Essential Vitamins For Acne Remedy

Many nowdays are deficient in vitamins and minerals due to improper diet. Studies show that fewer than 32 percent of Americans eat the required servings of vegetables each day. Also, the American diet is comprised of too much of processed sugar and not enough fruits and water. A deficiency in essential vitamins and supplements can only spell trouble for the skin. If your body does not get the required nutrition for skin renewal, tissue repair and for its organs to naturally detoxify, then your chances of getting acned skin, along with other health problems, are likely to increase.

Vitamin A strengthens the protective tissue of your skin and helps in acne remedy. It reduces the production of sebum and works in repairing the tissue that skin and mucous membranes are made of. It’s also a powerful antioxidant. Antioxidants are important and needed to help rid your body of toxins that have built up. A lack in Vitamin A can cause acne!

The Complex B vitamins are also helpful in preserving healthy skin through the relief of stress. Stress has been identified as a major trigger for acne for some people. The B vitamins should always be taken together. Thiamine is an antioxidant, helps circulation, and aids in digestion. Riboflavin works with Vitamin A and is essential for healthy skin, hair, and nails. Niacinamide helps with the metabolism of carbohydrates in your system and improving circulation. Niacinamide shortage in your diet can cause acne. Pantothenic Acid or B5 is popular for helping to reduce stress and is needed for the adrenal glands to function properly. Vitamin B6, or Pyridoxine is important for the correct function of your immune system and antibody production.

Vitamin C with biofavonoids is also referred to as the “super vitamin" and can play an important role in your acne remedy. Vitamin C is instrumental in at least 300 metabolic functions in your body, is needed for tissue growth and repair, and flushes toxins from your system. Vitamin C also improves immunity and protects against infection. If you have diabetes, check with your doctor for the dosage that is best for your body.

Chromium, widely used for weight loss also helps fight acne. Chromium should be taken in an added form since chromium in foods is not easily absorbed. Much of it is lost in processing and high doses of sugar cause the loss of chromium.

Zinc aids in acne remedy by regulating the activity of the oil glands. It promotes the healing in tissues and helps to prevent scarring. Zinc promotes a healthier immune system that in turn aids in the healing of wounds. In addition, a powerful antioxidant that helps prevent the forming of free radicals, or toxins that can harm your body.

Finally, Vitamin E is a powerful antioxidant. It improves healing and tissue repair and prevents cell damage by inhibiting oxidation of fats and the formation of free radicals.

One interesting fact about acne can be noted that is a multivitamin with added chromium supplement will give you most of what your body needs for the day. It should be also noted that taking too much of a vitamin or mineral can also be toxic and dangerous. Read the recommended dosage and stick with it.

With enough vitamins for your body, you are assured of a well nourished body. Your body organs, cells and tissues can perform optimally on the inside and you get to see the benefits on a physical level.

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Beauty Buzz: Givenchy Makeup Collection Spring 2009

Givenchy’s spring makeup collection was inspired by Indian beauty and bright colors of Bollywood, in particular. First of all, I love the packaging! Indian bindies décor ads special touch of exotic Indian glamour!Sari Glow Iridescent Blush (Limited edition) for a luminous complexion Maharani Orange (luminous golden peach) Maharani Pink (luminous rosy pink)Prismissime Visage Face Powder (Limited

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CREM Gene, Melatonin and ADHD

In the past, we have investigated several different ADHD genes, or genes that are believed to play some type of role in the disorder of ADHD. A recent article, titled CREM mutations and ADHD symptoms suggests that another specific gene, called CREM (short for Cyclic Adenosine Monophosphate Responsive Element Modulator), may actually play an integral role in the onset of ADHD and its symptoms as well.

Before we go any further, we must bear in mind that the journal in which this article is located is titled Medical Hypotheses. As the name suggests, we should be careful not to confuse hypothesis with thoroughly-investigated scientific data. However, the arguments are typically well laid out, and many of these hypotheses are in fact well-grounded based on a number of well-researched facts which point in their directions. In other words, a number of scientific studies or findings are often preceded by publications of these hypotheses, so we could very well be at the cusp of a new scientific discovery.

A second point worth mentioning is that the CREM mutation article is actually based on the mouse model. This in itself is not unusual, as numerous other studies on ADHD have used analogous murine models, such as the spontaneously hypertensive rat (SHR) model. Numerous comparison studies have supported the validity of SHR as a relevant and accurate model of ADHD in humans (although a few studies have disagreed, these disagreement studies are relatively small in number, however). Furthermore, based on the high degree of similarity between the DNA sequences in the human and mouse CREM genes, there is also a potentially high degree of functional overlap between the two. As a result, it is highly possible that CREM gene findings in the mouse may carry over well into CREM gene studies in humans. Additionally, mice with mutations in the CREM gene have been shown to exhibit ADHD-like behaviors.

Location of the CREM gene:
If you are not familiar with human genetics, the human genome typically has 23 different chromosomes (which come in pairs, so 46 chromosomes total), which are numbered 1 through 23. Scattered out through these 23 different chromosomes are some 30,000 to 50, 000 total different genes (the number is constantly in debate, but this is typically a good estimate), which means that the average chromosome will typically carry between 1,000 to 2,000 different genes on it. Further numbering and lettering schemes denote more specific locations of these genes on the chromosomes. In humans the CREM gene is located on the 10th chromosome. For a more detailed look at the specific location of the CREM gene, please click here.

The association between CREM function and ADHD:
The CREM gene is believed to play a significant role in regulating the secretion of the hormone melatonin throughout the day. Melatonin, which is chemically similar to another key hormonal and neuro-signaling agent serotonin (serotonin actually converts to melatonin in the body), plays a number of roles, such as the regulation of sleep patterns. Melatonin is typically secreted by a specific gland called the pineal gland. For most individuals, lower levels of melatonin are produced during daylight, while higher levels are produced during darkness, which leads to the feeling of sleepiness. Furthermore, emotional states such as chronic stress can also effect melatonin production and secretion.

The CREM gene is believed to exhibit a controlling mechanism on the melatonin secretion patterns throughout the daily process. However, mutations or deletions (i.e. removal) of the CREM gene can result in a number of changes, such as different melatonin secretion patterns and excessive movement (locomotion) and activity at night. In other words, day/night differentiation is typically reduced if mutant or lower-functioning forms of the CREM gene are present.

The connection to ADHD:
Numerous findings suggest that individuals with ADHD are prone to differences in genes which regulate key chemicals in the neurosignaling process (as well as their receptors, or biological targets to which they bind). These include serotonin, dopamine and norepinephrine. Melatonin levels are also typically different in individuals with ADHD, and these ADHD individuals are more prone to daytime sleepiness due to oversecretion of melatonin. Furthermore, several studies indicate that individuals with ADHD are more prone to sleep disorders and abnormal sleep patterns in general, although a number of other studies have indicated conflicting results to this assertion. As a result, the melatonin regulating activities of CREM may be at work as underlying factors to these melatonin-related sleep disorders.

The role of ADHD medications on regulating melatonin levels:
Abnormal melatonin levels (caused by CREM mutations or other factors) may be able to be offset by common ADHD medications. For example, methylphenidate (Ritalin, Concerta, Daytrana), has been implicated as a potential agent in correcting sleep disorders in children with ADHD. This is somewhat interesting, because it contradicts numerous other findings in which stimulant medications have been shown to interfere with sleep.

