http://www.quackwatch.org/06ResearchProjects/amen.html

Daniel G. Amen, M.D., runs the Amen Clinics, writes books, gives lectures, maintains a Web site, and makes other media appearances. He recommends single photon emission computed tomography (SPECT) to help diagnose and manage cases of brain trauma, underachievement, school failure, depression, obsessive compulsive disorders, anxiety, aggressiveness, cognitive decline, and brain toxicity from drugs or alcohol. He claims to use SPECT to "re-balance a brain whose activity patterns are clearly abnormal.” He claims that a SPECT scan provides “guidance in the application of specific medications or other treatments such as supplements, neurofeedback, transcranial magnetic stimulation, and hyperbaric oxygen therapy.”

The Amen Clinic's home page states:

How your brain and soul work together determines how happy you feel, how successful you become, and how well you connect with others. The brain-soul connection is vastly more powerful than your conscious will. Will power falters when the physical functioning of the brain and the health of your soul fail to support your desires, as seen by illogical behaviors like overeating, smoking, drug and alcohol abuse, and compulsive spending.

It is the aim of The Amen Clinics to provide instructional programs and materials, evaluations and medical treatment where necessary to help you to understand and direct your mind to enhance your relationships, your work, and your health!

"Comprehensive evaluation" at the Amen Clinics, which costs $3,250, includes the patient's history, two SPECT scans (concentration scan and baseline scan), a physician consultation, and a 30-minute treatment follow-up appointment. Follow-up scans after treatment are $795 each.

SPECT is an invasive procedure requiring injection of a radioactive material, with additional radiation exposure from the scanner. SPECT creates a colored picture representing blood flow or chemical reactions in different areas of the brain. Areas of low blood flow show up as apparent “holes” on colored pictures of the brain, giving a moth-eaten appearance. When a patient improves clinically, the appearance of the follow-up scan also improves. For example, patients using marijuana had areas of low activity in the temporal lobes compared to patients not using the drug. Dr. Amen says he can literally show his patients “this is what your brain looks like on drugs.” In one case he reported, a patient with attention deficit disorder, obsessive thinking, anger outbursts, and depression had demonstrable defects on the initial scan which were visibly improved after three years of clomipramine therapy. Dr. Amen says that this kind of graphic demonstration can help in convince patients that their problem is physical or physiological and might be helped with medication or other treatments.

The key question in evaluating a diagnostic test is whether or not its findings are useful in determining what treatment the patient should have. SPECT is a research tool useful for exploring how the brain functions, but the findings are nonspecific and uses related to treatment of emotional or behavioral problems should be considered experimental. Dr. Amen has vast clinical experience and says he has done more than 25,000 scans. However, I do not believe that he has demonstrated that specific scan patterns reliably reflect specific clinical problems and how they should be treated. Even when he is able to show a correlation between a diagnosis and an area of low perfusion, he has not shown what this really means and how it could aid clinical treatment. Is low perfusion an indication of the primary pathology or perhaps just a secondary brain response to the symptoms? His published research comprises “preliminary studies,” and most psychiatrists believe it is premature to use SPECT clinically. Dr. Amen claims to be able to choose the best therapy based mainly on scan results, but this claim is supported only by anecdotal evidence and testimonials.

The following questions might be useful for evaluating Dr. Amen's claims:

* Do patients treated at the Amen Clinics do better than patients treated by competent professionals who do not use SPECT?
* Are the SPECT findings consistent enough that blinded observers could agree on the diagnosis from the scan alone?
* What are the rates of false positives and false negatives?
* Have the effects of different treatments on the scans actually been compared?
* What is "brain balance," and how is it measured?
* What does the scan tell us that would change how we treat a patient?
* Does Dr. Amen claim that SPECT can help evaluate the patient's "soul"? If so, what gets measured?
* Why did Dr. Amen leap into clinical applications, writing for the public, appearing on television, and lecturing about findings that most doctors would consider preliminary?

I believe that it is improper to charge thousands of dollars for a test that has not been validated and may not be safe. I don't think any of his research has provided clear evidence that patients who have had SPECT scans have superior clinical outcomes to adequately treated patients who have not been scanned. That's really the bottom line—especially with an invasive, expensive test involving significant radiation. At the very least, he should be describing the test as experimental.

Some of Dr. Amen's treatment suggestions also worry me. For example, he recommends (a) uses for dietary supplements that are not supported by good evidence, (b) EMDR (a highly questionable approach), and (c) hyperbaric oxygen therapy for conditions not generally considered to warrant such therapy.

