{"podcast":{"title":"General Practice Clinical Sessions Podcast","slug":"general-practice-clinical-sessions-podcast-7705659","podcast_index_feed_id":7705659,"rss_url":"https://feeds.captivate.fm/general-practice/","website_url":"https://www.armchairmedical.tv/","image_url":"https://artwork.captivate.fm/7c6425be-c9cb-43f8-85b1-119cdf34389c/ArmchairMedical-60.png","author":"ArmchairMedical.tv/podcasts","episode_count":121,"summary":"General Practice Clinical Sessions is a GP podcast that removes the need to attend live webinars. Instead of giving up an evening with your family to watch live, or spending a weekend at a training day, you listen to the recordings here at 1.5 times the speed and while you're commuting, exercising, or doing chores around the house. It's the same education, in a fraction of the time and without the sacrifice. New episodes are delivered twice per week, so you'll always have something interesting to listen to. Subscribe to our newsletter to be notified of new sessions. https://www.armchairmedical.tv/","last_synced_at":"2026-09-20T18:22:14.442708+00:00","page_url":"https://stenobird.com/podcast/general-practice-clinical-sessions-podcast-7705659"},"episode":{"title":"Beyond the basics management of complex ADHD patients. When GPs should decline shared care. - Primary Care Masterclass Podcast","slug":"beyond-the-basics-management-of-complex-adhd-patients-when-gps-should-decline-shared-care-primary-care-masterclass-podcast","published_at":"2026-08-08T19:30:00+00:00","page_url":"https://stenobird.com/podcast/general-practice-clinical-sessions-podcast-7705659/beyond-the-basics-management-of-complex-adhd-patients-when-gps-should-decline-shared-care-primary-care-masterclass-podcast","show_page_url":"https://stenobird.com/podcast/general-practice-clinical-sessions-podcast-7705659","url":"https://armchairmedical.captivate.fm/episode/beyond-the-basics-management-of-complex-adhd-patients","audio_url":"https://podcasts.captivate.fm/media/94afc90b-e569-4b9e-910d-82a5a0526520/Beyond-the-basics-management-of-complex-ADHD-patients-Dr-Vicki.mp3?played_on=486c29fc-7248-4647-8c4e-940eddd72033","summary":"Dr. Vicki Nahamkes presents a guide for General Practitioners on managing complex ADHD patients, emphasizing that while treatment is rewarding, it requires rigorous monitoring and boundary setting. She introduces a \"3C Rule\" for patient reviews, assessing **Mental Clarity** (organized thinking), **Calm** (mood regulation), and **Consistency** (sleep, diet, and exercise). Cardiovascular safety is a primary concern, particularly for older patients. Dr. Nahamkes advises a cardiovascular risk assessment before starting stimulants, aiming for a risk score below 5%. Regular blood pressure checks are mandatory, as stimulants can increase pressure by 2–4 mmHg; hypertension must be managed or the stimulant withdrawn. A significant portion of the talk addresses special populations and comorbidities: * **Women’s Health:** Hormonal fluctuations during menopause can severely destabilize ADHD control. Dr. Nahamkes shares a case where a patient required increased stimulant dosage and Hormone Replacement Therapy to regain stability. * **Binge Eating Disorder:** She notes that Vyvanse is the only stimulant evidence-based for this comorbidity. * **Bipolar Disorder:** There is a risk of stimulants unmasking mania. A detailed case study describes a patient who developed hypersexuality and reckless behavior upon starting stimulants, eventually requiring a transition to mood stabilizers like Lamotrigine instead of ADHD medication. Dr. Nahamkes concludes with clinical pearls, noting that successful treatment often results in *decreased* steps on fitness trackers, indicating less chaotic movement and better organization. Finally, she empowers GPs to decline \"shared care\" for patients with complex presentations—such as those with Cluster B personality traits or unstable bipolar disorder—statin…","meta_description":"Dr. Vicki Nahamkes presents a guide for General Practitioners on managing complex ADHD patients, emphasizing that while treatment is rewarding, it require…","key_points":[],"chapters":[],"topics":[],"duration_seconds":1900,"processing_state":"not_requested","actions":[{"name":"request_transcript","method":"POST","url":"https://stenobird.com/v1/public/podcasts/general-practice-clinical-sessions-podcast-7705659/episodes/beyond-the-basics-management-of-complex-adhd-patients-when-gps-should-decline-shared-care-primary-care-masterclass-podcast/transcription-requests","description":"Idempotently request low-priority transcript generation for this episode."},{"name":"read_markdown","method":"GET","url":"https://stenobird.com/podcast/general-practice-clinical-sessions-podcast-7705659/beyond-the-basics-management-of-complex-adhd-patients-when-gps-should-decline-shared-care-primary-care-masterclass-podcast.md","description":"Read the agent-friendly Markdown representation of this episode resource."}]}}