**Blogger's note: While there are a number of studies regarding impaired sleep quality due to ADHD stimulant medication, we must remember that strategic timing and lower dosing of stimulant medications can significantly reduce the number of sleep-impairments. Most of the sleep problems, at least in my opinion based on personal experiences, are due to the administration of medication doses which are too high and given too late in the day. Although outnumbered with regards to the current number of publications for or against it, I personally side with the assessment that methylphenidate, when administered at the proper dose and the proper time for real ADHD cases, is actually beneficial for promoting and regulating sleep patterns. Again, I want to reiterate that this is simply my opinion based on personal observations and research.

The CREM mutations and ADHD symptoms authors referred to a small study they did on the effects of methylphenidate on lowering melatonin levels. Based on these (extremely limited) findings, it is possible that melatonin regulation via methylphenidate treatment may be a contributing factor to the drug's effect on sleep performance. However, we should be careful not to put too much stock into this finding, since melatonin levels are highly variable among individuals (i.e. comparison of absolute melatonin concentrations between individuals is often ineffective, and intra-individual fluctuation of melatonin levels occur throughout the day anyway).

While the hypothesis that the CREM gene (which, as mentioned, is located on the 10th chromosome in humans) may play a significant factor in regulating melatonin levels and affecting ADHD behavior is predominantly theoretical at this point, I personally believe that this possible connection is at least worth mentioning. Additionally, potential gene/medication interaction studies may emerge, such as studies involving different methylphenidate dosage requirements based on the different CREM gene mutations. We have discussed analogous gene/medication interaction studies in previous posts such as the one entitled ADHD Genes Influence Medication Dosage . We should remain on the lookout for future studies on the possible connections among these different areas.

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Beauty Buzz: Clinique Makeup Collection Spring 2009

Love blush!? Then clinique’s Spring Collection 2009 "First Blush" is for you. One of the most interesting items in the collection is Quick Blush - a blush brush.Quick Blush is available in Hurry Honey, Peach In-A-Pinch, Minute Mocha, Berry On Time.Further on collection includes New Fresh Bloom Eye Shadow compacts. They have a beautiful flower print and are available in 4 shades:- Maple Blossom -

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Beauty Review and Giveaway: Sigma Makeup Brushes - Eyes

This is part two of my review of Sigma Makeup brushes. Go to part 1 to read about Sigma Makeup brushes for facet. Today I will talk about eye makeup brushes.SS239 Eye Shading BrushI love this brush! It’s a must have! This brush is tapered and has rounded edge. Medium firm and very dense fibers make it an ideal brush to apply eye shadow on to the eyelid. It picks up shadow powder really nicely and

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Beauty Review and Giveaway: Sigma Makeup Brushes - Face

Did you ever buy some expensive makeup only to be disappointed with the results? If it happened to you, it may not have been the make up which was to blame. It may have been the brushes you used.Recently Sigma Makeup contacted me and asked if I was willing to review their makeup brushes. Willing? What fun I had!I not only had a great time trying their brushes and falling in love all over again

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Beauty Buzz: YSL Makeup Collection Spring 2009

YSL Makeup Collection for Spring 2009 is a modern interpretation of beauty inspired by contemporary art. Discover the secret of dazzling spring beauty with YSL!Palette D’Artiste - Collector Powder for the ComplexionPalette D’Artiste - Collector Powder for the EyesBlush Variation - Variation Blush (N° 18 Coral Sand)Ombres Duolumieres - Eye Shadow Duo (N° 17 Ivory Beige - Deep Black, N° 19 Oatmeal

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Beauty Buzz: Chanel Makeup Collection Spring 2009

Chanel makes us fantasize about bohemian beauty with their spring 2009 Collection “Bohemian Fantasy”Chanel's exclusive creation for this collection is an impressing palette for lips: Chanel Double-C Logo Lip Palette. Satin Lip Cream forms the legendary double C Chanel logo.Another centerpiece product is Chanel's spring palette for eyes: Les 4 Ombres Quadra Eye Shadow: Mystic Eyes: plum, pink,

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Options In Acne Treatment

Acne treatment is one of the most common requests dermatologists hear from their patients. The condition generally begins in the teenage years, but can affect people into their thirties and forties. Blemishes often cause people to avoid social situations and, in extreme cases, can lead to feelings of depression.

The exact cause of acne is not known, but there are several theories. One is that break outs tend to be hereditary. If parents and siblings suffer from it, you may too. Another is that the hormones that surge through the body in puberty cause the sebaceous glands to increase in size and produce more oils. This leads to an increase in blemishes. Other hormonal causes include pregnancy, menstruation and birth control pills.

Although the exact cause of this skin condition is unknown, there are factors that can aggravate it. Squeezing a blemish can spread bacteria and cause more break outs on your face. Excessive humidity and sweating can also spread bacteria and aggravate the condition.

There are several myths surrounding acne. Stress is thought to cause acne, but it does not. However, the stress you feel as a result of the pimples is real. Consider relaxation techniques, reading the bible and prayer as a way to reduce this stress. Other myths include diet and having dirty skin.

Proper skin care can help prevent the spread of acne. Improper skin care can actually make blemishes worse. Excessive scrubbing with harsh cleansers is drying, causes irritations and can create more pimples. Use a gentle cleanser no more than twice a day, if your skin is excessively oily, you can wash three times. Look for a gentle cleanser that is made for your skin type. Salicylic acid is a good ingredient to look for.

Don’t use astringent unless you have very oily skin. Astringents can dry out the skin and make it worse. You may be tempted to skip the moisturizer, but don’t do this. Your skin needs moisture. Choose a product that is made for people who are prone to pimples. Look for an oil free, non acnegenic lotion.

Dermatologists can help with acne treatment. Topical ointments and oral medications can be prescribed for extreme cases. Many of these prescriptions can cause photosensitivity. You should always wear a sunscreen with an SPF of at least 30, if you go in the sun while using prescription medications. For maximum rejuvenation, your doctor may recommend a chemical peel.

In the past, you could only have a peel in the dermatologist’s office. Now there is a home treatment alternative. Esthetician’s Choice is a medical grade peel that you can use in the comfort of your home. The main ingredient is Trichloroacetic Acid (TCA) which is considered to be the most effective skin peel product on the market. TCA is a non toxic chemical that has been used by dermatologists for over 30 years to treat acne and other skin conditions.

Peels exfoliate the skin on a deeper level than can be achieved with most other skin care products. Easy to follow, step by step directions allow you to perform the peel easily at home. Esthetician’s Choice takes only minutes to apply. You may experience a slight reddening for a day or tow and the skin will continue to peel, revealing clearer skin underneath.

You will notice results quickly, unlike topical ointments and medications, which can take months to see results. Use the peel full strength for a deeper peel, or you can dilute it for surface exfoliation. Visit www.bestskinpeel.com to learn more about this remarkable product, which is guaranteed to give you the results you want.

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Acne Treatments with the Use of Birth Control Pills and Antibiotics

Acne / Birth Control Pill

For some female patients, treatment-resistant acne is caused by excessive production of hormones called androgens. With extra androgens in your system, your oil-producing glands go into high gear ญ— and so does your acne. Several clues can help your doctor identify acne that may be influenced by hormones: acne that appears in adults for the first time; acne flare-ups preceding the menstrual cycle; irregular menstrual cycles; hirsutism (excessive growth of hair or hair in unusual places); and elevated levels of certain androgens in the blood stream.