I, personally, would not undergo SPECT scanning in Dr. Amen's clinic even if it were free. In my opinion, based on current knowledge, the possibility of harm outweighs any potential benefit. Pictures showing that "this is your brain on drugs" may impress some people, but I am far more impressed by quantifiable data (such as tests of mental performance) and clinical consequences (such as improved behavior) than by nonspecific pictures of "holes" in the brain.

Scuro, I don't know much about the Amen clinic and what he does, other than what I've read here, but a SPECT scan sounds just like a CT/PET scan. These also use injectible radioactive dyes, and radiography for the diagnostics. How is the SPECT scan different or more dangerous than these? I'm just curious.

A lot of people swear by Amen. I find his methods and pronouncements at odds with the best findings of the federally funded research by NIMH, and the CDC. Even with the absolute BEST imagery to date, bar none, they've come right out and said that barring higher resolution and massive studies they simply have no way of knowing if a brain image of ANY sort can reliably diagnose ADD.

So the massive expenses this guy racks up in the name of medicine on the insurance companies dime (or worse the patient's dime), are at best a leap of faith and at worst out and out fraudulent.

Having said all of that (and I've said it here before), I still know a great many people who have read his books and swear by his approach. All I can say to that is that if it works for you go for it. I'd just be very leery of forking over a ton of money for a scan that, according to pretty much everyone but Amens, is of questionable diagnostic value.

CT scans do not use injected radioactive dyes, or anything injected for that matter. I have had CT scans (prior to sinus surgery) and it involved no radiation other than that produced by the CT machine itself.

Dunno about PET scans.

MRIs, of course, do not use any radiation.

Maybe this should be the first question, pertaining to this 'therapy', that a patient would ask Dr. Amen:

*Does Dr. Amen claim that SPECT can help evaluate the patient's "soul"? If so, what gets measured?



Hypothetically, if it were me, personally...and he actually answered that question with any reference to 'my soul'...I would hightail outta there.

CT scans do not use injected radioactive dyes, or anything injected for that matter. I have had CT scans (prior to sinus surgery) and it involved no radiation other than that produced by the CT machine itself.

Dunno about PET scans.

MRIs, of course, do not use any radiation.I think you're mistaken about this. My husband works in CT and he has to wear a radiation meter badge to be sure his exposure isn't too high from working there. PET definately do use radioactive dye. He told me it is suppose to be out of the body in 24 hours in the urine.

As far as Dr. Amen's stuff goes, my therapist took some training with him and whlie he found it interesting he thought that it was unnecessarily costly and that Dr. Amen went too far in the the specificity of categories he assigned to the brian imaging scans.

Scattered

CT scans do not use injected radioactive dyes, or anything injected for that matter

We are now back in my neck of the woods!

Hyperion your doctor ordered a CT scan without contrast which is why you were not injected with any thing. CT scans can be ordered with contrast or without. When a CT with contrast is ordered that is when the radioactive dye is used.

PET definately do use radioactive dye

Scattered is correct the dyes are radio active other wise the CT machine would not pick them up. The fact they are done in a department called “radiology” should be a pretty good clue as well. The staff injecting the patient is wearing gloves, mask ,and a lead apron! Pregnancy questions out the wazoo for female patients, Plus next time you have a CT scan done note the lack of windows (unless the hospital has gone to the expense of those special lead lined varieties). The walls are painted with lead paint to keep the radioactive particles contained.

As mentioned above CTs can be ordered without contrast studies!


Amen Clinic discussion (http://www.addforums.com/forums/showthread.php?t=27425)

Here is a thread in diagnosis section written by some one wondering about the SPECT thing of Dr. Amen’s. This new person is actually considering going to one of his clinics. I think it is a very well balanced discussion that involves representation of both pro and cons. (Please fellow members of “main stream” you may want to be sitting down before reading my responses)

They all use radiation. Just different spectra. MRI use Electromagnetic radiation. X-rats are used in some other imaging. Both are part of the electromagnetic spectrum just in different areas of it.

Thanks for clearing that up, Tammy!:) I didn't realize they could also do CT's without contrast.

Scattered

I was pretty impressed by Dr. Amen's website. If I were to undergo a scan, I would definitely ask some professionals that I trust, however.

Even so, it was interesting enough to me to pursue more knowledge on the topic.

I'm interested to see where this thread goes.

Loved the post Tammy...learn something everyday.

