook it. You may need to
turn the placenta over a few times.
4. Grind the placenta into powder, and then load the placenta powder into capsules for usage.
Soup
Please Note: The person who prepares the placenta will usually lose the desire to eat the soup
due to the smell. Therefore, someone else shoul d clean and cook the placenta. The soup itself
does not have an unpleasant odor or taste.
1. Lightly wash the placenta under running water. It's not necessary to wash off all the blood
inside the placenta, as the nutrition content may be lost by over washi ng.
2. Cut the placenta into pieces that are approximately the size of 1/2 egg. Place the placenta
pieces in a cooking pot with other ingredients you like, typically chicken or black bone
chicken.
3. To enhance the flavor and add nutritional value to the sou p, you may add some herbs, such as
Huang Qi, Dang Gui, Dang Shen, Da Zao, Go Qi Zi, & etc. Ask your herbalist for specific
dosages of each herb.
4. Add water and a few slices of ginger to the pot. You may also add some salt, but salt is not
recommended for postpartum patients. Cook for 1 to 1.5 hours.
5. Consume all of the soup within one or two weeks. Eat a few pieces of placenta each
time. The soup does not smell unpleasant. You can add more chicken and herbs to re -cook

Complementary medicines (herbal and nutritional products) in the treatment of Attention Deﬁcit Hyperactivity Disorder (ADHD): A systematic review of the evidence
Jerome Sarris, James Kean, Isaac Schweitzer, James Lake

Psychopharmacology (Berl). 2011 Mar 18. [Epub ahead of print]
Ningdong granule: a complementary and alternative therapy in the treatment of attention deficit/hyperactivity disorder.
Li JJ, Li ZW, Wang SZ, Qi FH, Zhao L, Lv H, Li AY.

J Int Med Res. 2010 Jan-Feb;38(1):169-75.
Traditional Chinese medicine Ningdong granule: the beneficial effects in Tourette's disorder.
Zhao L, Li AY, Lv H, Liu FY, Qi FH.

PSAT, SAT and ACT Testing Accommodations and Inattentive ADHD

2011-11-14T14:57:00.000-05:00

I recently received a question from a reader about standardized test and the accommodations available for students with Inattentive ADHD. The testing providers are each a little different with regards to what they require to document an accommodation need.

Both major testing companies require documentation that the Inattentive ADHD diagnosis was made using an accepted diagnostic measure or diagnostic test and that this testing be no older than five years from the date of the standardized test. The basic documentation required by the SAT/PSAT College Board company is included at the bottom of this post.

Not every child with a diagnosis of ADHD-PI will need accommodations and some kids will require accommodations for problems unrelated, but co-existing, to their ADHD. Kids with Inattentive ADHD and visual convergence issues may need to be allowed to not "bubble-in" responses. These kids will write the letter of the correct answer next to each question. Kids with Dysgraphia and ADHD-PI may need a scribe to write their essay.

The testing companies generally will work with the school and the parents to provide the necessary accommodations once the diagnosis has been established and the process for applying for these accommodations can be found at the testing company websites. For the PSAT and the SAT, the information is at this site and for the ACT, the accommodation information can be found at this site.

Some kids will, as I mentioned before, may not need special accommodations. These students may simply need to practice taking many sample SAT or ACT exams to familiarize themselves with the process. All test takers should take as many PSAT, SAT and ACT practice tests as possible. Time saving tips need to be mastered and practice tests help with this.

Having a watch available during test taking and watching the time is necessary for many teenagers with ADHD as their sense of time passage is impaired. General test taking tips for the SAT can be found at this site and more comprehensive tricks and tips for taking standardized test can be found at this site. As an example, one time saving tip involves, on the reading comprehension part of the exam, reading the questions first and then reading the passage quickly rather than reading the paragraph, which is to be comprehended, word for word.

If you have a middle school child, as I now do, you may want to consider starting the process of getting the documentation that you need together so that if you need to ask the College Board or the ACT for accommodations for your child, all your ducks are in a row.

Keep me posted and let me know how you are doing and if you have found any other information that may help our readers with standardized testing. Thanks for visiting the Primarily Inattentive ADD Forum page and for being loyal visitors to this website!!

College Board SAT Basic requirements for disability documentation

The College Board Guidelines for Documentation lists the information that it considers fundamental in determining eligibility. Without the information, it is extremely difficult to determine if a student has a disability that requires accommodations, and whether specific accommodations meet a student's needs on our tests.
Seven guidelines for documentation

Documentation must:

1. State the specific disability, as diagnosed. Diagnosis should be made by a person with appropriate professional credentials, should be specific, and, when appropriate, should relate the disability to the applicable professional standards, for example, DSM-IV.

2. Be current. In most cases, the evaluation and diagnostic testing should have taken place within five years of the request for accommodations. For psychiatric disabilities, an annual evaluation update must be within 12 months of the request for accommodations. For visual disabilities, documentation should be within two years, and for physical/medical, an update must be within one year from the time of the request.

3. Provide relevant educational, developmental, and medical history.

4. Describe the comprehensive testing and techniques used to arrive at the diagnosis. Include test results with subtest scores (standard or scaled scores) for all tests. See Documenting Specific Disabilities for a listing of frequently used tests and what they measure.

5. Describe the functional limitations. Explain how the disability impacts the student’s daily functioning and ability to participate in the test.

6. Describe the specific accommodations being requested on College Board tests, including the amount of extended time required or the maximum amount of time the student can be tested in a day, if applicable. State why the disability qualifies the student for such accommodations on standardized tests.

7. Establish the professional credentials of the evaluator (for example, licensure; certification; area of specialization).

The Best Medicine for Inattentive ADHD Depends on Our Genes

2011-10-31T11:25:00.000-04:00

Best Medicine for Inattentive ADHD? It Depends...

The question that I get asked the most from readers of this webpage is, "What is the best medicine for Inattentive ADHD (ADHD-PI) ?” The answer to that question is not straightforward and researchers are starting to understand why.