Adult women and teenage girls whose acne has resisted treatment with antibiotics or topical retinoids may be candidates for hormonal therapy. Once a patient’s acne is identified as hormonally influenced, the doctor will be able to prescribe a number of different therapies, or perhaps a combination of several different drugs; "combination therapy" is often the best approach to this kind of acne. Following are a few common components of therapy for hormonal acne, but remember to consult your doctor before using any of the remedies listed here.

Acne / Birth Control Pill - Oral contraceptives. Birth-control pills (a combination of estrogen and progestin taken orally) are often prescribed for hormonal acne. Low doses of estrogen help suppress the androgens produced by the ovaries, and the newer progestin agents, including desogestrel and norgestimate, are less androgenic than those found in older formulations. While only Ortho Tri-Cyclen and Estro-Step are currently approved by the FDA for this indication, experts agree that low-dose contraceptives improve acne regardless of which formula is used. Consult your gynecologist to find the formula that’s right for you. While side effects are uncommon, some women may experience brownish blotches, or melasma (hyperpigmentation) on the skin. These can be treated with topical bleaching agents.

Acne / Birth Control Pill - Anti-androgens. In combination with oral contraceptives, doctors also may prescribe an anti-androgen ; these drugs inhibit androgen production in the ovaries and adrenal glands and help prevent existing androgens from causing excessive oil production. Spironolactone, a high blood pressure medicine with anti-androgenic properties, has proven quite effective in the treatment of acne. Side effects may include breast tenderness, menstrual irregularities (in women not using oral contraceptives), headache and fatigue; since it's also a diuretic, you may experience frequent urination as well.

NOTE: Spiranolactone is tetrogenic and can cause feminization of a male fetus. If you are sexually active and not taking “the pill,” it’s imperative that you use another form of birth control.

Acne / Birth Control Pill - Corticosteroids. Small doses of corticosteroids, like prednisone or dexamethasone, may curb inflammation and suppress the androgens produced by the adrenal glands. Keep in mind that in some acne sufferers, corticosteroids may actually aggravate acne; they’re most effective when used in combination with oral contraceptives.

In conclusion, if you think your acne is hormonally induced, see your doctor right away. While this kind of acne requires a different course of treatment, it is highly treatable. More about your hormones.

For patients who suffer from moderate to severe acne, doctors may prescribe a combination of topical remedies and oral antibiotics. The most common oral medications used to treat acne are tetracycline, minocycline, doxycycline and erythromycin.

Antibiotics for Acne - HOW THEY WORK

Like Benzoyl Peroxide, antibiotics control breakouts by curbing the body’s production of
P. acnes, the bacteria that causes acne, and decreasing inflammation. This process may take several weeks or months, so be patient. And remember, you’re not “cured” just because your breakouts have subsided. That’s the medicine doing its job — so if you stop taking it, your acne will probably come back. Likewise, doubling up on your medication won’t make your skin clear up twice as fast. Using your topical antibiotics more frequently than prescribed may actually induce greater follicular irritation and plugging, which slows clearing time. And taking your oral medications more often than prescribed won’t help your skin clear faster — but it will increase your chance of experiencing unpleasant side effects.

Antibiotics for Acne - WHERE TO GET THEM

If you have moderate to severe acne, consult your dermatologist; he or she will discuss your options and help you make the best choice. Once you’ve begun treatment, give it time to start working. Keep your doctor apprised of your progress, so he or she can make changes to the course of treatment if necessary. And again, don’t stop using your medication when your skin clears — let your doctor make that call.

Antibiotics for Acne - COMMON SIDE EFFECTS

With most of the antibiotics used to treat acne, side effects may include photosensitivity (higher risk of sunburn), upset stomach, dizziness or lightheadedness, hives, lupus-like symptoms and skin discoloration. Some women report a higher incidence of vaginal yeast infection while taking antibiotics; these can usually be treated with over-the-counter antifungal medication or a prescription antifungal, such as diflucan. Tetracycline is not given to pregnant women or children under 12 years of age because it can discolor developing teeth. Lastly (and least common), because doxycycline is also the treatment of choice for Lyme disease, there is the theoretical possibility that a patient who takes this medication for a long period of time would build a resistance, and therefore be unable to fight Lyme.

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Gender, Age and Subtype Effects on ADHD Comorbid Disorders

We have spoken extensively on some of the related or comorbid disorders associated with ADHD ("Comorbid" here refers to an accompanying disorder that frequently occurs alongside ADHD. These may include disorders such as depression, Tourette's Syndrome, allergies, substance abuse problems and the like). The topic of this post is to investigate whether there is a pronounced gender effect on these comorbid disorders; in other words, whether boys and girls are more prone to a particular disorder comorbid to ADHD based on their gender. As we will see later, age and ADHD subtype effects are also important factors with regards to comorbid disorders.

Much of this info was taken from an article titled Gender Differences in ADHD Subtype Comorbidity by Levy and coworkers. Here is a summary of some of the main points in the study:

• Approximately half to over three quarters of ADHD children carry some type of comorbid behavior disorder. These include oppositional defiant and conduct disorders, learning disabilities and communication disorders (including speech and reading difficulties). Additionally, many exhibit anxiety disorders such as generalized anxiety disorders or separation anxiety disorders.

• Additionally, ADHD has traditionally been separated into three different forms or subtypes: inattentive, hyperactive/impulsive, or combined (a combination of the other two subtypes). All three subtypes are heavily skewed towards the boys, which outnumber girls from anywhere around 2:1 to 5:1 (some studies skew this gender difference even higher, up around 10:1). Based on the study by Levy and coworkers, here is an approximate distribution (numbers indicate overall percentages among the study population, which includes non-ADHD individuals) among the prevalence of the three subtypes for both genders:
  

As we can see, all three subtypes are skewed heavily in favor of the boys.

• Of the three subtypes listed above, it appears that the subtype (again, perhaps not surprisingly) most associated with comorbid disorders (listed in the first point) is the combined subtype.
  

• There appears to be a discrepancy between the genders as far as internal/external symptoms of ADHD and related disorders. Some studies have suggested a general trend in which many of the symptoms or problems of girls with ADHD and related disorders are more internalized (i.e., they do not outwardly manifest themselves as readily as boys), which may contribute to the skewed gender differences mentioned above. On the contrary, the same study suggests that external or outward symptoms are more apparent in boys, which may compound this effect.

• Reading disabilities are, perhaps not surprisingly, more common in children with ADHD. It appears that reading disabilities correlate more to "internal" symptoms in girls and "external" symptoms in boys with ADHD, however, reading disorders appear to have very little overlap with conduct or oppositional behaviors such as aggression or delinquent behavior. Furthermore, reading difficulties appear to be more related to the inattentive side of the disorder of ADHD than the hyperactive/impulsive side of the disorder. In other words, the inattentive and combined ADHD subtypes are significantly more likely to have problems with reading than the exclusive hyperactive/impulsive subtype for both genders. It appears that reading difficulties and inattentive behavior may have an even stronger correlation in girls.

• Furthermore, with regards to reading and speech disabilities, there is a strong gender difference for non-ADHD individuals. However, once the disorder of ADHD is introduced, the gender difference becomes less of a factor (this holds for all three ADHD subtypes). This may at least suggest, that ADHD symptoms may override or overpower what appears to be more subtle gender differences with regards to speech and reading disorders.

• There is a significant association between generalized anxiety disorders and ADHD for both genders. Gender differences for the combined ADHD subtype were especially pronounced, with rates among females with the combined ADHD subtype being significantly higher than the combined subtype males. In addition, the combined subtype was more associated with generalized anxiety for both genders (when compared to the inattentive subtype), which suggests that hyperactivity/impulsivity may play some sort of role in generalized anxiety for both genders.
  

