Hi - this is Dr. Kenny Handelman. I am very excited to share with you the first edition of the ADHD Audio Newsletter. The first topic is “Looking Back, the History of ADHD”.

ADHD was first described in 1902 by Dr. Still. He recognized significant behavioral difficulties in a number of children in his practice. He realized that these behaviors were not related to brain damage or poor parenting. This is not a belief which was held for many years after that. In 1918 and 1919 there was a flu pandemic which led to many people developing brain damage related to it. These people had neurological difficulties and there were some people who also had concentration difficulties. This led to the recognition or calling of people who had inattention as having ‘minimal brain damage’. This was a common term in the 1930’s for what later became known as ADHD.

In the late 1950’s and early 1960’s it was thought that there was not actually brain damage in these individuals who have trouble with concentration but rather ‘minimal brain dysfunction’ (or ‘MBD’) so this term was used.

In the late 1960’s hyperactivity was thought to be the main issue in ADHD children, and the name ‘Hyperkinetic Reaction of Childhood’ came out in 1968. Research of course carried on and it was a Canadian researcher named Virginia Douglas who came up with a concept that attention was the main issue and that ‘attention deficit’ was the core concept.

In 1980 the DSM-III which is the Diagnostic and Statistical Manual, 3rd edition, of the American Psychiatric Association came out with a term ‘Attention Deficit Disorder with or without Hyperactivity’. So it was ‘ADD +/- H’ for the hyperactivity.

In 1987 there was the term ‘Attention Deficit Hyperactivity Disorder’ which came out or ‘ADHD’.

In 1994, the newest edition of the DSM came out - being version 4 (DSM-IV). The terminology for ADD or ADHD became: ADHD inattentive type, ADHD hyperactive impulsive type, or ADHD combined type (for those with both the inattentive and hyperactive impulsive subtypes).

As of 1994, the term ‘ADD’ is no longer an official diagnosis. That said, it is still used quite commonly.

Now I want to be clear about this on the first newsletter because some people in my office practice get upset when I say “ADHD” because they say that they have ADD or their child has ADD. In this situation, I always acknowledge them and say, “I understand that, just please don’t be upset if I say ADHD because my training is that that is the current terminology.” And then I say something like ‘tomato (US accent) vs. tomato (British accent)’.

So even if you have ADD or your child has ADD please stick with me when I’m saying ADHD, we’re talking about the same thing. I would just call it ‘ADHD inattentive type’.

Now we will spend a lot of time talking about treatments in future editions of the newsletter, but I just wanted to let you know about some of the history in this first newsletter. In 1937 Dr. Bradley first used a stimulant medicine. The medicine was shown to help the hyperactive children that it was tested on.

In 1957 methylphenidate or Ritalin was introduced and this became the start of using medications regularly to treat ADHD. Of course over time there have been newer medications developed and changes in the preparations available such as longer acting formulations etc. The newest addition to the ADHD armamentarium is the introduction of Atomoxetine (Strattera) which is a non stimulant for ADHD that came out in the U.S. in 2003 and has come out in eight or nine other countries to date.

Well, there is quick overview of some of the history of ADHD. I will be in touch next week with the next edition of the ADHD audio newsletter.

Thank you very much for joining me.

Thanks very much.

Dr. Kenny Handelman

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In May 2005, I began to use the power of the internet to share information with people about ADHD. I had people submit questions on my website, and then I would choose a ‘frequently asked question’, and answer it with an audio recording. I would then email out the answer to my subscribers.

Some people emailed me and said: “Thank you for the great information, but I learn better with written information. Can I get the transcripts of the audio newsletter?”

I answered: “Yes, when I get the time”.

Well, it has taken a long time - and I have started to use a very useful technique to get this done, called: Outsourcing! This is a great technique for ADHD Adults as well - i.e. getting someone else to do the work for you, so that you can get more done. So, now that I have my team together for transcribing, and my team for the blog, I will be getting this content out to you. I may even post the audios here for people. Hmm… there are lots of possibilities.

(as an aside - one of the possibilities is that I may podcast these audio newsletters - I am just learning how to do that - so watch for it soon)

So, I will gradually update this category on my blog so that my subscribers can get access to the transcriptions of the newsletter - and of course you can email the links of any page to your friends or family who may benefit from reading this information.

Enjoy, and please remember to post comments on anything that you find interesting, controversial, educational, offensive, or just leave a comment for any reason at all.

Enjoy!

Dr. Kenny Handelman

p.s. when I speak about outsourcing for adults with ADHD - the most common exchange is money - i.e. I get someone to do my typing, and I pay them.

However, if you are in a position where you need to outsource something but don’t have the money for it - just get creative! Let’s say you hate doing your taxes or bookkeeping - you may be able to find someone who loves to do that. In exchange, you may be able to do something for them that you love doing, and they dislike - maybe helping with a spring cleaning, walking their dog, or gardening.

Be creative so that you can leverage others to help you to get done what you need to get done.

One of my mentors said: “Get people who like to play at what you work at”. For many of us, doing accounting is a lot of work. But for some, it is play. That’s why we get bookkeepers and accountants.

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One of the most common questions I get in my practice, when medication is needed (particularly in a child) is: “How long will my child have to take this ADHD medication?”

The answer I give has just been confirmed by a Mayo Clinic study.

This is an important study, because it relates to a research program which studied 379 children with ADHD from diagnosis until almost 18 years of age. Most of the longer term studies do not carry on for this long.

This study looked at the stimulant medications - which include the Methylphenidate products, including: Ritalin, Concerta, Metadate CD; and the Amphetamine products, including: Adderall, Adderall XR, and Dexedrine.

In this study, they found that about 73% of these patients benefited from stimulant medication - similar to the response rates found in research studies. They also found that patients benefited from continuing the medication over time.

Regarding monitoring for long term ADHD medication use: the Mayo clinic study suggests that the patient should see their doctor (pediatrician, psychiatrist, etc) at least every 4-6 months. During these appointments, in addition to checking on the functioning with respect to ADHD, the doctor should check the: height, weight, blood pressure and heart rate.

The researcher explains that it is important to continue to take the medication, and then to have a trial without medication to see how the child will do. If they do well without it, then one can consider stopping it. If they still have many impairing symptoms of ADHD, then they need to continue to take the medication.

You can read the original story here: Mayo Clinic ADHD Research

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Hello and thank you for joining me!

I am thrilled to unveil my new blog.

Although the title of the blog is ADD and ADHD Blog, I will often just refer to it as ADHD. However, even when I leave out the term ADD, I still mean it as well. As of 1994, when the DSM-IV came out, the diagnosis all falls under the term ‘ADHD’. This relates to the fact that there are three subtypes of ADHD - the inattentive type (formerly just called ADD), the hyperactive impulsive type, and the combined type (which has both the inattentive and the hyperactive impulsive types involved). So, when I use the terms ADD or ADHD, I am really using them interchangeably.

What can you expect on this blog?

1) Up to date information on ADHD from a medical authority on the subject
2) Research updates
3) Transcriptions of my ADHD Audio Newsletter - Many of my subscribers have asked for written content of the ADHD Audio Newsletter - and now I am giving you the content. This blog will be updated with the different newsletters on an ongoing basis. Now you will not only be able to hear them - but you will be able to read them as well!
4) Coverage of a wide range of topics relevant to ADHD and handling it in children, teens, and adults

The great thing about a blog is that it can grow ‘organically’ - so please be sure to put comments up and I will see them! Let’s work on this together.

Thanks for joining me and watch for updates soon.

Dr. Kenny Handelman

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