Menu

adult ADD

Dr. David W. Goodman invited to speak at Regional CHADD conference February 22, 2014 at West Chester University, PA

, , , , , , , , , , , , , , , ,

Anticipating over 300 attendees, the 13th Annual ADHD Conference for parents, teachers, professionals and adults with ADHD on Saturday, February 22, 2014 from 8:00am to 1:00pm will feature several expert speakers. West Chester University is just outside Philadelphia. Below is the program of speakers and topics.

Marie Paxon, program coordinator, invited me to present on the science of diagnosis and treatment of ADHD in adolescents and adults. If you reside in the area, please consider attending because it is a great way to learn a great deal about ADHD quickly and network with people with ADHD and those who offer guidance and treatment. See you there.

CC%20ML%20w%20David%20Goodman%20edited%20version-2

ADHD and the Brain: Knowledge Matters Speakers

Marilyn B. Benoit, M.D. is a child and adolescent psychiatrist. She is senior vice president of Clinical and Professional Affairs and chief clinical officer at Devereux. She is a past president of the American Academy of Child and Adolescent Psychiatry. Dr. Benoit has served on the faculties of Howard and George Washington Universities and is a clinical associate professor of psychiatry at Georgetown University Medical Center, from which she received the Vicennial Silver Medal of Honor for 20 years of distinguished service.

David W. Goodman, M.D. is assistant professor of Psychiatry and Behavioral Sciences at the Johns Hopkins University School of Medicine. He is also director of the Adult Attention Deficit Disorder Center of Maryland in Lutherville and medical director of Suburban Psychiatric Associates, LLC. Dr. Goodman is the author of The Black Book of ADHD.

Marjorie Johnson, LCSW, PCC is a licensed clinical social worker and certified coach who provides leadership and career coaching, training, and counseling. She specializes in helping students and professionals with ADHD. Ms. Johnson serves on Chester County/Main Line CHADD’s Professional Advisory Board and is a professional member of ADDA (Attention Deficit Disorder Association.). She is past president of the International Coaching Federation-Philadelphia chapter and was named the 2011 Small Business Person of the Year by the Exton Chamber of Commerce (PA).

Jesse D. Matthews, Psy.D. is a licensed psychologist and has worked with individuals with ADHD for a number of years. He is in private practice at The Center for Psychological Services in Paoli and Ardmore and also works at Holcomb Behavioral Health Systems, a community mental health organization. He evaluates adolescents for substance abuse at the Chester County Youth Center in West Chester and does substance abuse evaluations and treatment in an outpatient program in Kennett Square. Dr. Matthews is an adjunct professor at Immaculata University. Previously, Dr. Matthews worked for six years as a counselor at Hill Top Preparatory School, and he facilitated the Chester County/Main Line CHADD teen ADHD support group for two years.

Joan M. Polka, Ph.D. is a psychologist in the Counseling Center at West Chester University assigned full time to the Act 101 portion of the Academic Development Program (a developmental education opportunity for underprepared first-time college students). She is also co-chair of Chester County/Main Line CHADD’s Adult Program and was the 2011 CHADD Educator of the Year.

Martin Patwell, Ed.D. is director of the Office of Special Services for Students with Disabilities at West Chester University. He has also been the director of evaluation clinic at Landmark School. He has presented “Trends and Issues in Disabilities in Higher Education” at Jiangxi University, Nanchung, China. He is also a consultant to The College Board, Inc.

Preeti Singh, M.S. is the associate director of the Twardowski Career Development Center at West Chester University.

Sharon Watson, M.S. is assistant director of West Chester University’s Office of Services for Students with Disabilities. She has over 20 years of experience working with students with learning differences, mental health, and physical disabilities.

8:30 a.m. Welcome

Chester County/Main Line CHADD and West Chester University

West Chester University

Earl F. Sykes Student Union

110 West Rosedale Avenue

West Chester, PA 19383

8:45 –9:15 a.m.

ADHD Across the Lifespan

Marilyn Benoit, M.D.

