VOLUME 9, NO.10 October 28, 2004

NJ ADD/ADHD ADULT NEWSLETTER

ADD ADULT SELF HELP SUPPORT GROUP

FOR ADD/ADHD ADULTS

AND THEIR SIGNIFICANT OTHERS

MEETING: THE NEXT MEETING OF THE ADD ADULT SELF HELP SUPPORT GROUP WILL BE ON OCTOBER 28, 2004 AT 7:30 PM AT MONMOUTH MEDICAL CENTER, COMMUNITY MEETING ROOM , LONG BRANCH, NJ. GO TO THE RECEPTION DESK IN THE MAIN LOBBY AND GET DIRECTIONS. THE TOPIC WILL BE: HOW TO DEAL WITH ANXIETY, STRESS AND TRAUMA TO HELP MANAGE ADD.

RESEARCH: In a research study by L.Tamm etal., Event-related fMRI Evidence of Frontotemporal Involvement in Aberrant Response Inhibition and Task Switching in Attention-Deficit/Hyperactivity Disorder, J.Am.Child Adolesc.Psychiatry, 2004, 43(11): 1430-1440, it was found that ADDers have significant problems with switching tasks. Response inhibition refers to the ability to stop a preplanned behavior, interrupt an ongoing behavior, delay an activity, avoid distraction and interference, and avoid errors of commission and omission. The task was defined as a Go/NoGo test. ADDers made more errors of commission (responding when they were not supposed to) and more errors of omission (failing to respond when they were supposed to). The fMRI revealed that the brains of the ADDers when compared to the controls were more widely active and there was underactivation in areas such as the right anterior-cingulate cortex and supplementary motor areas; in contrast, there was more activation in the left middle and superior temporal gyri areas. The temporal lobe activations were likely due to the finding that 60% of the ADDers reported either silently reading or silently reminded themselves of the instructions.

COMMENTS: Here we have yet another study demonstrating that ADD is real; that there are real differences in the brain functions of ADDers. The ADDers use of verbal mediation to improve performance was interesting, and consistent with my experience. It can be taught as a management strategy to cope with response inhibition problems.

STIMULANT MEDICATION CHART modified from Maureen Connolly in ADDitude, 2004, 5(2): 35.

Short Acting Methylphenidates: Ritalin (3-4 hours); and Methylin (chewable 3-4 hours)

Long Acting Methylphenidates: Ritalin SR (tablet 6-8 hours); Ritalin LA (Capsule 8 hours)

Metadate ER (6-8 hours); Metadate CD (Capsule 6-8 hours); Concerta (10-12 hours)

Dextro-methylphenidate: Focalin (4 hours; 2 times more potent)

Short Acting Dextro-Amphetamine: Dexedrine (3-4 hours)

Long Acting Dextro-Amphetamine: Dexedrine Spansules (4-5 hours)

Medium Acting Dextro and Levo-Amphetamines: Adderall (Tablet 3-6 hours)

Long Acting Dextro and Levo-Amphetamine: Adderall XR (8-10 hours)

COMMENTARY ON ANXIETY, STRESS AND TRAUMA: Brain research in the last few years has convincingly demonstrated that when we humans are under excess stress or trauma, our logical brain is tuned out and we engage in emergency/automatic survival behaviors. Sometimes the stress is so great that our brains produce enough morphine like hormones that we do not feel the pain; we experience numbness, a tuning out, a daydreaming. If we engage in enough of this tuning out, we can become like a morphine (opium) addict who needs a stimulant to stay awake, alert, and in tune to the world. There are many techniques that we can use to learn to stay tuned in besides the psychostimulants. Some of the newer treatments include: EMDR, TFT, EFT, SE, TIR, WHEE, PET, TAT, VKD, and others. We have frequently talked about meditation, biofeedback, imagery, exercise, talk therapy, and support groups as ways to diminish the anxiety, stress and trauma. Most of us have not yet tried the newer treatments.

PEACE!!! Bob

This newsletter is available free as an email at www.DrLoPresti.com. It is offered to readers only for informational and educational purposes and does not constitute medical or psychological advice; always consult your doctor.