• With regards to separation anxiety disorders (such as from parents or loved ones), it also appears that there is a higher correlation to girls with ADHD, especially with regards to the inattentive ADHD subtype. For boys, the separation anxiety disorders were highest for the combined ADHD subtype. The study suggested that separation anxiety disorders may be a sign of immaturity for both genders, and may be indicative of later "internalizing" problems in girls. Furthermore, this assertion is in agreement with several studies which associate ADHD with a delay in maturity.
  

• Based on the two findings above, in which girls with the inattentive ADHD subtype had higher rates of separation anxiety disorders and girls with the combined subtype having increased rates of generalized anxiety disorders (both of which are considered more "internal" symptoms) than their male peers, it may be suggest that screening for ADHD in girls who exhibit anxiety disorders may be beneficial, in that it may reveal underlying comorbid ADHD and offset some of the skew among gender differences and ADHD.

• Finally, age has been shown to be an important factor with regards to symptoms and severity of ADHD comorbid disorders. In this study, comparisons were done between the younger (ages and and under) and older (ages 11 and older) children in the study population. For males, the prevalence of most of the comorbid disorders (speech and reading difficulties, oppositional defiance, generalized and separation anxieties) decreased with age, with the notable exception being conduct disorders, which increased with age. For females, age was less of a factor for all of the comorbid disorders listed above with the exception of Separation Anxiety Disorders, which decreased with age (supporting the earlier assertion that this disorder is tied to maturity levels and would naturally decrease as a child gets older). In addition, inattentive symptoms associated with ADHD actually increased with age for the female population of the study. This was the exception to the overall trend of decreasing ADHD symptoms with age, which was seen in the other two subtypes for females and all three subtypes for males.
  

I would like to conclude with a final note of personal opinion. I firmly believe that when screening, diagnosing and attempting to treat ADHD and comorbid disorders, we employ far too little emphasis on the gender differences surrounding these disorders. This can lead to several potential problems such as stereotyping or pigeon-holing certain behaviors (i.e. attributing hyperactivity/impulsivity as being a "male" characteristic and either intentionally or unintentionally overlooking these symptoms or behaviors in girls).

In addition, it appears that girls may have a higher prevalence of the more "internal" comorbid disorders such as anxiety, which are often more difficult to detect than the more outward comorbid disorders of oppositional defiance and conduct disorders. This may play a major part in the gender discrepancy of ADHD diagnosis, which may leave a number of girls with ADHD undiagnosed and untreated.

Additionally, the more "internalized" nature of female cases may also lead to a lack of diagnosis and treatment for comorbid disorders associated with ADHD as well. The Levy study pointed this out, citing the discrepancy between referrals for ADHD-related reading disabilities. Reading disorders for boys were more likely to be associated with some of these outward characteristics, while girls with reading disorders exhibited more of the aforementioned "inward" traits. As a result, the rates of referral for boys with reading disabilities (based on their overall representation in the population) was almost twice that of girls.

Furthermore, this study by Levy, as well as several others, indicate that there are several (sometimes unusual or counter intuitive) associations between gender, and ADHD subtype and the expression of symptoms of specific comorbid disorders. For example, attributing an increase in Separation Anxiety disorders to younger females with the Inattentive ADHD subtype or Conduct Disorders to the Combined ADHD subtype in males may give us some possible insight as to which subpopulations of ADHD children are most "at risk" for developing some of the aforementioned comorbid disorders.

Since several of these comorbid disorders carry their own lines of medication and other treatments, the subclassification of ADHD children based on age, gender and subtype may be especially beneficial with regards to developing successful individualized treatment plans. I firmly believe that by separating out and subcategorizing ADHD and its comorbid disorders based on factors such as age, gender and subtype whenever possible could lead to a new a wealth of information for diagnosing and treating ADHD and its associated comorbid disorders.

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Excessive Talking as a Potential Methylphenidate Side Effect

Methylphenidate (Ritalin, Concerta, Daytrana) is one of the most common stimulant medications prescribed for ADHD. However, there have been several questions as to its side effects. Studies have been conducted on the effects of methylphenidate which include excessive talking, cardiac abnormalities, hallucinations, bruxism (teeth grinding), movement disorders, psychotic and manic-like symptoms, appetite suppression, and temporary weight and growth reduction.


Please note, however, that this list above is not meant to scare anyone off of this medication. While some side effects appear to be relatively common and well-grounded (such as appetite suppression and temporary growth impairment), many of these side effects are relatively rare, and the results are often based on isolated studies with poor reproducibility. To be fair, methylphenidate has been subject to a number of tests, with the vast majority supporting the claim that it is a relatively safe medication (provided one uses it appropriately as prescribed).

Furthermore, previous entries of this blog have dismissed the notion that methylphenidate carries an addiction potential on the level of cocaine or illegal amphetamines (a claim often erroneously made by many of the anti-medication crowd. Keep in mind that I personally do share many of the same concerns of these groups, but likening a controlled prescription drug with multiple addiction-reducing features to illegal street drugs is both irresponsible and does the overall argument on ADHD medication concerns a disservice in my opinion). Nevertheless, some of the above associations, while limited in scope and supporting data, do seem intriguing. For this post, I would like to briefly assess the results of the first unusual side effect of methylphenidate on the list, the surprising link between methylphenidate and excessive talking.


Before we proceed, we must bear in mind that this association is based on a single case report, and not a controlled clinical study. For those unfamiliar with the differences between the two, a case report is essentially a report of one (or a few) individuals, who exhibit particular symptoms, often in response to a particular medication or treatment strategy. While these reports lack the statistical power and overall scientific magnitude when compared to tightly-controlled clinical studies involving large sample sizes, we should not be quick to dismiss these findings. Individual anomalies, while often statistically small, do offer insight into some of the idiosyncrasies of medication and other forms of treatment, and involve real individuals (who are often in a more "natural" setting than those in clinical trials).

Given the recent advances in genetic studies and innovations in imaging and computational power, we appear to be at the dawn of a medical revolution, in which medication and treatment plans are becoming increasingly tailored towards individuals rather than groups or the general population. I personally believe that because of this general trend, individual case studies will begin to carry more weight and validity among the medical community than they have previously.

While not my intention to digress from the topic of today's post on methylphenidate and excessive talking, I did want to state some of the potential implications of the data accumulated from one particular individual. With regards to the study, here were some of the key findings and observations:

• The case involves a 5-year old Iranian boy who was prescribed methylphenidate (10 mg per day) for extreme hyperactivity and impulsive behavior, two key symptoms of ADHD. Treatment with this dose of methylphenidate produced significant improvements in both impulsivity and hyperactivity.


• Approximately 45 minutes after taking the medication, both parents and teacher reported a sharp increase in excessive talking. These results continued for 3-4 hours, which approximates the duration of effectiveness of methylphenidate (immediate release formula).


• Most interestingly, perhaps, was the apparently direct association between methylphenidate intake and hyper-talkative behavior. The study reported that methylphenidate treatment stopped and was reintroduced on over 20 different occasions within a 7 month period. In all 20 plus cases, the hyper-talkative behavior resumed when methylphenidate treatment was reintroduced. The magnitude of the difference, between talking behavior on and off the medication, while subjective, was significantly pronounced. On a 1-10 scale (done by parents and teachers, with 10 being the highest), the child's talking was around a 2-3 when off the medication and a 7-9 while on it. This extremely high frequency of association and pronounced behavioral differences between methylphenidate and excessive talking strongly attributes the abnormal behavior to the medication.


