ADHD CME for Primary Care Professionals

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Jonathan Marx AIA 15 YadkbH
This ADHD in Adults program is very exciting to us for a number of reasons.

First, it’s a groundbreaking campaign where we can educate all kinds of health professionals about the realities of ADHD, the treatment protocols we know that work, and the medications and other kinds of modalities that help make ADHD patients successful.

We’ve got the participation of the best clinicians and researchers in the country, who are taking part in educating healthcare professionals about this adult ADHD disorder. They’ll be bringing us the latest information and updates.

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We’re also using the latest technologies that help you as practitioners learn about adult ADHD. You’ll benefit from videos, from group updates, from emails, and you’ll really be able to take this information into your practice so that you can best change your practice behaviors and help your ADHD patients.

We’re looking to build a leadership-base of physicians, nurses, nurse practitioners, physician assistants, who want to take out this new research and information about ADHD and bring it to their patients for the benefit not only of the patients, but the millions of people who are around them.

We have fertile ground now in the treatment of ADHD. We have the research that proves it exists, we have the medications and treatment modalities that are successful. All we need now is to get the information out there so that everyone can benefit.

Join us in our information and educational program at adhdinadults.com. We will be helping over ten million adults and, as I mentioned before, everyone who supports them. Thank you.

Using Stimulant Medications for Adult ADHD

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Editor’s Note: We interviewed several leading ADHD experts on treating ADHD in primary care and acquired some very interesting insights into how clinicians can learn about and treat ADHD in their practices.

Anthony_L_Rostain_MD_MA_-_ADHD_in_AdultsAnthony Rostain, MD MA: Physicians are often afraid about prescribing stimulant medications because they’re not familiar with the diagnosis of ADHD and they’re not sure whether they’re legitimately correct in prescribing these medications. Let’s start first by examining ADHD as a diagnosis. It is a legitimate diagnosis.

There is a medical procedure for making the diagnosis that includes taking careful history, getting the patient to fill out scales, getting collateral information from important others who understand something about the patient’s behavior. In addition you have to gather developmental history and educational history. You have to be aware of all of the different facets of the patient’s functioning and understand that ADHD is impacting and impairing that individual.

Brendan Montano AIA jZJbzOBrendan Montano MD: With familiarity and use of stimulant medications in ADHD I know I became much more willing and able to use them. Also many pediatricians have no problem with stimulants and I feel that that will also occur when the primary care network begins to treat ADHD more vigorously, diagnose it and treat it. Our pediatric allies had been used to treating ADHD in childhood and they’d been familiarized and become comfortable with the use of stimulant medications. I believe the same thing will occur with our adult primary care providers. Familiarity and seeing the beneficial effect will give comfort to those who treat with stimulant medications. Remembering again there are some non-stimulants that are also quite effective. Now, it is important to be aware of the fact that stimulant medications can be diverted, they can be misused, they can be abused.

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Stephen Faraone, PhD: And that’s a reasonable concern. However, today that concern is mitigated by several factors. First, we have new formulations of stimulants that are much less abusable than the immediate-release Ritalin many of you are used to. Second, there are now FDA-approved non-stimulant alternatives for ADHD. So you really do have a very large toolbox of therapies to use for adultswith ADHD.

Brendan Montano, MD: The more you become familiarized and screen for this illness, the more you become familiarized with treating the illness. So I became comfortable by seeing the beneficial effects and the outcomes which were otherwise not going to occur in my ADHD patients. The lack of training of primary care practitioners has created a shortage of treatment for adults with ADHD. We have methodological studies that prove there are 10 million undiagnosed adults with ADHD in the United States. I think the 10 million people who have this disorder really deserve for us to become familiarized not only with how to diagnose ADHD but how to treat it.

Anthony Rostain, MD: It’s important to keep in mind that if you follow sound clinical practice and document what you’re doing, including how you made the diagnosis of ADHD, that you informed the patient about treatment options and that you gave the patient all kinds of patient education materials to warn them about the danger of misusing the medication, then you’re following standard medical practice and you won’t be in any medical or legal difficulty.