Our genetics likely contributes significantly to the way we respond to medicine. If there was one single genetic picture for people with Inattentive ADHD, we could probably all be put on the exact same medicine and we would all do beautifully. Alas, this is not the case and people with Inattentive ADHD differ in their gene profiles and they will also differ in their response to the different medicines used to treat ADHD.

The Journal of the American Academy of Child and Adolescent Psychiatry is about to publish another study that looked at why some people with ADHD respond well to Ritalin while others do not. This study looked at specific genes and concluded that if you had a certain type of DRD4 gene or a certain type of DAT gene then your ADHD hyperactive-impulsive symptoms would improve on Ritalin but if you had another type of these genes, there would be less of an improvement.

This study did look at inattention but it does not appear from a discussion of their findings that there was any difference in Ritalin's affect on inattention related to genes. This may have been because Ritalins improves hyperactivity and impulsive behavior more than it improves attention or it might be because the genetics of ADHD-PI is thorny. There is not one gene that identifies the sub-types and there is not one sub-type of the genes that predicts symptoms or treatment response.

There are a couple of questions in the forum that could use answers from you. I have purposely stayed quiet in the forum as you can find what I think here in the blog. I would like others, like you, to voice what has helped you or your family on the Primarily Inattentive ADD Forum. Thanks in advance for helping!!

Am Acad Child Adolesc Psychiatry. 2011 Nov;50(11):1129-1139.e2. Epub 2011 Sep 15.
Pharmacogenetic predictors of methylphenidate dose-response inattention-deficit/hyperactivity disorder.

Froehlich TE, Epstein JN, Nick TG, Melguizo Castro MS, Stein MA, Brinkman WB, Graham AJ, Langberg JM, Kahn RS.

Higher Doses of EPA Improves ADHD Inattentive symptoms

2011-10-24T14:38:00.000-04:00

EPA improves ADHD

I have written before about the Omega-3 fatty acids for the treatment of ADHD Inattentive as well as other forms of ADHD. It turns out that a recent review of the medical literature has found that it is the EPA rather than the DHA amounts in the Omega-3 fatty acids that most improve the symptoms of ADHD.

The researchers of a review paper published this month in the Journal of the American Academy of Child and Adolescent Psychiatry looked at ten trials involving 700 children and found that supplementation with Omega-3 fatty acids demonstrated a small but significant effect in improving the symptoms of ADHD and that the amount of Eicosapentaenoic acid (EPA) within the supplement was significantly correlated with the effect of the supplement.

This is very new information. Up to this point we thought that it was the total amount of Omega-3 that made the difference. This report advises that it is the EPA within the Omega-3 that matters. The amount of EPA in Krill oil is minimal. There are supplements that contain a lot more EPA than the Krill Oil including CorOmega for kids and MorEpa for adults.

I have switched my inattentive son and me from the Krill oil to the MorEpa. The Krill oil has the phophatidyl Serine that has been shown in some studies to be helpful for the symptoms of ADHD but the data behind the EPA is, at this point, stronger than the data showing benefits from the Phophatidyl and I believe strongly in following the data.

This table from the American Heart Association gives you the amounts of EPA and DHA in your most popular Omega-3 supplements. One of the problems with many of these supplements is that the fish oil gives you bad breath and fish burps. The MorEpa and the CorOmega products are both flavored in such a way that these side effects are minimized.

The abstract of the new study can be found under the fish supplement table. Send me your thoughts and let me know how you are doing.

**Fish Oil Supplements**
Supplement Name	Amount of EPA, DHA (in one soft gel or capsule)

Carlson Super Omega-3 Fish Oils	300mg EPA, 200mg DHA
Carlson® Norwegian Cod Liver Oil	460-500 mg EPA, 500-550 mg DHA per 5 ml liquid
Coromega™ Omega-3 Fish Oil	350 mg EPA, 230 mg DHA per packet
CVS® Natural Fish Oil Concentrate 1000 mg	180 mg EPA, 120 mg DHA
GNC Preventive Nutrition® Omega Complex	60 mg EPA, 40 mg DHA
Dale Alexander® Omega-3 Fish Oil Concentrate	234mg EPA, 125mg DHA
Health from the Sun: The Total EFA™ Essential Fatty Acid Dietary Supplement	72mg EPA, 46mg DHA
Nature's Bounty® Cold Water Salmon Oil 1000 mg	80 mg EPA, 120 mg DHA
Nature's Bounty® Natural Fish Oil 1000 mg Cholesterol Free	180 mg EPA, 120 mg DHA
OLAY™ vitamins essential balanced omega 3/6™, Enteric Coated for Better Digestion	93.6 mg EPA, 187 mg DHA
OmegaBrite 100% Natural Advanced Omega 3 Formula, 500 mg	375 mg EPA, 55 mg DHA
PhytoPharmica® ESKIMO-3® Naturally Stable Fish Oil®	70 mg EPA, 42 mg DHA
Puritan's Pride® Cholesterol Free Fish Oil 1200 mg	216 mg EPA, 144 mg DHA
Puritan's Pride® Cholesterol Free Natural Fish Oil EPA 1000 mg	180 mg EPA, 120 mg DHA
Puritan's Pride® Triple Omega 3-6-9 Flax, Fish and Borage Oil	120 mg EPA, 80 mg DHA
Rexall® Flax, Fish, Borage Oil	120 mg EPA, 80 mg DHA
Spring Valley Fish Oil 1200 mg	216 mg EPA, 144 mg DHA
Sundown® Fish Oil 100 mg	180 mg EPA, 120 mg DHA
The Vitamin Shoppe™ Essential Oils & Fatty Acids EPA-DHA Omega-3 Fish Oil 500	300 mg EPA, 200 mg DHA
Triomega® Omega-3	333,3ng EPA, 167 DHA
Vitamin World® Cholesterol Free Fish Oil 1200 mg	216 mg EPA, 144 mg DHA
Vitamin World® Naturally Inspired™ Omega-3 Fish Oil 1000mg Cholesterol-Free	180 mg EPA, 120 mg DHA
Vitamin World® Naturally Inspired™ Super EPA Natural Fish Oil 1000 mg Cholesterol-Free	300 mg EPA, 200 mg DHA
Vitamin World® Triple Omega 3-6-9 Flax, Fish & Borage Oil	120 mg EPA, 80 mg DHA

J Am Acad Child Adolesc Psychiatry. 2011 Oct;50(10):991-1000. Epub 2011 Aug 12.

