Posted by manowar on January 17, 2002, at 15:53:24
In reply to Re: Serotonin manipulation useful for ADHD?, posted by petters on January 16, 2002, at 1:13:16
Hi guys,
This is my opinion, which could be, and probably is wrong, but here goes:
ADHD (I like to call it ADD- because I think the H-which stands for hyperactivity--can be very misleading) is a very complex problem, just like depression is, and no two people (brains) are alike.
BTW: Amen believes that some depressions are not really depression, but Deep Limbic ADD.-- IT SURE SEEMS LIKE DEPRESSION TO ME, but I’m glad I learned this, because this distinction makes a HUGE DIFFERENCE in the treatment of the illness --(what ever you want to call it--for me-- I call it F***** up brain syndrome!) He also mentions something very interesting in his books. He says that the catecholamine neurotransmitters dopamine and serotonin seem to counterbalance each other. In other words if someone is taking an SSRI which increases serotonin, dopamine levels in the brain go down and vice-versa. I CERTAINLY BELIEVE THIS IS TRUE.
Dr. Amen (whom I think is a expert on the matter) distinguishes 6 different types of ADD. Some folks such as myself can have more than one subtype.
Here are the two that I have:
ADD Inattentive type- Sleep in class and bored all the time in youth. Sleep at work and bored all the time in adulthood.
-- Pstims are indicated for this subtype.Deep Limbic ADD-Just like depression, but not only is the deep limbic part of the brain overactive, the pre-frontal cortex (PFC) shuts down during concentration, which I think is a symptom of all ADD types. (I have a touch of the Deep Limbic ADD) -- Dopamine and Noradrenaline agents such as buprion (Wellbutrin), Modafinil (Provigil), or the dirty, dumb, Noradrenergic TCAs (do you’re best to avoid these-as far as I’m concerned) and stimulating MAOIs (never tried those- I like pepperoni pizza too much!) can be helpful for this subtype. SSRIs can be counterproductive.
These are the six types of ADD according to Dr. Amen:
BTW: I copied these from his website.1. AD/HD, combined type with both symptoms of inattention and hyperactivity-impulsivity. Brain SPECT imaging typically shows decreased activity in the basal ganglia and prefrontal cortex during a concentration task. This subtype of ADD typically responds best to psychostimulant medication.
2. AD/HD, primarily inattentive subtype with symptoms of inattention and also chronic boredom, decreased motivation, internal preoccupation and low energy. Brain SPECT imaging typically shows decreased activity in the basal ganglia and dorsal lateral prefrontal cortex during a concentration task. This subtype of ADD also typically responds best to psychostimulant medication.
(Right now I’m using Provigil)3. Over focused ADD, with symptoms of trouble shifting attention, cognitive inflexibility, difficulty with transitions, excessive worrying, and oppositional and argumentative behavior. There are often also symptoms of inattention and hyperactivity-impulsivity. Brain SPECT imaging typically shows increased activity in the anterior cingulate gyrus and decreased prefrontal cortex activity. This subtype typically responds best to medications that enhance both serotonin and dopamine availability in the brain, such as venlafaxine or a combination of an SSRI (such as fluoxetine or sertraline) and a psychostimulant.
4. Temporal lobe ADD, with symptoms of inattention and/or hyperactivity-impulsivity and mood instability, aggression, mild paranoia, anxiety with little provocation, atypical headaches or abdominal pain, visual or auditory illusions, and learning problems (especially reading and auditory processing). Brain SPECT imaging typically shows decreased or increased activity in the temporal lobes with decreased prefrontal cortex activity. Aggression tends to be more common with left temporal lobe abnormalities. This subtype typically responds best to anticonvulsant medications (such as gabapentin, divalproate, or carbamazepine and a psychostimulant.
5. Limbic ADD, with symptoms of inattention and/or hyperactivity-impulsivity and negativity, depression, sleep problems, low energy, low self-esteem, social isolation, decreased motivation and irritability. Brain SPECT imaging typically shows increased central limbic system activity and decreased prefrontal cortex activity. This subtype typically responds best to stimulating antidepressants such as buprion or imipramine, or venlafaxine if obsessive symptoms are present.
(I use buprion)6. Ring of Fire ADD - many of the children and teenagers who present with symptoms of ADD have the "ring of fire" pattern on SPECT. They often do not respond to psychostimulant medication and in many cases are made worse by them. They tend to improve with either anticonvulsant medications, like Depakote or Neurontin, or the new, novel antipsychotic medications such as Risperdal or Zyprexa. The symptoms of this pattern tend to be severe oppositional behavior, distractibility, irritability and temper problems and mood swings. We think it may represent an early bipolar pattern.
Get Healthy and good luck,
Tim
poster:manowar
thread:89555
URL: http://www.dr-bob.org/babble/20020116/msgs/90609.html