Research has proven that ADHD does not end with childhood. Over the course of a lifetime, the scenarios change, but the struggles might not. What does ADHD look like at each stage of life and what is the impact? This fast-paced-but-thorough presentation will help attendees learn more about this complex disorder and will provide a summary of current treatment and management options. Don’t miss this valuable session to gain a better understanding of childhood, teen, and adult ADHD.

9:15 –10:30 a.m.

ADHD and the Brain – What You Need to Know About Treatment and Management

David W. Goodman, M.D.

Those with ADHD express frustration with the disorder’s symptoms: trouble focusing, procrastination, forgetfulness, and difficulty filtering out distractions. Some people have a slower processing speed and others struggle with impulsivity. To make things even more complex, many people with ADHD will have a co-occurring condition like learning disabilities, anxiety, depression, or autism. The good news is that treatment is available, and there are strategies to counteract these challenges. Dr. Goodman will provide an overview of medications and pro-social treatments for ADHD and discuss common co-occurring conditions in this valuable presentation. Children and adults report that they receive unhelpful advice like “try harder,” “start applying yourself,” and “pull yourself up by your bootstraps.” Attend this session to learn about evidence-based treatments for ADHD and how they make a difference.

10:45 –11:30 a.m.

ADHD and Social Interactions

Jesse Matthews, Psy.D.

Social interactions can consist of anything from a casual conversation with an acquaintance to daily communication with loved ones. This can present challenges for both children and adults with ADHD. Those with ADHD may feel isolated and disconnected from others. They may find that executive function challenges can cause them to misinterpret social cues, which are usually unspoken or vague. The invisible challenges of impulsivity, forgetfulness, and an inability to regulate emotions can have a negative effect on forming and maintaining friendships. Fortunately, new information and strategies are available through the field of social learning and social cognition. Attend this session to learn more about this exciting topic and how to apply it to everyday life.

• Facilitated activity: Mindfulness Meditation and ADHD

Marjorie Johnson, LCSW

Mindfulness meditation is a way to calm the mind and relax the body while increasing the ability to sustain attention and manage distractibility. Hear about compelling research and daily applications of mindfulness meditation. Practice it to experience the deep relaxation it generates.

11:45 a.m. –1:00 p.m.

Becoming Successful in College and Early Career

ADHD and Career Success

Preeti Singh

Career development is a life-long process, involving decision making, self-awareness, exploration, preparation, and experience. What tools are available to help students successfully navigate this territory? This brief presentation will provide an overview of resources and strategies.

WCU Student Panel

Sharon Watson, facilitator

Current students at West Chester University who have “been there, done that” tell it like it is. Their transitions, challenges, and routes to where they are today provide a look at what real students face in college.

• Facilitated activity: ADD and Loving It?!

This video blends humor, hope, and science to dispel the myths about adult ADHD. Comedian Patrick McKenna seeks a diagnosis for adult ADHD and learns the facts from an impressive array of experts. Funny, moving, and transformative, this fascinating documentary will hold you spellbound!

WYPR interview on ADHD with Dr. David W. Goodman

, , , , , , , , , , , , , , , ,

My discussion with Dale Archer, M.D. (psychiatrist, best-selling author) on WYPR September 27, 2014 about ADHD, over- diagnosis, and over-prescribed medications was lively. While Dr. Archer advocates “medication as a last resort” and “the goal of treatment is to get off medication” after learning new skills, I offered the research on medication benefit and a quality of life measure to evaluate medication utility. Certainly, treatment of ADHD at all ages incorporates behavioral therapy, organization skills, couple/family/individual therapies, and academic/occupational accommodations, in addition to medication, when indicated.

For those of you interested, the radio broadcast is available and runs 35 minutes. I invite you to listen and decide for yourself the merits of each position. Ultimately, this information best serves those who have ADHD and their families.

Dr. Goodman interview on Dan Rodricks show on WYPR Jan 27 at 1pm

, , , , , , , , , , , , , , ,

I have been invited as an expert on ADHD to participate in an interview on the Mid-day with Dan Rodricks show on WYPR on January 27 1-2pm. This is a live panel discussion that will include Dale Archer M.D., a psychiatrist and writer, to discuss the use of medication and treatment options for ADHD. The discussion is moderated by Dan Rodricks who is a distinguished journalist in Baltimore with a regular feature in the Baltimore Sun newspaper.