• The study gives several potential explanations for this association between behavior and medication. For example, methylphenidate, which regulates free dopamine levels and dopamine-related neural function, was shown to regulate word production in individuals with schizophrenia.


• Additionally, methylphenidate has been used to restore talking in patients treated with anesthesia.


• Finally, methylphenidate has been shown to effect the striatal region of the brain (see below, original file source here), which has a regulatory effect on cognitive motor functions, including talking patterns.

The striatum region of the brain (shown in green in the figure above), which has been shown to have a response to methylpenidate, and may be an underlying reason for the connection between methylphenidate and excessive talking.

As mentioned above, we should obviously not put too much stock into one case study on the potential connection between the unusual side effect of excessive talking in response to methylphenidate. However, based on the severity and consistency of the association for the individual and the underlying theoretical basis of the association based on the results of other studies, we should not overlook the observations of this particular study. Furthermore, given the effectiveness of methylphenidate for reducing hyperactive and impulsive ADHD symptoms for this particular child, the fact that excessive talking behaviors (which can be a sign of ADHD-based impulse control problems) suggest the possibility that the methylphenidate treatment may have an effect on shifting the outward expression of symptoms of an underlying ADHD condition such as impulsivity. As a result, a number of questions should be raised on the basis of this study.

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Beauty Buzz: Estee Lauder Makeup Collection Fuchsia Now

Estee Lauder brightens up this spring with their new makeup collection Fuchsia Now. Pink and berry colors of this collection will sure bring you into the flirty spring mood! Estee Lauder Fucsia Now collection is based on combining bright bold colors with warm mild neutrals.If pink is your color, go with the Cool Pinks look.If neutral colors are more appealing to you, choose the Warm Nudes.Limited

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Beauty Buzz: Guerlain Makeup Collection Spring 2009

Guerlain promises Exotic Paradise with their new makeup collection for spring 2009. Exotic Paradise was developed by Olivier Échaudemaison and is like a hymn to spring. Colors for this luxurious collection have been inspired by the Garden of Eden. They range from shimmering emerald green to rich pinks and oranges. Limited Edition Eye Shadow Palette Ombre Éclat 4 Shades is a work of art! The

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Spring 2009 Makeup Collections

As Robin Williams said: Spring is nature's way of saying, "Let's party!" Photo by Zaara Kohime at flickr.comI agree! New spring makeup collections are out and I’m determined to get something nice this time! I have been on a strict budget past autumn-winter as I’ve been doing some redecoration work on a room. I didn’t buy anything from the past holiday collections and limited editions… sigh… I

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Nicotine Withdrawal Effects Differ in ADHD Individuals

There is a relatively strong connection between ADHD and drug abuse, with nicotine being one of the most common types of "self-medication". It is believed that ADHD and nicotine addiction share similar neural pathways, although there still remains a fair amount of debate as to the exact underlying mechanisms at work between the two conditions.

One topic of equal intrigue may be the relative effects of withdrawal from nicotine in ADHD vs. non-ADHD individuals. If smoking and ADHD do share overlapping neural pathways, then we might expect that cessation of smoking may have different effects between people with and without ADHD. According to a recent study by Kollins and coworkers on ADHD and smoking abstinence, individuals with ADHD have a much wider array of behaviors with regards to reaction times to specific stimuli and cognitive processing. In other words, smokers with ADHD who temporarily give up nicotine have a greater variety (and hence less predictability) with regards to concentration-related tasks than do non-ADHD smokers. A more detailed explanation of this study follows:

• Giving up cigarettes and other forms of nicotine has a wide range of negative effects such as working memory, attention, and the ability to control or inhibit ones' responses. However, these effect typically subside when one resumes original smoking behaviors. As a result, based on the negative side effects due to decreased cognitive function, quitting smoking can result in a number of disadvantages with regards to brain function.

• Many previous studies have shown that individuals with ADHD are more prone to some of these disadvantages, especially with regards to slower reaction times to external stimuli when abstaining from smoking. This may be one of many reasons why smoking is more popular among individuals with ADHD than within the general population.
  


• For example, using a special computerized test called Conners Continuous Performance Test, to test for reaction time, comparison studies were done between ADHD and non-ADHD smokers under conditions where they were allowed to smoke and conditions where they were required to abstain from smoking (typically starting the previous night before the morning Continuous Performance Test. Briefly, the test consists of pressing a specific key on a computer keyboard when any letter (except for "X") flashes on the computer screen continuously for a period of approximately 15 minutes. If the letter "X" were to appear on the screen, the test subjects were instructed not to press any keys on the keyboard. Reaction times and accuracies were based on these behaviors.

• However, based on the study by Kollins and coworkers on smoking abstinence and ADHD, there is a relatively significant amount of evidence that the above point may not entirely be true. Based on the results of their study, Kollins and coworkers suggest that the average impairment with regards to reaction times during smoking cessation may actually be less for most ADHD smokers when compared to non-ADHD smokers. For example, when deprived of smoking, the reaction time of highest frequency for ADHD smokers was somewhere around 0.3 seconds, while the non-ADHD group was slightly slower (but still significant and measurable), hovering around 0.35 seconds. However, the ADHD group is also more likely to have a few individuals who are prone to lengthy delays in reaction times (as in multiple seconds). Kollins instead attributes this to attention lapses in which the individuals concentration was broken. In other words, it appears that while the majority of individuals with ADHD smokers may actually have faster reaction times than non-ADHD smokers, ADHD smokers have more extreme cases of reaction time delays due to attentional lapses, especially when deprived of nicotine. Therefore, by separating out the "common" cases from the more "extreme" cases in their study, Kollins and coworkers may have uncovered this underlying trend.

• There are several possible causes for these potential attentional lapses due to smoking withdrawal. One may stem from a brain region called the cingulate gyrus, whose approximate location is shown below (region #7, for orignal file source, click here) on the diagram.
  

The actual area is a specific subsection of this region, but we will not go into the detail here. This region, the cingulate gyrus (#7), is in some ways analogous to a gear shifter in a car. If this brain region is underactive (think of a loose gear shifter), then an individual often bounces around from one thought, idea or focus to the next, which is a common characteristic of ADHD. Lapses in attention have been attributed to subsections of this cingulate region. On the other hand, generalized overactivity in this brain region often leads to excessive fixation on a particular topic, idea or behavior (think of it as pushing too hard on a gear shift and getting stuck in a gear). This latter condition is often seen in dysfunctions such as obsessive compulsive disorder (OCD). With regards to our topic of discussion, Kollins suggests that this brain region may be the culprit for increased attentional lapses in ADHD smokers.

• Kollins and coworkers also found that when the smokers are "satiated" (i.e. allowed to smoke their desired amounts leading up to the reaction-time test), the ADHD smoking group also had relatively faster reaction times when compared to the non-ADHD smoking group. The ADHD smoking group also had a greater variability in reaction times (i.e. more "extreme cases" or extra-long response times) during satiated conditions, but the differences in variation between these "extreme" cases of ADHD and non-ADHD groups' reaction times were less pronounced than during the nicotine abstinence trials.
  

