Archive for the ‘HIGHLIGHTS’ Category

Genomind

Genetic Testing

Genomind

 

The Genecept Assay Test Panel at a Glance

Pharmacodynamic

GENE PHYSIOLOGICAL ROLE IMPACT OF MUTATION TREATMENT IMPACT
Serotonin Transporter
(SLC6A4)
Protein responsible for reuptake of serotonin from the synapse Inhibition of this protein by SSRIs,
which may lead to increased risk for non-response/side effects
Use caution with SSRIs; atypical antidepressants or SNRIs may be used if clinically indicated
Calcium Channel
(CACNA1C)
A subunit of the calcium channel which mediates excitatory signaling Associated with conditions characterized
by mood instability/lability
Atypical antipsychotics, mood stabilizers, and/or
omega-3 fatty acids, which may help to reduce excitatory signaling, may be used if clinically indicated
Sodium Channel
(ANK3)
Protein that plays a role in sodium channel function and regulation of excitatory signaling Associated with conditions characterized
by mood instability/lability
Mood stabilizers and/or omega-3 fatty acids, which may help to reduce excitatory signaling, may be used if clinically indicated
Serotonin Receptor 2C
(5HT2C)
Receptor involved in regulation of satiety Blocked by atypical antipsychotics,
resulting in metabolic side effects
Use caution with atypical antipsychotics; inositol may be used to mitigate risk for weight gain if clinically indicated
Melanocortin 4 Receptor
(MC4R)
Receptor that plays a role in the control of food intake Increased risk for weight gain and higher BMI, which is exacerbated by atypical antipsychotics Use caution with atypical antipsychotics
Dopamine 2 Receptor
(DRD2)
Receptor affected by dopamine in the brain Blocked by antipsychotic medications and is associated with risk for non-response/side effects Use caution with antipsychotics
Catechol-O-Methyltransferase
(COMT)
Enzyme primarily responsible for the degradation of dopamine in the frontal lobes of the brain Altered dopamine states can have emotional/behavioral effects and impact response to dopaminergic agents Dopaminergic agents or TMS may be used if clinically indicated for Val/Val patientsUse caution with dopaminergic agents in
Met/Met patients
Alpha-2A Adrenergic Receptor
(ADRA2A)
Receptor involved in neurotransmitter release Associated with improved response to stimulant agents Stimulant agents may be used if clinically indicated
Methylenetetrahydrofolate Reductase
(MTHFR)
– A1298C
– C677T
Predominant enzyme that converts folic acid/folate to its active form (methylfolate) needed for synthesis of serotonin, dopamine, and norepinephrine Associated with varied activity and conversion of folic acid/folate to methylfolate Supplementation with L-methylfolate may be used if clinically indicated
Brain-derived
Neurotrophic Factor
(BDNF)
Important for proper neuronal development and neural plasticity Impaired BDNF secretion, which may be associated with altered SSRI response in Caucasians Increased physical activity/exercise may be beneficial for Met carriers if clinically indicated
μ-Opioid Receptor
(OPRM1)
Opioid receptor affected by natural and synthetic compounds Activated by opioids and associated with varied analgesic response, dosage, and abuse/addiction risk Use caution with opioids; non-opioid analgesics may be used if clinically indicated
Glutamate Receptor
(GRIK1)
An excitatory neurotransmitter receptor in the brain Associated with response to topiramate for alcohol abuse Topiramate may be used for treatment of alcohol abuse if clinically indicated

 

Pharmacokinetic

GENE PHYSIOLOGICAL ROLE IMPACT OF MUTATION TREATMENT IMPACT
CYP450
(CYP1A2, CYP2B6, CYP2C9, CYP2C19, CYP2D6, CYP3A4/5)
Enzymes that metabolize medications in the liver Large number of psychiatric medications are metabolized by CYP450s Dose adjustment (an increase or decrease) may be required

 

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Cleveland Heart Labs

Learn More about the comprehensive labwork Dr. Jones recommends for our patients!

