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David W. Goodman

Dr. Goodman discusses stimulant medications for ADHD on HCPLive

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With 28+ stimulant medications for the treatment of ADHD, there are many choices. The good news is there are many options, unfortunately this leads to confusion for the prescriber. A panel of national experts discussed topics on ADHD and I offered information on a basic concept to thoughtful choose medications. This information is useful for prescribers and patients who choose to understand the sequence of medication trials after the first one doesn’t work, doesn’t last long enough, or has side effects.

This segment is a portion of the longer discussion on ADHD topics by the panel. You can view other segments at HCPLive.

Better information for better treatment. Thank you for your interest.

David W. Goodman, M.D.

Burnout: Control out of Chaos in the age of COVID

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When a pattern is not seen, then chaos is perceived.

I was invited by PeerVoice, an international medical newsletter from Luxembourg, to write about the psychological pattern of adaptation to crisis and perceived chaos. While the duration of psychological stages may be different amongst individuals, there is a predictable pattern of psychological reaction to crises. You can read the details in my article.

In the mist of a crisis, anxiety rapidly rises because the circumstance are novel and unfamiliar. “We haven’t seen this before. It’s different than before.” You hear words like “unprecedented” that seem to convey we don’t know what to do because we’ve never seen this before. Crisis begets anxiety, anxiety perceives chaos, and chaos has no predictability.

To gain control and thereby reduce anxiety, one needs to see a predictable pattern in the chaos. For that predictability, I submit the premise of my article-a predictable psychological reaction to crisis. Regardless of the specific circumstances of the crisis, the stages of psychological adaptation are the same. In that way, we have a sense of what we need to do today, what we can anticipate for tomorrow, and what we need to plan for next week.

Understanding that the seeming psychological distress is simply a series of stages to be experienced in sequence, predictability is introduced to perceived chaos. With time, you emerge from the “tunnel” with a new set of psychological skills to weather the next crisis.

In my article, I reference a study from China and the psychological stages the health care workers went through when dealing with the COVID-19 patient care demands. It seems to be a universal human experience and very important to understand.

When patterns are seen, chaos is nonexistent.

David W. Goodman, M.D.

International Adult ADHD Evaluations with David W. Goodman, M.D.

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There is a tremendous international need for accurate diagnoses of ADHD in adults. With so few clinicians around the world trained in ADHD, people ask me to see them. With telepsychiatry, this now becomes a possibility. Visit us at www.ADDadult.com.

I recently conducted a comprehensive psychiatric evaluation of a 22 year old male residing in the Phillipines via Zoom, a video software. (I’m located in Baltimore, Maryland, U.S.A.-12 hour time difference). For 90 minutes, we were able to cover his life-long history of ADHD symptoms inquiring about other psychiatric symptoms that would indicate other disorders, the medical/developmental history, and the academic and social impairments experienced. With Zoom’s screen sharing, the man could complete the ADHD Rating Scale used to assess childhood symptoms and the Adult Self-Report ADHD Scale indicating current symptoms. As an outside informant, his aunt provided additional developmental history and trajectory of ADHD symptoms since childhood.

His aunt sought me out after hearing my lectures on adult ADHD. Because of advances in technology, the Zoom session went smoothly and allowed for an easy exchange of information.

Most importantly, the man said he was relieved to have had this evaluation and given some direction on how to manage. I did suggest medication would likely be effective and he was receptive.

Most countries have medications available to treat ADHD BUT they are often only used for children. A limited number of clinicians around the world are comfortable using these medications for adults with ADHD.

And so this is the challenge in seeking treatment after you’ve had the evaluation. Since I’m unable to prescribe medication outside the U.S., patients will need to find a clincian in their country and area.

Hopefully, with a full report from me, perhaps a doctor in your area would be reassured of the accuracy of the diagnosis in order to initiate medication. Of course, the effective use of the medication will depend on the doctor’s experience with ADHD medications.

Unfortunately, there are some countries that have banned stimulant medications entirely. Luis Augusto Rohde, professor of child psychiatry at Brazil’s Federal University of Rio Grande do Sul, and former president of the World Federation of ADHD has noted Russia, Algeria, Egypt, Morocco, and Jordan are in this group. However, treatment options for ADHD include behavioral/organizational skills beyond medications.

Most importantly, it is the relief that comes from knowing your ADHD is what you have, not who you are.

