Attention deficit-hyperactivity disorder stimulants

Leibel S, Bloomberg G. Attention-deficit/hyperactivity disorder stimulant medication reaction masquerading as chronic cough. Arm Allergy... 

Gibson AP, Bettinger TL, Patel NC, Crismon ML (2006) Atomoxetine versus stimulants for treatment of attention deficit/hyperactivity disorder. Ann Pharmacother 40 1134-1142... 

Comorbid conditions must be addressed in order to maximize desired outcomes. For comorbid bipolar disorder and attention-deficit/hyperactivity disorder when stimulant therapy is indicated, treatment of mania is recommended before starting the stimulant in order to avoid exacerbation of mood symptoms by the stimulant. 

Recommend second-line and/or adjunctive agents that can be effective alternatives in the treatment of attention-deficit hyperactivity disorder when stimulant therapy is less than adequate. 

Stimulants are first-line agents for the treatment of attention-deficit hyperactivity disorder. If the initial trial of a stimulant... 

The answer is a. (Hardman, p 22L Katzang, p L3L) Methylphenidate is similar to amphetamine and acts as a CN5 stimulant, with more pronounced effects on mental than on motor activities. It is effective in the treatment of narcolepsy and attention-deficit hyperactivity disorders. 

Wilens, T. E., Faraone, S. V., Biederman, J. and Gunawardene, S. Does stimulant therapy of attention-deficit/hyperactivity disorder beget later substance abuse A meta-analytic review of the literature. Pediatrics 111 179-185, 2003. 

MPH is an amphetamine-like prescription stimulant commonly used to treat Attention Deficit Hyperactivity Disorder (ADHD) and narcolepsy in children and adults. LC/APCI-MS enantiomeric separations of racemic MPH (Ritalin ) were reported using a commercially available vancomycin CSP [111-113]. 

Some psychiatric medications also produce a response within minutes of taking a single dose. Their therapeutic benefit can come very quickly. For example, taking a benzodiazepine such as diazepam (Valium) can quickly relieve panic and anxiety. Taking a stimulant can often rapidly relieve the symptoms of attention deficit-hyperactivity disorder (ADHD). When psychiatric medications work this quickly, we assume that the therapeutic benefit is a direct consequence of their initiating action in the synapse. 

Dopamine-Stimulating Medications. A variety of drugs that increase the availability of dopamine have been studied in cocaine addicts including L-DOPA, bupropion, amantadine, and methylphenidate. In small uncontrolled trials, these have shown some benefit, but definitive studies have yet to be performed. In addition, some dopamine-stimulating medications (in particular, the stimulants like methylphenidate or the amphetamines) are themselves subject to abuse, though, of note, this is typically not a problem when they are prescribed to patients who do not have a history of substance abuse such as, for example, in the treatment of attention deficit-hyperactivity disorder. 

Jensen P. Longer term effects of stimulant treatments for attention-deficit/hyperactivity disorder. J Attention Disord 2002 6(Supplement 1) S17-S30. 

Stimulants. A handful of case reports hint that treatment with stimulants (meth-ylphenidate or dextroamphetamine) can help manage behavioral agitation in patients who have suffered a TBI. Certainly, stimulant therapy helps control the impulsivity and hyperactivity of children with attention deficit-hyperactivity disorder. Despite these encouraging signs, we have to discourage any routine use of stimulants when attempting to manage behavioral lability in TBI patients. Because stimulants have the potential to exacerbate behavioral lability, we recommend that they only be considered when other medication alternatives have been exhausted. 

Gillberg C, Melander H, von Knorring AL, Janols LO, Themlnnd G Hagglof B, Eidevall-Wallin L, Gustafsson P, Kopp S. (1997) Long-term stimulant treatment of children with attention-deficit hyperactivity disorder symptoms. A randomized, donble-blind, placebo-controlled trial. Arch Gen Psychiatry 54 857-864. 

Attention deficit hyperactivity disorder (ADHD) For the treatment of ADHD in patients 6 years of age and older. Dexmethylphenidate is indicated as an integral part of a total treatment program for ADHD that may include other measures (eg, psychological, educational, social) for patients with this syndrome. Drug treatment may not be indicated for all patients. Stimulants are not intended for use in the patient who exhibits symptoms secondary to environmental factors or other primary psychiatric disorders, including psychosis. 

The therapeutic indications for the psychomotor stimulants are quite limited. They are beneficial in the treatment of the hyperkinetic syndrome (attention deficit-hyperactivity disorder with minimal brain dysfunction). This is generally a childhood disease characterized by hyperactivity, inability to concentrate, and impulsive behavior. Amphetamines and the more extensively used methylphenidate paradoxically are quite effective in calming a large proportion of children with this disorder. Pemoline Cylert) is also used in the treatment of attention deficit disorder with hyperkinetic behavior. The mechanism by which these compounds are effective in this disorder is not known. 

Solanto, M.V. (2001) Attention-deficit/hyperactivity disorder clinical features. In Solanto, M.V., Arnsten, A.F.T., and Castellanos, F.X., Stimulant Drugs and ADHD-.Basic and Clinical Neuroscience. New York Oxford University Press, pp. 3—30. 