Dr. Archer wrote an article online for Forbes on January 6, 2014 on his perspective of ADHD and the overuse of medication and the over-marketing of ADHD. His article highlights and echoes the sentiments of Alan Schwatz in his New York Times article “The Selling of Attention Deficit Disorder” published December 15, 2013.

This one-hour program will give me the opportunity to highlight the national and international scientific literature and research on ADHD. I hope to highlight the well documented negative consequences over the course of one’s life with untreated ADHD as reflected in several international prospective studies following ADHD children into young adulthood.

This program promises to be a lively discussion and offers listeners the opportunity to call in with questions. I encourage you to mark your calendar. I believe the program can be accessed online. If you listen, please leave me your comments for feedback.

Dr. David W. Goodman, M.D. awarded “Fellowship” status by the American Psychiatric Association

, ,

As a psychiatrist for 27 years, I am honored that the American Psychiatric Association has appointed me to a “Fellowship” status. The criteria for this award is a history of psychiatric contribution to teaching, research, and clinical care. For those of you familiar with my work, this is additional affirmation that I have maintained my professional skills and contribution to the field. For those of you not familiar with my work, I invite you to visit my website which enumerates my research and publications. In addition to my teaching chief residents in psychiatry at the Johns Hopkins Hospital, research publications, and pre-publication peer review, I continue to see patients my full-time practice. I look forward to attending the convocation ceremony in May in New York City.

“The Selling of Attention Deficit Disorder” The New York Times December 15, 2013

, , , , , ,

The New York Times article “The Selling of Attention Deficit Disorder” published December 15, 2013 had quoted me towards the end of article. As I had previously written in my blog posting, the quote was taken out of context and deliberately misrepresented my professional article with Medscape. I did send a letter to the editor in order to have this quote placed in appropriate context, however, in the letters to the editor, it went unpublished. So, I’ve posted my letter to The New York Times here.

The New York Times

Letter to the Editor

December 14, 2013

Dear Editor:

Let me congratulate Alan Schwartz on his extensive review of ADHD in his article “The Selling of Attention Deficit Disorder”, December 14, 2013.  He highlights the increased identification of people with ADHD and the growing use of medication as a treatment option. Unfortunately, he presents information that malign physicians and researchers who have committed their life’s work to investigating the causes of ADHD and pursuing research to prove treatments effective. Mr. Swartz would have served his readers well by revealing his a priori agenda in writing this article. A case in point, Mr. Schwartz quotes me in regards to an article I authored for Medscape on adult ADHD. In this article, he knowingly and deliberately eliminated my notation that the six-minute video accompanied a 2000 word article with 86 scientific references that extensively detailed the clinical evaluation process for ADHD in adults.  Therefore my quote, out of context, misrepresents my work and misleads your readers.  Perhaps his article would have been better placed in the Op-Ed section of The New York Times.

David W. Goodman, M.D.

The moral: Discern the agenda of the journalist before you make sense of the information provided. As I like to teach my psychiatric residents at Johns Hopkins, the credibility of the information is a function of the intent of the provider.

Dr. David W. Goodman featured as ADHD expert in The Washington Post article’s December 17, 2013

, , , , , , , , , , , , , ,

The Washington Post took the initiative to write an article in today’s (December 17) paper on ADHD in adults ages sixty and older. This article is also accompanied by a sidebar article discussing adult ADHD Older adults with ADHD are a group that has not been specifically researched and about whom very little is written. The Washington Post article includes two or three people with ADHD who were diagnosed much later in life. They speak about their lifetime experiences with untreated ADHD and the positive change they and others have noticed with treatment.