If people around the world think they have ADHD, help is available. Before seeking an evaluation, go to credible websites (ADDadult.com; CHADD.org; CADDRA.org; ADHD Europe; and read/listen to information to see if it describes your experiences of your life. If so, we may be able to help.

“What can I expect as an adult from my ADHD treatment in the first 6 months?” David W. Goodman, M.D. CHADD Webinar

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If you were recently diagnosed with ADHD as an adult, I invite you to listen to this webinar. I was asked to speak online LIVE for the Children and Adults with ADHD Association (CHADD) Webinar Series “Ask the Expert”. I discussed the benefits of ADHD treatment as they unfold over the first 6 months of treatment. If effectively treated with the sequence of medication and psychotherapy, there is a predictable pattern of improvement that can be expected. Understanding this pattern will help you discover what gets better and when. Patients and families are often amazed that I can predict what will happen over the first 6 months and you may be too.

Because it is a long all inclusive video, you may choose to watch two months at a time depending on where you are in treatment. I would encourage the ADD adult to share this video with family members in the house. It will faciliate discussion and help others understand how to be helpful.

I owe my patients the insight I have gained from their journey of distress to satisfication. Hopefully this is helpful to you.

David W. Goodman, M.D.

Find your Adult ADHD Expert with Confidence

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As an internationally recognized expert in this field, I would like people to review my credentials and understand how my expert reputation has developed over 30+ years of patient care, research, peer reviewed publications, national and international speaker, peer-publication reviewer, author, faculty and teacher for psychiatric residents at Johns Hopkins and University of Maryland, expert podcaster, and national media consultant on adult ADHD.

Contact us and see what we can offer you. For COVID-19 safety, we are now offering virtual online new patient comprehensive evaluations in the safety of your home.

With the increasing recognition of ADHD (ADD) in adults, people are looking for competent comprehensive evaluations to see if ADHD may be an explanation for their daily struggles and challenges. Public awareness has increased over the years as national newspapers/magazines and TV media feature stories on life-long symptoms and impairments.

While people want to get evaluations, they may not know how to determine which professional to see for an accurate diagnostic conclusion. With a broad range of professionals (psychiatrists, psychologists, social workers, licensed counselors, primary care physicians, nurse practitioners, psychiatric nurses) claiming experience and expertise in ADHD, how to you determine what’s best for you.

Beyond the credentials, you want a physician who will listen to the specific nature of your experiences, understand the distress it causes every day, and offer specific treatment options that will improve daily function leading to a more satisfying and rewarding life. I will bring my diverse knowledge base, patient experience, and resources to offer expertise at the top of the field. With all that, I hope that you and your family will feel confident that you are getting the help and treatment you and your family deserve.

Thank you for doing your research for your best care.

David W. Goodman, M.D., LFAPA

The Wall Street Journal quotes Dr. David W. Goodman on Older Adult ADHD

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The Wall Street Journal published an article on ADHD in older adults over age 50. Quoted in the article, I helped provide important information on this subject. Highlighting why ADHD needs to be considered in older adults complaining of cognitive difficulties, the article serves to increase public awareness on a disorder clinicians don’t ever consider when seeing older adults.

Fortunately, ADHD in older adults responds very well to the traditional ADHD medicine and therapies. It is so important to get a comprehensive psychiatric evaluation from an expert who understand how to make this diagnosis accurately.

If you are reading this blog, then you are interested in this topic. I encourage you to listen to my NPR interview on ADHD in older adults. It is never to late for an accurate diagnosis and effective treatment.

David W. Goodman, M.D., LFAPA

Depression or ADHD in adults? A 2 Part video with Dr. David W. Goodman

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Distinguishing clinical depression from ADHD in adults may be difficult for patients and clinicians. Adults with ADHD may complain about being depressed because they are about to lose their job, get separated from their spouse, or some other “really bad thing” happening in their lives. This “bad” circumstance may have grown out of their ADHD symptoms and inability to do correctly what was expected of them.

I was invited to present a 2 part video series for psychiatrists located internationally helping to distinguish ADHD and clinical depression. PeerVoice developed this 2 part ADHD activity entitled “Is it More Than Just Depression? Identifying and Managing Comorbid Depression and ADHD“. It can be viewed online.  Each part is approximately 10 minutes with accompanying slides.

This video program has been rolled out to an audience of 7,500 psychiatrists from Israel, Brazil, Mexico, Australia, Canada, Germany, Spain, United Kingdom, Denmark, Finland, Iceland, Netherlands, Norway and Sweden.

