View Full Version : Help me understand the inattentive brain


ToInfinity
12-28-16, 02:19 AM
There are two types of ADHD. Hyperactive who have racing thoughts, talkative. Inattentive type who are slow moving, slow talking, slow talking, sluggish, daydream. I have inattentive ADHD.

http://www.youtube.com/watch?v=spdSSKFKZNU

I don't understand why ADHD medications would suit the inattentive type since they slow down the brain. They are more tailored towards the hyperactives. The video and other sites recommend Strattera for inattentive but I don't understand why Strattera cause Strattera works by slowing down the brain! Why would you even give that to an ADHDPI when they are already slow? I can vouch this because I am a slow person, slow at thinking and am a space cadet.

That said, wouldn't taking microdoses of speed, lsd, mdma theoretically work for the inattentive type? It essentially speeds up the brain. Or even meds to treat alcohol intoxication as they suffer from similar symptoms. There's actually a med currently on trial, Metadoxine that is used for treating alcohol intoxication is being tested on ADHDPI with significant results.

I'm still on search with the right meds. I've taken many stimulants and non-stimulants and none have worked.

someothertime
12-28-16, 02:45 AM
You will be approaching this better if you first look at neurology in a broad sense rather than an oversimplification of neurochemistry.

"Slow down" and "speed up" the brain is sort of like saying you can;t have a fast sad song in music.

Now, in terms of medicines..... I suggest that your number one resource is qualified professionals and peer input ( those with similar symptomatology and medicinal response as you ). Given that the medical treatment and understanding is really in it's infancy .... in effect.... you'll never reach a kind of hard and fast answer when trying to ask broad questions.

To help the other respondents..... can you highlight or be more specific any particular symptoms? neurological processes? more details about pertinent effects of certain medicines you've tried.... etc. etc.???

You say nothing has worked... Has your doctor / research listed other conditions that exhibit similar symptoms?

sarahsweets
12-28-16, 03:37 AM
I think you are over-simplifying things. I guess I get what you are talking about but I dont think its that cut and dried. What are the things you have tried?

ToInfinity
12-28-16, 06:03 AM
I think I know what you mean that you can't have a fast sad song in music. I'm mainly the slow type so it'll be great if there's a med that could focus on what's most concerning. Likewise how the typical ADHD have racing thoughts so stimulants slows down the brain which is what the most concerning is.

If you actually watched the video, then all the symptoms talked about resembles me. You'll understand the bell curve. I feel like I'm in the low 20% non responders as I've tried practically everything.

Yes a qualified professional and peer input. My psychiatrist. I've tried dexamphetamine, ritalin, reboxetine (a cousin of strattera with less side effects), wellbutrin, I pushed to give vyvanse ago when my pdoc said it's just a long acting version of dexamphetamine which I already don't respond to. I didn't respond to vyvanse but it was just an antidepressant. Donepezil. My doctor has given up on me telling me to accept my problem and see a psychologist to try to work on coping with the disability.

If you're gonna recommend dexedrine, we don't have it here in Australia. Concerta is pointless since I did not respond to Ritalin. Ritalin made me suicidal.

If you do an actual search on the internet, there are the portion of inattentive types like me who are not responsive and their psychiatrist have just given up on them, and they are just feeling hopeless still searching for answers.

This was my post on reddit
This may be similar to my previous post but I'm starting a different topic.
There's the typical fast thinking racing thoughts adhd and there's the slow thinking spacey type that is unheard of. They suffer from it mentally and physically.
Mentally, I am so spaced out. I think really slow, processing what people say, reading etc if I person talks to me for more than 2 secs I'm already spaced out. They tell me to switch on! or pay attention. Asking me a question or talking in a sentence then I can absorb it, but if their talk extends 2 seconds or something I'm out. This is why I always blank out in lectures and conversations.
Physically people would tell me to hurry up and do it faster. It's like I'm in slomo. My talking is also slomo as well. Because of my slomo, I mostly come out stuttering (not the typical type of stutter like repeating first letter/s).
I'm so annoyed because psychiatrists and people keep thinking that my mind's thinking about something else but it's just really blank and spacey in here. (Makes me wonder if it's dissociation instead)
This has been a life long problem. I'm struggling in my 20s.
Does anyone here have it? I hope there is someone I can relate to. If you have it, what have helped treat the problem?
Mods: Please forgive me if this is not the correct place to post this. I feel like this community is more knowledgable in neurochemistry/neuropsychology and hence could provide a better advice.
Edit: I couldn't find much info of this kind of adhd and it makes me wonder whether this could be dissociative disorder instead? It is the closest link You just feel like you're deprived of oxygen