• Finally, it may seem strange that the majority of ADHD smokers appeared to have faster reaction times both with and without smoking. What is even more interesting is that in the nicotine-deprived state, most of the ADHD smokers actually showed a slightly faster reaction time than in the nicotine-satiated state (although the extreme cases of multi-second attention lapses were also greater). One potential explanation of this may be due to the increase in impulsive behaviors, where the individuals attempted to "guess" or predict when the designated letter flashed on the screen (see the previous point about the nature of the Conners Continuous Performance Test). This would be in agreement with fact that nicotine, which is a stimulant and a common form of "self-medication", may help curb impulsive behaviors in ADHD individuals.

• A final take-home message from this study is that it highlights a relatively common and important trend which we must often consider when dealing with ADHD: studies of ADHD groups which deal with response or reaction times have shown data which is more skewed with a higher variability (and hence a lower predictability) than comparative non-ADHD groups. If study sample numbers are small, these highly variable measurements can sometimes throw off the data and lead researchers to the wrong conclusions. In other words, when doing comparative studies between ADHD and non-ADHD individuals, we must be careful to consider these higher degrees of variability and unpredictability in the ADHD groups and factor these in to our calculations and conclusions accordingly. I will be touching on other cases where we see this significantly greater levels of variability and unpredictability in ADHD in future posts.

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CWLA

Come and see our poster at the CWLA Annual conference poster session in Washington on February 24th! In addition to our beautiful poster which illustrates the change to trauma-informed care and the results, a client, Ashley will be joining us and sharing her viewpoint about this change. We would love to see you!

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Making Connections by Having Problems

We don’t know what to do for Katrina! She keeps cutting herself, putting cords around her neck to hang herself, and recently she has begun using an eraser to create serious burns in her skin. She has given up running away and having sex with strangers, but she keeps up the unremitting self harm. Staff can work with her for hours, and she seems better, but an hour after they leave, she cuts and they feel the whole effort was useless. We are getting so exhausted and depleted. Please help!

Discussion with Katrina, her mother and her treatment team made clear how three facets of the effects of trauma interact to create dilemmas both for the child and the treatment team.

Katrina had a history, as so many of our children do, of repeated moves, changes of caretakers, and of serious abuse in each new home. Following her adoption at age seven she had many treatment episodes such as hospitalizations, emergency shelters, in home interventions and finally residential treatment.

This history had left Katrina with the following three characteristics (as well as others):

A deep sense of shame and self hatred, resulting from blaming herself for all the abuse, the moves, the symptoms and failures she had experienced: Her self hatred combined with a lack of a sense of self- who was she really? She has a tendency to take on the personality of whomever she is with. This lack of self and deep self revulsion results in her conviction that no one could possibly just like her. It also produces the conviction that she does not deserve anything good, or to have any fun, which results in sabotaging whenever something good does happen.

A lack of inner connection to others: for Katrina, when a person is not physically present it is as though they never existed. She cannot keep a representation of them in her mind to encourage her and help her, because she has not had the relationship stability in her life that would be necessary to develop that ability. So when a staff moves away from helping her it is although they disappear completely.

No self soothing skills: Katrina had not been taught how to manage life’s ups and downs. Her models had used drugs and violence to manage emotions. She has not been taught to recognize or name her own emotions, or what to do when she feels them. Through DBT Katrina is learning some of those skills, and she can name and describe them when she is calm. However, due to her over-active nervous system, when something goes wrong she becomes so over whelmed with emotions that her skills desert her.

Like all of us, Katrina needs connection, attention and support. However, both in her homes and in the many treatment programs she has experienced, it has been hard to engage adults by doing well. Early on Katrina learned that the easiest way to draw adult connection was through problems. Although her caretakers were absorbed in their own life pain, when Katrina was suicidal they had to pay attention to her. It is almost as thought she becomes addicted to having problems.

And this becomes harder and harder to change.

Start with Katrina’s conviction that no one would want to be with her just for herself.

Then, something happens, and Katrina becomes upset. Her need for help is intense and unbearable. Life feels hopeless and frightening, and she blames herself. So she does something to hurt or erase herself, which has the added benefit of bringing in the resources she needs.

In an adult’s calming presence, Katrina can some times gradually calm down. And when she does, what happens? The adult leaves. For Katrina, they disappear completely, never to return.

And Katrina does not know how to re-engage them in a positive way. She does not even have any idea this is possible.

So- she tumbles into another problem.

The intervention strategy that will help to change this is to give Katrina a lot of attention whenever she is doing well, and to be less emotional, less intense and less involved when she is doing self-destructive things. But this turns out to be quite difficult. One reason is that Katrina is rarely doing well. When ever she does start having fun or succeeding, she stops herself, because this is not her and she doesn’t deserve happiness. However, staff can still catch the moments in which she is more relaxed or more normal and engage with her then.

And this takes incredible stamina, planning and thoughtfulness of the staff, and demands much reinforcement and praise from those supporting the staff. Because if a child this needy is NOT calling your name, is doing well and enjoying life, who would want to approach her? Better to stay back and enjoy the momentary respite. And yet, this perpetuates the pattern- that she only gets attention and caring by having problems. Staff will have to work hard for quite a while before this pattern changes- but what a gift they will give Katrina! The gift is the repeated experience (more powerful than any words) that she is a normal girl who can be competent and can receive attention, caring and connection through achievement and every day life activities. This is what she needs to experience in order to move towards a life worth living.

 

 

 

 

 

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Does ADHD improve your sense of smell?

Due to a high degree of overlap in symptoms with other disorders, finding accurate ways of differentiating ADHD is of utmost importance. Based on a recent study by Romanos and coworkers, it appears that individuals with ADHD may be able to "sniff out" their disorder. In a publication on Improved Odor Sensitivity in ADHD, Romanos and others found that children with ADHD had significantly better sensitivity for particular odors when compared to their non-ADHD peers. In other words, children with ADHD may be able to better detect minute or trace levels of certain smells when compared to other children. As an interesting aside, the study noted that boys actually had a slight advantage as far as odor detection when compared to girls (which goes against many other study findings which indicate that females have better senses of smell).

However, when these children were investigated in two other "smell" categories, which included discrimination between different smells, and the actual identification of particular agents causing the smell, they should no advantages over their non-ADHD peers. Similar studies have also been done on adults with ADHD, and have shown little to no effect between ADHD and sense of smell. These findings seem to agree with another recent report on olfactory impairments in children with ADHD. This study found that children with ADHD were worse at identifying the nature of particular odors than non-ADHD children. It appears that these deficits are tied to a specific brain region called the orbitofrontal region, the outer section which is approximated by the green region in the diagram below (original file source can be found here). Note that this region has numerous implications with regards to the disorder of ADHD.

To throw another wrinkle into the mix, it appears that stimulant medication treatments for ADHD may negate these olfactory advantages (with regards to the increased ability of ADHD children to detect minute levels of odors better than their peers). The Romanos study also investigated another group of similar age and gendered individuals with ADHD who were on the medication methylphenidate (Ritalin, Concerta, Daytrana, etc.). Like the non-medicated ADHD children, this group all had the combined subtype of ADHD (meaning that both hyperactive/impulsive as well as inattentive symptoms were present to a large extent). They found that the medicated children did not have the improved smell sensitivity that their non-medicated ADHD peers did, but rather had an odor detectability level similar to that of the non-ADHD group. In other words, it appeared that methylphenidate (as well as other ADHD stimulant medications, potentially), may offset any improvements in smell detection in ADHD individuals.

