Paging Dr. J.!! (as well as anyone else interested) re: Spect Imaging

[wolfshades]

Hoping the subject line got your attention.

I’ve been hearing about a technique for discovering the type of ADD a person has, and the specific treatments for each type. The pioneer in this field appears to be a psychiatrist named Dr. Daniel Amen, and he advocates that doctors perform a spect image of the patient’s brain to get a better understanding of the type of ADD involved.

Since finally getting my diagnosis this week, I’m anxious to go down the right path for treatment and therapies. My question on spect scans and Dr. Amen’s treatments are twofold: 1) is there validity to what he’s talking about?; 2) does CAMH or any other treatment center provide for focused diagnosis of the type of ADD via spect scans, which would result perhaps in a focused treatment plan?

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[Anonymous]

You posted about this already. Give it some time.

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[Anonymous]

Wolfshades, you will ALWAYS get a “focused” treatment plan, depending on what your own symptoms are. The treatment is a combination of medication and behavioural therapy to assist you with coping strategies for your individual needs. You can’t get much more focused than that.

From what I know, MRI scans have been used to show the differences in brain development between ADHD and neurotypical individuals, but not between different types of ADHD. All types respond to stimulants in similar ways, but there is no way of telling which drug you will respond to best, and this is true for pretty much any psychoactive drug.

So, no matter what, you WILL get a focused treatment plan.

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[wolfshades]

@Shane: yup, I know. I wanted Dr. J. to weigh in though. Hence,the change in topic title.

@Nimthiriel: it’s funny you should mention that. When the psychiatrist gave me my diagnosis, he basically said “here – try taking this type of medication, and try taking martial arts. Go back to your doctor for all of it”. I asked him if I needed to see him anymore, and he said “no”.

I know – from attending a support group, and from reading folks’ experiences here – that it’s not ever that cut and dried. Some medications will work, while others will not.

Which is kind of what Dr. Amen is getting at. His method for treatment appears to be:

1) going the usual route to determine first whether a patient has ADHD or not (family history, etc. etc.)

2) after a patient is diagnoses as having ADHD, he then does a spect scan

3) he believes there are at least six different types of ADHD, and so he structures the resulting drug and psychotherapy treatments accordingly.

I’ve yet to see my family physician for the first course of drug treatments. Hence my desire to get some input from someone (anyone) here who may have gone Dr. Amen’s route, or at least knows something about it.

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[Anonymous]

There are many ways that ADHD presents, but they all seem to have the same root causes: Lack of dopamine and underdeveloped prefrontal cortex.

I don’t think we yet have the knowledge to deduce the “type” of ADHD someone will show, except that girls tend toward the inattentive type and boys toward the hyperactive type. anything else is more like a coping strategy. My father, for instance, hyperfocuses a LOT. It’s not a “type” of ADHD, it’s how he survives it without medication.

See your physician and ask about a referral to a behavioural psychologist, or some other type of psych who understands ADHD.

I recommend that you stop focusing on this one guy’s ideas and start looking for ways of actually managing your own symptoms, because the latter will probably be more fruitful in forseeable future :-p

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[wolfshades]

Nimthiriel – have you checked out Dr. Amen’s site? In particular, this sub-section discusses the various types of ADHD that are out there. http://www.amenclinics.com/clinics/information/ways-we-can-help/adhd-add/

The whole point of my looking into this is to do exactly as you mentioned in your last line: to find a way to manage my own symptoms. I trust my doctor to help with this, but want to go in with as much information as possible, so as to have a halfways intelligent discussion with her. There is nothing worse than walking out of the doctor’s office more confused than when you went in – and that has happened a number of times. (Some doctors are used to moving fast and blurting out info, before the brain gets a chance to register it).

I may have given the impression that I’m only focusing on this one guy – Dr. Amen – but rest assured: I am not. I’ve been researching ADHD ever since taking the online test here a little under a year ago, up and until I got my diagnosis finally from a psychiatrist. I’ve already lined up a psychotherpist – one I’ve seen already and am ready to start down the avenues of managing my symptoms. The only reason I brought this guy up is because his theory and methods are new to me, and I wanted to know who in our community here might be familiar with him. Don’t want to leave any one stone unturned.

I am not an evangelist for the man, and I apologize if that’s how it sounded. I simply want to know. That’s all. If you haven’t read his theory, you may wish to take a few minutes and go to the website.

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[Anonymous]

@Nimthiriel

Unfortunately, I have the hyperactive ‘boy’ type and don’t fit into the inattentive ‘girl’ type.

I had no idea that there were gender differences..always just knew how I was.

My Dr. says I am very self-aware and wonder how much gender-biased opinions are out there rather than scientifically based through tests or scans…..

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[Anonymous]

OK, I’m here, I’m here. Anybody see my sandwich? Oh, here it is. I was sitting on it. OK, Amen’s stuff. Currently, there has been no definable research that validates his theory (and that is the operative word) or any study that has replicated his beliefs. I understand that he sold 5 million last year from publicity he got from PBS on books and visits to his clinic. Clearly, he believes in what he does and no doubt there may be something there but without either validation and replication, it will remain just that, a theory. But from his point of view, why would he want to do a study? For credibility? He is raking in the dough. Clearly his credibility is that he is either a very good salesman or that people find his help positive. What does he have to lose doing a study if he believes in his work? What if the study shows that his results are no better than placebo, as it shows in Neurofeedback. That would mean that he is just a good salesman. Frankly, he will leave it to others to do the studies and will likely claim, as others before him have done, “Of course their study was negative. They just put in enough flaws to make it slant that way because they are jealous.” As if we all have beaker envy! The real reason he should do sufficient evidence-based work: because someone truly interested in the science and not the money wants to change the way we think and make a difference in a more everlasting manner. For now, I think Amen has guts and chrisma and has opened peoples eyes with both awe and skepticsm: the stuff of soap opera science. And you thought we were all boring nerds……well, maybe some of us. Back to my sandwich.