Home

 

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Eat Fat Get Thin

“Everyone seems to be talking about fat these days. That fat somehow is good now and can help with weight loss and disease prevention.  How can that be true when for decades we all were told that fat was the bad guy?” asks this week’s house call. “What are its benefits? Are there any downsides to eating more fat?”

To see full article visit: http://drhyman.com/blog/2015/12/27/separating-fat-from-fiction-10-fat-facts-you-need-to-know/

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HAPPY NEW YEAR 2014!!!!!

 

Happy New Year to all my fellow ADHD friends. Remember, you DO NOT have a disorder. I hate that. You have a very unique temperament and many gifts. The major problem is that this temperament is created in the prefrontal cortex of your brain. That controls “executive functioning”.. that means mainly the things you hate to do you probably won’t, because you have to have stimulation to make your brain increase dopamine, which drives us. So….when possible, delegate out the things that need to be done, but you hate to do and always procrastinate. Learning to compensate for our areas we lack interest in (or feel inadequate about, for that matter) is a SMART thing to do. Some people get down on themselves because of this.

 

Instead of being bummed about the things you don’t do, concentrate on your strengths. Embrace what you are good at and do it! Most people with ADHD are creative, likely to be entrepreneurs, innovators, challengers of the system, and passionate with their interests, whatever they are!

 

If you don’t have a person that is your own “personal secretary”, BARTER out your boring stuff!

 

Some of the people I love most dearly in the world have ADHD….So Happy New Year to all of you!!!!!!!

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We Will Remember Siggie – 2000-2013 RIP!

Pets play a major and significant role in our lives.

Many studies have indicated that having a pet in the home is particularly good for elderly people that live alone.  They become a part of our family.  Our Bassett Hound, named of course, Sigmund (but we called him Siggie,) died June 15th.  He was 13 years old.  Needless to say, our whole family, especially our daughter that raised him, miss him and have gone through a true grieving process over his loss.  Some people don’t think that their grief over a pet is appropriate, and/or embarrassing.  The truth of the matter is that grief helps us heal after losing a beloved pet, and we should all allow that process to happen.  Most of us will outlive our pets, so losing them at some point in time is usually inevitable.

Dr. Jones has always been amazed at how many pet owners do not think they should be devastated over the loss of a pet.  It is perfectly normal to grieve and to miss them, just like any family member that is lost!  He always assures them that it is okay and normal to be upset over their loss!

I am attaching our tribute video to Siggie.  I hope you enjoy it!      RIP Siggie, we love you!

http://video214.com/play/nUjXSEF4KERjetBHXgVG0w/s/dark[spider_facebook id=”- Select Form -“]<div class=”fb-like”” data<href=”http://developers,facebook.com/docs/reference/plugins/like”

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ADHD Resources

Book/Audio Suggested Reading:

  • Shadow Syndromes, by John Ratey, M.D.
  • Driven to Distraction, by Edward Hollowell, M.D.
  • Women With Attention Deficit, by Sari Solden
  • Crazy Busy, by Edward Hollowell, M.D.
  • Taking Charge of Adult ADHD, by Russell Barkley, PhD
  • Straight Talk about Psychiatric Medications for Kids, by Timothy Wilens, M.D.

Online resources:
http://www.chadd.org/
http://www.add.org/
http://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml
http://www.mayoclinic.com/health/adhd/DS00275
http://www.russellbarkley.org/
http://www.drhallowell.com/

 

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Perspectives by Penny – ADHD

ADHD… Perspectives by Penny

I hope I can accomplish through the privilege of writing this blog helping someone gain more insight into understanding the challenges of living with ADHD every day.

And I have to put this disclaimer in: these are all my opinions, not those of Dr. Jones.

“Our future lies in the hands of the creatively maladjusted” Martin Luther King Jr.