Omega-3 Fatty Acid supplementation for the treatment of children withattention-deficit/hyperactivity disorder symptomatology: systematic review and meta-analysis.

Bloch MH, Qawasmi A.

Source

Yale Child Study Center and Yale University.

Abstract

OBJECTIVE:

Several studies have demonstrated differences in omega-3 fatty acid composition in plasma and in erythrocyte membranes in patients with attention-deficit/hyperactivity disorder (ADHD) compared with unaffected controls. Omega-3 fatty acids have anti-inflammatory properties and can alter central nervous system cell membrane fluidity and phospholipid composition. Cell membrane fluidity can alter serotonin and dopamine neurotransmission. The goal of this meta-analysis was to examine the efficacy of omega-3 fatty acid supplementation in children with ADHD.

METHOD:

PubMed was searched for randomized placebo-controlled trials examining omega-3 fatty acid supplementation in children with ADHD symptomatology. The primary outcome measurement was standardized mean difference in rating scales of ADHD severity. Secondary analyses were conducted to determine the effects of dosing of different omega-3 fatty acids in supplements.

RESULTS:

Ten trials involving 699 children were included in this meta-analysis. Omega-3 fatty acid supplementation demonstrated a small but significant effect in improving ADHD symptoms. Eicosapentaenoic acid dose within supplements was significantly correlated with supplement efficacy. No evidence of publication bias or heterogeneity between trials was found.

CONCLUSION:

Omega-3 fatty acid supplementation, particularly with higher doses of eicosapentaenoic acid, was modestly effective in the treatment of ADHD. The relative efficacy of omega-3 fatty acid supplementation was modest compared with currently available pharmacotherapies for ADHD such as psychostimulants, atomoxetine, or α(2) agonists. However, given its relatively benign side-effect profile and evidence of modest efficacy, it may be reasonable to use omega-3 fatty supplementation to augment traditional pharmacologic interventions or for families who decline other psychopharmacologic options.

Brain Anti-oxidants for ADHD Inattentive and the ORAC Food Scale

2011-10-18T12:53:00.000-04:00

Brain Anti-oxidants for ADHD Inattentive and the ORAC Food Scale

A study just published has shown that salivary protein thiol level can be used to identify children with ADHD. Salivary protein thiol levels are good indicators of the antioxidant status of the brain. Increased brain protein thiols signal a poor antioxidant brain status.

I have written several posts on brain oxidant level as a possible cause or contributor to the symptoms of Inattentive ADHD. I have also written several posts of why diet is so important for improving ADHD Inattentive symptoms.

I know that you know what antioxidants are but as a brief reminder, antioxidants are micronutrients that are typically found in foods that protect the tissues in our bodies from harm. These micronutrients do this by blocking chemical reactions that cause oxidation.

Oxygen can 'rust' or corrodes our brain tissue similarly to the way oxygen rusts metal. This oxidation harms the brain because it causes the chemicals inside our brains to not work as they should. Damage caused by oxidative stress has been known to be the cause of many illnesses. ADHD is one of the many conditions that may be the result of a poor brain antioxidant status.

The National Institutes of Health has developed a score for foods that are good antioxidants. They call this score the ORAC score. The way it works is that each fruit, vegetable and spice has a certain score based on well each food raises the level of blood antioxidant levels. Brightly colored foods such as blueberries and raspberries and some types of apples, and beans have very high antioxidant ORAC scores. Your can find the ORAC food scale here.

Researchers have found that increasing daily intake of micronutrients to between 3,000 and 5,000 ORAC units seems significant increase the blood, brain and tissue antioxidant capacity. It is probably a good idea to increase our antioxidant intake to these recommended levels so as to minimize the symptoms of Inattentive ADHD.
Neurochem Res. 2011 Oct 1.
Altered Biochemical Parameters in Saliva of Pediatric Attention Deficit HyperactivityDisorder.
Archana E, Pai P, Prabhu BK, Shenoy RP, Prabhu K, Rao A.

Smart But Scattered, Executive Function Help for Inattentive ADD

2011-10-12T10:44:00.000-04:00

Executive Function Help for Inattentive ADD

I just finished reading the book Smart But Scattered and I wanted to tell you about it. This book is essentially a 'how to' book on the development of Executive Function skills in people with Inattentive ADHD and other subtypes of ADHD. The first part of the book explains the function and necessity of Executive Functions and the second part of the book gives you concrete exercises and strategies to improve the Executive Functioning of children and adults with ADHD.

This book is amazingly easy to read, to absorb and to apply which is what makes it a must have for any household suffering from the chaos and inefficiencies of the symptoms of ADHD Predominantly Inattentive.
Many of the suggestions in this book have been covered before in this blog but I always feel it is important to remind us all of what it takes to stay on task so that we can complete them.

I have linked to some of the older blog posts that specifically address the Executive Function difficulties that this book covers. The difficulties addressed in this fantastic book include:

Looking at a task to determine exactly what needs to be done or in the case of a school assignment, looking at the assignment from the perspective of what needs to be learned and what are the most important components of what is being learned.
Planning is the second step and that involves forging a doable plan, making a to-do or task list and putting it front and center so you do not lose site of where you are and where you are headed.
Organizing is crucial and it is the third step. We have spoken about getting rid of clutter and staying organized in many, many posts on this blog.
Planning, include time management, developing a timeline and breaking the big steps of a task into little steps so that the task does not overwhelm you is another crucial part of accomplishing tasks when you are dealing with the symptoms of Inattentive ADHD.
Adjusting your plan when necessary and being flexible is another stumbling block for people with ADHD Inattentive and Executive Function problem. It can be a monumental hurdle for someone with an Executive Order disorder to shift gears and find another way to tackle a problem when the first way has failed.
Completing the plan is the last step; of course, The inability to "JUST DO IT" can be one of the most frustrating aspects of living with someone with an Executive Function disorder.