and

I've got plethora of inattentive problems but these are the ones I'm concerned out most. I suffer terribly from this, mentally and physically.
Physically people would tell me to hurry up and do it faster. It's like I'm in slomo. My talking is also slomo as well, unless if I rehearse in my head what to say I might slightly be able to pull it off talking at an average pace. Because of my slomo, I mostly come out stuttering (not the typical type of stutter like repeating first letter/s). Mentally, I think really slow, processing what people say, reading etc if I person talks to me for more than 2 secs I'm already spaced out. Asking me a question or talking in a sentence then I can absorb it, but if their talk extends 2 seconds or something I'm out. This is why I always blank out in lectures and conversations.
I'm so annoyed because psychiatrists and people keep thinking that my mind's thinking about something else but it's just really blank and spacey in here. I've tried stimulants and non stimulants (dex, meth., vyvanse, wellbutrin, reboxetine (better version of Strattera).
I don't understand what I'm deficient in. Like should I be getting another blood test? This has been a life long problem and I'm in my 20s now.
I get a full blood test every once a year and am fine.
I feel lost as there's nothing that can help me.
I hope there is someone that I can relate to.




My pdoc has given up, research seems to have gravitated more towards treating the hyperactive type since they are more obvious and hard to deal with. Nowadays if I know any meds that supports potential treatment of ADHD, I will tell my pdoc and he decides whether it's okay. We've exhausted our options anyway. There is mirtazipine an option left but many users report it not helping with their ADHD.

If you've read my reddit links, I have resorted to other places since psychiatry didn't really help. Nootropics have helped only physically but not mentally. Talking slow and thinking slow was still present which are the core symptoms.

sarahsweets
12-28-16, 07:30 AM
Is the dextroamphetamine you mentioned equivalent to adderall? I thought Aus allowed dexedrine? Or maybe its the other way around and its adderall? I didnt mean to downplay what you are going through or make it seem like meds were the only option I just meant that I dont think you can purely assume meds slow down the brain. I think thats a factor but I also think they target more receptors which is why they help. :)

someothertime
12-28-16, 04:25 PM
thanks for elaborating. well, you've certainly been trying, as has your doc. you might need a rest and to come back at this from a different angle. and it may be the case that, as you say you are one of the non responsive few.

there are university research / outpatient services that would be well worth getting in touch with..... as are specialist/alternative pdocs. there was a post here some years ago..... discussing SCT and a medication being trialled that was normally used for ..... ( was it coma??? ) i'm sorry i forget at the moment.... i'll try come back and look for it. it comes to mind when i consider what you have discussed.

in any event i commend your efforts and pursuit of answers.

aeon
12-28-16, 04:48 PM
Your reductionist statements and assertions are facile, at best.

A proper survey of ADHD presentations and psychoneurobiology including pharmacokinetics would help greatly in understanding the hows and whys of first-line treatments which are based on clinically-validated, peer-reviewed research.


Cheers,
Ian

Letching Gray
12-30-16, 01:18 AM
From what I understand stimulants "work" the same way in everyone. If paying attention poorly is due to distractibility through hyperactivity or if we are tuning out through a lack of interest or boredom, the therapeutic impact of stimulants is the same. They increase the brain's capacity to focus. Stimulants work in the brains of non-ADHDers to improve their ability to concentrate through the same biochemical actions.

The "mechanism" of action that promotes the brain's attending to is still not well understood, but obvious improvements are often astounding to the individual receiving treatment and to those close to the sufferer with attentional deficits.

For me, it is important to keep in mind that recognizing the letters of the alphabet does not mean I'll be able to read, however. IOW, the proper diagnosis and treatment for ADHD is an first enormous step. Learning, now that we can, is altogether a different kind of process.

Little Nut
12-30-16, 12:08 PM
TI, There are other meds used for ADHD treatment. Not sure about Australian/regional limitations on a Docs prescribing abilities. From general reading TCA's and MAOI's were mentioned as well as others. iirc the issue wasn't effectiveness, but potential side effects. -LN

Fraser_0762
12-30-16, 12:20 PM
There are 2 main types of meds for ADD/HD. The Amphetamine class which increases the level of Dopamine released into the synapse and the Methylphenidate class which blocks the reuptake of Dopamine from the synapse.