Imagine that you spent 60 years of your life distracted, disorganized, forgetful, and chronically tardy.  Imagine that you have dropped out of school, lost jobs, or were divorced as a direct consequence of that state of mind.  Imagine that you seek help from  a professional and you are told that you have a disorder that can be effectively treated.  Imagine your reluctance and hopefulness that these experiences can diminish. Imagine that you agree to treatment and discover that all of these experiences were symptoms of the disorder and not you as a person.  I know, that’s a lot to imagine. At this age, the goal of treatment is not only to treat ADHD  but to help a person understand the difference between what they have (disorder) versus who they are (person).  In my experience helping people, this process helps resurrect a person’s self-image.

I invite you to read these two articles and seek professional help if these  symptoms resonate with your experience. If you are an older adult with possible ADHD, I recommend that you see an expert in ADHD who will be able to make an accurate diagnosis. Because older adults may have both medical and psychiatric disorders in addition to taking medications, it’s critical that an expert be able to distinguish multiple disorders and  evaluate the presence of ADHD accurately. Effective treatment is completely dependent on the accuracy of the diagnosis.
Thank you for your interest.
David W. Goodman, M.D.

Dr. David W. Goodman quoted in The New York Times Today (December 15, 2013)

, , , , , , , , , , , ,

Today the New York Times published an article “The Selling of  Attention Deficit Disorder” by Alan Schwarz. This is a lengthy article highlighting the increased identification of people with ADHD and  the concomitant increase in the prescriptions of effective medications.  The article is a feature story on the New York Times website today.

Toward the end of this article I am  quoted for the authorship of a continuing medical education article I wrote for Medscape.com in August 2012. In the Times article, he references a six-minute video clip of an interview between physician and patient I had included in my Medscape article.  He uses my quote “That was not an acceptable way to evaluate and conclude that the patient has A.D.H.D.” to  indict me for using  the short video as an example of how to evaluate adult ADHD. He sat with me for 30 minutes in Washington DC and recorded our interview.  However, what he failed to mention in his New York Times article was that the video clip he referenced accompanied a 2000 word continuing medical education article with 86 scientific references that was estimated to take physicians 2.5 hours to complete.  It would appear that Mr. Swartz had an a priori agenda in presenting his information. His remarks in the article malign and misrepresents physicians’ and researchers’ commitment to exploring causes and effective treatments for ADHD.  Unfortunately this is not my first experience with journalists dispensing with facts that don’t support their biased premise.

This evening I composed my  Letter to the editor and have forwarded it to them.   Let’s wait and see what develops. And now you have the back story to my quote.  Thank you for your interest.

David W. Goodman M.D.

The Selling of Attention Deficit Disorder – New York Times

, , , ,

“The Selling of Attention Deficit Disorder” The New York Times December 15, 2013

The New York Times article “The Selling of Attention Deficit Disorder” published December 15, 2013 had quoted me towards the end of article. As I had previously written in my blog posting, the quote was taken out of context and deliberately misrepresented my professional article with Medscape. I did send a letter to the editor in order to have this quote placed in appropriate context, however, in the letters to the editor, it went unpublished. So, I’ve posted my letter to The New York Times here.

The New York Times

Letter to the Editor

December 14, 2013

Dear Editor:

Let me congratulate Alan Schwartz on his extensive review of ADHD in his article “The Selling of Attention Deficit Disorder”, December 14, 2013.  He highlights the increased identification of people with ADHD and the growing use of medication as a treatment option. Unfortunately, he presents information that malign physicians and researchers who have committed their life’s work to investigating the causes of ADHD and pursuing research to prove treatments effective. Mr. Swartz would have served his readers well by revealing his a priori agenda in writing this article. A case in point, Mr. Schwartz quotes me in regards to an article I authored for Medscape on adult ADHD. In this article, he knowingly and deliberately eliminated my notation that the six-minute video accompanied a 2000 word article with 86 scientific references that extensively detailed the clinical evaluation process for ADHD in adults.  Therefore my quote, out of context, misrepresents my work and misleads your readers.  Perhaps his article would have been better placed in the Op-Ed section of The New York Times.

David W. Goodman, M.D.

The moral: Discern the agenda of the journalist before you make sense of the information provided. As I like to teach my psychiatric residents at Johns Hopkins, the credibility of the information is a function of the intent of the provider.