04-30-2013

Blog Entry 1 Introduction

I have worked with Dr. Jones for 17 years, gone to most of the CME courses he attends (continuing medical education), which has been literally hundreds of hours, and have a bachelors degree in Psychology and Marketing. I have developed slides for his presentations, as well as edited and help write his newsletters and website. I have also been on the board of directors of the Dallas chapter of CHADD which is a national ADHD organization. Their website is: http://www.chadd.org/

I think I have an extremely unique, multi-faceted slant on ADHD and stress related mental health issues. (I have also seen the pharmaceutical company industry very up close and personal concerning neuropsychiatric drugs.) So, I am starting my first blog with that subject specifically.

I have known and interacted with many physicians that treat ADHD. I have also had direct contact with the pharmaceutical companies all the way down the chain of hierarchy from their ivory tower corporate executives (they get the really big money), the specialists with “big credentials that answer questions for the few doctors that inquire”, the regional managers, and then the pharmaceutical reps that really work in the trenches with doctors and see the real world that clinical physicians deal with everyday.

I have attended countless meetings and conferences, including: data and research updates on new drug studies, pharmaceutical company “launches” of new products, physician speaker training meetings, and reviewed endless studies of medications relevant to treating psychiatrically related issues.

Because of negative press, the pharmaceutical industry has made an attempt to “self police” by creating PhRMA (Pharmaceutical Research and Manufacturers of America). This self-regulatory group was created by the pharmaceutical industry as an attempt to try to avoid complete control by the FDA (Food and Drug Administration)… (They would probably deny that observation, however).

The fact of the matter is, the reason pharmaceutical companies exist in the first place is capitalism, (which translates ultimately into profits made for the shareholders). This industry is unique because the “products” they produce effect real people in a very personal, crucial, and sometimes “life or death” way. This makes them extremely vulnerable to regulation, and public criticism and scrutiny. It also causes dissonance, and conflicts of interest between the industry, the consumers that use their products, and their shareholders. And, of course, there is a strong, hungry, greedy segment of the legal industry that is just salivating at the chance to sue them for some drug that proves to have a negative outcome because of unforeseen adverse side effects, (or, god forbid, deception through hiding adverse data in studies of bad or life-threatening findings.)

However, I am still NOT against capitalism, and that includes the pharmaceutical industry. One of the great freedoms we have living in America is that anybody can go from complete poverty to billionaire, and the only thing stopping any of us is our own drives and talents (in a perfect world we could also add “integrity” to drives and talent) .

I want to challenge anyone to tell me who else would bother to spend millions and millions of dollars trying to develop new medications that might end up proving through complex research and studies to be a wash, or, could possibly help people function and contribute to society, find cures for disease and illnesses, and even give someone more years to live than they would have had otherwise. The answer to that question is NO ONE I can think of. So without them, even with all the good and bad, they play an extremely important role in our lives because they research and study new and novel ways to, yes, make a profit, but also to literally save lives, and make life bearable/and or functional for those that often desperately need help.

As an aside, they also have many patient assistance programs that they should be recognized for. Most of them will supply free medications to patients in low income categories. A good source to find out if you are eligible for these programs is: http://www.needymeds.org/. This industry is in no way perfect, but they do not deserve to be “thrown under the bus completely” in my opinion.

My hope is that we can all put biases and blame aside and just at least listen to each other’s opinions and experiences. I certainly don’t have all the answers, but I do have insights into my own unique world that I hope you can at least consider. I want to always be open to new knowledge that will allow me to have a “shift of paradigm” if another point of view can sway my stigmas and biases. I think the rigidity and prejudices that continually cause us all pain and injustice need to be challenged. I don’t think any of us have all the answers to everything (to think otherwise is delusion and/or arrogance), and my personal goal is to grow and learn and be open to new ideas…and I hope that is your goal.

