This Reality Presentation is the *entire slide set* in the Reality series. *Why* Reality matters, *How* we can apply Reality insights in everyday ADHD understanding for diagnosis and treatment, and exactly *What* we can do about this new ADHD/Executive Function Reality on an everyday basis. Neuroscience evidence changes thinking. If this presentation helps you please forward to your social networks and friends. Then sign up at http://corebrain.org/reality for updates on exactly how to understand and apply these useful details.

1. RealityReality
Changes TheChanges The
ADHD RulesADHD Rules
New ADHD Medication RulesNew ADHD Medication Rules
Brain Science & Common SenseBrain Science & Common Sense
http://adhdmedicationrules.comhttp://adhdmedicationrules.com
Dr Charles ParkerDr Charles Parker

2. 1.1. WhyWhy RealityReality For ADHD MedsFor ADHD Meds
2.2. HowHow To Rethink StandardsTo Rethink Standards
3.3. WhatWhat Specifics Need ChangeSpecifics Need Change
Overview:Overview: Let’s Take a Moment ToLet’s Take a Moment To
Consider:Consider:

3. WhyWhy Think…Think…
About New ADHDAbout New ADHD
Med Rules?Med Rules?

4. Take This Home!Take This Home!
……Serious problemsSerious problems
regularly do occur withregularly do occur with
ADHD Meds.ADHD Meds.

5. ……That Everything isThat Everything is
OK in ADHD LandOK in ADHD Land

6. Office Tragedy EverydayOffice Tragedy Everyday
- Heartbreak- Heartbreak
- Anger- Anger
- Overwhelming Side Effects- Overwhelming Side Effects
- Treatment Failures Abound- Treatment Failures Abound
Too Many WastedToo Many Wasted
LifetimesLifetimes

7. The Current Standard ofThe Current Standard of
Care – Think About It -Care – Think About It -
Almost CompletelyAlmost Completely
IgnoresIgnores BiologicBiologic
RealityReality

8. Globally,Globally, Too Often:Too Often:
Both Public andBoth Public and ProfessionalsProfessionals AreAre
DisillusionedDisillusioned With ADHD TreatmentWith ADHD Treatment
OutcomesOutcomes
------------------
New Objective:New Objective: No IllusionsNo Illusions
In the First PlaceIn the First Place

9. So, WhatSo, What isis thethe
Problem?Problem?

10. RealityReality RemainsRemains
Dynamic - andDynamic - and
Changes:Changes:
You can’t stick your footYou can’t stick your foot
in the same river twice.in the same river twice.
Heraclitus 500 BCHeraclitus 500 BC

11. On the other hand…On the other hand…
DreamsDreams andand
FantasiesFantasies OccurOccur
in thein the DarknessDarkness

12. DreamsDreams andand
FantasiesFantasies OftenOften
Create ConfusionCreate Confusion

13. TheThe BiggestBiggest
ProblemProblem withwith
ADHD Treatment?ADHD Treatment?
>> Ambiguity…Ambiguity…
DenialDenial Of TheOf The DarknessDarkness

14. Just How MuchJust How Much
Inattention isInattention is
Inattention?Inattention?

15. How MuchHow Much
Hyperactivity isHyperactivity is
Hyperactive?Hyperactive?

16. WhereWhere
AreAre
WeWe
Going?Going?

17. How Often Do WeHow Often Do We
TreatTreat AppearanceAppearance
CriteriaCriteria
Not People?Not People?

18. TwoTwo ProfoundProfound DeficitsDeficits Exist withExist with
AttentionAttention DeficitDeficit::
1. Diagnostic Specificity1. Diagnostic Specificity
&&
2. Treatment Precision2. Treatment Precision
Outcome…Outcome… GuessworkGuesswork

19. MedsMeds
WrittenWritten
WithoutWithout
Clear MapsClear Maps

20. Remember…Remember…
GalileoGalileo

21. MeasureMeasure what iswhat is
measurable, andmeasurable, and makemake
measurablemeasurable what is not so.what is not so.
Galileo Galilei ~ 1615Galileo Galilei ~ 1615

