Going out on a limb here(*): just watched a 56 minute Google Video of Robert L. Hendgren speaking about AD/HD (http://video.google.com/videoplay?docid=-1756566292420454238&q=ADhD&hl=en).

I searched the forum but didn't find any postings mentioning this one yet; there's this (http://www.addforums.com/forums/showthread.php?t=8266&highlight=robert+hendren), but the link that it's referring to is broken.
Just do a search for adhd on Google Video (http://video.google.com/videosearch?q=ADhD&hl=en) and there's a few more lectures.

(*): I don't have any knowledge as to whether this person is some kind of beacon in the scientific world or not ... (man, that's awkwardly phrased ... just using what is popping up in my Flemish brain, sorry).

I watched the first 5 minutes or so. This guy knows what he is talking about. He is not well known but there are a lot of good Dr.'s out there who have educate but never really get into the spotlight.

Thanks a ton for posting the video. Answered a LOT of questions for me! But manomanoman it's Soooo long. But worth it.

[...]manomanoman it's Soooo long. But worth it.Heh. Yeah. If it helps any: I don't have enough fingers to count the number of times I paused the video to watch the slides ;););) or to review some of his statements! I'm thinking the slides should be online somewhere; if days permit I'll do some digging.

Going out on a limb here(*): just watched a 56 minute Google Video of Robert L. Hendgren speaking about AD/HD (http://video.google.com/videoplay?docid=-1756566292420454238&q=ADhD&hl=en).
Thanks so much BartStorm! It sounds like Dr. Hendren has treat a LOT of ADHD children and had interesting insights on which drugs work on which parts of the brain and how many differences there can be in an ADHD brain from one patient to another. He had some interesting comments on Strattera being an MAOI antidepressant and not at all related to stimulant meds. He said Strattera can induce a modest improvement in depression and anxiety, and improves social and family functioning. (Anxiety is one of my problems.)

He had intersting coments about the differences between bipolar and ADHD, saying delusions, irritability and aggressiveness are more typical of Bi-polar than of ADHD, and ADHD meds will make these worse in Bi-polar. A Psychiatrist once told me "you might be bi-polar." But Dr. Hendren's video along with my own observations tell me I'm not.

I stopped for the slides also and took some notes. Yes, it is a long video!

He also said if ADHD is the right diagnosis, stimulant meds help patients have an impressive 60-80% response in relieving some of the symptoms (at the right dose), which he calls the "therapeutic window." And he also said that Adderall was better for the slightly bipolar patient.

He teaches at Univ California Davis, and is part of something called the M.I.N.D. Institute. Going to look at that more.

Thanks again! :cool:

After that wonderful synopsis Jeaniebug, I almost feel like I don't even need to go watch the video! LOL :D

Thx! :)

Ok, I'm off to go watch it now! :)

He had some interesting comments on Strattera being an MAOI antidepressantJust a quick correction, he said thatit was essentially a tricyclic anti-depressant. MAOIs and TCAs actually have almost nothing in common, and confusing the two could have some Very Bad consequences.

and not at all related to stimulant meds
No, tricyclics are actually somewhat similar to the stimulant meds, which is part of why he mentioned the potential of some of the pre-atomoxetine TCAs to cause heart problems. Methylphenidate, Ampnetamine, Atomoxetine, and Tricyclic Antidepressants all affect the reuptake of dopamine, norepinephrine, and serotonin. The differences are in the extent to which they affect those different chemicals (for instance, amphetamine's effect on serotonin reuptake is minimal), as well as how exactly they accomplish it, as well as pharmacokinetic differences.

I guess I'd never really thought about the similarities between TCAs, Atomoxetine, and stimulant meds before. It's very interesting that he mentions it. It should be noted, of course, that this does not necessarily mean that all antidepressants (like MAOIs) will necessarily be beneficial for ADHD. The term "antidepressant" covers a fairly wide range of drugs that have very different effects. It just happens that certain tricyclics will raise DA and NE levels in a manner which might help. Part of what makes TCAs unique (along with Wellbutrin) is that effect on dopamine and norepinephrine. SSRI antidepressants (Paxil, Zoloft, Prozac) do not have much of an effect on dopamine or norepinephrine reuptake.