Smart But Scattered may be at your library. That is where I found my copy but I have since ordered a copy from Amazon so that I can have it at home. Order the book or get it at the library. It is worth the read. After you read it, let me know what you think of it. Keep in touch!

Bacopa Monieri and Dosing for Inattentive ADHD

2011-10-03T13:17:00.000-04:00

Bacopa Monieri and Dosing for Inattentive ADHD

Regular readers of this Blog will remember that I posted a while back about a product that was developed in Israel to treat Inattentive ADHD and ADHD called Nuture and Clarity. The primary ingredient in that preparation is the same ingredient that has been used for centuries in India to enhance brain function, an herbal medicine called Bacopa Monieri.

You can find Bacopa Monieri in table form on Amazon.com but the product that I reported on several months ago is called Mentat and it can be found on Amazon, Ebay and also in Indian grocery stores. Mentat comes in both syrup and tablet form. The syrup comes in single and double strength. The single strength contains 144mg of Bacopa per teaspoon and the double strength contains 288mgs. The tablets contain 220mgs of Bacopa.

My son has tolerated the Mentat tablets well and he does take these in addition to his multivitamin and Krill Oil. No study that I read indicated that any child or adult had side effects of any adverse reactions from taking Mentat.

The Israeli study and the Indian studies found that Bacopa treats and improves the ADHD symptoms of inattention, hyperactivity, working memory deficits and other behavioral problems. Several of the studies performed in India have even found IQ improvements in children who have been treated for 6 months with Mentat Syrup.

A reader recently asked an excellent questions regarding dosing of Bacopa. Most of the Indian studies and the Israeli study used a dose of roughly 140mg three times a day for your average 12 year old and 70mg three times a day for your average six year old. Doses as high as 288 mgs three times a day have been used in studies but it did not appear that higher doses yielded higher results. Nature and Clarity contains 136 mgs of Bacopa per teaspoon and they recommend dosing their product by the weight of the child. You can find the Nuture and Clarity dosing table hear. Please keep in mind that 5cc = one teaspoon.

I mentioned in my previous post about treating Inattentive ADHD with Bacopa or Mentat that buying a bottle of Mentat tablets is FAR cheaper than buying Nuture and Clarity even though the ingredients are very similar.
The three times a day dosing is a huge pain for children and can be best accomplished by giving a dose with breakfast, a dose right after school and a dose at bedtime.

I know I have been very lax and have not posted much recently. My bad, I have been busy beyond belief. I do have several interesting things that I want to share with you though and I will try to get to it this week. Leave a comment. Let me know how things are going!!

Anger and Stress Control and ADHD Inattentive

2011-09-14T09:45:00.000-04:00

Anger and Stress Control and ADHD Inattentive

School has started for all of us now and I wanted to post a quick reminder about anger control, B vitamins, exercise, stress reduction and ADHD Inattentive. We know from previous posts that stress, anger, B vitamin deficiencies and lack of exercise all play a number on the brain hormones and the brain's Hypopituitary Axis (HPA) and that these disruptions of the HPA worsen the symptoms of ADHD Inattentive and ADHD Combined type.

The reason for this disruption may all be related to the fact that stress and these other risk factors increase our levels of homocysteine. Homocysteine must remain low for our brains to properly make and use the all important neurotransmitters that are thought to be faulty in people with symptoms of ADHD Inattentive. Homocysteine levels are lowered with high protein diets and some people believe that this homocysteine lowering is why high protein diets can sometimes help ADHD.

I recently found an excellent post by a psychiatrist writes a blog called Evolutionary Psychiatry where she describes anger and the homocysteine problem in great detail. There are some very interesting posts on her blog and you should check it out.

I have been trying to make certain that my sons go out for at least an hour a day and run around and have been monitoring their stress levels with regards to their school work and their social endeavors. It is early in the year but so far both of them are, pretty much, holding steady.

My ADHD Inattentive son has just started Middle School and I am very proud of the way that he has buckled down and, without any prompting, completed his school work. My ADHD Combined type son has just started 5th grade and he is in a very demanding class this year. I am more worried about him as the stress in this class can be terrible. He totally lost it yesterday because he thought he had lost a piece of paper that I was supposed to sign that had something to do with his band instrument. I emailed the band director who told me that they page that he had lost was simply a piece of paper with a list of places where we could rent instruments. I am on high alert because I got a feeling that this year will be a doozy, I will keep you posted and please let me know how things are going for you.

Dirty Electricity and Inattentive ADD (ADHD I)

2011-09-12T10:21:00.000-04:00

Dirty Electricity and Inattentive ADD (ADHD I)

Sam Milham , an MD with a Masters in Public Health, has published a book called Dirty Electricity where he proposes that electromagnetic fields (EMF) can cause health problems in people who are sensitive. He also thinks that increases in electromagnetic radiation is part of the reason that we are seeing increased rates of Inattentive ADD (ADHD I) and other forms of ADHD.

There are many people that disagree with him and this site is devoted to discounting any claim that EMF are dangerous. There are other people who believe that he is right including Dr. Thomas Rau, Medical Director of the well respected Paracelsus Clinic in Lustmühle, Switzerland.

In Interviews, Dr. Rau reports that he is certain that ‘electromagnetic loads’ can lead to cancer, concentration problems, ADD, tinnitus, migraines, insomnia, arrhythmia and Parkinson’s disease. Rau reports that EMF exposure is known to impair brain function and learning, He says that if you install mobile phone towers near schools, which radiate to the children, their intelligence and their brain capacity decreases and you will have more ADD symptoms in children.