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[Anonymous]

‘Beaker envy’!….I love it!

Hey…was that a tuna on rye?

Just found one under the papers here….

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[wolfshades]

Thanks for your note, Dr. J. It was certainly worth asking the question – precisely because of what you pointed out: the popularity of his practice. There’s enough buzz out there to provide just the right amount of confusion. I suppose it’s like the latest buzz about the “miracle cure” for MS. It might be valid, but without the requisite studies, it remains just as you said: theory.

Your statement is what I was looking for: “there has been no definable research that validates his theory, or any study that has replicated his beliefs”. That’s exactly it. ’nuff said. I’ll turn that stone back over and wander off…..

Thanks again!

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[Anonymous]

Dr J: Without replication and peer-review, it’s not even a theory! It is mere hypothesis.

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[Anonymous]

Agreed, but without being too cynical, I always like to believe that people are genuinely seeing something that works and we shouldn’t discount them but we can’t sanction them. Who knows, someone may have an answer that is credible. Even hypotheses have their merit but are much lower down on the decision tree.

At the end of the day, we all have to be good consumers.

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[Anonymous]

Dr .J

I have been looking into Neroplasisty and also the ArrowSmith School in Ont. This women had put together a program for students with learning dissabilities you might of her of her. She had learning problems herself. She gets the kids to put a patch over there one eye to make the other side of the brain work. In order to get into the school they have to take a test to see were there learning problems are.

then she sets up a program for them. She was on a documearty couple of years ago along with other Dr’s on neroplasisity.

Also in Nova Scotia they really don’t have much down here. I was told that I have cognitive problems and I might not have

ADHD. After one DR put me on meds then another is changing his view on weather I have it or not. I’m taking on more myself because most Dr’s in Nova Scotia just don’t have the rescourse’s. The test cost 1,600 to see what my problem is. But I already know I’m 53 and ADHD runs in my family my sister’s kids plus grandchild plus my mother’s ,sisther’s kids but I have to pay out for this for them to help ;me. And now there taking away my meds that I have been on since Aug until I have this test done. So I got a feeling I’m going to be left on m;y own again to figure things out. On cognitive problems is there a computer program that I can buy to do at home. When I type in cognitive a few things come up Lumosity that is back by NeoScience people one other one was put out by The Brain that change itself with some of the NeroScience there. Do you know any thing that might be on the market? Clamdigger.

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[Patte Rosebank]

Which doctor threatened to take you off meds, unless you paid $1600 for a test to prove what was already so obvious???

Making you pay $1600 for a test they say you need to get before they’ll help you, even though there’s already plenty of evidence that you have ADHD, sounds a lot like those “talent scouts” or “agents” who tell you that you have the perfect look to be an actor or model—but you have to spend thousands of dollars on courses with their teachers, and photos with their photographer, before they can try to get you work.

Were the meds you were on actually working for you? If not, your doctor should have tried a different med or meds. Every person is different, and just because a person doesn’t respond to one med doesn’t mean they don’t have ADHD. It may just mean that they have to try a different med. In treating any mental or mood disorder, the only way to find the right med(s) and dose(s) is by trial and error. It’s tough, and frustrating, but it’s the only way.

I can understand your desperation to find things that will help you, but please, please, please, thoroughly investigate every possible solution BEFORE you spend money on it! While something may work for some people, every case is different. You need to determine the science behind each of these “new miracle” treatments. And that means, looking at whether or not there’s been any proper, independent, double-blind, clinical testing, and what that testing found. If the results were quantifiable and repeatable, then the chances are pretty good that the treatment may work for you. But if the only “proof” that the treatments work, is anecdotal evidence (i.e., people saying, “It worked for me, when nothing else would”), then the chances are pretty good that the treatments are (at best) ineffective, and (at worst) a scam.

Keep an open mind to possibilities, but be careful. And ask your doctor (or perhaps a different doctor whom you trust, if yours is the one who forced you to fork out all that money) what (s)he thinks of it, before investing your money, time, and hope.

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[Rick Green – Founder of TotallyADD]

I like what you’ve written, Larynxa, about keeping an open mind. As you say, every ADHD person seems to be different and due to their background, their circumstances and their experiences, they are suffering impairment in different areas and at different levels. By adulthood some of us have managed to find a way around some of the areas where we struggle. Through some strategy we came up with on our own. Or a tool like a PDF. Or by simply deciding, “I don’t do that,” and handing off our paperwork to someone else who is good at it.

So your own symptoms may lessen as you age, they may also be more or less severe depending on your changing circumstances. If you’re not great at organizing, but the kids are now grown and off on their own, it may be less of an issue.

The point of all this is, things change. So you want to keep checking in and assessing where you are.

You may also want to do the same with the diagnosis itself. Always keep an open mind. This is difficult to diagnosis, for a number of reasons…

http://totallyadd.com/confusion-comorbidities/

http://totallyadd.com/the-biggest-myths/

http://totallyadd.com/informed-consent/

…so you want to keep checking.

And finally, as Larynxa points out, you really, really want to check any and all ‘solutions’ before you spend money on them.

If getting the diagnosis is going to be expensive because your health care doesn’t cover the costs, then do as much testing, reading, understanding and reflection as you can before you get to the Doctor. Be up to speed and informed.

It speeds up the process when you arrive informed. And it helps you spot the ‘scams’ or ‘ineffective’ treatments that Larynxa is warning about.

Rick

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