ADHD Medication Rules: What To Do

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The ADHD Medication Book: Coming Soon
Yes, I've been talking about my ADHD Medication book for more than a year – and in that year it has been updated with increasingly interesting and useful information for immediate street application. I will not only tell you why so many are having problems with meds, I will tell you the remarkably easy and predictable solutions for those many problems based on new brain science.

If you have ADHD, or know anyone who does, this book is definitely a game changer.

Because we already know each other I am sending this out to give you a heads up on a forthcoming special pre-publication offer with – ADHD Medication Rules: Paying Attention To The Meds For Paying Attention –

1. Prepare: Sign up right now for the discounted Launch Special – ADHD Medication Rules will be available for less than half price for about 1 week, and that's all, the door will be closed for that launch offer. When I do set it up to launch, you will get an email, I will post the launch on my blogs, and I will also Tweet it up, and I will send it out to my special colleagues on my mailing list – so be connected and ready – sign up now for the free 2o page White Paper: Precise Solutions for ADHD Medication – It's a brief outline of the book contents – shop it up and see if you are interested.

Signing up for Precise Solutions will put you squarely on the mailing list – with no obligation if you don't want it.

2. Coaches: If you are an ADHD coach or counselor, if you are a maven friend of mine through Twitter, if you have your own ADHD blog, even if you work with me in Va Beach, you could become an affiliate. I want this book to be seen by as many people as possible, so I will be offering you an opportunity to promote ADHD Medication Rules and make a few bucks in the meantime. Hint: the commission percentage will be BIG. I want you to have some fun with your audience, and I really do want to change the way we identify and treat ADHD and all the multiple comorbid conditions. And, yes, I do disagree with Amen who has seen only 6, – I have delineated more than 3o comorbid conditions that show an ADHD appearance on the surface. Further, I added a blog post that differentiates 171 comorbid conditions that present as ADHD.

3. Students: I think that college students are often the most in need of ADHD Medication Rules, but often do not have a clue about what to do with the meds – even though stimulants are too easily available on campus. Thanks to the deafening background noise of mismanaged care – and their encouragement of immediate release meds – college students are frequently missing the useful big picture regarding how to use meds most effectively. So if you are a college student, looking for some entrepreneurial gas money, want to go out to dinner once in awhile, and are interested in ADHD, you could become an affiliate as well. Just think about it: peer recognition through becoming an ADHD maven? 😉 Sign up for Affiliate Partnership here.

So let's get on with it – the book is coming out soon – do get signed up for the launch special, and we'll hear from you on the affiliate page when it's set up.

Don't forget, this book will be a game changer – soon everyone will think the message there was their own idea – and that means we have all done our job exactly right. [We're past the launch special now, but you can order Rules here.]
cp

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24 Comments

  1. Bonnie P says:
    August 20, 2012 at 10:26 AM

    Hello Dr. Parker,
    Thanks for all the good information over the years. I’ve been searching through your site again and just found a previous post from me from a couple of years ago about my 11 year old. He is now 13 and still having lots of trouble with ADHD meds. We’ve been on so many–seem to work for awhile, then either they stop working or he complains so much that we switch.

    He has finally put on some weight–two years ago I told you he was 70 lbs. and that remained true until the previous school year when he gained 25 lbs. Yay!

    But school is about to start. We just took a weeklong family vacation where my husband and I tried to observe whether current med (30 mg Metadate each morning) is effective enough. We couldn’t see ANY signs of the med being on board. He was hyper, unfocused, annoying, and often mean.

    Tried the corn test yesterday and, at least according to him, transit time was THREE HOURS! I see lots of info on your site about transit time being too long, but could find nothing about it being too short. Please advise or point me toward some further information.

    Thanks in advance for your time–
    Bonnie P

    • Dr Charles Parker says:
      August 22, 2012 at 5:44 AM

      Bonnie,
      Time marches on! I would jump on the corn test one more time before school and if it is 3 or so hours he is absolutely loosing serious neurotransmitters down that way. If it is less than 18 hr you should talk to your doc, wherein you will meet some resistance, to Qualitative IgG [not quantitative]. If you have trouble chasing down that testing we can get it to you from our office, we send it out, and read it everyday. Another point, not to be alarmist, but from my experience: If you don’t get the bowel straight the meds will continue not to work.
      cp

      • Bonnie Prinsen says:
        August 23, 2012 at 1:17 PM

        Thanks once again, Dr. Parker, for being so generous with your time and responding to me. I have been in touch with your office and am working on setting up a consultation with my son. Hope to see you soon!
        Bonnie

  2. drcharlesparker says:
    July 6, 2011 at 9:09 PM

    tlie,
    Thanks so much for your kind remarks… I can tell you right now, without saying a word to you, – you are asking the right questions and moving forward on the correct path. It is quite possible that you have some combination of conditions like depression and ADHD and one can never get them both right with meds that only treat 1/2 of the presenting symptoms. All this would require a more comprehensive interview process with questionnaires etc, but it seriously can be done.

