Natural Treatment Options for ADD and ADHD


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Holistic physician and pediatrician, Dr. Vivian DeNise at Patients Medical gives information on how to tell if a patient needs to be evaluated for ADD or ADHD, tests to find the "root cause" of the symptoms, and natural treatment options for both children and adults living with ADD or ADHD.

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  • Good Evening, My name is VivianDeNise. And before we begin I would like to give you some background on myself. Before I became knowledgeable in the Integrative field my first love has been pediatrics which I have been practicing for 25 years. During this time I have never been comfortable with the treatment of ADHD. So much so I would not prescribe the medications. I have seen many children on multiple medications often begging their parents to stop them because of how these meds made them feel. I knew all along there had to be a better way, I always felt treatment should address the cause and not just the symptoms. I would like to share what I have discovered with you today.
  • The DSM-IV TR is published by the American Psychiatric Association and covers all categories of mental health disorders for both adults and children. This is the bible so to speak of American Psychiatry. The manual is non-theoretical and focused mostly on describing symptoms as well as statistics concerning which gender is most affected by the illness, the typical age of onset, the effects of treatment, and common treatment approaches
  • I hope what has become apparent to all of you is that there is no magic pill and no quick fix.
  • Essential fatty acids are important as anti-inflammatory and as the primary building material for cell membranes, which let nutrients in and toxins out. In fact, in the Journal of American Child and Adolescent Psychiatry 8/2011 determined that children receiving omega 3 fatty acid had a small but significant improvement.Ltyrosine 500-1500 mg tid-pfc5 HTP 100mg tid-Ant cingulateGaba 100-500 mg bid-tid for temporal DL phenylalanine 400 mg tid
  • Essential fatty acids are important as anti-inflammatory and as the primary building material for cell membranes, which let nutrients in and toxins out. In fact, in the Journal of American Child and Adolescent Psychiatry 8/2011 determined that children receiving omega 3 fatty acid had a small but significant improvement.Ltyrosine 500-1500 mg tid-pfc5 HTP 100mg tid-Ant cingulateGaba 100-500 mg bid-tid for temporal DL phenylalanine 400 mg tid
  • Natural Treatment Options for ADD and ADHD

    1. 1. Vivian F. DeNise,DOIntegrative PediatricianPatients Medical
    2. 2.  A holistic medical center Full-service
    3. 3.  Discover health, rediscover vitality Focus on the root cause Integrate modern medicine, holistic practices, and natural supplements
    4. 4.  Our goal  Promote healing and prevent disease
    5. 5. Physicians collaborate to approach each patient holistically.
    6. 6. Result:Gain health and nutritional wisdom that can be applied for years to come.
    7. 7. Founder, Dr. Warren Levinbegan practicing his ground-breaking holistic protocols in 1974.
    8. 8.  Conditions Treated  Chronic Fatigue Syndrome  Multiple Sclerosis  Osteoarthritis (OA)  Rheumatoid Arthritis (RA)  Diabetes  Heart disease  Crohn’s disease, IBS, IBD  Alzheimer’s disease  Lyme disease  Thyroid disease  Auto-immune diseases  Many other secondary medical conditions
    9. 9.  Staff  Medical Doctors ▪ Internal Medicine ▪ Family Practice ▪ Gynecology ▪ Osteopathy  Nutrition  Kinesiology  Cranio-Sacral Therapy  Maya Abdominal Therapy and Reflexology  Oriental Medicine and Acupuncture  Homeopathy
    10. 10. Integrative Medicine
    11. 11. Introducing our speakers: Vivian DeNise, DO Integrative Pediatrics
    12. 12.  Completed her medical degree at New York College of Osteopathic Medicine Residency in Pediatrics Certifications in Integrative Medicine with the American Academy of Anti-Aging Medicine (A4M)
    13. 13.  Specialties include  Behavioral Concerns  Hormonal Imbalances  Nutritional Imbalances  Gastro-Intestinal Problems  Detoxification  And many more!