Thanks Tammy. I believe that these scans are as safe as the other neuroradiography diagnostics, just that you wouldn't want to do them frivolously, as with anything, there is some risk.

I also want to add, just my personal opinion, that Mr. Quackwatch goes a little overboard on his opinions and claims as well.

I've seen the Quackwatch site and it's Dr. Amen entry.

What's interesting is all the questions this guy asks are answered in several books Dr. Amen wrote.

He also omits that the Amen Clinics don't recommend SPECT scans for every patient. They also have non-scan ADD testing for about $1,000, give or take. What that entails, I have no clue since I didn't take that route.

Meadd823 - I didn't read your reply to what I wrote in the other thread (didn't go back to check that thread after I posted there), so I'll respond here.

Your comment is in italics:

Jack I am glad you were helped however at this time research is still inconclusive about the value of imaging studies in the diagnosing of ADD .....in other words the accuracy of imaging doesn’t justify the cost when compared to through exam by qualified health care profession familiar with ADD.

Please bare in mind you mention previous head trauma this alone may indicate need for imaging to rule out injury. Image studies maybe useful during the diagnosis process as a means of ruling out other causes for the symptoms which was your case.
However the image studies them selves are not currently being advised as a diagnostic tool for diagnosing ADD!

The SPECT scans are used in conjunction with a detailed questionnaire the ADDer fills out, and it's also recommended someone else the ADDer knows fills out the questionnaire as well to give it some balance. The scans are then compared with the questionnaire results and the diagnosis is formed from there.

The diagnosis isn't based on the scans in and of themselves.

Thanks for clearing that up, Tammy! I didn't realize they could also do CT's without contrast.


No problem I can see why they would not use a contrasting dye on a CT of the sinus. The sinuses are pretty surface the dye would only serve to obscure the view. Contrasting dye would be use for deeper images. Think blood flow because the dye is injected into the vein=dye radioactive isotopes. It is nice when conversations wander into my area for a change.

There is radiation involved and one my contingencies for use with ADD diagnosis especially in children

To further emphasis my point here.

Medscape radiation cancer risk (http://www.medscape.com/viewarticle/523000_3)

Imaging and Cancer: Kids Most in Peril
The above being said, the indisputable fact, and in my opinion rendered truly indisputable by the BEIR VII report, is that medical x-rays cause cancer.[1] BEIR VII also emphasizes that there may be no safe lower limit.[1] This statement taken as said has the potential to cause considerable alarm, so my intuitive modification is that perhaps below the dose of a standard body CT, which is approximately 10 mSieverts (mSv; units that radiation dose is measured in), there is likely negligible if any risk for an individual test.
However, even 1 body CT scan (1 CT scan of only 1 of the following regions: the chest region, the abdominal region, or the pelvic region) carries with it some element of risk. The risk that BEIR VII reports is 1 in 1000 chance of developing cancer from a 10 mSv radiation dose. In my prior report, I described what is written on the US Food and Drug Administration Web site, which is a 1 chance in 2000 of developing cancer from a dose of 10 mSv. The BEIR VII report doubles that risk. The risk in children is even higher, with a reported chance of 1 in 550 of developing cancer.[2,3] The following is a table of the standard reported dose of radiation for various common imaging procedures***End Quote

Until CT and SPECT scans are shown to have actual evidence(yea I am talking medical science evidence here=amazing) in improving the Diagnosis of ADD it is inadvisable to risk exposure to the radiation as well as acquire the additional cost as I am sure many insurance companies would not pay for this procedure in simple ADD diagnosis.

The only exclusion to this would be to use a CT scan to rule out brain damage cause by trauma or brain tumors in the event of a “sudden” onset of ADD like symptoms. This is one of those areas I will side with main stream empirical evidence data being necessary to show evidence of usefulness. We are talking quality of life issues and radiation exposure!

Remember radiation is cumulative which is why people who work in the radiology department wear those little badges, those badges and the amount of exposure they record will follow the person for life. Once up to 5 rads the fat lady has sung no more radiation work stuff. The half life of these radio active rays is some thing like 5000 years!

I'm breaking up my post so I can say this and not lose anyone in single long post.

:soapbox: One thing I've noticed is everyone focuses on the SPECT scan cost as well as the scans themselves (Yes, I know it's expensive because I paid for it and my insurance didn't. If anyone wants to help defray the cost, you can put your change/dollar bills in that coffee cup right in front of me. Thanks! :D;)).

I think everyone gets so hopped up about whether or not the SPECT scans are a valid way of testing that the research Dr. Amen's done is falling by the wayside.