Most case/control studies performed on EMF have shown little danger with regards to cancer or learning disabilities but this is a complicated area has all EMF are not the same and exposure to certain types of EMF may be more problematic than exposure to others. The verdict is not clear and great minds are busy researching EMF exposure but I wanted to report on a recently published study performed on one physician that showed some interesting findings.

This physician was described as "EMF sensitive", and in a well done controlled study she was monitored and found to have changes in heart rate, muscle twitching, headache and temporal pain when the EMF was turned on or off . The physician had no symptoms when she was continually exposed to the EMF but she did experience symptoms when the EMF exposure changed. Who knows what that means exactly but I am sure that someone will continue to study this and eventually figure it out. The abstract of the study is printed below.
Let me know what you think about EMF exposure and health risks.

The International Journal of Neuroscience
Int J Neurosci. 2011 Sep 5. [Epub ahead of print]
Electromagnetic Hypersensitivity: Evidence for a Novel Neurological Syndrome.
McCarty DE, Carrubba S, Chesson AL, Frilot C, Gonzalez-Toledo E, Marino AA.
Source

1Department of Neurology, LSU Health Sciences Center, Shreveport, Louisiana, USA.
Abstract

ABSTRACT Objective: We sought direct evidence that acute exposure to environmental-strength electromagnetic fields (EMFs) could induce somatic reactions (EMF hypersensitivity). Methods: The subject, a female physician self-diagnosed with EMF hypersensitivity, was exposed to an average (over the head) 60-Hz electric field of 300 V/m (comparable with typical environmental-strength EMFs) during controlled provocation and behavioral studies. Results: In a double-blinded EMF provocation procedure specifically designed to minimize unintentional sensory cues, the subject developed temporal pain, headache, muscle twitching, and skipped heartbeats within 100 s after initiation of EMF exposure (p < .05). The International Journal of Neuroscience

Int J Neurosci. 2011 Sep 5. [Epub ahead of print]
Electromagnetic Hypersensitivity: Evidence for a Novel Neurological Syndrome.

McCarty DE, Carrubba S, Chesson AL, Frilot C, Gonzalez-Toledo E, Marino AA.
Source

1Department of Neurology, LSU Health Sciences Center, Shreveport, Louisiana, USA.
Abstract ABSTRACT Objective: We sought direct evidence that acute exposure to environmental-strength electromagnetic fields (EMFs) could induce somatic reactions (EMF hypersensitivity). Methods: The subject, a female physician self-diagnosed with EMF hypersensitivity, was exposed to an average (over the head) 60-Hz electric field of 300 V/m (comparable with typical environmental-strength EMFs) during controlled provocation and behavioral studies. Results: In a double-blinded EMF provocation procedure specifically designed to minimize unintentional sensory cues, the subject developed temporal pain, headache, muscle twitching, and skipped heartbeats within 100 s after initiation of EMF exposure (p < .05). The symptoms were caused primarily by field transitions (off-on, on-off) rather than the presence of the field, as assessed by comparing the frequency and severity of the effects of pulsed and continuous fields in relation to sham exposure. The subject had no conscious perception of the field as judged by her inability to report its presence more often than in the sham control. Discussion: The subject demonstrated statistically reliable somatic reactions in response to exposure to subliminal EMFs under conditions that reasonably excluded a causative role for psychological processes. Conclusion: EMF hypersensitivity can occur as a bona fide environmentally inducible neurological syndrome. as assessed by comparing the frequency and severity of the effects of pulsed and continuous fields in relation to sham exposure. The subject had no conscious perception of the field as judged by her inability to report its presence more often than in the sham control. Discussion: The subject demonstrated statistically reliable somatic reactions in response to exposure to subliminal EMFs under conditions that reasonably excluded a causative role for psychological processes. Conclusion: EMF hypersensitivity can occur as a bona fide environmentally inducible neurological syndrome.

We Know Exercise Helps ADHD so Let's Get Moving

2011-09-08T19:18:00.000-04:00

Let get Moving to help ADHD symtoms

Regular exercise reduces all ADHD symptoms. You know this, right? I have written about exercise helping inattentive ADHD in several other posts but I guess we could all use a reminder.

This study, just published in the Journal of Physical and Activity and Health reminds us that kids that get regular exercise, have fewer Inattentive ADHD and other ADHD symptoms too. Green space activity helps too. Let's all go outside and run a bit!

J Phys Act Health. 2011 Sep;8(7):964-70.
The association between physical education and symptoms of attention deficithyperactivity disorder.
Barnard-Brak L, Davis T, Sulak T, Brak V.
Dept of Educational Psychology, Texas Tech University, Lubbock, TX.

Abstract

OBJECTIVE:

The purpose of the current study was to examine the association between structured physical activity, specifically physical education, and symptoms of Attention Deficit Hyperactivity Disorder (ADHD). Physical activity may be associated with lower levels of symptoms of ADHD and this rationale provided the impetus for the current study.

METHODS:

A community-based, nationally representative sample of children from the Early Childhood Longitudinal Study, Kindergarten cohort (ECLS-K) was used. Structural equation modeling was used to examine the association of physical activity with symptoms of Attention Deficit Hyperactivity Disorder. Two random subsamples were drawn for the purposes of cross-validation of our model. Statistics reflecting model fit are reported.

RESULTS:

With a standardized path coefficient value of -.23, findings from the current study indicate a significant, inverse association between physical education, as a structured form of physical activity, with the symptoms of Attention DeficitHyperactivity Disorder in children.

CONCLUSIONS:

Using a community-based, nationally representative sample of children aged 5 to 7 years old from the United States, the results of the current study suggest that physical education, as a structured form of physical activity, may be considered as associated with lower levels of symptoms of ADHD across time.

Understanding ADHD Inattentive and Aging

2011-09-06T16:10:00.000-04:00

Understanding ADHD Inattentive and Aging

I write this blog as much to understand what happened to me growing up as I do to understand what my sons are going through. Regular readers of this blog will know me as the child described in post titled 'The Primarily Inattentive Child' and also as the child described in the blog post titled Predominantly Inattentive in School and Beyond., and will remember that I did far worse in school than my kids are currently doing (they, in fact, are both doing remarkably well).