The biological effects of these stimulants work in pretty much the same way on every human being. Stimulants don't "slow down the brain". They increase neural activity in every individual.

The reason they're so effective in decreasing hyperactive tendencies within the ADHD mind, is because they help people to focus.

Not everybody that has difficulties concentrating react in a hyperactive way. Different people have different ways of dealing with a lack of concentration. Some people jump from task to task (appear hyperactive), other people just kind of zone out and (appear hypoactive). But the fundamental issues are still the same. It's a lack of concentration and is therefore treated in the same manner.

ginniebean
12-30-16, 01:11 PM
There are two types of ADHD. Hyperactive who have racing thoughts, talkative. Inattentive type who are slow moving, slow talking, slow talking, sluggish, daydream. I have inattentive ADHD.

A lot of people think this and unfortunately it is a myth. There are three presentations of adhd. The hyperactive one is almost exclusively found in young children and not in adults. The second presentation of adhd is called combined type and generallt speaking is signified not by jyperactivity but more impulsive symptoms mixed with the inattentive symptoms. So, things like impulsive shopping, speeding, being abrupt, blurting etc can be characteriatic of adults with combined type adhd. Combined types do not have to be extraverted. I have all of the inattentive symptoms and all of the impulsive symptoms yet I am very introverted.



http://www.youtube.com/watch?v=spdSSKFKZNU

I don't understand why ADHD medications would suit the inattentive type since they slow down the brain. They are more tailored towards the hyperactives. The video and other sites recommend Strattera for inattentive but I don't understand why Strattera cause Strattera works by slowing down the brain! Why would you even give that to an ADHDPI when they are already slow? I can vouch this because I am a slow person, slow at thinking and am a space cadet.


A presentation of adhd is still adhd. Meds help eith arrentoon, with starting and stopping tasks, switching between tasks, word retrieval, short term memory. And more. all of these things are experienced by both adult presentations of adhd. Slowness is often caused by excessive movements not needed for a task. my mother, for instance, is diagnosed with adhd and if she got any slower she'd be going backwards. I've spent time observing her and what I have noticed consistently is that she makes many extra, multiple times more than required, to perform an action that only requires 1-2 actions to complete. It would be easy to assume slow is equal to inattentice but extra movements not required by a task is not an inattentive aymptom it's actually a hyperactive symptom. Adhd is a disorder that doesn't make sense. By that I mean things we assume to be true just by looking at them are often quite the opposite. adhd can often be counter intuitive.


That said, wouldn't taking microdoses of speed, lsd, mdma theoretically work for the inattentive type? It essentially speeds up the brain. Or even meds to treat alcohol intoxication as they suffer from similar symptoms. There's actually a med currently on trial, Metadoxine that is used for treating alcohol intoxication is being tested on ADHDPI with significant results.

This is why having solid research on mediction used to treat adhd is so good. Wild speculations such as above might be tempting for those given to self medicating and the adhd would be poorly treated ending in tragedy all around. it has been shown quite concluaively, regardless of presentation, stimulants are the best and firat line of treatment for adhd. i would like to see this study.


I'm still on search with the right meds. I've taken many stimulants and non-stimulants and none have worked.

Good luck

dvdnvwls
12-31-16, 06:26 AM
To the OP:

Find out more about the medications currently in use for ADHD. I think you'll find that what you're suggesting is exactly what's already being done, and that maybe you just haven't seen the whole picture yet.

DJ Bill
12-31-16, 11:34 AM
I'm inattentive....and I wouldn't consider myself sluggish and slow. What I am is easily distracted, inattentive to my surroundings or anything I'm not hyperfocused on, and extremely disorganized. I could be reading a book in my car waiting for someone, and have a bank robbery happen across the street, and not even know it did.I do a lot of leg jiggling, biting my tongue, or other repetitive movements when I am the most concentrated on something. (Don't bite your tongue when skiing.....it could be bad if you have a wreck..lol) Ritalin works ok for me, why or how, I have no clue.

MrAcid
01-04-17, 10:22 AM
The way I see it, the inattentive type is slow acting because the brain has a hard time structuring thoughts in a linear form, making the mind hyperfocused on structuring itself rather than observing the world creating a difficulty for the person having it to focus on what is happening.