22. HowHow
Reality DoesReality Does MatterMatter

23. Overlooked in ADHD:Overlooked in ADHD:
BiologicalBiological RealitiesRealities
Do ApplyDo Apply
For MedicalFor Medical DiagnosisDiagnosis
1.1.Brain:Brain: FunctionalFunctional RealityReality
2.2.Body:Body: BiomedicalBiomedical RealityReality

24. ADHDADHD RealitiesRealities
OverlookedOverlooked
In Routine TreatmentIn Routine Treatment
1.1.Measurable:Measurable: Medication DurationMedication Duration
2.2.Measurable:Measurable: Therapeutic Window Therapeutic Window
3.3.Measurable:Measurable: Drug InteractionsDrug Interactions
4.4.Measurable:Measurable: Medication Seesaw -Medication Seesaw -
Antidepressants and StimulantsAntidepressants and Stimulants

25. Start: The DiagnosticStart: The Diagnostic
RealityReality OfOf
Brain FunctionBrain Function

26. HowHow WeWe DenyDeny
TheThe Reality ofReality of
Brain FunctionBrain Function

27. How We HandleHow We Handle
Changing RealityChanging Reality

28. Brain Function:Brain Function:
Is Based OnIs Based On
Changing RealityChanging Reality

29. Working MemoryWorking Memory
ManagesManages
ChangingChanging RealityReality

30. Changing RealityChanging Reality
AmplifiesAmplifies ADHDADHD

31. Labels Don’tLabels Don’t
ConsiderConsider
ContextContext oror
-- Changing RealityChanging Reality

32. What setsWhat sets
ourour BrainsBrains
apart from cats,apart from cats,
cows and elephants?cows and elephants?
Yes - Working MemoryYes - Working Memory

33. Working MemoryWorking Memory TimedTimed
Sequence:Sequence:
1.1. ThinkingThinking AboutAbout RealityReality
2.2. ActingActing Upon thatUpon that RealityReality
3.3. CarryingCarrying RealityReality Results toResults to
the next daythe next day

34. TimingTiming isis
Everything…Everything…
WorkingWorking
MemoryMemory
Must Be,Must Be, Timed,Timed,
Synchronized…Synchronized…
- In Sequence- In Sequence

35. FrozenFrozen Working MemoryWorking Memory IsIs
DesynchronizedDesynchronized by:by:
-- Increased VariablesIncreased Variables
-- Decreased StructureDecreased Structure
-- No Stimulating FocusNo Stimulating Focus
The PFC BrainThe PFC Brain Desynched =Desynched =
yes -yes - ADHDADHD

36. Desynchronized ADHD:Desynchronized ADHD:
Acting ADHDActing ADHD
1.1. Acting without ThinkingActing without Thinking --
more explicit than “Hyperactive”more explicit than “Hyperactive”
and can be placed in each Realityand can be placed in each Reality
ContextContext

37. Thinking ADHDThinking ADHD
2.2. Thinking without ActingThinking without Acting,,
- The Most Commonly Overlooked- The Most Commonly Overlooked
- “Cognitive Anxiety”- “Cognitive Anxiety”
- Often without Anxious Feelings- Often without Anxious Feelings
- Video:- Video: www.bit.ly/adhdanxwww.bit.ly/adhdanx

38. Avoidant ADHDAvoidant ADHD
3.3. Not Thinking & Not ActingNot Thinking & Not Acting
-- See YouTube ‘Avoidant’ VideoSee YouTube ‘Avoidant’ Video
-Biologically correctableBiologically correctable
-Social Anxiety, Intimacy, ProcrastinationSocial Anxiety, Intimacy, Procrastination
- Avoidance of specific- Avoidance of specific RealitiesRealities

39. Thinking, Acting andThinking, Acting and
Remembering,Remembering,
Working Memory MattersWorking Memory Matters
----------------
But, Last Time IBut, Last Time I
CheckedChecked The Mind WasThe Mind Was
Connected To BodyConnected To Body