It is believed that the dopamine system and pathways play a critical role in smell differences between ADHD children and their peers. Keep in mind that methylphenidate and most other stimulants for ADHD work by increasing the concentration of the neurotransmitter dopamine in the areas between neuronal cells, by reducing the transport of this important brain chemical into the cells themselves (individuals with ADHD often have an imbalance between the dopamine levels inside and outside of these neurons, and often have insufficient dopamine levels in the surrounding areas outside the neuron cells). Dopamine levels have been shown to have a protective effect on olfactory neurons (neurons related to smell). Chemical alterations of dopamine levels, such as those introduced by methylphenidate or other ADHD stimulants may therefore interfere with odor sensitivities in key regions of smell such as the olfactory bulb region of the brain.

On a final note, the findings by Romanos and coworkers are of potential interest because of the fact that many neuropsychiatric disorders are accompanied by a sharp decrease in odor detection and sense of smell. These include Parkinson's Disease, obsessive-compulsive disorder (OCD), schizophrenia, autism, and depression. Because of this, it may be possible to use odor sensitivity tests to help differentiate between ADHD and other neuropsychiatric disorders, at least in children. Although we have seen that there is some conflicting evidence surrounding studies, it appears that we could, at least in theory, administer some type of smell test of trace levels of specific odorous chemical agents that are undetectable to the majority of the child population and see whether the potential ADHD candidate could detect these minute traces. Furthermore, it would be interesting to see whether other stimulant medications besides methylphenidate have the same effects on curbing the increased odor sensitivities exhibited in ADHD children.

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Perfume Review: Ageless Fantasy

Ahhh… Youth… to what lengths don’t we go to look younger… All the sophisticated creams we religiously use, all the lifting, light reflecting, contouring makeup we apply, even the plastic surgery we resort to in despair… In our endeavors to reverse the time we overlook something very obvious that’s right under our noses – figuratively and literally speaking. The way we smell! That’s right, the

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Do ADHD Stimulant Drugs Stunt Growth?

Here are seven questions or factors we need to address to assess the validity of studies on ADHD stimulant medications and their effects on growth:

1. Is there a history of prior stimulant medication use? Surprisingly, a number of studies on the inhibitory effects of ADHD stimulant medications either neglect or downplay the fact that children in their studies had a previous history of stimulant medication usage for their conditions. This can seriously confound effects, for if a child was taking a stimulant medication previously, he or she may still be on track for a lower baseline growth rate. Furthermore, if a child was taken off stimulant medications recently, there remains the possibility that his or her system is beginning to play "catch-up" by displaying a greater-than-normal increase in growth following a medication "holiday". In either case, baseline readings are skewed, and these effects muddy the accuracy of current stimulant medication studies on growth effects. Poulton and Nanan make this observation in their article on prior treatments with stimulant medication and growth in children with ADHD. They go on to say that growth is an accurate indicator of prior treatment with stimulant medication.
   
   
2. Beware of the pretreatment bias with regards to effectiveness of stimulant medications: Poulton and Nanan also warned about the natural bias of individuals with a previous treatment history of stimulants in that they have already proven to have a greater tolerance to potential side effects (otherwise they would have likely discontinued earlier stimulant treatments) and an overall higher levels of compliance and positive response to stimulant medications. This too, can give a potential "false positive" with regards to evaluating the effectiveness of current stimulant medication treatments for ADHD.
   
   
3. Do untreated children and adolescents with ADHD have different growth patterns than non-affected children? This is also a much-neglected consideration. Spencer and coworkers performed a study in which they saw a slower growth rate in the earlier years for children with ADHD, which was followed by a significantly later "catch" up period. In other words, compared to non-ADHD children, individuals with ADHD may be more predisposed to being "late bloomers", even when they are unmedicated. This potential difference in growth patterns between ADHD'ers and non-ADHD'ers, while still highly debatable, should at least raise the question as to whether delays in growth patterns for medicated individuals with ADHD can actually be attributed to the medications or to the nature of the disorder itself (or a combination of both).
   
   
4. Do "drug holidays" work? This is actually comprised of several questions and considerations. It is not uncommon for parents or prescribing physicians to allow for "drug holidays" for unmedicated ADHD children. These holidays can vary from a few days to longer periods such as an entire summer vacation. If the period of these drug holidays is long enough, such as in a summer-long study by Gittleman-Klein and coworkers on methylphenidate and growth, significant changes may be seen. This study saw a relative increase in weight but not in height following a summer off of medication of the stimulant methylphenidate (Ritalin). Of potential interest was the observation that following a second holiday from medication the following summer, a relative increase in height but not in weight was observed. It is entirely possible that the duration and frequency of drug holidays may effect the two parameters (height and weight) in slightly different fashions. Another article by Poulton suggests the possibility that height gains may take longer to remedy because gains in weight may drive subsequent growth in height.
   
   
5. Does the type of stimulant medication make a difference? In a preliminary sense, it appears that the answer would be "yes". For example, it appears that the stimulant drug dexamphetamine (d-amphetamine, also called by common name Dexedrine) has a greater inhibitory effect on growth during the first year of treatment than does methylphenidate (Ritalin, Concerta, Daytrana).
   
   
6. What is the typical extent of growth impairments due to stimulant medications? We need to be careful on this one, especially with regards to some of the earlier factors and considerations mentioned above. Nevertheless, a review of the literature seems to indicate a relative deficit in growth of around 1 cm per year for up to about 3 years which can be attributed to stimulant medication treatment. Furthermore, it appears that weight may be even more affected than height due to stimulant medication treatment, although it also appears that weight differences are easier to remediate than height differences and therefore pose less of a concern.
   
   
7. Are the growth changes due to stimulant medication temporary or permanent? Although hotly debatable, it appears that growth impairments due to prescribed stimulant medication usage is more of a short-term effect. A follow-up study of medicated ADHD children into adulthood indicated that even at moderately-high doses of the stimulant medication methylphenidate (45 mg/day average), medicated children with ADHD eventually reached normal final heights when compared to controls. It is worth mentioning, however, that these children eventually discontinued their medications. It is unclear as to what the effects may have been had they continued on with the methylphenidate usage into adulthood (especially since there has been a sharp trend towards continuing stimulant medication treatment into adulthood for adult ADHD).

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Ritalin vs. Cocaine: Addiction Potential of Methylphenidate

If you were to read the opening couple of pages of most natural or alternative treatment books on ADHD, you would likely find some version of the following argument: "Ritalin is chemically similar to cocaine and amphetamines and studies have shown it has a high addiction potential". There actually is a fair amount of truth to that statement, but the latter half leaves out some equally important information concerning the nature of these studies.

This post is not meant to be a pro-stimulant drug message, I certainly do see some apparent risks for many ADHD medications, especially concerning young children and their developing nervous systems. However, I also feel that we should carefully examine the nature of many of these "anti-methylphenidate" studies and evaluate the relevancy of their findings. To facilitate this discussion, I have taken data from a serious of research articles on the topic of habit-forming potentials of methylphenidate (Ritalin, Concerta, Daytrana, etc.) and have attempted to box together some of the overlapping information with relevant conclusions that are, to the best of my ability, as unbiased as possible. Here are some key points worth noting:

• Chemical similarity to cocaine and amphetamines. The chemical structure of methylphenidate is given below. As a comparison, the structure of methamphetamine is also given. I realize that the majority of readers here are not organic chemists, so I have highlighted the similar regions of the two molecules (which is a relatively big overlap as far as chemical structure and function is concerned). The purple/red regions below highlight chemically similar regions between the two drugs, while the green/blue areas show chemical differences. For brevity and simplicity, I have not included the structure of cocaine, because there are fewer obvious similarities between the chemical structures of methylphenidate and cocaine. Just realize that there are chemical and functional similarities between the two drugs.