I'd be suspicious of the scans too, but what was a major factor in getting it done for myself was reading his Healing ADD book.

Even then, it wasn't any promises of SPECT scans leading me to a more normal life, but his findings on ADD behavior he talked about. There was a chapter on particular ADD destructive behaviors where I had to put the book down several times and walk away because it hit home in regards to an old boss I had who had ADHD and was incredibly difficult to work for. I didn't see it in other books I read at the time.

So many things in the book made sense to me and explained why I acted the way I did. I know a couple others who have ADD and they thought the book explained a lot, even though they weren't going to get scans or testing done for themselves.

If you don't think SPECT scans are worth anything, that's fine. (And I'll repeat it again - not every patient is recommended to get scanned) Just check out his book at the bookstore and at least see what he's written about ADD before you dismiss what he's done as garbage.

If you don't think SPECT scans are worth anything, that's fine. (And I'll repeat it again - not every patient is recommended to get scanned) Just check out his book at the bookstore and at least see what he's written about ADD before you dismiss what he's done as garbage.

I was not trying to be accusing and the hyperlink I connected to had both people like you who were impressed and people like me who were skeptical. It is quiet alright to disagree with what I have to say. There are no rules saying we have to agree as long as we are not disagreeable all is cool.

It is your body and your condition you are free to treat your ADD in what even manner you deem necessary. When it comes to radiology and many areas of medicine I tend to be pretty consertive “main stream” because that is where I "live" in my professional life. Radiation should only be done when it is clearly needed I think the difference comes into play with “clearly needed” . My definition differs greatly than that of Dr. Amen. I am sorry unless he is ruling out head injuries or tumors (doing a study that is cleared via proper channels) then SPECT or CT scans are exposing patients to radiation unnecessarily in my opinion.

Now if they come up with some evidence based properly done medical research studies indicating that SPECT scans are indeed more informative than present traditional methods used for diagnosing ADD I shall be more than happy to recant. (think Scuro may have just fainted :o )

Notice , last sentence on above paragraph, my quotation in the paragraph below my source quote last post, “(yea I am talking medical science evidence here=amazing)” This gives a clue as to how often I am in line with main stream thinkers of this membership. I also advise those who are of main steam theology to sit down before reading my post in the diagnostic thread, last line on my post with the hyperlink to the other thread. This gives clues that I am far from main stream /traditional in most of my ADD approaches and ideas.

I have many of my own beliefs ideas and experiences in the subject of ADD that are far from "main stream" and yea I catch “heat” (other times I am the one giving it) You know that is part of believing differently it comes with the diversity of this membership. As long as no flames insults or personal attacks are part of the conversation then I have to accept the fact many believe differently which is what I am asking of you now. I know first hand where you are coming from and it is hard not to become defensive. Odd as it may seem we all do.

I personally am glad you found the answers that helped you understand ADD and the help you needed to treat it. I am glad you are happy with your choice. Successful control of the bothersome symptoms is the main idea behind seeking treatment in the first place(IMHO). I can be happy for your treatment success despite my disagreement with Dr. Amen’s use of SPECT. I understand you feeling the need to defend what has been so helpful for you, please remember my opposition is to a method of ADD diagnosis not to you personally.

Contrast is icky. AND I DO MEAN ICKY! Last time I had any of that crap put into me it was the consistency of corn syrup and made me want to projectile vomit every time they pushed it too fast. Then afterwards I felt like it was the morning after a week long bender. Ouchies! Different kind of contrast than they use for brains I suppose... I was getting my kidneys lit up.

I've had SPECT scans done, previously, but they were for another cause, not ADHD.

My insurance covered them, otherwise I wouldn't have agreed to having them done, due to the cost.

Ummm... Not that I'd know what the morning after a week long bender would feel like or anything... Yeah, that's it..... I'm just using my imagination. :-)

I personally am glad you found the answers that helped you understand ADD and the help you needed to treat it. I am glad you are happy with your choice. Successful control of the bothersome symptoms is the main idea behind seeking treatment in the first place(IMHO). I can be happy for your treatment success despite my disagreement with Dr. Amen’s use of SPECT. I understand you feeling the need to defend what has been so helpful for you, please remember my opposition is to a method of ADD diagnosis not to you personally.I didn't take what you wrote personally. If you have different opinions about SPECT scans, that's fine.

I think we're on different wavelengths here so I'll backtrack.

My other post referred to how people concentrate on whether or not SPECT scans are worth anything without actually looking at what Dr. Amen has found in his research.