What I believe to be ADHD is a desynchronisation of networks in the brain, probably caused by a lack of ressources or/and hypoactive neurons. Hyperactive would structure their thoughts and actions before they structure their goal or motivation, while inatentive would organise their goals and motivations before their thoughts and actions, making the specific symtoms come out.

I myself am Inattentive, and find that what helps me the most is Noopept, L-theanine, Acetylcholine supplement and proper Omega3 to Omega 6 ratio intake. Altho I haven't tried strattera yet which is know to increase Dopamine and Noradrenaline by 3x in the Prefrontal cortex a part of the brain that holds big responsibilities in the organization of thought patterns. Altho every1 is different and react differently to medication.

I think that ADHD meds are not researched enough and should be a bigger priority, altho I also think that alot of ADHD case could be resolved by cognitive behavior therapy on apparition of symptoms by recognizing the pattern of action that lead to the symptoms and getting rid of it.

julialouise
01-04-17, 11:21 PM
The way I see it, the inattentive type is slow acting because the brain has a hard time structuring thoughts in a linear form, making the mind hyperfocused on structuring itself rather than observing the world creating a difficulty for the person having it to focus on what is happening.

What I believe to be ADHD is a desynchronisation of networks in the brain, probably caused by a lack of ressources or/and hypoactive neurons. Hyperactive would structure their thoughts and actions before they structure their goal or motivation, while inatentive would organise their goals and motivations before their thoughts and actions, making the specific symtoms come out.

I myself am Inattentive, and find that what helps me the most is Noopept, L-theanine, Acetylcholine supplement and proper Omega3 to Omega 6 ratio intake. Altho I haven't tried strattera yet which is know to increase Dopamine and Noradrenaline by 3x in the Prefrontal cortex a part of the brain that holds big responsibilities in the organization of thought patterns. Altho every1 is different and react differently to medication.

I think that ADHD meds are not researched enough and should be a bigger priority, altho I also think that alot of ADHD case could be resolved by cognitive behavior therapy on apparition of symptoms by recognizing the pattern of action that lead to the symptoms and getting rid of it.

i just bought some omega-3 fish oil capsules today, have they helped you quite a bit? i've also been taking a B-complex and vitamin D (also for mood)

Alaskamoose
01-08-17, 03:10 PM
Is the dextroamphetamine you mentioned equivalent to adderall? I thought Aus allowed dexedrine? Or maybe its the other way around and its adderall? I didnt mean to downplay what you are going through or make it seem like meds were the only option I just meant that I dont think you can purely assume meds slow down the brain. I think thats a factor but I also think they target more receptors which is why they help. :)
I agree

amoselvis
01-23-17, 01:23 AM
Hello ToInfinity

Have you explored bipolar, depression, anxiety, ptsd as possibilities? For me, that has been my therapeutic world ..... It still is, but my psychiatrist, decided maybe this adhd might be something going on. I think it became obvious because the depression/anxiety/ptsd was finally stabilized for a couple years. Had I taken adhd med prior to this stabilization, none of it would have worked, guaranteed.

amoselvis
01-23-17, 01:31 AM
Hello ToInfinity

Have you explored bipolar, depression, anxiety, ptsd as possibilities? For me, that has been my therapeutic world ..... It still is, but my psychiatrist, decided maybe this adhd might be something going on. I think it became obvious because the depression/anxiety/ptsd was finally stabilized for a couple years. Had I taken adhd med prior to this stabilization, none of it would have worked, guaranteed.

Jenn1202
01-23-17, 07:28 PM
As far as I understand it, those who think "slower" don't actually think slower. They get things done slower and have slower processing speeds because they are constantly distracted by their racing thoughts and external things to the point where things get done very slowly. ADD meds slow down these racing thoughts and reduce distractibility which makes things get done faster.

Fraser_0762
01-23-17, 07:40 PM
I agree with Jenn, my thought process certainly isn't sluggish. There's just so much going on in there that it's impossible to keep track of it. That's why I hate it when people ask me what's on my mind, because I never really know myself. My mind does go through periods where it seems "blank", but that usually occurs when i'm trying to draw information from it.