All of my blogs are dedicated to Jeff, Melissa, and Wayne, and ….Madison and Brooklyn, and of course Unkie, Kirsten and Will!

I love you all dearly!

Penny

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COMPARISON OF VYVANSE AND ADDERALL

(more…)

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“REPORTS OF MY DEMISE HAVE BEEN GREATLY EXXAGERATED!” (Mark Twain) by Dr. Wayne Jones

I’m glad to be back! We have had technical issues with our site for several weeks. Everything should now be operational.

FYI, in case you didn’t catch this before,  I’m a “sport bitcher”.  I love complaining, and being sarcastic, especially  about “the system”.  After 52 years of observation and study of neuroscience there is only one thing I know for sure…if the government is involved it’s screwed.  (This is to be continued later.)

In order to bitch convincingly I stay well informed through informal as well as formal study every day.  I realized many years ago that every patient is a teacher,  so I spend many hours in the “classroom” every week.

To me the most important knowledge is where science meets practical day to day reality. The best medication in the world is irrelevant if it’s not available or it’s unaffordable.  Making the best possible treatments  happen or getting as close as we can is part of the art of medicine.

As I try to answer questions for my patients, as well as those that inquire on my website, I draw on many sources of information.  My facts will almost always be right.  Some of my ideas, assumptions, and beliefs may turn out to be wrong, but looking back at the the things I’ve written over the years I’ve found most of it is still right on target using the current scientific data and my own clinical observations!

I believe that the foundation of medicine/psychiatry is empiric science. That means we gather information and observations, and then develop hypotheses…and ultimately theories to explain them.  One thing that characterizes scientific ideas is that they can be proven wrong. We are constantly modifying our understanding of how things work.

When we look back 100, 200 years at what philosophers/scientists thought, we think, “are you kidding me?”  Well, guess what? …one hundred years from now we are not going to look so bright.  Unfortunately, the more we learn, the more we realize we don’t know.  An example within the last century is that we have gone from the solar system, to the galaxy, to billions of galaxies – each with greater and greater complexity and mystery.  As we have expanded outwardly we have explored the seemingly infinite micro-diversity of each cell and atom.  To paraphrase Socrates, what I know best is there are a lot of things I don’t know.

I see my job as educating patients about the pros and cons of each option and then let them make the decisions that effect their personal lives. Time will tell if we are going the right direction, and we will expect to make adjustments along the way.  As circumstances change, new insights are developed, new studies are conducted, and new options are available we will be better able to meet the needs of  each individual patient.  This should be very encouraging for those that are struggling to function well, feel good, and live better lives.

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Russell Barkley, Ph.D., is considered by many professionals to be the most authoritative expert (researcher), on the cognitive/behavioral aspects of ADHD.

Russell Barkley, Ph.D., is considered by many professionals to be the most authoritative expert (researcher), on the cognitive/behavioral aspects of ADHD.
In his book, Adult ADHD (2010), he details a study where he followed a group of non-ADHD young kids to age 30 and compared them to a group of ADHD kids. There were about 100 kids in each group.
The most striking finding in this study is that untreated ADHD impairs functioning in every area of life. They are less likely to be employed, and if employed, make less money, have had more jobs, have less education, worse grades, or took longer to get through school. They were also in greater debt, had more relationship problems, worse health, more traffic tickets, and other legal problems.
In my clinical experience over the past 40 years I have seen more people’s lives dramatically improve with ADHD treatment than any other mental health condition I treat, usually by prescribing a stimulant.
Long-term adherence to treatment is a problem with all medical and mental health problems, but many times it is because patients did not get the right medication(s) at the right dose(s). Sometimes cost is the primary problem but adequate generic medications and sometimes patient assistance programs can solve that issue.
We ADHD personalities are driven by interest rather than importance. We tend to be easily distracted and have way too many things on our mind at any given moment. ADHD medications can help us be calm and focused, and not only cope with our rapidly changing modern world, but actually thrive.

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