They haven't read any of his books or really looked at his website, they just jump into whether or not SPECT scans in and of themselves are valid or just a moneymaker. That was my point.

What I was referring to in that post is the general perception I've seen, it wasn't directed at you personally.

Lmao !!

I have managed to once again get lost researching research-one of these days I will have to swear off this. Maybe tomorrow. :o


They haven't read any of his books or really looked at his website, they just jump into whether or not SPECT scans in and of themselves are valid or just a moneymaker. That was my point.

Well if it help I just poped back from one of his sites well right before coming to this one. The thread "sub-type of your ADD" the initial post opening the thread topic is to his on-line ADD testing site, your right this would not apply to me.

Because I believe in fairness I will make this easy by providing the hyperlink to Dr. Amen's site explaining his reasoning behind the use of this test.

Brain Place (http://www.brainplace.com/bp/articles.php?articleID=5)

***Quote
If we agree that mental disorders and difficult behaviors may be related to functional problems in the brain, and that brain SPECT imaging is a reliable measure of regional cerebral blood flow and thus activity patterns (1), then it follows that we should take advantage of this powerful tool when faced with complex situations or with patients unresponsive to treatment? How can we fully evaluate the cause for mental illness unless we look at brain function -- otherwise we are left to deduce or guess or assume what may be going on in the brain***End Quote

Below this is a letter to physicians.


The only thing I have a problem with concerning Dr. Amens research is it has not been repeated by independent researches (not associated with or taught by Dr.Amen )

Medical research studies have to be repeatable by people not associated with or connected to Dr. Amen. The result from the independent separate study must be “compatible” with the finding of Dr. Amen to be considered valid in the medical profession’s “main stream” standards of care.

However you may be interested to know this approach has gained much interest in medical science research so maybe before to long we will all have the answer.

This is the other side of the coin. Produced Jan 2005 so not the latest but not to to bad.

Americican Phychiatric Association (http://psych.org/psych_pract/clin_issues/populations/children/SPECT.pdf)
(I will warn ya it is in PDF format.)

This is addressing:

"Brain Imaging and Child and Adolescent Psychiatry With Special Emphasis On
SPECT
American Psychiatric Association
Council on Children, Adolescents and Their Families
Clinical Use for Single Photon Emission Computed Tomography (SPECT)"

***Quote
Particular caveats are indicated with regard to brain imaging involving
radioactive nucleotides for children and adolescents because of children’s known greater sensitivity to radiation and risk of radiation induced-cancer. The long termrisks of initial and repeated exposure to intravenous radio nucleotides are unknown.

We conclude that, at the present time, the available evidence does not
support the use brain imaging for clinical diagnosis or treatment of psychiatric
disorders in children and adolescents.***End Quote

Goes on to list some specifics.The language is easy to follow.


I did not take your post personally although I do appreciate the clarification. ;)


Perhaps knowing I question scientifically validated results (okay their interpretations any way) may help you understand I question every thing. I do “joust about” with ADD theories and challenge research result interpretations and ideas expressed by experts (just ask any one here) however when it comes to medical practice, diagnostic tools, treatment procedures which involve people’s health, money, resources and most importantly their lives I am surprisingly “main stream” by the book. In medicine it is always best to be safe with other people lives (not to mention one’s professional license) than sorry or wasteful.


I offered the truth based upon the knowledge I have available what is done with that truth is up to the individual reader.

I am learning that any thing I write weather based upon a mountian scientific study or my own experiences is subject to disagreement(some times even down right debate). I am working on not taking it persoanlly although some time I will admit it can be hard. Must be an ADD thing although I have no other evidence other than offering a quick run about on this site :p




Ummm... Not that I'd know what the morning after a week long bender would feel like or anything... Yeah, that's it..... I'm just using my imagination. :-)

Maybe try the week long bender then the contrast dye maybe an improvement. If it does work then re-try the bender- (just kidding :p )

Seriously the reaction is more than likely real I am sure it is rrrealy real to you! Yes people can have reaction to the dye just like people can react to certain foods and other drugs so doubtful it was your imagination.

Hey the local anesthetic Novocain makes me feel tired and sick to my stomach. I thought it was all in my head too I mean I am talking local anesthetic. Come to find out my mom reacts to Novocain the same way.Go figure!

It's about more than whether it's a money maker or not. It's bad science, and bad medicine. My understanding is that his books are pretty much up with the times and quite well liked, but the scannin issue is arguably insurance fraud, or fraud on patient's. No one has been able to duplicate his results, and more precise imaging techniques can't do it either. People have been jailed for less.