ADHD Success Story #1: Eva

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Eva O’Malley, ADHD Adult: My son’s ADHD was diagnosed when he was six and I call it his gift to me because it eventually got me to where I am now. After so many years of researching and looking for answers and going to doctors, I started to become very clear about some of these behaviors that are existing in my world as well.

Adults with ADHD often get labeled with some very mean things like “lazy”, “rude”, “crazy” – things that you know are attributable to some of their symptoms, and it hurts. I’m guilty of doing this to my children because my daughter was diagnosed when she was 20.

I couldn’t understand why a 20-year old could not do these basic things. 

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After I was diagnosed it was easier for me to be aware that people’s behavior is not necessarily all that’s going on. And just to look past the behavior and to look into what’s driving the behavior is more important. So those labels then fall off of the people that are “rude” and the people that are “lazy.”

My daughter’s issues all of a sudden became crystal clear once I was diagnosed. It wasn’t selfishness, it wasn’t laziness. It was ADHD.

Editor’s note: Subscribe to our YouTube Channel for frequent video updates.

ADHD Treatment More than Just Drugs

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Editor’s Note:  We combined two interviews into an intertwining post for you.

Anthony_L_Rostain_MD_MA_-_ADHD_in_AdultsAnthony Rostain, MD, MA: So ADHD medication is really only one part of what we call a multimodal approach to treating ADHD. The other components include patient education. It’s really important to sit down with the patient and educate them about what ADHD is and how it affects their life and to review the treatment options.

The next thing we recommend is self-education. It’s having the patient learn about online resources that can help them cope better with their ADHD.

The next component of treatment is ADHD coaching. Many people find it helpful to find somebody to coach them through the day, keep them on track, and give them ideas about how to organize their lives. Coaching is a growing resource for people with ADHD.

Robert Tudisco,Esq, ADHD Adult: A very interesting story about my boss who was an adult with ADHD. He was and still is a successful entrepreneur. Both of his children were diagnosed with ADHD and they were struggling in school. Both he and his son and his daughter were very successful after working with ADHD coaches. What he ultimately did was to decide to be able to create a network of coaches to provide support for all adults and students with ADHD.

He created this foundation and I actually ran it for him. The name of the organization is the Edge Foundation and they have a network of coaches that work with students all over the country, and in public schools in Washington State. My boss and I both really benefitted and were able to do the work we’re doing because we were diagnosed and we know that there’s a name for it and we understand it. I really think that puts us in a better position to help students and other adults. Now, there are also problem focused support groups.

Anthony Rostain, MD, MA: Some of these are sponsored by advocacy groups like CHADD. Others are sponsored by mental health facilities. But meeting with other people who share your problem and talking about it with others is a very helpful step to take.Then if indicated, there are a host of psychotherapists, in particular, cognitive behavioral therapy, which has been shown to really improve patient’s functioning and help patients to cope better with their ADHD.

Occasionally, individuals will need social skills groups to help them become better at managing friendships and other important relationships and were indicated in getting vocational assessment and vocational counseling, particularly in situations where the individual is having a hard time at their chosen occupation. We recommend all of these things in addition to medication in order to enhance functioning and help patients lead a better life. We cover these alternative approaches in our educational seminars with Free ADHD CME.

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Subscribe to your YouTube Channel.  Frequent updates.

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ADHD Success Story #2: Robert’s Story

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Robert Tudisco: I was diagnosed with ADHD after a number of problems that I had in my life. Coming out of law school, I got what I think was probably the perfect job for someone with ADHD. I was a prosecutor in the South Bronx and it was tailor made for someone with ADHD. Everything was an emergency, the motto in the office was “baptism by fire,” and it was just an exciting place to be. When I left the DA’s office and I started a private practice, that’s when I really had some problems. I had to keep track of my time, I had to bill my clients, I had to run an office. It was all of those administrative tasks that were really a problem.