    Do read my ADHD Medication Rules… You are in there! With that info you will be much better armed for your next foray into the medication picture.

    Thanks again, hang in there!
    cp

  3. Anonymous says:
    July 1, 2011 at 11:12 PM

    Hi, Dr. Parker.  Upon finding your site, I was (literally) brought to tears after watching your video-blogs “Thinking Without Acting,” and “Avoidance or Just a Bad Personality.”  (I’m 31, and this was my first time hearing someone accurately describe what I suffer with.)  As opposed to “Acting Without Thinking,” I tend to (as you beautifully articulated) “Think Without Acting” – which you labeled “COGNITIVE ANXIETY.”  This condition, consisting of repetitively thinking the same (often very negative) thoughts over and over usually leaves me in a paralyzed mental-state.  Operating in life becomes nearly impossible due to the lack of gaps between the repetitive, negative thoughts.  (i.e., How can I converse with people while these repetitive thoughts hinder my ability to pay attention to them?)  I loved your mention of OCD, which I feel as though I deal with in my head, but not through my actions. 
    This leads me to your 3rd video-blog which focused on “AVOIDANCE.”  Isolation, while excruciatingly lonely, is less stressful than dealing with people.  (When dealing with people, I have to pretend to pay attention when, in reality, I’m only staring at them – but not truly listening to them, as my repetitive thoughts make listening extremely difficult.)  As you mentioned, the increased variables only increase the speed and tenacity of the repetitive thoughts.  (I believe you used the words “worrying,” “fretting,” etc.)
    I’ve had therapists suggest I could be bi-polar, but that never seemed accurate to me.  As I understand it, being bi-polar leads to mood-swings ranging from “HAPPINESS/BLISS” to “SADNESS/HELPLESSNESS.”  I would describe my mood-swings as “ENERGETIC/FAST-PACED” (i.e., working on a structured project) to EXHAUSTION/EMPTINESS.  (Constantly repeating the same worrisome thoughts, at what seems like a thousand miles per hour, is mentally and emotionally exhausting.) 
    Again, watching your video-blogs were among the most significant and powerful moments of my life; the notion that someone actually grasps this condition is what brought tears of relief and gratitude to me.  Unfortunately, the doctors I’ve talked to, only seem to have two medicinal solutions:  Ritalin and/or Adderall – neither of which seem to work very well.  While providing a boost of ‘brain-energy’ (which is nice because it helps with the EXHAUSTION) – it’s not what I hoped for.  Here is my question:  Is there medication that focuses more on COGNITIVE ANXIETY (described in your video-blogs) that I can mention to a psychiatrist?  (By the way, I will be purchasing all of your books, as I’m quite desperate – to the point of battling suicidal thoughts in order to escape the frustration and loneliness that come up with this condition.)
    Words simply cannot express how grateful I am to have come across your blog, and any type of advice, suggestions, etc. will be appreciated more than you can possibly imagine.

  4. Courtney says:
    January 27, 2011 at 4:13 PM

    Hi Dr. Parker, your blog is both informative and exciting. I have recently decided to pursue a masters in psychology from the Chicago School of Professional Psychology. I know you are more involved on the psychiatric side, but you are still a great motivation. If you can give me any advice about my future education, it would be much appreciated!

