Children and Adults with Attention Deficit Disorders

Children and Adults with Attention Deficit Disorders, 499 N.W. 70th Ave., Suite 101, Planation, FL, USA, 33317, (800) 233-4050, . 

Not everyone agrees. For instance, the organization Children and Adults with Attention Deficit Disorder (CHADD) strongly argues for Ritalin use as a way to improve performance,... 

Children and Adults with Attention Deficit Disorder (CHADD)... 

Founded in 1987, Children and Adults with Attention Deficit Disorders (CHADD) has now expanded its horizons to include adults, as well, with... 

At the time of the first edition of this book in 1983, the organization called itself CH.A.D.D. That has been simplified to CHADD. Its official name has been expanded into Children and Adults with Attention Deficit Hyperactivity Disorders. 

Dulcan, M. (American Academy of Child and Adolescent Psychiatry) (1997) Practice parameters for the assessment and treatment of children, adolescents and adults with attention-deficit/hyperactiv-ity disorder. / Am Acad Child Adolesc Psychiatry 36(Suppl) 85S-121S. 

It is important to carefully document core ADHD symptoms at baseline to provide a reference point from which to evaluate effectiveness of treatment. Improvement in individualized patient outcomes are desired, such as (1) family and social relationships, (2) disruptive behavior, (3) completing required tasks, (4) self-motivation, (5) appearance, and (6) self-esteem. It is very important to elicit evaluations of the patient s behavior from family, school, and social environments in order to assess the preceding. Using standardized rating scales (e.g., Conners Rating Scales-Revised, Brown Attention-Deficit Disorder Scale, and IOWA Conners Scale) in both children and adults with ADHD helps to minimize variability in evaluation.29 After initiation of therapy, evaluations should be done every 2 to 4 weeks to determine efficacy of treatment, height, weight, pulse, and blood pressure. Physical examination or liver function tests may be used to monitor for adverse effects. 

Children with ADHD are inattentive, impulsive, and hyperactive. The areas of their brains that control attention and restraint do not function properly. Stimulant drugs, specifically amphetamines, have been used in the United States to treat children with inattention and hyperactivity disorders since the 1930s. MPH was also discovered to have a calming effect on hyperactive children and a focusing effect on those with attention deficit disorder (ADD). However, it was not until the 1960s that the U.S. Food and Drug Administration (FDA) approved methylphenidate for the treatment of ADHD. At the turn of the twenty-first century, approximately 90% of all methylphenidate was prescribed for ADHD children. Most of the rest was prescribed to treat adults with a sleeping sickness known as narcolepsy. 

It has been suggested that abnormalities in attention-deficit/hyperactivity disorder in children and adults may be similar to those seen in early stages of PD (McCracken 1991). Of interest is that nicotinic mechanisms interact closely with dopamine systems (Kirch et al. 1988) and that nicotinic receptors may serve to regulate dopamine release (Clarke and Pert 1985 Rapier et al. 1990) in striatal and mesolimbic pathways. Nicotine is now being tried as an experimental treatment for attention-deficit/hyperactivity disorder in adults (Levin et al. 1995). 

Initially, the neuroleptics were used to manage severe anxiety, agitation, and aggression in individuals with severe mental illness such as schizophrenia, a psychotic illness characterized by delusions, hallucinations, and disorganized, illogical thinking. The first neuroleptic used in schizophrenia was chlorpromazine (Thorazine) in 1952. Additional neuroleptics were later developed to treat a variety of other disorders and conditions in children and adults, including autism, attention-deficit hyperactivity disorder (ADHD), bipolar dis-... 

Methylphenidate (Ritalin). Ritalin is a sympathomimetic agent with psychostimulant properties similar to S(+)-amphetamine. It is widely used to treat attention deficit hyperactivity disorder (ADHD) in children and adults. There has been increasing diversion and abuse of methylphenidate among children and adults for its stimulant and purported aphrodisiac properties. In overdose, the clinical effects of methylphenidate are similar to those of amphetamine. Relatively few cases of serious overdose have been reported. 

Dr. Lynn Crismon s work in developing the Texas Medication Algorithms for treatment of depression in children and adults and the treatment of attention-deficit hyperactivity disorder in children" "" laid the groundwork for psychiatric pharmacists to work with psychiatrists, psychologists, other health care professionals, and consumer groups to develop and implement national therapeutic guidelines. 

OTHER THERAPEUTIC USES OE THESE DRUGS The various antidepressant agents have found broad utility in other disorders that may not be related psychobiologicaUy to the mood disorders. Current applications include rapid but temporary suppression of enuresis with low (e.g., 25 mg) pre-bedtime doses of tricyclic antidepressants, including imipramine and nortriptyline, by uncertain mechanisms in children and in geriatric patients, as well as a beneficial effect of duloxetine on urinary stress incontinence. Antidepressants have a growing role in attention-deficit/hyperactivity disorder in children and adults, for which imipramine, desipramine, and nortriptyline appear to be effective, even in patients responding poorly to or who are intolerant of the stimulants (e.g., methylphenidate). Newer NE selective reuptake inhibitors also may be useful in this disorder atomoxetine is approved for this application. Utility of SSRIs in this syndrome is not established, and bupropion, despite its similarity to stimulants, appears to have limited efficacy. 

Drug treatment of childhood psychosis and other behavioral disorders of children is confused by diagnostic inconsistencies and a paucity of controlled trials. Antipsychotics can benefit children with disorders characterized by features that occur in adult psychoses, mania, autism, or Tourette s syndrome. Low doses of the more potent or modem atypical agents usually are preferred in an attempt to avoid interference with daytime activities or performance in school. Attention deficit disorder, with or without hyperactivity, responds poorly to antipsychotic agents, but... 

McCarthy S, Cranswick N, Potts L, Taylor E, Wong IC. Mortality associated with attention-deficit hyperactivity disorder (ADHD) drug treatment a retrospective cohort study of children, adolescents and young adults using the general practice research database. Drug Saf 2009 32 1097-100. 

The developing human brain is much more susceptible to injury caused by toxic agents than the brain of an adult. Probably all potential neurotoxic compounds would also cause damage to the developing brain and at much lower doses [1], Indeed, neuro-developmental disorders in children such as attention deficit, mental retardation or autism are often associated with the exposure to chemicals in the environment during early fetal and postnatal development [1-3]. 

Given the attentional improvement that has been demonstrated with nicotinic receptor stimulation, there are implications for nicotine or novel nicotinic agonists as a possible treatment strategy in attention deficit-hyperactivity disorder (ADHD). This is a disorder primarily of children, but affects adults as well. ADHD afflicts as many as 3-5% of American children (American Psychological Association, 1994) and is characterized by inattention, restlessness, impulsiveness and hyperactivity. There is sig-... 

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