I invite you to watch the 2 part program. It will provide concise information on making this diagnostic distinction and the effective treatment options to consider.

Thank you for your interest.

David W. Goodman, M.D., LFAPA

NBC News interviews Dr. David W. Goodman for the new study on stimulants for ADHD and psychosis risk. March 21, 2019

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Stimulants for ADHD and risk of psychosis has been a clinical concern but the risk has thought to be quite low. Dr. Goodman’s comments about the study can be read here. The recent New England Journal of Medicine study has demonstrated the risk of psychosis with amphetamines is 0.2% and methylphenidate is 0.1%. These findings were generated from two very large health insurance databases. The study analysis are statistically sound and the authors duely note limitations to be considered when interpreting the data. While the risk of psychosis is a clinical concern and should be identified quickly when it occurs, it is a rare phenomenon. The Number Needed to Harm is 1 in 660. That means that this event may occur once in 660 patients.

For patients, families, and prescribers, effective medications for ADHD should not be avoided because of these findings. While the risk of psychosis from stimulants is rare, the negative consequences of ADHD are numerous: more likely to not finish high school, more likely to drop out of college, more likely to take longer to finish college degree, more likely to be involve in criminal behavior and get arrested, more likely to abuse drugs and alcohol, more likely to have concussions, more likely to have multiple jobs over 10 years, more likely to be in motor vehicle accidents/injuries, more likely to get divorced, more likely to declare personal bankrupcy, more likely to be fired from a job….get the idea! Untreated ADHD impact on life is far greater than the rare risk of psychosis occurring.

If you or a loved one starts acting peculiar or saying things that sound bizarre while on ADHD medication, this is the time to consider psychosis. Contact the treating prescriber and alert them. The person should get evaluated as quickly as possible.

David W. Goodman, M.D., FAPA

Dr. David W. Goodman interviewed by NPR April 4, 2017

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National Public Radio  interviewed me this week to comment on a research publication about a revised adult ADHD screener developed in coordination with the World Health Organization. What the journalist didn’t know at the time, that I will share with you, is that I was a pre-publication peer reviewer on this study. That means I was very knowledgeable about the details of the study and had offered my critique prior to publication.

As background, my colleagues just published a research paper revising the adult ADHD screener developed in coordination with the World Health Organization. Because of the diagnostic changes from DSM-IV to DSM-5, the previous adult ADHD screener needed to be revised accordingly.  While the six question screener looks rather basic, the article details the rigorous methodology and statistical factors that contributed to the selection of each of the six ADHD questions.

It should be enphatically stated that the screener simply allows clinicians to identify adults who may have ADHD, but it in no way makes a diagnosis. Because primary care clinicians are increasingly requested to provide mental health diagnoses and treatment. Because their time spent with patients is limited, the screener simply highlights someone who has some symptoms.  This encourages a further evaluation by someone with adult ADHD expertise.

Given that ADHD is a world wide disorder, the World Health Organization has been very interested in developing a preliminary screener to be performed in the offices of clinicians around the world. The previous screener has been translated into many languages to be used internationally.

To those who follow my blog, I apologize for the delinquency in posting any recent material.  My time has been consumed taking care of patients, developing slide decks to educate clinicians, serving on the national boards of directors for APSARD ( American Professional Society for ADHD and Related Disorders Association) and CHADD (Children and Adults with ADHD Association),  and working with journalists in order to present the latest science of ADHD.

Thank you to those who continue to read my blogs.

Psychiatric Times interviews Dr. David W. Goodman about ADHD in older adults

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Psychiatric Times interviewed Dr. Goodman about the unrecognized prevalence of ADHD in adults over age 50. The Psychiatric Times, , a profession psychiatric print newspaper, is  distributed to 30, 000 U.S. psychiatrists. You can listen to the concise 6 minute interview and learn more about ADHD that persists throughout one ‘s life. While the challenges of life change at different developmental phases (school, college, first job, marriage, children, job changes/promotions), ADHD symptoms persist to an impairing degree for 60% of children with ADHD.

The impact of untreated ADHD later in life can have significant negative impact on your ability to effective handle daily tasks and responsibilities. In fact, no adults over age 60 diagnosed with ADHD were diagnosed as children. Makes sense since ADHD was rarely considered in the 1950s and 1960s.

Treatment seems to be effective later in life and people with chronic symptoms of ADHD should seek an evaluation with an experienced doctor or clinician. My older patients have been grateful to discover “It was ADHD, not me as a person.”

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