    • Dr Charles Parker says:
      January 28, 2011 at 5:36 AM

      Courtney,
      You have chosen well, as you will never be bored and will always have new and exciting opportunities to contribute to the lives of your fellow travelers.
      1. Stay with brain and neuroscience – biology and psychology now converge, and that is the place to be.
      2. Think team. As a psychologist plan on scalability and communication from the start – blog, connect, get with a physician who gets you so you can synergize both sides – some states might be a cool certified family nurse practitioner – they get it.
      3. Even tho you are busy, do sign up over on this page for CoreBrain Training as I will have a virtual program for you and your colleagues this summer – on the biologic side of things and how to run it in your practice – the best care, economics, communication, international team play.
      Best to you!
      cp

  5. Dale C. says:
    December 22, 2010 at 10:48 PM

    Seasons greetings Dr.Parker and to one and all!
    I found myself running away at the fingers, so I have redisgned my post with the question first, followed by my run-on sentence.
    My psychiatric meds are: sertaline 150 mg am; Lithium ER 450 bed; clonazapam 1.0 mg bed; adderall 30 mg bid; buproprion SR 450 mg am. I noticed that when I started the buproprion, as the levels stablized, I found the adderall less effective. Methylphenidate meds dont really work that well. I tried Vyvanse (to 70 mg) but found it took me through the afternoon.
    Does buproprion diminish the efficacy of adderall? I have found conflicting information. This doctor is (as he should be) guarded with going over recommended dosage limits with medication. Adderall XR seemed to be “front loaded”. I know the medication has the 4 hour component, but never seemed to last more than 5- 6 hours for the days dosage. I have thought about discussing a switch to dexedrine, thinking that perhaps just a dextroamphetamine compound might prove more effective. I would appreciate any insight on the buproprion/adderall issue and thoughs (nonbinding of course) on dosage or medication change.
    I have been a longtime fan. I recently reviewed your Youtube videos. Wow! I had never seen ADHD framed in those perspectives. I am a 48 y/o suffering from (likely) Bipolar II (somewhere in the spectrum and more than just depression) as well as Adult ADHD. I started suffering from severe depressive and hypomanic bouts in about
    1976. I lived in medium size Illinois city where I saw some psychologists. There was only a few psychiatrists in town, mostly alligned with the state Psychiatric hospital and long term institutional cases. None of the psychologists ever mentioned depression, let alone anything else. The information superhighway was still in the planning stages.
    The story continues on and on like so many. Severe substance abuse from ages 14 to 26. I sometimes wonder if the multiple substances (including good old ETOH) helped me complete college (barely, and only by the hair on chin). Failed jobs,relationships, Several hospitalizations, etc… the whole 9 yareds. I started on desipramaine back then just prior to Prozac. It had little effect, though the professionals said it stablizied. Antidepressants use to work but eventually lose efficacy to the point where nothing really worked and I have been in neutral for years. I even tried Parnate up to 60 mg/ day. The only result was what I believe to have been a type over serotonin syndrome experience
    I get SSDI but, like many people, I expected big things (at least a little more than where I am at) and truly feel capable of more. I had a battery of tests a few years ago including the Wechsler and the Connors computer test. They found I tested at the right end of IQ range ( I know, that and $2 will get me a cup of joe) and showed pretty severe deficits in areas related to attention. I reckon that I have pretty good adaptive skills. I kind of joke with people that I am like Woody Allen in “Zelig”; that is, I can work into any conversation and talk about wherever their conversation is (Zelig morphed into the people he was around).
    Your articless in and videos were incredible. I have been researching (since I found Google Scholar, its a bit easier to access journals, though there are a few I have to check out in a roundabout way). Thinking and not acting. Thats it! My wheels have been spinning since I was a little kid (though I must have been really good adaptively, as most of my work I finished pronto then talked to everybody else in the class still working on assignment. It caught up with me in high school, with the polysubstance abuse and difficulty establishing or maintaining relationships (and jobs). Its as if I could resolve an issue in my head, yet it continues to race and I eventually dont have resolution. I have accomplished quite a bit, but I am always returning to my first day of school (figuratively, of course). I got so tired of starting over again and again (and…). I had a decent resume at one point, nows it been years since I have worked. I tore the internet apart (Universy rehab departments, Government info)and called employment specialists trying to find an acceptable way to duct tape the holes in my swiss cheese resume.
    I have found a good therapist and seeing a psychiatrist I used to see years ago before I relocated to my folks home in Orlando (I drive the 90 miles each way because he is good and does listen). He was patient and was supportive in trying to get a good combination. I worked as a counselor with adolescents for 10 years, so I am somewhat hip to the “game” and know quality and less than quality Psychiatrists. I am starting treatment with a fairly straight ahead CBT therapist in 2011 ( this may sound bad, but there are a lot of good therapists out there who claim to use CBT intervention , but probably took one class or had an in-service).I feel more optimistic right now than I have in some time. I essentially lost contact with friends of many years and stay in. I am not agorophobic, its just that everything seems pointless). I have developed a name for my thinking thinking thinking; I call it “The Shredder”. I can shoot almost anything down with solid logical argument. I know and I have to weed through, because some if it is accurated and realistic).
    Thanks for your site, your time and energy, and doing the right thing. I tended to stand up to systems (surprise) and always got in trouble. I am going to get your book soon. I have read all kinds of stuff; Barkley, Adler, Brown, and countless others. Your presentation provides a lot of information with great summaries. It just seemed so clear…. Thank you!