One of the things that fascinates me the most is the fact that I seemed to have, at some point, "out grown" many of my symptoms. As I aged my inattention improved, my organizational skills improved, my anxiety improved, my introversion improved, my reading improved and my analytic skill improved. I have thought that these improvements have had to do with many positive things occurring in my life (coffee,exercise, an improved diet, continued family support) but I have also thought that the main thing that happened to me is that my brain "grew up".

When I read a study like the one copied below it gets me thinking again about the role of aging and inattentive ADHD symptoms. I am totally unfamiliar with SLC9A9, with the solute carrier family , with Na+/H+ exchanger, with NHE9 and, for that matter, with membrane proteins that regulates luminal pH of endosomes but there is a sentence in this abstract that is interesting to me, "We observed an age-dependent abnormal expression of SLC9A9 in brains of this inattentive model". Now granted this is a rat study but other studies have shown that the Inattentive rat can be a good sample to study the brain's of people with the Inattentive type of ADHD.

The authors report that the SLC9A9 protein is essential for proper synaptic transmission and proper brain plasticity and it appears that they found the abnormality to be age dependent. It is unclear if the abnomalities improve or worsen with age but the fact that these changes are age dependent are interesting to me. Aging changes our brain and it sometimes does so for the better. In the old days, ADHD was considered to be a disorder of delayed brain development. Adults were expected to improve either because they learned to manage their symptoms of because their symptoms, as I believe happened to me, improved.

What do you think? How have your ADHD symptoms changed with age. I would love to hear from you.

Am J Med Genet B Neuropsychiatr Genet. 2011 Aug 19. doi: 10.1002/ajmg.b.31229. [Epub ahead of print]

SLC9A9 mutations, gene expression, and protein-protein interactions in rat models ofattention-deficit/hyperactivity disorder.

Zhang-James Y, Dasbanerjee T, Sagvolden T, Middleton FA, Faraone SV.

Source

Department of Psychiatry, SUNY Upstate Medical University, Syracuse, New York.

Abstract

SLC9A9 (solute carrier family 9, member 9, also known as Na+/H+ exchanger member (NHE9)) is a membrane protein that regulates the luminal pH of the recycling endosome, an essential organelle for synaptic transmission and plasticity. SLC9A9 has been implicated in human attention deficit hyperactivity disorder (ADHD) and in rat studies of hyperactivity. We examined the SLC9A9 gene sequence and expression profile in prefrontal cortex, dorsal striatum and hippocampus in two genetic rat models of ADHD. We report two mutations in a rat model of inattentive ADHD, the WKY/NCrl rat, which affect the interaction of SLC9A9 with calcineurin homologous protein (CHP). We observed an age-dependent abnormal expression of SLC9A9 in brains of this inattentive model and in the Spontaneous Hypertensive Rat (SHR) model of ADHD. Our data suggest a novel mechanism whereby SLC9A9 sequence variants and abnormalities in gene expression could contribute to the ADHD-like symptoms of rat models and possibly the pathophysiology of ADHD in humans.

Kids and ADHD Melatonin Use, ADHD I. A Review

2011-09-04T08:13:00.001-04:00

Kids and ADHD Melatonin Use

Regular readers of this blog know that my kids often need to use Melatonin for sleep. I have posted about the melatonin deficiencies and the sleep problems seen in kids with ADHD and have explained before that neuro-researchers believe that the same processes that bring on the symptoms of inattention, etc, may cause kids with ADHD-I to have melatonin deficiencies.

This review article from the Journal of Pineal Research in encouraging in that it supports the use of Melatonin in the Pediatric population and indicates that the benefits of Melatonin may extend beyond its use for sleep. This article reports that Melatonin's anti-oxidant and radical scavenging properties may promote health in many other ways.

J Pineal Res. 2011 Jan;50(1):21-8. doi: 10.1111/j.1600-079X.2010.00814.x. Epub 2010 Oct 1.
Update on the use of melatonin in pediatrics.
Gitto E, Aversa S, Reiter RJ, Barberi I, Pellegrino S.

Source

Neonatal Intensive Care Unit, Department of Pediatrics, University of Messina, Messina, Italy. egitto@unime.it

Abstract

Melatonin, an endogenously produced indoleamine, is a highly effective antioxidant, free radical scavenger, and a primary circadian regulator. Melatonin has important antioxidant properties owing to direct and indirect effects. It directly scavenges reactive oxygen and reactive nitrogen species, prevents molecular oxidation, improves mitochondrial physiology, and restores glutathione homeostasis. Its indirect antioxidant effects stem from its ability to stimulate the activities of the enzymes involved in the glutathione cycling and production. Melatonin, by reducing free radical damage, may be an effective protective agent for the fetus as it is in adults. Several clinical studies on melatonin have shown that it reduces oxidative stress in human newborns with sepsis, hypoxic distress, or other conditions, where there is excessive free radical generation. A role of melatonin in infant development has also been suggested. Pineal dysfunction may be associated with deleterious outcomes in infants and may contribute to an increased prevalence of sudden infant death syndrome. Delayed melatonin production is evident in infants who had experienced an apparent life-threatening event. Melatonin has been used as a pharmacologic treatment for insomnias associated with shift work, jet lag, and delayed sleep onset in adults for decades. In children as well, melatonin has value as a sleep-promoting agent. Evidence suggests that melatonin has utility as an analgesic agent presumably related to its ability to release β-endorphin. The data support the notion that melatonin, or one of its analogs, might find use as an anesthetic agent in children.

ADHD Inattentive Type,Can't see Forest For Trees

2011-08-30T10:33:00.000-04:00

ADHD Inattentive, Can's see Forest For Trees

Most researchers and scientist believe that people with ADHD Inattentive type (ADHD-I, ADHD-PI) cannot pay attention to details. They report that the inattention of ADHD-PI is best described as a failure to pay close attention to details. A new study just published in the Journal Brain Development believes that the problem is not that.