Kunga Dorji
01-23-17, 11:40 PM
I think I know what you mean that you can't have a fast sad song in music. I'm mainly the slow type so it'll be great if there's a med that could focus on what's most concerning. Likewise how the typical ADHD have racing thoughts so stimulants slows down the brain which is what the most concerning is.

If you actually watched the video, then all the symptoms talked about resembles me. You'll understand the bell curve. I feel like I'm in the low 20% non responders as I've tried practically everything.

Yes a qualified professional and peer input. My psychiatrist. I've tried dexamphetamine, ritalin, reboxetine (a cousin of strattera with less side effects), wellbutrin, I pushed to give vyvanse ago when my pdoc said it's just a long acting version of dexamphetamine which I already don't respond to. I didn't respond to vyvanse but it was just an antidepressant. Donepezil. My doctor has given up on me telling me to accept my problem and see a psychologist to try to work on coping with the disability.

If you're gonna recommend dexedrine, we don't have it here in Australia. Concerta is pointless since I did not respond to Ritalin. Ritalin made me suicidal.

If you do an actual search on the internet, there are the portion of inattentive types like me who are not responsive and their psychiatrist have just given up on them, and they are just feeling hopeless still searching for answers.

This was my post on reddit


and



My pdoc has given up, research seems to have gravitated more towards treating the hyperactive type since they are more obvious and hard to deal with. Nowadays if I know any meds that supports potential treatment of ADHD, I will tell my pdoc and he decides whether it's okay. We've exhausted our options anyway. There is mirtazipine an option left but many users report it not helping with their ADHD.

If you've read my reddit links, I have resorted to other places since psychiatry didn't really help. Nootropics have helped only physically but not mentally. Talking slow and thinking slow was still present which are the core symptoms.


Many things to say on the whole thread- however:

Dexedrine is sold as dexamphetamine in Australia
The classifications of inattentive and hyperactive ADHD are really very loose. They do not correlate at all well with the way individual people present in real life.

Kunga Dorji
01-23-17, 11:48 PM
I agree with Jenn, my thought process certainly isn't sluggish. There's just so much going on in there that it's impossible to keep track of it. That's why I hate it when people ask me what's on my mind, because I never really know myself. My mind does go through periods where it seems "blank", but that usually occurs when i'm trying to draw information from it.

That can look "inattentive" though.

Equally, a strong tendency to hyperfocus can look inattentive.

I hyperfocus a great deal, and can pursue things I am thinking about/researching over many years, but that can create lapses of conversations in social settings that make me look inattentive.

Equally, I have minor impairments in spatial perception, and they mean I have to pay a lot of attention to driving. So my partner sees that as me being inattentive. She's ADHD too (more hyperactive by far) but finds it difficult to see my subtle impairment and the fact that I have to factor that in while on the road.

I really think that the subdivision between inattentive ADHD and hyperactive ADHD has only one real use-- it helps doctors see that there is more to ADHD than hyperactive little boys. I doubt that it reflects brain functioning in any consistent way.

Re Barkley's proposed subclassification "sluggish cognitive tempo" that is something quite temperate. Nobody is sure if it really exists as a part of ADHD. Certainly the DSM committee did not accept its validity when making DSM V.

Kunga Dorji
01-23-17, 11:56 PM
There are 2 main types of meds for ADD/HD. The Amphetamine class which increases the level of Dopamine released into the synapse and the Methylphenidate class which blocks the reuptake of Dopamine from the synapse.

The biological effects of these stimulants work in pretty much the same way on every human being. Stimulants don't "slow down the brain". They increase neural activity in every individual.

The reason they're so effective in decreasing hyperactive tendencies within the ADHD mind, is because they help people to focus.

Not everybody that has difficulties concentrating react in a hyperactive way. Different people have different ways of dealing with a lack of concentration. Some people jump from task to task (appear hyperactive), other people just kind of zone out and (appear hypoactive). But the fundamental issues are still the same. It's a lack of concentration and is therefore treated in the same manner.

Amphetamines also have a big role in increasing noradrenergic activity. They can improve alertness via the locus coeruleus (output norepnephrine increases alertness and sympathetic response.

In fact what happens when an ADHD individual is treated with stimulants, you get a shift from a great deal of random activity to a coning down of activity to a couple of key regions associated with the task at hand.
This change matches the sort of change seen in meditation in skilled meditators.