I could feel the contrast hit my kidneys. Man that was bizarre... It was just before lunchtime too so the corpsman (think paramedic insofar as level of training goes) kept pushing the plunger faster and faster trying to get it over with and every time they did that it was instant power puke time. After one or two near explosive episodes they could tell by my facial expression they were gonna get a extra large syringe of contrast up their kiesters if they kept that crap up.

It's about more than whether it's a money maker or not. It's bad science, and bad medicine. My understanding is that his books are pretty much up with the times and quite well liked, but the scannin issue is arguably insurance fraud, or fraud on patient's. No one has been able to duplicate his results, and more precise imaging techniques can't do it either. People have been jailed for less.If you say so.

My reasons for getting scanned were because I fit the criteria for it. The results showed something which had an ADD related impact which I seriously doubt would've been picked up by answering questions on a piece of paper. A couple other results were non-ADD related but were still good to know.

So I'll agree to disagree with you on that.

I had a CT scan done too. I think it was with contrast because the only thing which kept me from yakking was something the tech gave me to smell & made the nausea much easier to handle.

Icky stuff is right.

When you throw out the issue of money I have this question. Has anyone ever bothered to keep track of how much they spend in co-pays or what-not for the traditional trial and error type of treatment? From reading this forum I have gathered there are more than a few that have seen therapists and psychiatrists for years. Psychiatrists can prescribed medication but what of therapists? How often do they have a goal of getting a person out of therapy?

As far as medication, I have seen what not having the right medication for depression can do. People die from that. If there is one person that is trying to take the guesswork out of that whole ordeal then it is about time. I'm tired of seeing psychiatrist experiment on people with this medication or that and ultimately blaming the patient if nothing they come up with helps.

Unless your insurance covers all mental health services 100%, it is all a raquet. If yours does then please give me the name cause I could use it - except for the navy guy - I'm to old to join.

As far as medication, I have seen what not having the right medication for depression can do.

In science there is no 100% for sure type figures. Minute chemical difference in individuals means some people are not going to respond favorable. As illustrated above by E-Boy some times a person doesn't even have to reach the medication phase to experience bad effects.

Reaction that are serious can happen when some one's body reacts severely to the radioactive dye used in these SPECT (any other contrast imaging technique).





People die from that. If there is one person that is trying to take the guesswork out of that whole ordeal then it is about time.

Because the drug is injected and radioactive the reaction can quickly become life threatening. Scientific research does help as the results will often mean avoiding procedures not yet proven to be any more effective than more conservative approaches.

SPECT or no SPECT imaging it is al a trail and error experience when it come to medications (any treatment for that matter) We are all just different enough biologically to prevent medicine from being an exact science however I fell better knowing that there are groups of people working together to make it as close as possible.




I'm tired of seeing psychiatrist experiment on people with this medication or that and ultimately blaming the patient if nothing they come up with helps.

I have yet to see a prudent physician blame the patient for medications not working unless it is patient compliance that is the problem. Medication compliance is a big factor in effectiveness. Effective phanrmological approaches simply can not happen with out cooperation . Biological factors are rarely (if ever) blamed on the patient






From reading this forum I have gathered there are more than a few that have seen therapists and psychiatrists for years. Psychiatrists can prescribed medication but what of therapists?

I have been seeing my ADD doctor sense 1993 he originally diagnosis me some 13 years ago. I went through a trial and error period but I was happy to have a medical professional who was willing to work with me until the proper drug dosage ect was found I am one who's body does not play by the biological rules so when it comes to the trial and error thing I have been there done that I own the T-shirt factory. Trying until the right pharmaceutical regime could be found was not some thing my doctor forced upon me I was like a cognitive responsible adult that always made the finial decision. I could and still can stop treatment any time I choose the same holds true for all legally responsible adults.





How often do they have a goal of getting a person out of therapy?

I have been to therapy and when my goal was reached I no longer went. In standard therapy like most members of this forum would participate in goals are normally set up between the patient and the counselor after and session or two These goals are reviewed intermittently to check progress need for changes ect,

Some people may decide they need therapy on a long term basis, and that is their choice just as it was some people's choice to go to Amen's clinic and others to peruse special diets, herbal remedies or traditional methods. Individual treatments are choices made by the responsible adult being treated. Medical professional do not have the legal authority to force any treatment on any one who is competent and of adult age period.





Unless your insurance covers all mental health services 100%, it is all a raquet.