    • Dr Charles Parker says:
      December 23, 2010 at 5:39 AM

      Dale,
      Much appreciation [!] for the kudos and a few notes back on your inquiries.
      1. Wellbutrin, even sometimes in lower doses, can interfere with the metabolism of Adderall by moderately blocking 2D6, the AMP pathway. Problem downstream: agitation, anger, and more ADHD symptoms secondary to the interaction.
      2. Adderall XR DOE of 4-5 hr is simply not dosed right in most presentations. Expect for XR a 8-10 DOE [4-5 hr for IR] with correct dosing and should have no problem with sleep or appetite the two main side effects out the Top of the Window.
      3. Likely, without specific info, cause of meds petering out: too few neurotransmitter chickens in the ranch.
      4. With a bipolar, mood history, one has to be careful with stimulants, – but dosed carefully, treating the sleep, and correcting the underlying neurotransmitter deficiencies can significantly turn even the most chronic folks down an improved path.

      Best of luck on turning around that Swiss cheese resume! Remember: Self esteem comes from self mastery, period. Stay on the path, don’t quit. You are a smart guy with a good doc, and an inquisitive mind. Those in denial remain arrested in ignorance – you have some hope.

      Best for the Holidays, and thanks again for your kind remarks,
      cp

    • Dr Charles Parker says:
      September 17, 2011 at 7:59 AM

      Dale,
      Gotcha covered on the anonymity issue, corrected here and may take a little time to change on the blog – but done. And thanks again for your comments and serious support out there. Stay tuned for the CoreBrain haps – you will be interested in those connections.
      cp

  6. terri says:
    October 26, 2010 at 3:46 PM

    so i need some help.been to the amen saved my daughter Sams life.her dx is adhd combined type,impulse control dis. mood dis.posable bipolar dis.overanxious dis.and RAD still so much med.history born with hap c. cerosess and fatty liver at 1 1/2 yr.started interferon and robevirin at 3 1/2 for 1 year.she is 12 now hep c undetectable cense then.just found out that the sphincter at the end of the esophagus does not close. she has severe acid refulx have been dealing with that for 3 yr.is on zantac 150 at PM and nexium 40mg AM she all so takes abilify 5mg PM, concerta 18mgAM,zyrter 10mg PM,fish oil 1500AM,PM,gaba750AM,PM,phosphatidylserine 100AM,PM,vit D3 5000 iu AM,PM,coenzyme B-complex AM,5-HTP 50MG pm.Tri-fiber complex with psyllium power 750mg,oat bran 710mg apple pectin power 40mg AM,PM.and some times miralax. i did the corn test sunday morning at 9am its tuesday at 1230pm still no corn has had 3 BM.so at times she is realy stable then at times she becomes so angry at a perceived slight im thinking it must have to do with it transent time.she has been on concerta sents aug 2010 ,abilify dec.2009 and every thing else april 2009 from what im reading here there could be vit c issues and other stuff not sure where to start .if you could point me in a direction ? i only found you a bout 3 week ago already so much help thanks

    • Dr Charles Parker says:
      October 29, 2010 at 6:16 AM

      terri,
      The corn and transit time issue is a very big clue. The details for what to do would require a full hour to review, even with IgG testing. I would strongly recommend IgG testing, and a consult for Neurotransmitter testing as she will undoubtedly have significant NT challenges with that kind of transit time aberration.
      cp

  7. Customized, Personalized Medicine: Dr. Parker’s Methodology for ADHD Treatment | Jeff's A.D.D. Mind says:
    October 7, 2010 at 8:47 AM

    […] post, Filling in the Gap, which was a reflection on one of Dr. Parker’s posts, examines the issue of mapping the observed to the […]

  8. Bonnie P says:
    September 1, 2010 at 9:26 AM

    Dr. Parker–
    I’m a regular reader and you’ve offered me some helpful advice through your website here. My son switched from Concerta to Vyvanse based on what I’d read here. Now with school starting, he and I both feel his meds need to be tweaked, but I’m not sure which direction to go.