Compare with caffeine: a broad increase in activity across the brain. I have seen a good article on this and it included PET scans to support this, but I have no idea where I have put it. I have a totally unreasonable amount of articles and references on this computer and filing it all is a nightmare.

Responses to amphetamines vary hugely between individuals, both in terms of qualitative response and dose. Many individuals get too strong an anxiety response for them to be useful.

oldtimer
01-26-17, 09:38 AM
After reading all your comments most of you could stand to read Amen's book "Healing ADD". Amen has more categories of ADD.

Here is a questionnaire which will put you into an Amen type of ADD. From there the medication is easy.
See addtypetest (dot) com.
That is so much faster than the trial and error way of finding the correct medication. That can range from years to never.

BTW your brain doesn't actually think faster or slower even though the overall effect can be faster or slower. For inattentive ADD the brain manager that coordinates the different parts of your brain to work properly isn't fully on. With his brain scan while you are trying to solve a puzzle the manager manager should be lit up with activity but is dark like you are sleeping. With the proper medication, the management center looks about normal with a brain scan. The medication shouldn't speed up or slow down. The proper med in the proper dose makes you closer to normal.

Letching Gray
01-26-17, 09:48 AM
After reading all your comments most of you could stand to read Amen's book "Healing ADD". Amen has more categories of ADD.

Here is a questionnaire which will put you into an Amen type of ADD. From there the medication is easy.
See addtypetest (dot) com.
That is so much faster than the trial and error way of finding the correct medication. That can range from years to never.

BTW your brain doesn't actually think faster or slower even though the overall effect can be faster or slower. For inattentive ADD the brain manager that coordinates the different parts of your brain to work properly isn't fully on. With his brain scan while you are trying to solve a puzzle the manager manager should be lit up with activity but is dark like you are sleeping. With the proper medication, the management center looks about normal with a brain scan. The medication shouldn't speed up or slow down. The proper med in the proper dose makes you closer to normal.

I look forward to finding Amen's research published in peer reviewed journals. I would like to see his data replicated independently, too.

Letching Gray
01-26-17, 08:12 PM
Dr. Amen’s Love Affair with SPECT Scans
Harriet Hall March 19, 2013
SCIENCE-BASED MEDICINE


Patients should not be subjected to the radiation and expense of a SPECT scan without credible evidence (from controlled, peer-reviewed studies) that it is likely to help them.
He (Amen) is relying on experience and anecdote rather than on acceptable scientific evidence.
He has not validated that scans show what he claims they show.
He uses unscientific terminology like “your brain is cool at rest.”
He has not shown that his outcomes are better than those of doctors who do not do SPECT scans.
He has created his own idiosyncratic classifications of illness based on scan results, classifications that go beyond the DSM and that have not been validated elsewhere. For instance, he divides ADHD into classic, inattentive, over-focused, temporal lobe, limbic and “ring of fire,” and obesity into compulsive, impulsive, impulsive convulsive, sad, and anxious.
He prescribes inadequately tested natural remedies, irrational mixtures of nutritional diet supplements, hyperbaric oxygen, and other questionable treatments.

And, he's making huge bucks.

Kunga Dorji
01-26-17, 10:47 PM
Here is a small sample of Amen's published research:

https://www.ncbi.nlm.nih.gov/pubmed/?term=Amen+D
There are 48 papers listed in PubMed - which is only listing peer reviewed papers.

Remember that Amen has been appointed as a member of the Californian Medical Board and is a distinguished fellow of the College of Psychiatrists.

What he charges for his services is actually between himself and his patients, but I have gone into some detail and bought some of his patient assessment tools. He clearly offers a very comprehensive service in which his patients are assessed and treated by a number of different professionals.
His clinics are busy- and these clinics grow by word of mouth from satisfied customers.

Re Classification- DSM is very questionable anyhow. An ADHD diagnosis, for instance, really just gives us reason to think that stimulants might be helpful and are unlikely to be as troublesome as they are to non ADHD individuals. With his classification system, Amen is attempting to correlate symptoms with brain area involved. That is a perfectly legitimate approach, and it is frustrating that the rest of the psychiatric profession has not gone as far as he has in terms of trying to localise and quantify problems.

On radiation- the dose is about 8mSv-- round about 1/2 of an abdominal CT scan.
Equally he is now tending to use more quantitative EEG and less SPECT- and notes overlap in results.

Again it comes down to patient choice.