The researchers of the Brain Development study believe that the problem in ADHD-I is related more to the fact that people with ADHD Inattentive type cannot "see the forest for the trees". They believe that the problem is a failure to screen out the trees (the details) in order to be able to concentrate on the global or big picture. These findings are brand new and will be controversial but the study scientist state that their study shows that the ADHD-PI 'failure to pay attention to detail' theory is wrong. They believe that the problem is with 'global' attention, big picture attention, and not with focused or detail attention.

This study (which I have included below) reads like gobbly-gook but essentially what the study found is that people with ADHD-PI continue to concentrate on the trees and screen out the forest even when they are supposed to be focused on the forest. It is not that they are not paying attention to details, it is more that they are paying too much attention to the details and failing to see the 'forest'.
This naturally is complicated because at my house the details that I or my son get focused are sometimes the 'shiny' details and not the details that we probably should be focused on. The implication of these findings are huge because the treatment traditionally used for ADHD-I , the stimulants, are supposed to improve focused attention. If focused attention is not the problem, as this new study reports, then these medications are not going to help very much. Furthermore, if, on top of everything else, the medications make us more focused on the 'shiny' details as opposed to the appropriate details, we are going to be in even more trouble.

My pediatrician told me a story of a teenage boy that she treated for ADHD Inattentive type. She had placed him on Adderall LA and when she saw him 12 weeks later he reported that he felt that his attention was much better. His mother however felt that he was still not getting his homework done and his teachers reported that he was still not paying attention in class. When my pediatrician asked him why he felt he was more focused he told her, "I have been wanting to talk to this girl that I like in school for months and after I went on the medicine, I was able to talk to her." He was more focused, he just was not focused on what his parents and his teachers wanted him to be focused on.

Brain Dev. 2011 Aug 19. [Epub ahead of print]

The interference of local over global information processing in children withattention deficit hyperactivity disorder of the inattentive type.

Song Y, Hakoda Y.

Source

School of Psychology and Cognitive Science, East China Normal University, China; Faculty of Human-Environment Studies, Kyushu University, Japan.

Abstract

A classic finding in perception of compound patterns is normal individuals cannot skip global analysis in local-oriented processing, but they can successfully resist local analysis in global-oriented processing-the so-called global interference [1]. Recently, studies examining the role of brain hemisphere activity in the Navon task have indicated that the processing of global and local information can be, respectively, attributed to the right and left hemispheres. Moreover, many neuroimaging researches have revealed that certain core symptoms of attentiondeficit hyperactivity disorder (ADHD) are related to dysfunction of right hemisphere. These findings imply that global interference will be substantially less evident, and possibly even replaced by local interference in ADHD. The present study compared the performance of children with and without attention deficit hyperactivity disorder of theinattentive type (ADHD-I) in the processing of global and local information to examine the local interference hypothesis in ADHD. An ADHD-I group (n=15) and a paired control group (n=19) completed tasks using two versions of the Navon task, one requiring divided attention, in which no information was given to participants regarding the level at which a target would appear, and the other requiring selective attention, in which participants were instructed to attend to either the local or the global level. The results showed that children with ADHD-I exhibited local interference, regardless of which attention procedure was used. These results support the weak right hemisphere hypothesis in ADHD, and provide evidence against the deficit hypotheses for ADHD in the DSM-IV criteria [29], which postulates that inattention symptoms may manifest as a failure to provide close attention to details.

Strattera, Atomoxetine, Kids and ADHD Inattentive

2011-08-20T09:36:00.000-04:00

One of the questions that I get asked frequently is whether Strattera or Atomoxetine works for kids with ADHD Inattentive. As you may remember from our review of ADHD Inattentive medication, Strattera is a non-stimulant treatment for ADHD. It is not a schedule II drug so it is not a controlled substance and is considered to be non-addicting and for many parents and patients, this drug is less scary than the standard ADHD Inattentive medications which are in the Ritalin or Adderall families.

Strattera acts on the norepinephrine neurotransmitter which is a brain component that is thought to play a large part in the control of attention, alertness and arousal levels. Because people with ADHD Inattentive (ADHD-I, ADHD-PI) are known to have issues with focus and alertness, it has been proposed that Strattera might be a perfect medication for their symptoms.

No studies, that I know of, have been performed looking at how and if Atomoxetine helps ADHD-PI but a brand new study published in Psychiatry Investigation has found that at a dose of 1.2 mg/kg/day or a dose of about 50 mg per day, which is the dose of the average 75 pound child, Strattera helps ADHD children ages 6-18 years of age. The study found improvements on both inattention scores as well as impulsive behavior and hyperactivity scores.

Unfortunately, the study also found that most of the kids treated will have at least one side effect that will be mild to moderate. Strattera comes with a black box warning because of an increased risk of suicide in teenagers who take this medication but this is not the most common side effect. The most common side effects include irritability, sleepiness, nausea and abdominal pain. Slowly increasing the dosage to the target dose of no more than 1.2 mg per kg per day seems to lessen side effects.

Strattera helps ADHD Inattentive but other studies have found that, when compared to the stimulants, it does not, in most people perform better. I know of patients with ADHD Inattentive who have had great relief of their symptoms using Strattera and I know of patients where Strattera has simply not worked at all.

As we have discussed before, people with ADHD Inattentive symptoms (or any ADHD symptoms for that matter) are not a uniform group. They are all different, they have varying degrees of other mood issues, and they are all unique in the way their symptoms present and manifest themselves. It is very likely that the brain processes of people with ADHD-I are all unique as well so a medication that may work well for one person, will not work at all for another.

I know that this is not what you wanted to hear but there you have it. Please comment below if your ADHD Inattentive symptoms been helped by Atomoxetine or Strattera. I would love to hear from you!!