• A huge factor in a drug's addiction potential rests on how fast the drug can both enter and leave the brain. In short, the faster the entry and the faster the clearance of the drug from the brain, the greater the "high" and the greater the addiction potential. We have seen this before in earlier posts, such as the one on Vyvanse for ADHD treatment. The chart below summarizes some of the key comparisons between methylphenidate and cocaine (most of the data comes from studies by Volkow and coworkers on brain entry and clearance times of cocaine vs. methylphenidate:

We can see from the chart above that cocaine and methylphenidate show similarly quick routes of entry into the brain when administered intravenously (note that this is not the typical route for taking methylphenidate for ADHD patients). However, note that the clearance time from the brain is significantly longer for methylphenidate than cocaine (half-life is a common measuring tool, which refers to the amount of time it takes for half the drug to clear the system). Also note that when methylphenidate is taken in the appropriate manner (orally), the time to arrive at a peak concentration (based on a mammalian model) is significantly longer as well. Both the longer clearance time and times to peak concentrations play a crucial role in reducing the involved "high" and addiction potential for methylphenidate, when compared to drugs such as methamphetamines and cocaine.

• The type of methylphenidate administered may also play a role in the addiction potential. There is a general trend towards prescribing longer-lasting sustained release versions of methylphenidate over the original immediate-release version (although cost is also a factor, with the longer-release versions typically carrying a higher price tag). At the 20 and 40 mg levels, one study showed that the immediate-release version of methylphenidate produced a higher degree of addictive level effects than the longer-release version, although this was based on more qualitative subjective measurements than hard, concrete numerical data.

• On somewhat of an interesting note, it appears that the reinforcing effects of methylphenidate may be much more pronounced in the case of sleep deprivation. One study indicated that methylphenidate only produced reinforcing effects when study participants were limited to 4 hours of sleep the previous night. Given the fact that sleep problems and disturbances are remarkably common in individuals with ADHD, this may actually lend a fair amount of support to potential for abuse among ADHD individuals. However, I personally believe that, based on the other points regarding individuals with ADHD, this population is still relatively "safe" from stimulant medication abuse when the medication is administered and taken in a proper manner.

• We have spoken extensively on the role of Dopamine Transporter (DAT) proteins and their role on governing levels of dopamine, a key neuro-signaling agent which is thought to be critically involved with regards to the onset and symptoms of ADHD. In short, DAT proteins are responsible for shuttling dopamine into and out of neuronal cells and maintaining an overall balance of this important chemical. Individuals with ADHD are thought to have more of these DAT proteins in their brain systems, which results in lower levels of dopamine in the areas between nerve cells, a phenomena which is commonly seen in cases of ADHD and related disorders. DAT proteins are therefore common targets of many ADHD stimulant drugs, which typically act by binding to these DAT proteins and reduce their shuttling effects, which, in turn, helps restore higher dopamine levels in these key regions between nerve cells. It is hypothesized that drugs, even at low doses (such as 20 mg methylphenidate) which bind to and saturate these DAT proteins may contribute to some of the "high" associated with these drugs. However, other findings have contradicted this, with regards to the role of the DAT proteins on "highs" associated with stimulant medications such as methylphenidate.

• Finally, in what may be the most important piece of the puzzle with regards to addictions and ADHD stimulant medications, there was a review done by Kollins which examined the nature of pre-existing studies on the abuse potential of methylphenidate. Kollins noted that a large number of the studies which suggested high addiction potentials for methylphenidate and related subjects gathered their data from non-ADHD individuals. This is important to note, especially considering some of the aforementioned differences between ADHD individuals and non-ADHD individuals with regards to chemical balances (such as the dopamine levels) and hard-wiring issues (such as a higher density of Dopamine Transporter Proteins or DAT's in individuals with ADHD). While this should not be grounds for immediate dismissal of these findings, the lack of studies on actual ADHD patients should raise some serious questions as to whether methylphenidate deserves its "guilty" label with regards to addiction potential. Of course, these studies provide ample evidence to support the assertion that ADHD medications such as methylphenidate can be abused if they are taken by the wrong individuals (non-ADHD patients, such as healthy individuals with few to no signs of ADHD as well as generalized drug abusers), but there appears to be an overall lack of evidence to support the claim that needy patients who do suffer from ADHD will turn into stimulant abusers if they begin to take methylphenidate at prescription-based levels.

• Kollins does conclude with some more relevant (at least in this blogger's opinion) concerns surrounding the use of methylphenidate for ADHD. He questions the impact of methylphenidate and related drugs with regards to:

1. Their impact on brain development, especially in young children (a topic in which there is still relatively little conclusive data available).
2. How dopamine level changes due to these medications may alter the dopamine system, including the levels of dopamine transporter proteins (DAT proteins).
3. The role of early stimulant exposure on latter stimulant abuse (although Kollins notes that early treatment with appropriate stimulants may actually have a protective effect against latter stimulant abuse).

For the most part, I am in agreement with this line of thinking. It is my opinion that we should shift our focus away from the fears of addiction potentials with regards to stimulant medications taken via appropriate doses and methods for ADHD and related disorders, and instead shift our attentions to the effects of these substances on the developing nervous systems of young children. We have seen that methylphenidate has several built-in safety measures with regards to reducing its abuse potential. Furthermore, I personally believe that there are much greater potential risks of stimulant medications with regards to their effects on the critical early neural developmental stages (such as those in the first 5 years of life) than to overall addiction potentials of these substances, and that our research focuses with regards to overall safety of these medications should shift in this direction.

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Beauty News: Appetite Suppressing Lipgloss?

We always want more from our beauty products so in response to demand more and more products-multitaskers hit the market. The most recent one combines lipgloss and appetite suppressing extract of hoodia in one! Photo by Jimmie xx at flickr.comHuge Lips Skinny Hips lip gloss to be launched in Europe (UK) and in the US in March was developed by the brand called Purple Lab. Vitamin B3 contained in

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Acne Scars- Treat Them At Home With Tretnoin

Acne scars- why do they form?

When we get acne many times it resolves without getting infected. This kind of acne leaves hyper pigmentation that fades over a time. When acne becomes infected, it spreads deeper inside and damages the collagen in the dermal layer. As the inflammation increases, more of skin tissues are killed and when the acne gets treated, it leaves a scar, which is normally a deep scar. The depth depends upon the damage done by acne, which depends upon it's severity.

Acne scar treatment option-

If the scar is deep, you may have to get deep or medium depth chemical peeling done. Laser is another option while dermabrasion is also effective. Your doctor will decide about how to remove such deep scars because some filler may also be needed to fill the scarred skin. If the scar is not deep, you can do superficial peeling with tretinoin at home.

Superficial acne scars and tretinoin-

Tretinoin peels the upper layer of the skin. By repeated application, your mild superficial scar will become less prominent. You have the option of using an OTC product or a prescription product. Please consult your doctor about that. Along with treating mild scars tretinoin also removes dead skin cells and removes superficial age lines and spots.

This article is only for informative purposes. This article is not intended to be a medical advise and it is not a substitute for professional medical advice. Please consult your doctor for your medical concerns. Please follow any tip given in this article only after consulting your doctor. The author is not liable for any outcome or damage resulting from information obtained from this article.

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