This past weekend Dr Banov participated in an research meeting in
Philadelphia involving a new FDA-regulated clinical trial studying the prevalence
of certain genetic markers that may help researchers develop innovative drugs
for ADHD. Studying genotype/phenotype has already led to the development of life saving drugs for Cystic Fibrosis, Pulmonary Hypertension and other serious medical disorders. This is a very exciting area of clinical research and Dr. Banov will continue to monitor potential ADHD medications currently in the “Pipeline” which may ultimately receive FDA approval and become available to our patients.
At the Atlanta Center For Adult ADHD, we are often asked about natural approaches to help manage ADHD. An important study was published this year that analyzed the effect of aerobic exercise on ADHD using rating scales and functional magnetic resonance imaging. Aerobic exercise was found to improve clinical symptoms as well as cognitive function in adolescents with ADHD. Brain activity in areas affected by ADHD such as the right frontal and temporal cortices was increased as well.
Fewer than half of individuals with ADHD seek treatment, according to a study published in August in Psychiatric Services.
Researchers used the 2001 to 2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and the 2004 to 2005 follow-up survey. The NESARC is a nationally representative sample othe adult US population. A total study sample of 34,653 adults had face-to-face interviews.
Approximately 46% of those with lifetime ADHD reported having sought treatment for the disorder.
The estimated median delay to treatment seeking from ADHD onset is longer than 20 years. The study did not look at undiagnosed Adult ADHD which clearly remains a huge public health issue.
At the Atlanta Center for ADULT ADHD, we are striving to improve patient access to ADHD diagnostic and treatment services in our metro area.
A study published in July in the British Journal of Psychiatry has shown that adolescents with ADHD who were not treated with a stimulant medication had a doubling of their risk of developing subtance abuse problems compared to untreated individuals. The study also found that children who start stimulant medications at a younger age are better protected. Physicians treating ADHD have known for some time that there is an association between addiction and ADHD. In my clinical experience at the Atlanta Center for Adult ADHD, patients with ADHD receiving addiction treatment have significantly more difficulty in recovery and a higher relapse rate if their ADHD is not properly managed.
During their initial evaluation at the Atlanta Center for Adult ADHD, individuals-both young and old-often report problems with driving.These issues include close calls from changing lanes without checking for nearby cars, hitting curbs, “fender-benders”, rear-end collisions and worse.
New reseach suggests that treating ADHD effectively may help improve driving performance in young people with the condition. (It is well know that this age group has high rates of automotive crashes and speeding tickets.)
A simulated driving program, completed within a simulated automotive environment, was recently administered to participating young adults at the Massachusetts Institute of Technology AgeLab.
Participants treated with Vyvanse (lisdexamfetamine dismesylate) for 5 weeks reacted 9% faster to startle events and were 67% less likely to have a collision during a driving simulation than those who received placebo.
This research is very consistent with our own clinical experience. In fact, we encourage patients that prefer to take medication only during the daytime to consider taking additional medication to cover evening/night hours if they plan to be driving during these times.
Patients often mention that their ADHD causes them to get speeding/red light violations and to become involved in fender-benders and other accidents. In fact, individuals with ADHD often have trouble staying “in the moment” and have a much higher risk of driving incidents as their minds begin to wonder behind the wheel. While attention during driving is usually improved with medications, driving mishaps can still persist.
The following is a simple technique that I developed to help my patients deal with this problem.
Here’s how it works: First turn off your car radio, IPod, etc. Every few minutes, quietly speak aloud your destination, the road or highway you are on, the direction you are travelling, and your general location. For example, you might say “I am focusing on driving to the airport. I am going North on I-95 and just passed exit 35.” You also can take notice of the traffic immediately around you and describe it out loud every few seconds as well to help you stay focused on your driving. You might say, for example, “There is a white van ahead of me and a blue Volkswagen to the right”. In addition, before you make a lane change, check for traffic on all sides and then say out loud, “Left lane is clear” or Right lane is clear” before actually moving into the next lane over. Finally, you can get used to saying, “Clear to back up” before backing out of a parking space to help ensure you actually check for other cars and pedestrians behind you.