I didn't know that having medical insurance was a requirement to be a member here on ADDF. I do not have insurance I pay for my medications doctor's visits ect in cash. Yes it is expensive but so is not treating my ADD and other conditions.

I take my medications as directed and have followed my doctor's advice and my ADD symptoms have improved greatly, this would be defined as a "racquet" how?.

I wasn't trying to insult anyone with my earlier post. Allow me to explain. Dr. Amens is basically claiming he can diagnose both ADD and specific subtypes thereof on the basis of SPECT scans. Now, while I'll grant that there are very few SPECT machines out there last I heard, the persons with access to them cannot duplicate any of Amens published claims. This is a basic tenet of scientific procedure. Findings have to be duplicatable or they're of suspect value. Dr. Amen's actual treatments are, as near as I've been able to tell, are up to date and match up well with the general current standard of care for ADD. Many people have spoken highly of the results they've gotten from him. If it worked for you my answer is "GOOD ON YA!"

I just believe in empiracally verifiable results. For years people commonly believed that food dyes and other addititives (or too much sugar) were culprits in ADD. Thousands of parents put their children on strict diets, and when studies finally clarified the matter it turns out that a fraction of a percent of people have food allergies that can cause ADD like symptoms, but they aren't a significant contributor for the rest of us.

I believe in similar verification of efficacy in treatment for other mental illnesses too. Did you know a good many frequently used therapies are used on the basis of anecdotal evidence with no attempt having been made to verify they have any effect whatsoever? That's well on it's way to changing now, but several of these therapy varieties have been found with empirical methods to actually be harmful or ineffective, or both. In theory, Amens could well be onto something, but didn't properly document when he published (which would have the same effect on attempts to duplicate it as his ideas being wrong would because they still wouldn't be able to duplicate them). I prefer to take the conservative stance is all.

When I was refering to the wrong medication - as in anti-depressant - I was refering to how long you have to give a medication to get up to theraputic levels. When you have someone that is on suicide watch and you are waiting four to six weeks for the medicine to get to a level that you can decide "nope that one doesn't seem to be working either" before moving on to yet another one. Maybe it is anedotal but when you have a child that you are desperately trying to keep from hurting themselves it is a big deal. And before anyone says that a person trying to hurt themselves should be in a hospital think about your insurance coverage. They will not keep someone indefinitely and the reality is that doctors and hospitals will send a person home when the insurance runs out rather than eat the costs. Even when they haven't succeeded in helping them.

Maybe Dr. Amen doesn't have the answer or right approach but he at least is looking. What other part of the body do they take a list of symtoms down and then make their best guess what the problem might be? The psychiatric field is just too comfortable with keeping things that way.

A question for those of you that can get through those research articles. It seems to me that I have been seeing more and more publications in regards to spect imaging. Are you saying that they don't support what Amen claims or that they haven't studied exactly the same things or what? Are the images on his site and books fake? Or is he just presenting the few that support what he believes to be true?

One additional thing - I'm not upset about the subject. It's just something that I feel passionately about because of what I have had to go through.

That is a REAL issue Bored. In fact the feds are trying to make Medicade coverage available to parents with mentally ill children to address this. because insurance in many states won't cover mental illness (although they are trying to Pass the parity in insurance act to fix that. (Not sure if it passed.... I lose track)). Huge numbers of children have actually been taken from their parents and placed in foster care (where they still don't get the treatment they need) because of this. It doesn't make the news, but it sure did make the senate debate.

CT scans do not use injected radioactive dyes, or anything injected for that matter. I have had CT scans (prior to sinus surgery) and it involved no radiation other than that produced by the CT machine itself.

Dunno about PET scans.

MRIs, of course, do not use any radiation.
when i was hospitalised, my psychiatrist ordered a ct scan as well as an electroencephelogram. during the ct scan i was injected with dye. i remember vividly because i was unaware of it until i felt my veins heat up.

That is a REAL issue Bored. In fact the feds are trying to make Medicade coverage available to parents with mentally ill children to address this. because insurance in many states won't cover mental illness (although they are trying to Pass the parity in insurance act to fix that. (Not sure if it passed.... I lose track)). Huge numbers of children have actually been taken from their parents and placed in foster care (where they still don't get the treatment they need) because of this. It doesn't make the news, but it sure did make the senate debate.We were paying over $800 a month for our family plan that covered the most that any insurance plan would that was available to us through the university. It covered a lot and she even had double coverage because of her father but there were still limits. It's not just the limits of the insurance but the very real impression that they were guessing and they never agreed with each other. And they don't tolerate you disagreeing with them.

