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I went to a presentation by a psychiatrist in our area who is a provider of Cogmed software. She has a dh and dd with ADHD as well and became a Cogmed provider while researching how to help her family. Medication (Be forewarned: this info may concern some people. I'm just the messenger and if your kiddo is on some of the meds mentioned, don't shoot me. I'm only repeating what I heard!) She said there are basically only two kinds of meds; the rest is "packaging/marketing: 1. Methylphenidate (Dexmethylphenidate): basically Ritalin related meds: Daytrana, Concerta, Ritalin, Metadate CD, methilyn, Ritalin SR, Focalin, Focalin XR, Ritalin LA 2. Amphetamines (Dextroamphetamines) Dexedrine (the generic), Dexedrine spanules, Adderall, Aderall XR, Vyvanse. Dexedrine is the active drug in all these. Adderall and Vyvanse were repatented with additional nonactive drugs. She mentioned that the ability to get a new patent is one motivation for the reformulation and that the inactive part can be the part that causes the side-effects. She said that there have always been warnings on ampehtamines of neurotoxicity in high doses with rodents . Recently (I didn't write down the date, but she might have said this past December) the first study was done on primates, using therapeutic dosages (equivalent to presciption amounts) and that also showed neurotoxicity. She tries to avoid the use of the second class of medications with her patients. (Despite saying there were only two kinds of meds, later she mentioned Strattera as being helpful sometimes with ADD.) She presented a lot of graphs of the curves of when various meds "kick in", when they peak, and how long they are in your system. That was beyond me to follow closely, because I've never had my ds on meds, and there was a whole lot of info. What I did pick up though, was that med increases can actually cause increased "symptoms" of ADHD, and it becomes a negative cycle of "more ADD symptoms" leading to increases which aggravated symptoms, so more increases, etc. One of the issues was what she called "transitioning." She said that what meds do is give a person access to hyperfocus, which she also called "flight or fight" focus: it gives you a narrow, tunnel view and you can focus really well on what's right in front of you, but you lose some ability to "transition" (to stop what you're doing if it isn't high priority right now, or you need to move on to the next thing, etc.) and that ability to transition is like an inverse curve to dosage, so it goes down as the dose goes up. More hyperfocus (on higher dosages) makes it worse and the inability to transition can cause as many or more problems as the ability to focus. Cognitive training There was more research on Cogmed than I realized. I knew about 3 or so double-blind studies on normal folks and ADHD kids by the research team who developed the original protocal. However, here is an additional one that I didn't know about that I find impressive. A guy named Baddeley had years ago developed the model of working memory organization that had long been accepted by the scientific community and that model postulated that working memory could be trained for a specific task, but could not be improved in general. After the first studies by Klingberg came out which challenged that model, his group at the Univ. of York set out to replicate the studies and show that they were wrong. So the researchers' bias was to find that working memory couldn't be improved and to add proof for their own model. In their study, they took students in the bottom 15% of working memory at a school and did the working memory program with them. Here's what the lead researcher said: " We started out from a fairly skeptical basis but our data are very clear: you get major gains with working memory training. In fact, we've found that the majority of these kids go from the deficit range to average or above average range in working memory." (Dr. Gathercole) There are studies that have since been done or are ongoing in several major universities. There is one at Duke U. right now on using this program on kids whose working memories have been damaged by chemotherapy. Klingberg's research was duplicated at Notre Dame by Gibson who found working memory increases in children with ADHD and significantly improved scores on parent and teacher ADHD rating scales. Those are a couple I have in my notes. In her experience, she said she's seen 20-50% improvement in working memory. She says her observation is that the clients that are on the higher end of the improvement are not on meds. (50% of ADHD kids are not on meds--either because parents don't want them or the kids can't tolerate them) . Once the working memory is remediated, then a person needs to learn the skills that they haven't been able to acquire developmentally because of working memory issues: time management, planning, etc. Miscellaneous Motor control is affected by the same dopamine problem as is working memory, which is why there is a high correlation between ADHD and dysgraphia and other motor skills issues. The working memory subscale on the WISC IV and the Processing Speed subscale overlap. This is because the processing tasks utilize working memory; also because of the dopamine issue affecting motor tasks ( The coding test involved motor skills. If you are slow at writing, you'll have a depressed score.) So processing speed doesn't actually tell you how fast someone thinks--it's contaminated by working memory and motor ability. She explained why, but I didn't get it in my notes, but she recommends Fish Oil to all of her ADHD clients and recommends Nordic Naturals because of the oversight in the country in which it's made. (Eliminates the worry over mercury.) She recommends 1000-2000 mg of DHA/EPA (Combined I think) Untreated, the brain of a person with ADHD will show shrinkage. The constant stress that ADHD causes releases a kind of chronic state of adrenaline and cortisol, and the cortisol kills off brain cells over the long term. So unstress your kids with ADHD! (Medication is one way of doing that as they help the person function so much better, but there are conflicting studies, one of which shows that the longer meds are used, the more the brain shrinks. ) If you have questions and I have the answer in my notes, I'd be glad to share more.