In addition to helping you drive more safely, the above technique can be an effective mental exercise to improve focus in general.
Often patients at the Atlanta Center for Adult ADHD will ask “what to look for” after they take their medication for the first time. In other words, what symptoms will immediately improve? Prompt improvement of three symptoms often takes place: disorganized thinking, procrastination and lack of focus in reading and listening. Individuals whose thoughts seem to be “pinging” around their brain in random fashion can experience a slowing down of thoughts and a more logical progression of one thought to another. ADHD patients often have difficulty getting started on tasks they find uninteresting, difficult/unfamiliar and/or requiring organized steps to complete (for example, balancing the checkbook.) With medication, they may find that they can “attack” or “engage” these tasks more readily. Furthermore, they may be able to work on them for a longer period of time with fewer interruptions due to inattention or distraction.Finally, patients often find they can read easier with less “re-reading” and listen better with less effort and more immediate comprehension. It should be kept in mind that the degree of improvement is usually related to finding the optimal medication and dosage.Symptoms such as poor organization, prioritization and time management issues usually take longer to resolve. Counseling and coaching, in addition to the right medication and dose, can be extremely helpful in these areas.
Atlanta-ADHD Research News:
Northwest Behavioral Research Center, in north metro Atlanta (Alpharetta) is currently recruiting children and teenagers (6-17) to take part in an investigational research study to better understand and possibly treat attention deficit hyperactivity disorder (ADHD).
Study qualifications include:
1. Children between 6-17 years of age.
2. Diagnosed with ADHD
3. Have tried one ADHD treatment and continue to have symptoms.
If interested in learning more about this trial please call 678-992-0109, visit www.psychatlanta.com or contact us with the form below:
The FDA has approved Vyvanse (lisdexamfetamine dimesylate) as maintenance therapy for adults with attention deficit hyperactivity disorder (ADHD).
The approval is based on results from a randomized study designed to evaluate the efficacy of the drug in 123 adults aged 18 to 55 years who were receiving treatment with Vyvanse for a minimum of 6 months before enrolling in the study and who were responsive to the drug. 8.9% of patients in the active treatment group experienced a relapse of symptoms compared with 75% of those in the placebo group during the 6-week double-blind withdrawal phase of the study Shire, the drug’s manufacturer, stated in a press release that “Vyvanse is the first medicine both proven to work and approved to maintain efficacy in adults with ADHD.” The FDA approval included the proviso that Vyvanse should be used as part of a total treatment program that may include counseling or other therapies. The FDA also noted that physician who elects to use Vyvanse for extended periods should periodically reevaluate the long-term usefulness of the drug for the individual patient.The bottom line is that Vyvanse, while previously approved for Adult ADHD, now has been definitely shown to be effective for the long term treatment of this condition. For more information on the Atlanta Center for Adult ADHD, please visit www.Atlanta-ADHD.com
At the Atlanta Center for Adult ADHD, one of the most common medications patients try is Vyvanse (lisdexamphetamine). Vyvanse has an FDA indication (approval) for childhood, adolescent and adult adhd/add. Vyvanse has the advantage of an exceptionally long duration of action, up to 13 hours. This is due to the novel way Vyvanse is metabolized. Lisdexamphetamine is a prodrug which is inactive until metabolized in the body to dextroamphetamine, which in turn is responsible for increasing the release of dopamine and norepinephrine between neurons in the brain. This increase in neurotransmitters produces the improvement in ADHD symptoms that patients usually experience with Vyvanse.
Vyvanse may be taken with or without food (which is always more convenient). The medication is started at 30mg and may be increased up to 70mg as needed. However, many patients do well at the starting dose and no upward titration is needed. One drawback to Vyvanse is the cost and this medication is sometimes not covered under health insurance plans. Because of its long duration of action, Vyvanse is usually one ofthe first medications tried by adults in our practice. All patients who are started on amphetamine medications are carefully evaluated for any health issues such as underlying cardiovascular disease to ensure the medication can be taken safely.
For more information on the Atlanta Center for Adult ADHD, please visit Atlanta-ADHD.com or call 770-753-9898