Dr. Eric

My Forum Comments

Viewing 15 posts - 1 through 15 (of 219 total)
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  • in reply to: ADHD diagnosis #187964
    Dr. Eric
    Participant

    Why are you worried about being labeled a hypochondriac?

    in reply to: Adderall and slipping rib syndrome #187926
    Dr. Eric
    Participant

    I have been following ADHD issues since I was diagnosed in the early 1990’s. This is the first time that I recall it being brought up.

    in reply to: ADHD child and cell phone use #187450
    Dr. Eric
    Participant

    I recommend the following:
    – Activate the ScreenTime option or equivalent, review with child every week.
    – Chargers in parents room with a strict time to have them in the room.
    – Check out the website smartsocial.com for internet safety tips with children.

    in reply to: Newly diagnosed, prescribed wellbutrin but not depressed? #187377
    Dr. Eric
    Participant

    This is a very popular and useful prescription for the anxiety/ADHD combo.
    I often see it for students that had their anxiety increase with stimulants.

    I don’t understand where the belief that you need to be depressed comes from.

    in reply to: How to get teen up in the morning? #187164
    Dr. Eric
    Participant

    What does your evening look like, and are ALL the electronics on chargers in the parent’s bedroom one hour before bedtime?

    in reply to: COVID question #187130
    Dr. Eric
    Participant

    At our school, kids that don’t tolerate masks are doing better with the face shields.

    Adults have to wear both on campus, so we have them in stock.

    in reply to: Newly diagnosed family seeks input #187040
    Dr. Eric
    Participant

    My favorite quote about medication is from Ned Hallowell’s podcast.

    “Waiting to try meds for ADHD is like telling someone with bad eyesight to squint harder for a year before trying glasses.”

    in reply to: Switching from stimulant to non-stimulant, anxiety question #187036
    Dr. Eric
    Participant

    I don’t have first-hand experience, but I have had students that have dealt with the ADHD combo… It really is trial and error.

    The general consensus is that stimulants work for 80% of the population per Dr. Ned Hallowell’s podcast.
    However, this is based on ADHD alone.
    The other consensus is that non-stimulants work, but not as potently as the stimulants.
    Hoewever, this is not a bad thing if you don’t respond to stimulants or the side-effects are too much.

    Unfortunately, stimulants can potentially not work, or even make worse, anxiety and panic symptoms (especially if you get triggered by elevated pulse, palpitations, etc.)

    In fact, I use a strong negative reaction to stimulants as a reminder that I should make sure that I have ruled out the anxiety that looks like ADHD.

    When you have both, you need to experiment with your medical provider on your personal balance of managing your therapeutic benefit of the medications with the side-effects/negatives. Unfortunately, there is not magic formula, everybody is unique.

    in reply to: Has anyone held their child back a grade #186901
    Dr. Eric
    Participant

    Retention is a very loaded topic with a lot of emotion.

    Some things to consider.

    1. The research base is very negative on retention, but the data set is generally huge population sets of people who do it right and wrong. Generally speaking, the data is skewed by states and districts that blindly retain off of a test where students haven’t met a cut-off score – which is exactly the wrong way to do it.

    2. Retention is not really an intervention unless done in 1st grade when a student receives two years of direct instruction of basic phonics and math skill development. This is challenge in grades 3-5 where the students are transitioning from Learning to Read to Reading to Learn. An extra year will not equal more direct instruction in those missing skills because it is unlikely that they are being explicitly taught anymore. And of course, distance learning and COVID has complicated anything related to the last year.

    3. When I have seen retention done correctly in grades other than 1st, the student is receiving excellent interventions and is improving, but they cannot close the head start that their classmates have on them to catch up. If the student is not receiving those interventions and improving at the same rate as their classmates, retention only delays addressing the problem another year – which does more harm than good.

    in reply to: 26yo reading psych eval from 15 – feeling hopeless #186900
    Dr. Eric
    Participant

    Kerry C

    This is my favorite comment that I have read in a while.
    Great job seeing the strengths in the post and pointing them out!

    in reply to: took Adderall for 10 years, but new doctor won’t prescribe #186897
    Dr. Eric
    Participant

    Also, for clarification, the DSM requires that you have symptoms of ADHD before the age of 7, not that you have a formal diagnosis.

    This is a big deal for older folks like me who were 7 in the 1970’s, when folks had little knowledge of ADHD.

    in reply to: Vyvanse increasing blood pressure #186898
    Dr. Eric
    Participant

    It is a stimulant, so cardiovascular issues such as BP and pulse increase are possible side-effects.

    In addition, both therapeutic response and side-effects can be very individualized, so this is an important conversation to have with your medical provider about your individualized response.

    I am generally against Dr. Google beyond general education, but, in this case, I even more strongly urge you to discuss with medical provider ASAP.

    in reply to: What's been your experience with ADHD meds? #186769
    Dr. Eric
    Participant

    I have done two self-studies where I compared similar day’s work on meds and another off. I have done this twice, once in college (’90’s) and once in the 2010’s at work.

    I consistently came in 6 times more productive on meds than off.

    I must also state that my first MD was very systematic in his approach.
    Instead of guessing a good initial dose for me, we started in 5mg of methylphenidate and slowly increased.
    I kept a daily log of my blood pressure, good things, and side-effects.
    We did three weeks at 5mg, 3 weeks at 10mg, 3 weeks at 15mg, started 3 weeks at 20mg – had side-effects – I called the office and 15mg became my prescribed dose at the time. The technical term for this is “titrating.”

    I love that my MD did it this way.

    in reply to: ADHD meds and athletic performance #186768
    Dr. Eric
    Participant

    The stimulants are banned under NCAA rules, but I believe there is a Therapeutic Use Exemption process for them.

    http://www.ncaa.org/sport-science-institute/topics/2020-21-ncaa-banned-substances

    http://www.ncaa.org/sport-science-institute/medical-exceptions-procedures

    However, for practical purposes, most therapeutic doses for ADHD are lower than what I hear athletes take for performance enhancement purposes.

    (For reference, in addition to being an educational psychologist, I have a side gigs on amateur sports commissions (U.S. Fight League and the CA Amateur MMA Organization). I have an awareness of what PEDs professional and amateur athletes take as a result.))

    Dr. Eric
    Participant

    I am curious about two things.

    #1 – If you don’t have ADHD, why prescribe Strattera?
    #2 – What diagnostics did the new provider do? Is there a report, or is this a clinical impression after an office visit?

Viewing 15 posts - 1 through 15 (of 219 total)