I would like to add that while I think Amen is breaking ground on some things. I seriously doubt that I would have my child go through a scan until they know the full extent of the repercussions. I think if one were available to me that I would do it though. But not by anyone around here.

It is important to ensure the providers in question are using established diagnostic criteria. Many times, even "Specialists" and "Experts" don't.

While there is a lot of symptom overlap, a proper screening can establish the particulars quite accurately for many disorders. Done in this manner the "accuracy" medically of an ADD screening is the same as the accuracy of a test for diabetes.

When I was refering to the wrong medication - as in anti-depressant - I was refering to how long you have to give a medication to get up to theraputic levels. When you have someone that is on suicide watch and you are waiting four to six weeks for the medicine to get to a level that you can decide "nope that one doesn't seem to be working either" before moving on to yet another one.

Yep that sure does um how do I sat this correctly . .. . .. . .. .okay it “bites”!

I had a child slash her wrist and we were joined at the hip for eight weeks and not because I was informed to do so by the doctor treating her. I was informed and knew that during the initial phases of anti-depressant therapies the suicide chances can actually rise. The medication elevates the mood enough so that they have more energy but not enough to lift the depression thus the increase chances in suicide attempts. I do find it odd I learned this from a doctor I worked with in the mid-nineties and they are just now publishing this in the public arena.




Maybe it is anedotal but when you have a child that you are desperately trying to keep from hurting themselves it is a big deal.

Your right it is a big deal. I big scary deal!




What other part of the body do they take a list of symtoms down and then make their best guess what the problem might be?

Well honestly yes this is how it works. Ever go in to see a doctor and have him just walk in and hand you a script without any questions by him or his nurse? If you do RUN!!!




A question for those of you that can get through those research articles. It seems to me that I have been seeing more and more publications in regards to spect imaging.

I wrote in my previous post that research is taking a serious look at the imagining studies to see if they can find any evidence that would help them to be able to improve the accuracy of ADD diagnosis as well as looking into causes of ADD by looking at the living brain “in action”.




Are you saying that they don't support what Amen claims or that they haven't studied exactly the same things or what?

In so far other doctors have not been able to duplicate Amen’s study results. The studies being done apart from Dr. Amen’s are not yet conclusive. The studying of the brain in this way is still in it’s infancy (okay maybe pre-school).




Are the images on his site and books fake? Or is he just presenting the few that support what he believes to be true?

This is not known either way I would not go so far personally to accuse him of fraud or lying. The fact that the only ones who are able to reproduce his study findings are himself or his students is why his claims are not supported by empirical evidence. Dr. Amen’s research studies have to be duplicated and results compatible to be considered “valid” by medical care standards.





One additional thing - I'm not upset about the subject. It's just something that I feel passionately about because of what I have had to go through.

Understood completely. Disagreeing points of view is part of life when so many people from diverse back grounds and personalities come together. Nothing wrong with standing up for what you believe I am the exact same way. So far you have communicated your point of view respectfully (without insulting other member’s personhood) which is all that is required by ADDF guidelines.




In fact the feds are trying to make Medicade coverage available to parents with mentally ill children to address this. because insurance in many states won't cover mental illness (although they are trying to Pass the parity in insurance act to fix that. (Not sure if it passed.... I lose track)). Huge numbers of children have actually been taken from their parents and placed in foster care (where they still don't get the treatment they need) because of this.

When my children had Medicaid their ADD visits were covered as well as their medications. Now when the conversation turns to the topic of insurance now I begin seeing “racquet” UGGGGG insurance companies !!!!!!

I can’t write what I think of most insurance companies (and their meddling in medicine) if I tried I would end up having issue myself a few formal warnings. :eek:


And they don't tolerate you disagreeing with them.

Here is a big huge medical secret . . . .the doctors are working for you and if yours doesn’t get that then find one who does. They should be able to handle your opinion and they should be willing to answer reasonable questions you have about their conclusions.

You can imagine what I am must be like as a patient . . .. . .. .. . :o



While there is a lot of symptom overlap, a proper screening can establish the particulars quite accurately for many disorders. Done in this manner the "accuracy" medically of an ADD screening is the same as the accuracy of a test for diabetes.

EEk not sure I would go that far. Diabetes has specific blood testing that is used to diagnosis it. That is a pretty black and white thing, kind of like myopia. ADD diagnosis is a bit more ambiguous (INHO)