Today we interview Richard Brown on three cognitive problems that don't improve with stimulant treatment of ADHD.

Welcome to the Carlyte Psychiatry Podcast, keeping psychiatry honest since 2003.

I'm Chris Agen, the editor-in-chief of the Carlatte Psychiatry Report.

And I'm Kelly Newsome, a psychiatric MP and a dedicated reader of every issue.

Up to 50% of people with ADHD have other cognitive problems that get in the way of full recovery.

We caught up with psychiatrist Richard Brown at his home in upstate New York to understand them.

I feel like we can help patients with the ADD better than any other diagnostic group in psychiatry.

I mean, stimulants work for many people.

You know, you'll see different things in literature, 60 to 80%.

But, of course, there are side effects, and I get to see the ones who don't respond.

You know, the other thing is they only help certain aspects of ADHD, and a lot of other stuff

remains.

What kind of symptoms tend to remain after stimulant use?

Well, I think there's still a lot of executive system dysfunction and higher level cognitive

issues.

And then, of course, there are comorbid conditions, whether it's dyslexia or processing

things.

Two things I try to ask all of my patients to get neuropsych testing one way or another.

I mean, it can be expensive privately, but like in New York, I have them go to a graduate school of

psychology and be tested by somebody who's got a really good supervisor, for example. That's one way of bringing the price down.

And what I look for is processing deficits and which kind of processing problems they have,

as well as working memory.

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