Attention-deficit/hyperactivity disorder dependence

Somoza EC, Winhusen TM, Bridge TP, et al An open-label pilot study of methylpheni-date in the treatment of cocaine-dependent patients with adult attention deficit/ hyperactivity disorder. J Addict Dis 23 77—92, 2004 Sora 1, Wichems C, Takahashi N, et al Cocaine reward models conditioned place preference can be established in dopamine- and in serotonin-transporter knockout mice. Proc Natl Acad Sci U S A 95 7699-7704, 1998 Soral, Hall FS, Andrews AM, etal Molecular mechanisms of cocaine reward combined dopamine and serotonin transporter knockouts eliminate cocaine place preference. Proc Nad Acad Sci U S A 98 5300-5305, 2001 Spear J, Alderton D Psychosis associated with prescribed dexamphetamine use 0etter). 

Tennant FS, Tarver AL, Rawason RA (1983) Clinical evaluation of mecamylamine for withdrawal from nicotine dependence. In Harris LS (ed) Problems of drug dependence, NIDA Research Monograph 49. USDHHS publication no, 84-1316, pp 239-246 Tercyak KP, Herman C, Audrain J (2002) Association of attention-deficit/hyperactivity disorder symptoms with levels of cigarette smoking in a community sample of adolescents, J Am Acad Child Adolesc Psychiatry 41 799-805... 

Vandenbergh, D. J., Thompson, M. D., Cook, E. H., et al. (2000) Human dopamine transporter gene coding region conservation among normal, Tourette s disorder, alcohol dependence and attention-deficit hyperactivity disorder populations. Mol. Psychiatry. 5, 283-292. 

Riggs, P., Thompson, L., Mikulich, S., Whitmore, E., and Crowley, T. (1996) An open trial of pemoline in drug-dependent delinquents with attention-deficit hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 35 1018-1024. 

Hill JC, Schoener EP. Age-dependent decline of attention deficit hyperactivity disorder. Am J Psychiatry 1996 153 1143-1146. 

Whitmore, Elizabeth A., Susan K. Mikulich, Laetitia L. Thompson, Paula D. Riggs, Greg A. Aarons, and Thomas J. Crowley. 1997. "Influences on Adolescent Substance Dependence Conduct Disorder, Depression, Attention Deficit Hyperactivity Disorder, and Gender." Drug and Alcoltol Dependence47 87-97. 

Also falling within the scope of modern psychiatric diagnostic systems are organic mental disorders (e.g. dementia in Alzheimer s disease), disorders due to substance misuse (e.g. alcohol and opiate dependence—see Chapter 10), personality disorders, disorders of childhood and adolescence (e.g. attention deficit/hyperactivity disorder, Tourette s syndrome) and mental retardation (learning disabilities). 

The administration of ginseng has also been studied in the treatment of attention-deficit hyperactivity disorder (ADHD). Lyon et al., conducted a pilot study (n = 36) evaluating the effects of a combination product containing ginseng and ginkgo for the treatment of ADHD (44). The investigators reported improvement in 31-67% of the subjects depending on the outcome measure however, no placebo control was included, so it is difficult to ascertain if the effect was caused by the treatment or a placebo effect. 

The philosophy of evidence-based practice is widely accepted, although operational and implementation issues represent major barriers. One of the significant barriers is a shortage of evidence reports on topics of critical interest, and the lack of a national infrastructure to prepare such reports. In response to this need, AHRQ has funded 12 Evidence-based Practice Centers to conduct systematic, comprehensive analyses and syntheses of the scientific literature to develop evidence reports and technology assessments on clinical topics that are common, expensive, and present challenges to decision makers. Since December 1998, 11 evidence reports have been released on topics that include sleep apnea, traumatic brain injury, alcohol dependence, cervical cytology, urinary tract infection, depression, dysphasia, sinusitis, stable angina, testosterone suppression, and attention deficit hyperactivity disorder. 

Analysis of structured psychiatric interviews makes it possible to identify different subtypes of the disorder, depending on the prevalence (and persistence for at least 6 months) of different symptoms (9 for the attention deficit variant and 9 for the hyperactive variant) (i) ADHD, combined type subtype (6/9 or more inattention symptoms and 6/9 or more hyperactivity/impulsiv-ity symptoms) (ii) ADHD, predominantly inattentive type subtype (6/9 or more inattention symptoms, but fewer than 6/9 hyperactivity/impulsivity symptoms) (iii) ADHD, predominantly hyperactive-impulsive type sub-type (6/9 or more hyperactivity-impulsivity symptoms, but fewer than 6/9 inattention symptoms). The minimum score for a child to be considered to be affected with ADHD is therefore 6/9 for both ADHD, predominantly inattentive type and ADHD, predominantly hyperactive-impulsive type subtypes, and at least 12/18 for the ADHD, combined type subtype. 

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