At the same time, I thought I was setting a bad example for my son and I was having some difficulty in my marriage. And so, I sought some help, I found out about ADHD, and I was diagnosed pretty quickly, and that was about 14 years ago and it started this whole journey. My ADHD diagnosis was a major turning point in my life. It really helped me understand a lot about how I grew up and the struggles that I had as a child. I always knew, when I was a child, that there was a lot more going on behind my eyes than I was getting credit for and that was enormously frustrating for me.

Robert Tudisco tremendous benefit of ADHD diagnosis DI00O3
There’s an enormous amount of comfort in knowing that you’re not alone and being involved in the disability community and meeting other people with ADHD, I really found a lot of comfort there, that I was in this with other people that were challenged by the same things that I was. And so I kind of look at the work that I do now as like a second chance to help children and adults cope with their ADHD and really maximize their potential. There have been so many benefits since I’ve been diagnosed with ADHD. I think I’m a better father. I’m certainly a better husband. My relationship with my wife is much more relaxed because we understand each other a lot better. We also understand that ADHD is not an excuse for what happened, and we understand where the behaviors come from so we can kind of work around them in the future.

I really think that a lot of adults would benefit from a diagnosis and it’s just one of the barriers, I think, to a lot of adults getting diagnosed is that there aren’t more clinicians that are diagnosing adults with ADHD. I think it’s important to manage ADHD as an adult or a child in a multimodal way. I take medication for my ADHD. I actually take two types of medication but that’s just a part of a multimodal approach. I run religiously to manage my ADHD. I employ a lot coping mechanisms that I’ve developed over the years that work for me. They may not work for somebody else but that was a process that I went through.

I think the important thing to stress about medication is that it’s not a cure for ADHD. When it works, it can be a very effective tool that helps people make positive changes in their life. I also think it’s important to give myself permission to fail and kind of let myself off the hook. It’s very important for adults to have a sense of humor about their ADHD. And when something doesn’t work, try to look at why it didn’t work and that may help you come up with a better way to solve that problem. And so don’t piece it as a failure-failure, it’s a learning experience.

Editor’s note:  Subscribe to our YouTube channel for frequent updates, education, and information.

 

ADHD Success Story #3 – Parallel Interviews

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In two separate interviews, a clinician and an ADHD adult describe the two sides of ADHD symptoms and ADHD diagonsis.

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Lenard Adler, MD: I can think of an adult in their forties, a male, who came in after having their seven year old child diagnoses with ADHD, and in fact identify that, as he’s having his symptoms, he coped with them not all that well, was in a managerial position but not functioning optimally, had been passed over for promotions on numerous occasions mainly because he didn’t met his deadlines.

Robert Tudisco, Esq, ADHD Adult: I had to keep track of my time, I had to bill my clients, I had to run an office. It was all of those administrative tasks that were really a problem. At the same time, I thought I was setting a bad example for my son and I was having some difficulty in my marriage. And so, I sought some help, I found out about ADHD.

Lenard Adler, MD: In discussing things with the patient and his wife, she described lots of instances around at home where he didn’t listen to her, to do lists just weren’t completed, things weren’t being done on the weekend and she kind of felt that she was not only taking care of their seven-year-old son but also taking care of the husband. So the diagnosis of ADHD became clear after thorough evaluation and, in fact, this individual went on to treatment with a non-stimulating medicine and actually did quite well.

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Robert Tudisco, Esq: There have been so many benefits since I’ve been diagnosed with ADHD. I think I’m a better father. I’m certainly a better husband. My relationship with my wife is much more relaxed because we understand each other a lot better. We also understand that ADHD is not an excuse for what happens and we understand where the behaviors come from so we can kind of work around them in the future. And I really think that a lot of adults would benefit from a diagnosis and it’s just one of the barriers, I think, to a lot of adults getting diagnosed is that there aren’t more clinicians that are diagnosing adults with ADHD.