    14. 14.  ADD and ADHD Allergies Anxiety Asperger’s Syndrome Asthma Autism Celiac Disease Chronic fatigue Chronic pain Depression Fibromyalgia Headache & migraine Immune dysfunction Irritable Bowel Syndrome Stress disorders Weight gain Weight loss
    15. 15. Attention deficit hyperactivity disorder, is avariable neurobehavioral condition generally characterized by inattentiveness and/or hyperactivity and impulsivity.
    16. 16. DSM-IV Criteria for ADHDEither A or B:Six or more of the followingsymptoms of inattentionhave been present for at least6 months to a point that isinappropriate fordevelopmental level:
    17. 17.  Inattention Often does not give close attention to details or makes careless mistakes in schoolwork, work, or other activities. Often has trouble keeping attention on tasks or play activities. Often does not seem to listen when spoken to directly. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions). Often has trouble organizing activities. Often avoids, dislikes, or doesnt want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework). Often loses things needed for tasks and activities (e.g. toys, school assignments, pencils, books, or tools). Is often easily distracted. Is often forgetful in daily activities.
    18. 18. Six or more of the following symptoms ofhyperactivity-impulsivity have been present forat least 6 months to an extent that is disruptiveand inappropriate for developmental level:
    19. 19. Hyperactivity  Often fidgets with hands or feet or squirms in seat when sitting still is expected.  Often gets up from seat when remaining in seat is expected.  Often excessively runs about or climbs when and where it is not appropriate (adolescents or adults may feel very restless).  Often has trouble playing or doing leisure activities quietly.  Is often "on the go" or often acts as if "driven by a motor".  Often talks excessively.
    20. 20. Impulsivity  Often blurts out answers before questions have been finished.  Often has trouble waiting ones turn.  Often interrupts or intrudes on others (e.g., butts into conversations or games).
    21. 21. II. Some symptoms that cause impairment were present before age 7 years.III. Some impairment from the symptoms is present in two or more settings (e.g. at school/work and at home).IV. There must be clear evidence of clinically significant impairment in social, school, or work functioning.V. The symptoms do not happen only during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder. The symptoms are not better accounted for by another mental disorder (e.g. Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder).
    22. 22.  ADHD, Inattentive Subtype: Diagnosis is confirmed if the criteria of Category 1 have applied for six months or longer, but not those of Category 2. ADHD, Hyperactive-Impulsive Subtype: Diagnosis is confirmed if the criteria of Category 2 have applied for six months or longer, but not those of Category 1. ADHD, Combined Subtype: Diagnosis is confirmed if the criteria of both Category 1 and Category 2 have applied for six months or longer. This is referred to as Mixed Subtype. ADHD Not Otherwise Specified: Diagnosis is confirmed in this subtype if children do not meet the certain the classic criteria of the three types, but still have certain qualities and characteristics of ADHD.
    23. 23.  Classic PFC/CB- Dopamine Inattentive PFC/CB- Dopamine Over-focused-AC/PFC-Dopamine/Serotonin Limbic-Limbic/PFC-(NE)/Dopamine Temporal Lobe- TLs/PFC-Dopamine/Gaba Ring of Fire-Gaba/Dopamine
    24. 24.  Short attention span for routine tasks Distractibility Organizational problems Difficulty with follow through Poor internal supervision
    25. 25.  Trouble shifting attention, looks like they cannot pay attention Worrier Tends to hold grudges Gets stuck on thought patterns or behavior patterns Upset if things don’t go they’re way Often argumentative/oppositional
    26. 26.  Emotional instability Memory problems Periodic anxiety Illusions/shadows Frequent headaches Too sensitive to others External or Internal aggression
    27. 27.  Sad, moody, irritable Many negative thoughts Low motivation/ finds little pleasure Sleep/appetite problems Social isolation
    28. 28.  Too many thoughts Often very hyper Hyper-verbal Oppositional Aggressive Hypersensitive to light, sound, taste, touch Moodiness Cyclical behavioral changes *may be bipolar equivalent
    29. 29. The American PsychiatricAssociation states in theDiagnostic and StatisticalManual of Mental Disorders(DSM-IV-TR) that 3%-7% ofschool-aged children haveADHD. However, studies haveestimated higher rates incommunity samples.