    He’s 11 years old, 70 lb (always been a skinny guy with little appetite), diagnosed clearly ADHD at age 8, also diagnosed as having moderate anxiety.

    Current meds are Vyvanse (40 mg), Strattera (40 mg) and Zoloft (50 mg). While observing him on a weeklong vacation last month, where the pharamacy had accidentally shorted us some pills, I noticed that ironically, the days when he DIDN’T take the Zoloft, he seemed a bit happier and had LESS anxiety.

    What I’ve noticed about him lately, even on his meds, is that he cannot ever sit still. While sitting, is still fidgeting with neckline, shoulders, shuffling legs and feet. He’s often obnoxious and impulsive emotionally, to point where family gets really frustrated.

    In a moment of real clarity, he told me he thinks he should go back to Concerta before school starts because he feels he cannot focus. This was unusual: he generally despises both his meds AND school.

    Our doctor generally listens well to what I think and then makes a decision. I’m leaning toward either slightly increasing both the Vyvanse and Strattera and maybe cutting out Zoloft altogether. Or maybe follwing his instinct and going back to Concerta (he ended at 54 mg dose and complained he disliked it–but not sure why). Am I way off in my thinking? Do you have time to share any thoughts?

    Eating and sleeping have ALWAYS been a problem for him, since birth. Have never found anything that really made that better.
    Bonnie P

    • Dr Charles Parker says:
      September 4, 2010 at 5:34 PM

      Bonnie,
      You probably know what I am going to say on the breakfast situation… simply has to be corrected. Check out this Protein Breakfast post for many options some of which might be helpful. Shakes, protein on the cereal can all help.

      But, in an effort to offer more than axiomatic diligence, I strongly suggest right behind that remark, that it very likely may not work, no matter what you try for breakfast if he has an immune dysregulation. Picky eaters almost always have underlying metabolic problems – see this CorePsych Blog post with many comments about Picky Eaters.
      cp
      cp

  9. Stuart Frazer says:
    May 21, 2010 at 9:35 AM

    I wonder if some of the quantitative self-measurement tools mentioned in the recent NY Times Magazine article below might assist doctors and patients with really getting a handle on dosage questions. Of course, would still depend on the patient being diligent in collecting the data.
    “The Data-Driven Life”
    http://www.nytimes.com/2010/05/02/magazine/02self-measurement-t.html

    • Dr Charles Parker says:
      May 23, 2010 at 2:39 PM

      Stuart,
      Completely agree with the message on your excellent link – it is indeed my own theme – and yes, soon everyone will be using more careful measures.
      cp

  10. Filling in the Gap: Some Thoughts on Dr. Parker’s “Psychiatric Diagnostic Labels: Functional or Static?” | Jeff's A.D.D. Mind says:
    April 20, 2010 at 6:49 AM

    […] duration of effectiveness and related neurophysiological factors. Be sure to visit his website and this particular post to get more information about the forthcoming book and the available white paper that will give you […]

  11. Do you agree poor parenting is what causes ADHD? says:
    April 18, 2010 at 2:48 PM

    […] ADHD Medication Rules: What To Do […]

  12. Kristine Noonan says:
    April 18, 2010 at 10:25 AM

    http://www.autism.com/treatable/recovered/recovered2006videos.htm

    If we fix the gut and replete nutrients and micronutrients and if necessary chelate heavy metals and treat candida, we do not need ADHD meds..true for kiddos and adults.

    Kristine Noonan RN CHHC

    • Dr Charles Parker says:
      April 18, 2010 at 10:29 AM

      Kristine –
      Completely with you, except when the folks are straight ADHD, and have no interest, no reason, absolutely no motivation to walk the deeper path. If you take a look at my white paper and book, you will see that I am also trying to bridge that important expansive gap between symptoms and the actual underlying biology.
      cp

  13. Tweets that mention ADHD Medication Rules: What To Do -- Topsy.com says:
    April 18, 2010 at 10:22 AM

    […] This post was mentioned on Twitter by Dr Charles Parker. Dr Charles Parker said: New post: ADHD Medication Rules: What To Do http://goo.gl/fb/bIDxX […]