40. TechnologyTechnology
Denial:Denial:
FunctionalFunctional
BodyBody
RealityReality

41. Are YouAre You
PrePre-Technology-Technology
StuckStuck or…or…
PostPost-Technology-Technology
Connected?Connected?

42. Let’s BuildLet’s Build Mind-BodyMind-Body
New Roads TogetherNew Roads Together

43. BodyBody Diagnosis:Diagnosis:
Measurable BodyMeasurable Body
Biomedical Data =Biomedical Data =
MeasureableMeasureable ImpedimentsImpediments

44. Medical BiomarkersMedical Biomarkers
((Just As Cholesterol or CRProtein,Just As Cholesterol or CRProtein, AreAre NotNot
CategoricallyCategorically CorrectCorrect, e.g.:), e.g.:)
-SPECTSPECT
-NeurotransmittersNeurotransmitters
-Immunity - IgGImmunity - IgG
-Trace Elements, Heavy MetalsTrace Elements, Heavy Metals
-Genetics: D2 Receptor, CYP 450Genetics: D2 Receptor, CYP 450

45. Biomedical Data:Biomedical Data:
Neurotransmitters - NTNeurotransmitters - NT
-Measure With UrineMeasure With Urine
-Without them Meds Don’t WorkWithout them Meds Don’t Work
-Meds Collect NT ChickensMeds Collect NT Chickens

46. Biomedical DataBiomedical Data::
ImmuneImmune System ChallengesSystem Challenges
IgIgGG:: TheThe GhostGhost
ImmunoglobulinImmunoglobulin [[7-10 Days]7-10 Days]
IgIgEE:: TheThe EmergencyEmergency
Immunoglobulin:Immunoglobulin: [24-48 Hrs.][24-48 Hrs.]

47. Biomedical DataBiomedical Data
HormonesHormones
-Adrenal Function - DHEAAdrenal Function - DHEA
-ThyroidThyroid
-Estrogen [Dominance]Estrogen [Dominance]
-TestosteroneTestosterone

48. Biomedical DataBiomedical Data
Trace ElementsTrace Elements
-Tissue Mineral Analysis – Drug TestTissue Mineral Analysis – Drug Test
-Deficiency = NT DeficiencyDeficiency = NT Deficiency
-Excess = Toxicity e.g Cu, CheerleaderExcess = Toxicity e.g Cu, Cheerleader
-Effect Autonomic Nervous System = PNS andEffect Autonomic Nervous System = PNS and
SNSSNS
-Heavy Metals Block NT Activity - NEJMHeavy Metals Block NT Activity - NEJM

49. Biomedical DataBiomedical Data
Genetic TestingGenetic Testing For PolymorphismsFor Polymorphisms
-CYP 450 2D6 – 4 Different PipesCYP 450 2D6 – 4 Different Pipes
-D2 Receptor Changes –D2 Receptor Changes – Reward DeficiencyReward Deficiency
SyndromeSyndrome – Food, Substance Abuse,– Food, Substance Abuse,
Addictions, ADHD Meds Don’t Work – KenAddictions, ADHD Meds Don’t Work – Ken
Blum PhDBlum PhD

50. TheThe MeasurableMeasurable
RealityReality OfOf
MedicalMedical
TreatmentTreatment

51. WhatWhat
To DoTo Do

52. “Pills have to pass throughPills have to pass through
youryour bodybody before they reachbefore they reach
youryour brain”brain”..
New RulesNew Rules OutlinesOutlines
Exactly What WorksExactly What Works
Most OftenMost Often

53. - Almost- Almost every problemevery problem withwith
ADHD medication isADHD medication is directlydirectly
relatedrelated toto realreal,, measureablemeasureable,,
body metabolic challengesbody metabolic challenges..
- Body- Body MetabolismMetabolism DirectlyDirectly
EffectsEffects Mind FunctionMind Function