    30. 30. Recent data from surveys of parents indicate that:  Approximately 9.5% or 5.4 million children 4-17 years of age have ever been diagnosed with ADHD, as of 2007.  The percentage of children with a parent-reported ADHD diagnosis increased by 22% between 2003 and 2007.  Rates of ADHD diagnosis increased an average of 3% per year from 1997 to 2006 and an average of 5.5% per year from 2003 to 2007.  Boys (13.2%) were more likely than girls (5.6%) to have ever been diagnosed with ADHD.
    31. 31. • Rates of ADHD diagnosis increased at a greater rate among older teens as compared to younger children.• The highest rates of parent-reported ADHD diagnosis were noted among children covered by Medicaid and multiracial children.• Prevalence of parent-reported ADHD diagnosis varied substantially by state, from a low of 5.6% in Nevada to a high of 15.6% in North Carolina.
    32. 32.  Attention Deficit/Hyperactivity is a serious public health problem because of the large estimated prevalence of the disorder, significant impairment in the areas of school performance and socialization, the chronic nature of the disorder. Using a prevalence rate of 5%, the annual societal ‘‘cost of illness’’ for ADHD is estimated to be between $36 and $52 billion, in 2005 dollars. It is estimated to be between $12,005 and $17,458 annually per individual.
    33. 33.  35% never finish high school 43% of untreated boys with ADHD are arrested Up to 50% of the prison population has ADD/LD 52% of ADD adults abuse substances 75% have interpersonal problems
    34. 34. Two thirds of children with AD/HD have at least one other coexisting conditions
    35. 35.  Oppositional defiant disorder (ODD)-40% Conduct disorder (CD)-25% of children, 45-50% of adolescents and 20-25% of adults
    36. 36.  Depression  10-30% of children with AD/HD  47% of adults with AD/HD Mania/Bipolar Disorder 20% of individuals with AD/HD Anxiety  30% of children with AD/HD  25-40% of adults with AD/HD
    37. 37.  Only about 7% of those with AD/HD 60% of those with Tourette Syndrome have AD/HD
    38. 38. 50% of children with AD/HD have a co-existing learning disorder.
    39. 39. 25%-50% of parents of children with AD/HD reportthat their children suffer from a sleep problem,especially problems with falling asleep and stayingasleep.This includes greater activity during sleep restless legs/periodic leg movements during sleep (PLMS) unstable sleep patterns greater sleepiness than other children during the daytime
    40. 40.  Researchers speculate that AD/HD is associated with hypo-arousal rather than hyper-arousal. The coping mechanism of hyperactivity may be to counteract the daytime sleepiness.
    41. 41.
    42. 42. Black Box Warning for Ritalin Give cautiously to patients with a history of drug dependence oralcoholism. Chronic abusive use may lead to marked tolerance and psychological dependence with varying degrees of abnormalbehavior. Careful supervision required during withdrawal from abusive use.
    43. 43. Black Box Warning for Adderal High potential for abuse; avoid prolonged use. Misuse ofamphetamine may cause suddendeath and serious cardiovascular adverse events.
    44. 44. Black Box Warning for Concerta Caution with history of drug dependence or alcoholism. Marked tolerance and psychological dependence with varyingdegrees of abnormal behavior may occur with chronic abusive use. Careful supervision isnecessary during withdrawal from abusive use to avoid severe depression.
    45. 45. Many medications used to treat ADHD aim to restore chemical balance. Medication Neurotransmitters Affected Ritalin® Dopamine Strattera® Norepinephrine Concerta® Epineprhine Adderall® PEA
    46. 46.  Neurotransmitter Imbalance Vitamin Deficiency Mineral Deficiency Heavy Metal Intoxication Allergies Food additives Thyroid Disorders Sleep Disorders Pandas Syndrome
    47. 47. The brain is the master controller of nervous system, using chemicals called neurotransmitters to “talk” with itself.
    48. 48. The brain usesneurotransmitters to maintain focus & concentration
    49. 49. Imbalances in brainchemistry can leadto inattentive andhyperactivebehaviors.
