Attention deficit-hyperactivity disorder treatment

Treatment of attention deficit hyperactivity disorder (ADHD) in children with psychostimulants... 

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

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). 

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. 

Treatment goals for attention-deficit hyperactivity disorder are to improve behavior, increase attention/response inhibition (ability to stay on task), and minimize side effects associated with pharmacotherapy. 

Pharmacotherapy is superior to behavioral therapy in the treatment of attention-deficit hyperactivity disorder. Behavior modification provided by parents and teachers in conjunction with pharmacotherapy improves treatment outcomes more than behavior therapy alone. 

American Academy of Pediatrics Subcommittee on Attention-Deficit/Hyperactivity Disorder and Committee on Quality Improvement. Clinical practice guideline Treatment of the school-aged child with attention-deficit/hyperactivity disorder. Pediatrics 2001 108 1033-1044. 

Wolraich ML, Wibbelsman CJ, Brown TE, et al. Attention-deficit/hyperactivity disorder among adolescents A review of the diagnosis, treatment, and clinical implications. Pediatrics 2005 115(6) 1734-1746. 

Brown CS and Cooke SC (1994). Attention deficit hyperactivity disorder, clinical features and treatment options. CNS Drugs, 1, 95-106. 

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. 

Dresel, S., Krause, J., Krause, K. H. et al. Attention deficit hyperactivity disorder binding of 99mTc TRODAT-1 to the dopamine transporter before and after methylphenidate treatment. Eur. J. Nucl. Med. 27 1518-1524,2000. 

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. 

Elia J, Ambrosini PJ, Rapoport JL. Drug therapy treatment of attention-deficit-hyperactivity disorder. New Engl J Med 1999 340(10) 780-788. 

Greenhill LL, Ford RE. Childhood attention-deficit-hyperactivity disorder pharmacological treatments. In Nathan PE, Gorman JM (eds), A Guide to Treatments that Work, 2nd Edition. London Oxford University Press, 2002, pp 25-55. 

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

Rubia K, Smith A. Attention deficit-hyperactivity disorder current findings and treatment. Curr Opin Psychiatry 2001 14(4) 309-316. 

Spencer TJ, Biederman J, Wilens TE, Earaone SV. Novel treatments for attention-deficit/ hyperactivity disorder in children. J Clin Psychiatry 2002 62(Supplement 12) 16-22. 

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. 

Popovic B, Bhattacharya P, Sivaswamy L. (2(X)9) Lisdexamfetamine A prodrug for the treatment of attention-deficit/hyperactivity disorder. Am J Health-Sys Pharm 66 2005-2012. 

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. 

Attention deficit disorder (ADD)/Attention deficit hyperactivity disorder (ADHD) As an integral part of a total treatment program that typically includes other remedial... 

APPROVED TREATMENTS FOR ATTENTION DEFICIT HYPERACTIVITY DISORDER AMPHETAMINE (ADDERALL ), METHYLPHENIDATE (RITALIN ), AND ATOMOXETINE (STRATERRA )... 

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. 

Uniabeied Uses Treatment of attention-deficit/hyperactivity disorder, brain injury-re-lafed underarousal, depression, endozepine stupor, multiple sclerosis-related fatigue, parkinson-related fatigue, seasonal affective disorder... 

Unlabeled Uses Treatment of Alzheimer s disease, attention-deficit-hyperactivity disorder, depression, early Parkinson s disease, extrapyramidal symptoms, negative symptoms of schizophrenia... 

PHARMACOLOGICAL TREATMENT FOR ATTENTION-DEFICIT HYPERACTIVITY DISORDER RELEVANCE TO MODULATORY PROCESSES... 

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. 

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