ADHD Inattentive and Stress Response

2011-08-10T11:43:00.000-04:00

The stress response of people with Inattentive ADHD 'ain't right'.

I will soon be back from all our various trips this summer and will start posting regularly. I know that I have been very slack and I am sorry about this. We are in town for a few days while my eldest son takes a Middle School, study skills course and I thought that I would post a quick report. I wanted to let you know about a brand new study on the Inattentive ADHD HPA axis and on stress, cortisol, and how all of these factors influence people with ADHD Inattentive type.

We have all been in the situation where we are stressed out and as a result of this stress become totally inattentive and distracted. How we deal with our stress has to do with how well our HPA axis is working and as it turns out, the HPA axis of kids with Inattentive ADHD does not work so well. It may turn out that the inattentiveness of people with ADHD-PI has as much to do with how well their HPA axis works as with anything else.

The new study, published last month in the Journal of Psychiatric Research found that both boys and girls with ADHD Inattentive symptoms had abnormal cortisol, stress and HPA responses and that this abnormal stress response was unique to the study participants that had inattentive ADHD symptoms.

These findings are especially important when you take into account the affect that the stimulant treatments can have on Inattentive symptoms and on the HPA axis. Stimulants in general can cause symptoms of anxiety or increase the 'fight and flight' response because they work on dopamine receptors that have an effect on these brain functions. Ritalin works on these receptors more strongly than the Adderall family but all stimulants can affect our stress response.

From reading this study it appears that boys have a blunted stress response whereas girls have a heightened response that then bottoms out. What I take from this study is that the cortisol response of people with ADHD Inattentive 'just ain't right'. Treating ADHD-PI may involve medications and non-medical ADHD interventions that improve the HPA axis functioning because these improvements may result in dramatic improvements of Inattentive ADHD symptoms.

Journal of Psychiatric Research 2011 Jul 27.
Symptoms of attention deficit hyperactivity disorder in children are associated with cortisol responses to psychosocial stress but not with daily cortisol levels.
Anu-Katriina P, Kajantie E, Alexander J, Pyhälä R, Lahti J, Heinonen K, Eriksson JG, Strandberg TE, Räikkönen K.

Source

University of Helsinki, PO BOX 9, Institute of Behavioral Sciences, 00014 Helsinki, Finland; Children's Hospital, Helsinki University Central Hospital and University of Helsinki, PO BOX 280, 00029 Helsinki, Finland.

Abstract

We tested associations of diurnal hypothalamic-pituitary adrenal axis (HPAA) activity and its response to stress with behavioral symptoms of Attention Deficit Hyperactivity Disorder (ADHD) among 272 eight-year-old children.We measured their diurnal salivary cortisol and salivary cortisol responses to the Trier Social Stress Test for Children (TSST-C). Mothers rated their child's behavior with the ADHD-IV Rating Scale and the Child Behavior Checklist (CBCL). There were no significant associations between ADHD symptoms and diurnal cortisol concentrations. The boys with predominantly inattentive symptoms of ADHD (ADHD-I; scores at or above the 90th percentile) had 26% lower mean salivary cortisol levels during the TSST-C than the boys with scores below this cutoff. In the girls with symptoms of ADHD-I, initial salivary cortisol levels prior to the TSST-C were higher and fell more rapidly during and after the TSST-C, which was not seen in the remaining girls (P = 0.007 for interaction 'ADHD-I × sampling time'). Controlling for Oppositional Defiant Disorder/Conduct Disorder and Anxiety Disorder or excluding children with these comorbid problems did not substantially affect these findings. We conclude that the boys and the girls with behavioral symptoms of ADHD-I had reduced HPAA responsiveness to stress, which is also seen in people after traumatic events or with chronic stress. Their diurnal cortisol rhythm was not affected. Thus, ADHD-I may be associated with dysregulation of the HPAA or reduced engagement with stressful stimuli.

DMAE and Inattentive ADHD

2011-07-31T01:28:00.000-04:00

Will Help Inattentive ADHD? I was reviewing the most recent ADHD articles on Pubmed when I came across a review article that listed some of the non-prescription treatments and the article reported that DMAE could offer some help for the symptoms of ADHD. Apparently in the 1970s DMAE was used as a stimulant and some people with ADHD had improved symptoms while taking this supplement.

DMAE is Dimethylaminoethanol and it is one of the building blocks for acetylcholine. Acetylcholine helps with cell communication and it is a neurotransmitter. Many researchers believe that neurotransmitter issues are what causes the symptoms seen in people with ADHD.

DMAE is found in salmon and fish oil and is marketed today as a supplement that helps memory and aging. In the seventies it was prescribed by physicians for ADHD under the name Deanol and several studies reported benefits in behavior and learning at a dose of 500mg a day. I have included a summary of a study comparing Ritalin and DMAE below.

The FDA removed DMAE which was called by the prescription name 'Deanol' from it's list of approved medications for ADHD in the early 1980s because of a lack of research on it's effectiveness and it became an orphan drug which means it was a drug that no one was interested in testing any further so it fell by the wayside.

When I trolled the ADHD forums for information on DMAE, I got a mixed bag of reports from parents and patients who reported some success and some non-success with the use of this supplement. Apparently some company named Nature's Plus makes a product called PediActive that has 254mg of DMAE as well as Phosphatidylserine and Phosphatidycholine in a chewable tablet form that is marketed for the "Active Child". The Amazon reviews for this product are few but all positive.

When I went to Amazon to find out how adults where faring on the DMAE tablets, most all the reviews reported positive results. People reported that they were more focused, had more energy, were more productive, etc but I have found that people tend to write more positive Amazon reviews than negative ones and it is entirely possible that the folks that got no results from the DMAE tablets did not bother to write a review.

So will DMAE help ADHD Inattentive. I don't know. All indications point to this supplement being safe and well tolerated. The only ill effect that I read about were people who reported that there dreams were more vivid.

If anyone has had experience with this supplement I would love to hear about it. please comment and let us know. If I decide to give DMAE tablets a try, I will let you know how it goes.