54. In the FogIn the Fog
WithoutWithout
Landmarks…Landmarks…
Any MarkersAny Markers
MatterMatter

55. MeasurableMeasurable MedicationMedication
DDurationuration OOff EEffectiveness:ffectiveness:
RealityReality IsIs Built Into EachBuilt Into Each
Med =Med = DOEDOE
Short Acting – e.g. Ritalin IR 4hrShort Acting – e.g. Ritalin IR 4hr
Long ActingLong Acting – e.g. Adderall XR 8-10hr– e.g. Adderall XR 8-10hr
Vyvanse – 10hr Kids, 12hr adults.Vyvanse – 10hr Kids, 12hr adults.
Daytrana 12hr, - Strattera 10hrDaytrana 12hr, - Strattera 10hr

56. Measureable Sweet SpotMeasureable Sweet Spot
Therapeutic WindowTherapeutic Window
Sides =Sides = DDurationuration OOff EEffectiveness:ffectiveness:
DOEDOE
Top = Too MuchTop = Too Much
Bottom = Too LittleBottom = Too Little

57. ADHDADHD MedicationMedication
IntroIntro TutorialTutorial::
- These 8 Videos Describe- These 8 Videos Describe HowHow
To Work With ADHD MedsTo Work With ADHD Meds
http://bit.ly/medstutorialhttp://bit.ly/medstutorial

58. ADHDADHD MedicationMedication
DosageDosage TutorialTutorial::
- 9 Short Explanatory Videos- 9 Short Explanatory Videos
onon HowHow Dosage StrategiesDosage Strategies
http://bit.ly/dosevidshttp://bit.ly/dosevids

59. Dark CirclesDark Circles
EncourageEncourage
PrecisePrecise
QuestionsQuestions

60. 1. Measurements1. Measurements
Matter :Matter : IgGIgG

61. IgG

62. ADHD,ADHD, ImmunityImmunity
Mind & GutMind & Gut TutorialTutorial::
- 8 Short Videos on- 8 Short Videos on
YouTube | IgG ExplainedYouTube | IgG Explained
http://bit.ly/mindguthttp://bit.ly/mindgut

63. PredictablePredictable
Drug InteractionsDrug Interactions
2D62D6 Makes A DifferenceMakes A Difference
- Video:- Video: Prozac & PaxilProzac & Paxil --
NotNot With StimulantsWith Stimulants
http://bit.ly/prozacadhdhttp://bit.ly/prozacadhd

64. 2. Measurements2. Measurements
Matter :Matter : TraceTrace
Elements -Elements - TMATMA

65. TMA
Tissue
Mineral
Analysis

66. 3. Measurements3. Measurements
Matter :Matter :
NeurotransmittersNeurotransmitters

67. NeurotransmittersNeurotransmitters

68. Depression & ADHDDepression & ADHD
Serotonin/DopamineSerotonin/Dopamine
SeesawSeesaw – See Video– See Video
http://bit.ly/2diagnosehttp://bit.ly/2diagnose

69. Coaching & CorePsych UpdatesCoaching & CorePsych Updates::
Treatment Options:Treatment Options: CorePsych.com/servicesCorePsych.com/services
400+ Articles400+ Articles:: CorePsych.comCorePsych.com
Coach Partners:Coach Partners: CoreBrain.org/coachesCoreBrain.org/coaches
ReviewsReviews && New RulesNew Rules Excerpts:Excerpts:
http://adhdmedicationrules.comhttp://adhdmedicationrules.com
Free White PaperFree White Paper: Predictable Solutions: Predictable Solutions::
http://corepsych.com/adhdbookhttp://corepsych.com/adhdbook

70. HOWHOW
Three ImportantThree Important
ComplimentaryComplimentary
How To ADHD MedicationHow To ADHD Medication
YouTube Tutorial Playlists at:YouTube Tutorial Playlists at:
www.youtube.com/ drcharlesparkerwww.youtube.com/ drcharlesparker

71. Learn More AboutLearn More About
Reality for ADHDReality for ADHD
MedicationsMedications ––
Webinar Details At:Webinar Details At:
http://corebrain.org/realihttp://corebrain.org/reali
tyty

72. ManyMany
Thanks!Thanks!
cpcp