And as an aside, it was pretty clever of Lilly to think to look at TCAs for future ADHD meds, definitely a good application of knowledge of the underlying pharmacology on their part, good investigative work. I mean, it may seem obvious in hindsight, but given how long it can take to get these drugs through R&D and testing and approval and such, they must have been thinking way ahead on this.

And of course, finding that a TCA may help ADHD isn't the oddest finding of a second use for an old medication...after all, Viagra was originally in development as a heart medication when male patients in their tests started reporting a rather odd side effect...

It would be nice if they had more than just one SNRI on the market to choose from than just Strattera! :(

Well, if you don't mind a little dopamine with your norepinephrine, there's always bupropion or methylphenidate :)

Actually, I think SNRI is a misnomer anyways, since I think dopamine uses NERT in some regions (at least in the frontal/prefrontal regions where Strattera is acting). I'm not sure that it is possible to create a pure norepinephrine reuptake inhibitor or a pure dopamne reuptake inhibitor, they're just too similar.

He teaches at Univ California Davis, and is part of something called the M.I.N.D. Institute. Going to look at that more. :cool:
UCDavis has the M.I.N.D institute which works with a wide range of syndromes--children only. Though UC Davis also has a medical psychiatric unit that treats children and adults. UC San Diego has the Adult ADD clinic handled by their Neuropsychiatry & Behavioral Medicine section. The M.I.N.D. institute is listed on the local CHADD listing, but I haven't been able to find anyone who knows much about the san diego clinic. Their brochure looks good.

Excellent video -- very informative! Thanks for sharing the link!:)


Scattered

Thanks for sharing the link!:)
ScatteredYou're welcome. If only I would have shared the man's name right (apologies to you as well Sir).

Sorry guys, I only now [red cheeks] discovered this: it's Robert L. Hendren, not Hendgren ... awwww.

Just a quick correction, he said thatit was essentially a tricyclic anti-depressant. MAOIs and TCAs actually have almost nothing in common, and confusing the two could have some Very Bad consequences.


No, tricyclics are actually somewhat similar to the stimulant meds, which is part of why he mentioned the potential of some of the pre-atomoxetine TCAs to cause heart problems. Methylphenidate, Ampnetamine, Atomoxetine, and Tricyclic Antidepressants all affect the reuptake of dopamine, norepinephrine, and serotonin. The differences are in the extent to which they affect those different chemicals (for instance, amphetamine's effect on serotonin reuptake is minimal), as well as how exactly they accomplish it, as well as pharmacokinetic differences.

I guess I'd never really thought about the similarities between TCAs, Atomoxetine, and stimulant meds before. It's very interesting that he mentions it. It should be noted, of course, that this does not necessarily mean that all antidepressants (like MAOIs) will necessarily be beneficial for ADHD. The term "antidepressant" covers a fairly wide range of drugs that have very different effects. It just happens that certain tricyclics will raise DA and NE levels in a manner which might help. Part of what makes TCAs unique (along with Wellbutrin) is that effect on dopamine and norepinephrine. SSRI antidepressants (Paxil, Zoloft, Prozac) do not have much of an effect on dopamine or norepinephrine reuptake.


And as an aside, it was pretty clever of Lilly to think to look at TCAs for future ADHD meds, definitely a good application of knowledge of the underlying pharmacology on their part, good investigative work. I mean, it may seem obvious in hindsight, but given how long it can take to get these drugs through R&D and testing and approval and such, they must have been thinking way ahead on this...
Thank you so much hyperion. A little knowledge is a dangerous thing, and that is all I have right now. Plus my brain doesn't seem to process information correctly :p

Have so much to learn. . .. Thanks again for the thread!