While Amen's methods are not being widely used outside the substantial group of doctors he has directly trained, this does not mean they are invalid, nor does in mean they should not be used. ( Harriet Hall and her colleagues belong to a group of conservative doctors who act as though they should have the last say in all things medical). We have the same problem here and right now there are a large number of doctors doing innovative treatments (like platelet rich plasma infusions to treat arthritic joints) who have been referred to the medical board multiple times by hostile competitors.

I am sure that the rules in the US allow for exactly the same sort of complaint, and I am sure that Amen has passed all fair scrutiny.

ToneTone
01-26-17, 10:56 PM
Wow, I had no idea that Amen had published so much research.

Kunga Dorji
01-26-17, 10:57 PM
I look forward to finding Amen's research published in peer reviewed journals. I would like to see his data replicated independently, too.

Further to my previous reference to PubMed

http://www.amenclinics.com/spect-research-introduction/peer-reviewed-scientific-papers-book-chapters-amen-clinics/

Letching Gray
01-27-17, 01:01 AM
Further to my previous reference to PubMed

http://www.amenclinics.com/spect-research-introduction/peer-reviewed-scientific-papers-book-chapters-amen-clinics/

None of his research demonstrates that using SPECT is a scientifically acceptable tool to diagnose nor to treat depression or the various sub-types of ADHD as he defines them, by using the standard double blind, controlled testing protocol. His evidence is anecdotal and speculative.

Letching Gray
01-27-17, 01:07 AM
His clinics are busy- and these clinics grow by word of mouth from satisfied customers.

His clinics have grown in part because he's been an effective fund raiser for PBS. IMO, PBS has taken another plunge into mediocrity and crass commercialism by using this individual to promote his unscientific agenda.

As someone who has purchased some of his "tools", I hesitate to trust your objectivity.

Letching Gray
01-27-17, 01:14 AM
(Harriet Hall and her colleagues belong to a group of conservative doctors who act as though they should have the last say in all things medical)

She is an M.D. with a long medical pedigree and retired as an admiral in the navy, just like my grandfather. The University of Washington and Northwestern University (respectfully) carry far more scholarly weight than the defunct Oral Roberts.

Letching Gray
01-27-17, 01:23 AM
While Amen's methods are not being widely used outside the substantial group of doctors he has directly trained, this does not mean they are invalid, nor does in mean they should not be used.

His methods for diagnosing ADHD are not proven to be valid. There's a big difference. He should always present a disclaimer whenever he sells his opinions privately or in public. His methods should be open for public review and to public criticism until he can present repeatable medical outcomes using the scientific testing measurements and standards acceptable to the AMA the APA, etc.

Kunga Dorji
01-27-17, 02:54 AM
His methods for diagnosing ADHD are not proven to be valid. There's a big difference. He should always present a disclaimer whenever he sells his opinions privately or in public. His methods should be open for public review and to public criticism until he can present repeatable medical outcomes using the scientific testing measurements and standards acceptable to the AMA the APA, etc.

He actually diagnoses ADHD exactly the same way as any other doctor- based on history and using symptom scores to quantify. I have seen virtually all of his patient assessment protocol and can only commend it for its thoroughness.

As I mentioned before, as in the example on the Australian scene, it is always open to any critic to make a complaint and have the complaint investigated. Undoubtedly Amen Clinics would have been through the complaint system a number of times simply because they have a large patient base, they charge a high fee, and they have a number of hostile colleagues.

If you take the trouble to check the California Medical Board you will find no Public Record actions taken against him.

If you bother to to an internet search on him you will find only complaints and criticisms levelled by commercial competitors or by their conservative retired colleagues.

There is a faction in medicine that styles itself proponents of "science based medicine" and it rubbishes anything that does not fit into its paradigm. That faction is often extremely aggressive towards anyone who does not fit in to their paradigm, and they are prone to making sweeping criticisms with no fact base to support them. Hall is definitely one of them, a lover of authority over enquiry. There are plenty of others Stephen Novella, in Australia Sue Ieraci, Michael Vagg are some that come to mind.

I have read Hall's criticisms of Amen on "quackwatch" and am not impressed by her impartiality, her logic, her ability to write concisely or her knowledge of the material the thinks she is debunking all leave much to be desired from my point of view. It is clear that she has only an outsider's view of Amen's work. If she would consent to it, I am sure it would be a valuable experience for her to have a direct dialogue with Amen and understand what he is doing, then maybe to sit in ona few patients as they work their way through his system, because at the moment she is making criticisms of what she thinks she is doing.