The increasing use of stimulants in the United States to treat attention deficit hyperactivity disorder (ADHD) has aroused parental concern and compelled both medical professionals and the media to question the safety and efficacy of this type of treatment. Because ADHD is among the most common reasons for seeking mental health services for children, these questions are more pertinent than ever. This chapter will examine the history of stimulant use, the mechanism of action, pharmacokinetics, side effects, and issues related to their clinical use in children and adolescents. More detailed information on clinical applications is provided in Section III. 

Despite the overwhelming evidence for short-term effectiveness, only recently have studies begun to address long-term benefits of stimulant treatments. Prospective randomized controlled trials with durations of 12 to 24 months and doses up to 60 mg/day of MPH have been conducted to address this issue. The largest of these studies, the National Institute of Mental Health (NIMH)-sponsored Multimodal Treatment Study of Attention-Deficit Hyperactivity Disorder (MTA Study), showed that stimulants (either by themselves or in combination with behavioral treatments) lead to stable, long-term improvements in ADHD symptoms as long as the medication is taken (MTA Cooperative Group, 1999). 

Pliszka, S.R. (2000) Comparing the effects of stimulant and nonstimulant agents on catecholamine function implications for theories of attention deficit hyperactivity disorder (ADHD). In Solanto, M. and Castellanos, X., eds. The Neuropharmacology of Psychostimulant Drugs Implications for AD/HD, 1st ed. New York Oxford University Press, pp. 141-160. 

Douglas, V. Barr. R, Desilets, J. and Sherman, E. (1995) Do high doses of stimulants impair flexible thinking in attention-deficit hyperactivity disorder J. Am Acad Child Adolesc Psychiatry 34 877-885. 

Pelham, W., Greenslade, K., Vodde-Hamilton, M., Murphy, D., Greenstein, J., Gnagy, E., Guthrie, K., Hoover, M., and Dahl, R. (1990) Relative efficacy of long-acting stimulants on children with attention deficit-hyperactivity disorder a comparison of standard methylphenidate, sustained-release methylphenidate, sustained-release dextroamphetamine, and pemoline. Pediatrics 86 226-237. 

Lipkin, P.H., Goldstein, I.J., and Adesman, A.R. (1994) Tics and dyskinesias associated with stimulant treatment in attention-deficit hyperactivity disorder. Arch Pediatr Adolesc Med 1994 148 859-861. 

Varley, C.K., Vincent, J., Varley, R, and Calderon, R. (2001) Emergence of tics in children with attention deficit hyperactivity disorder treated with stimulant medications. Compr Psychiatry 42 228-233. 

McCracken JT A two-part model of stimulant action on attention-deficit hyperactivity disorder in children. J Neuropsychiatry Clin Neurosci 3 201-208, 1991... 

Stimulants are a class of psychoactive medications approved by the U.S. Food and Drug Administration (FDA) for use in the treatment of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents and narcolepsy. A hst of available stimulants is shown in Table 6-1. 

Adderall XR (package insert). Wayne, PA, Shire US Inc, 2004 Angrist B, d Hollosy M, Sanfilipo M, et al Central nervous system stimulants as symptomatic treatments for AIDS-related neuropsychiatric impairment. J Clin Psychophamiacol 12 268—272, 1992 Arnold LE, Lindsay RL, Connors CK, et al A douhle-hlind, placebo-controlled withdrawal trial of dexmethylphenidate hydrochloride in children with attention-deficit hyperactivity disorder. I Am Acad Child Adolesc Psychiatry 14 542—554, 2004 Belle DJ, Ernest CS, Sauer JM, et al Effect of potent CYP2D6 inhibition by paroxetine on atomoxetine pharmacokinetics. I Clin Pharmacol 42 1219-1227, 2002... 

Connor DF, Steingard RJ New formulations of stimulants for attention deficit hyperactivity disorder therapeutic potential. CNS Drugs 14 1011— 1030, 2004... 

Russell V, de Villiers A, Sagvolden T, et al Differences between electrically, Ritalin-, and D-amphetamine-stimulated release of pH]dopamine from brain slices suggest impaired vesicular storage of dopamine in an animal model of attention-deficit hyperactivity disorder. Behav Brain Res 94 163-171, 1998... 

Wigal S, Swanson JM, Feifel D, et al A double-blind, placebo-controlled trial of dexmethylphenidate hydrochloride and tf,/-iArco-methylpheni-date hydrochloride in children with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 43 1406-1414, 2004 Wilens TE, Biederman J The stimulants. Psychiatr Clin North Am 15 191-222, 1992... 

Psychostimulants are medications that can increase drive and performance. Their most frequent use is in attention deficit hyperactivity disorder (ADHD) and in narcolepsy. They are also called stimulants or, less commonl today, analeptics. 

According to Saletu (1976), latencies of primary and secondaty responses are shortened after stimulants. Methylphenidate was reported to enhance P300 amplitudes in children with attention deficit hyperactivity disorder (Jonkman et al., 2000). and whether the compound has similar effects in healthy volunteers is not known. The amplitude of the CNV was reported to be increased after stimulants, although the opposite effect has also been observed in some studies. 

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