Analysis of individual items on the attention-deficit/hyperactivity disorder symptom rating scale in children and adults: the effects of age and sex in pivotal trials of lisdexafetamine dimesylate

, ,

Weisler R, Adler LA, Kollins SH, Goodman DW, Hamdani M, Dirks B, Childress AC. Neuropsychiatric Disease and Treatment 2014:9 1–11.

Abstract

BACKGROUND:

Attention-deficit/hyperactivity disorder (ADHD) symptom presentation across age and sex has not been fully elucidated. The present post hoc analyses qualitatively explored the baseline levels of ADHD symptomatology across subgroups in two clinical trials of children and adults with ADHD to elucidate differences in participant presentation. The response to treatment was examined to determine patterns of response among items of the ADHD Rating Scale IV.

METHODS:

Exploratory post hoc analyses of ADHD Rating Scale IV item scores were conducted on data from two 4-week placebo-controlled trials in children (6-12 years) and in adults (18-55 years) with ADHD. Baseline and endpoint mean item scores were determined for subgroups defined by age (6-9, 10-12, 18-39, and 40-55 years) and sex.

RESULTS:

The baseline mean item scores were generally numerically similar for all age-by-sex subgroups. The inattention (IA) items were numerically higher than hyperactivity/impulsivity (H/I) items among older children and adults. The endpoint mean item scores were numerically lower after lisdexamfetamine dimesylate treatment for IA and H/I items in all subgroups.

CONCLUSION:

These results suggest that regardless of age or sex, baseline IA and H/I symptom profiles were comparable; however, IA vs H/I symptoms were more severe in older participants. In all age-by-sex subgroups, IA and H/I symptoms appeared to decrease after active treatment.

[button size=’large’ color=’btn-b76lpc214h’ link=’https://www.ncbi.nlm.nih.gov/pubmed/24363557′ align=’center’ block=’0′ icon=’FontAwesome/fontawesome-chevron-sign-right||color:ffffff’ shadow=’2′]Read Full Article[/button]

High Dose Stimulant Treatment for Adult ADHD

, , , , , , , ,

All ADHD medications that are FDA approved to treat adults have designated maximum daily doses. It is important to understand how these daily maximum doses are determined in order to consider higher doses beyond these thresholds.  The FDA receives the clinical registration trial research and it makes a determination of maximum daily dose based on the presented data. If, for example, a clinical trial had a maximum dose of 50 mg a day then the FDA will only approve the drug with a maximum daily dose of 50 mg.  An example of this is Vyvanse where the trial looked at 30 mg, 50 mg and 70 mg a day. Maximum daily dose approved is 70 mg.

In some cases where the clinical trial evaluated several doses, the FDA may only approve a maximum dose in the middle dose range from the trial because the higher dose didn’t demonstrate a statistically significant difference in effect. Case in point, Concerta maximum daily dose in the package information is 72 mg, although the U.S. adult trial went to 108 mg a day. However the trial protocols are not designed to answer the question “If you don’t respond to 72 mg a day, will you respond to 108 mg a day”.

Where am I going with this? I have several patients at what would be considered as very high doses of stimulant medication-methylphenidate 400 mg a day, Vyvanse 200 mg a day. Unsafe? Well neither patient complains of problematic side effects for which they would stop the medication. Also, blood pressure and pulse are in normal range. We got to these doses because lower doses didn’t have any effect until we went higher. In each of these cases, I have ordered stimulant blood levels to see if blood levels were too high. In fact, in each case the levels were lower that what was expected by mathematical extrapolation.

The point? There are a group of ADHD adults who are very fast metabolizers who will only respond to very high stimulant doses. Since most of the metabolism of amphetamines and methylphenidate occurs outside the liver, I’m not sure obtaining a liver P450 enzyme profile to determine metabolism will be useful.

If you have ADHD and have not responded to appropriate stimulant doses, then consider seeing an ADHD adult psychiatrist who has experience and comfort with this dosing concept.  That’s what true expert clinicians are for.

Load More