However, in short, the efforts of some self styled proponents of "Science Based Medicine" to attack Amen when it is perfectly clear that neither the Medical Board nor the College of Psychiatrists have a problem with him is deeply dishonest and is based on the mistaken opinion that the self anointed status of these critics should override the public authorities that are set up to preserve standards.

Please do not take this personally, it is meant to help open debate. I think that we are way too ready to kow tow to authority.

As a declaration of interest here I have actually had a SPECT done on myself in Australia. It was definitely helpful, but neither myself or my 2 doctors knew enough neuroscience to understand just how useful until very recently.
As far as diagnosis went it was helpful corrobotating information- and that was a good thing as I was not sure I believed in ADHD at the time.

Kunga Dorji
01-27-17, 03:16 AM
We are in danger of a thread hijack here, so I would like to split the Amen question off to a new thread. The thread will be broader than Amen, but it is very much directed at the qualifications and independence of much of the Medical advice on the Web-- especially that from "skeptical websites"
I will call it
"Can You Trust What You Read?"

Letching Gray
01-27-17, 07:45 AM
Amen hasn't proven that using SPECT is a useful, legitimate, repeatable diagnostic tool to establish the presence of ADHD or depression through double-blind, controlled, scientifically established testing procedures.

He actually diagnoses ADHD exactly the same way as any other doctor

No. That's not true. He uses SPECT at close to $4,000 a pop exposing those he tests to radiation completely unnecessarily.

Letching Gray
01-27-17, 08:11 AM
None of the nation’s most prestigious medical organizations in the field — including the APA, the National Institute of Mental Health, the American College of Radiology, the Society of Nuclear Medicine and Molecular Imaging and the National Alliance on Mental Illness — validates his claims. Washington Post

No major research institution takes his SPECT work seriously, none regards him as “the number one neuroscience guy,” and his revelations, which he presents to rapt audiences as dispatches from the front ranks of science, make the top tier of scientists roll their eyes or get very angry.

“In my opinion, what he’s doing is the modern equivalent of phrenology,” says Jeffrey Lieberman, APA president-elect, author of the textbook “Psychiatry” and chairman of Psychiatry at Columbia University College of Physicians and Surgeons. (Phrenology was the pseudoscience, popular in the early 19th century, that said the mind was determined by the shape of the skull, particularly its bumps.) “The claims he makes are not supported by reliable science, and one has to be skeptical about his motivation.” Washington Post

“I think you have a vulnerable patient population that doesn’t know any better,” says M. Elizabeth Oates, chair of the Commission on Nuclear Medicine, Board of Chancellors at the American College of Radiology, and chair of the department of radiology at the University of Kentucky.

“A sham,” says Martha J. Farah, director of the Center for Neuroscience & Society at the University of Pennsylvania, summing up her thoughts on one of Amen’s most recent scientific papers.

“I guess we’re all amateurs except for him,” says Helen Mayberg, a psychiatry, neurology and radiology professor at Emory School of Medicine and one of the most respected researchers into depression and brain scanning. “He’s making claims that are outrageous and not supported by any research.”

“I can’t imagine clinical decisions being guided by an imaging test,” says Steven E. Hyman, former director of the National Institute of Mental Health and current director of the Stanley Center for Psychiatric Research at the Broad Institute of MIT and Harvard.

The APA, in fact, has twice issued papers that dispute “claims being made that brain imaging technology ... was useful for making a clinical diagnosis and for helping in treatment selections.”

The most recent paper was published last month. It was the work of 12 doctors who spent three years assessing the latest research. The summary: “There are currently no brain imaging biomarkers that are currently clinically useful for any diagnostic category in psychiatry.” Washington Post

These kinds of criticisms go on and on.

I apologize if my comments are off topic and should be posted elsewhere. I'm unclear how to do that.

Letching Gray
01-27-17, 08:21 AM
She is an M.D. with a long medical pedigree and retired as an admiral in the navy, just like my grandfather. The University of Washington and Northwestern University (respectfully) carry far more scholarly weight than the defunct Oral Roberts.

My mistake. She is not a retired admiral. She's a former Air Force flight surgeon and offers a 10 set video series on science-based medicine and alternative medicine for free.