    50. 50. EpinephrineHistamine Serotonin GABAPEA Glutamate Norepinephrine Dopamine
    51. 51. Inhibitory Excitatory GABA  Glutamate Glycine  Neorepinephrine Serotonin  Epinephrine Taurine  Dopamine  Histamine  Aspartic Acid  PEA
    52. 52. Excitatory Inhibitory
    53. 53. Responsible for feelings of pleasure and satisfaction muscle control muscle function GI issues
    54. 54. Limit video games
    55. 55.  Important for motivation, energy, and mental focus. Also, known as adrenaline. Primarily made in the adrenal glands.
    56. 56.  Necessary for learning and memory One of the most common neurotransmitters in the brain
    57. 57. Important for mental focus, emotional stability and endocrine function.
    58. 58. The Primary neurotransmitter in the brain necessary to feel calm and relaxed. Glutamine Glutamate B6 GABA
    59. 59.  Plays an important role in mood, sleep and appetiteTryptophan 5-HTP B6 Serotonin
    60. 60.  High levels of stress Poor dietary habits Toxins Lack of sleep
    61. 61.  Chronic stress leads to imbalances in brain chemistry  Busy schedules  Emotional trauma  Personal issues
    62. 62. Symptoms can be:• Numbness• Tingling• Facial pressure or tightness• Headache• Nausea• Rapid Heartbeat• Drowsiness• Chest pain• Difficulty breathing
    63. 63. Always contains MSG Often contains MSG or creates MSG during processing Glutamate  Flavorings such as natural Monopotassium chicken flavoring Glutamate  Stock  Seasonings Textured Protein  Soy Sauce Hydrolyzed protein  Broth Yeast Nutrient  Cornstarch Calcium Caseinate  Pectin Gelatin  Bouillion Glutamic Acid  Barley Malt
    64. 64.  Vitamin C Vitamin B6, B12
    65. 65.  Reduces harmful oxidants Balances levels of dopamine Helps balance phenylalanine and tyrosine
    66. 66.  Zinc Copper Iron Magnesium
    67. 67.  Toxins: environmental, occupational, and recreational poisons can disrupt proper communication in the brain Heavy Metals: Lead and Mercury Sources of Mercury:  Eating fish or shellfish  Dental work such as Mercury amalgams  Breathing contaminated vapors or skin contact with: antiseptics, bactericides, batteries, cosmetics, fabric softeners, floor wax and polish, paints, tattoo inks, perfumes, etc.
    68. 68.  Poor sleeping habits  An inadequate amount of sleep, or having a poor or irregular sleeping schedule can lead to poor brain function and a lack of concentration.  Exhibited by up to 50% of children in the United States.
    69. 69. Sleep deprivation adds up over time, so an hour less per night islike a full night without sleep by the end of the week. Amongother things, sleep deprivation can lead to:  decreased attentiveness  decreased short-term memory  inconsistent performance  delayed response time  generally bad tempers, problems in school, stimulant use, and driving accidents (more than half of "asleep-at-the- wheel" car accidents are caused by teens).
    70. 70. A careful history physical
    71. 71. Vitamin Deficiencies Thyroid MineralDisorders Deficiencies Heavy Allergies Metals
    72. 72.  Feed Your Brain  Lean protein  Complex carbohydrates  Decrease simple sugars  Decrease bad fat not all fat  Omega 3 Fatty Acids
    73. 73.  Lifestyle Changes  Head injuries matter  Avoid toxic substances  Get enough sleep  Manage stress  Exercise  Limit video games
    74. 74. Supplements that can help Omega 3  5 HTP Probiotics  DL phenylalanine Vitamin C  SAMe Vitamin B complex L theanine Phosphatidylserine L-tyrosine Gaba
    75. 75.
    76. 76. Please fill out your pink event evaluation form and return it to us.
    77. 77. Get started TODAY by making an appointment with Dr. DeNise.
    78. 78. Patients Medical’s Team of Holistic Doctors
    79. 79.
    80. 80.
    81. 81. To get more information or to schedule an appointment, call 212-679-9667 or email