Hyperactivity syndromes

There is no place anymore for the amphetamines in our therapeutic armamentarium. The only indications for the other stimulants, modaflnil and methylphenidate, are respectively narcolepsy and the attention deflcit disorders (ADHD) and hyperactivity syndromes in children. Their mechanisms of action include enhanced release of dopamine and norepinephrine, re-uptake inhibition of dopamine and norepinephrine and to some extend monoamine oxidase inhibition. 

Ferguson, FI. B., Pappas, B. A., Trites, R. L., Peters, D. A., and Taub, FI., Plasma free and total tryptophan, blood serotonin, and the hyperactivity syndrome No evidence for the serotonin deficiency hypothesis, Biol. Psychiatr., 16(3), 231, 1981. 

Dalteg, A., Gustafsson, P., Levander, S. (1998). [Hyperactivity syndrome is common among prisoners. ADHD not only a pediatric psychiatric diagnosis] Lakartidningen 95(26—27)4078—3080. [Article in Swedish]... 

Cessation of prolonged heavy alcohol abuse may be followed by alcohol withdrawal or life-threatening alcohol withdrawal delirium. Typical withdrawal symptoms are autonomic hyperactivity, increased hand tremor, insomnia and anxiety, and are treated with benzodizepines and thiamine. Alcoholism is the most common cause of thiamine deficiency and can lead in its extreme form to the Wernicke s syndrome that can be effectively treated by high doses of thiamine. 

Liddle s syndrome is an autosomal dominant disorder that is caused by persistent hyperactivity of the epithelial Na channel. Its symptoms mimic aldosterone excess, but plasma aldosterone levels are actually reduced (pseudoaldosteronism). The disease is characterized by early onset arterial hypertension, hypokalemia, and metabolic alkalosis. 

Signs and symptoms of sympathetic nervous system activity are invariably found in MH. Levels of catecholamines are markedly increased in MH. Whether activation of the sympathetic nervous system is a primary or a secondary response in the syndrome has not been fully elucidated. Gronert reported that stress-induced sympathetic hyperactivity can initiate a malignant hyperthermic episode in susceptible swine without a triggering agent. Stress-induced MH in humans has been inferred because susceptible families have been shown to have an increased incidence of sudden death. Gronert s reasons that activation of the sympathetic... 

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. 

ACLS advanced cardiac life support ACS acute coronary syndrome, American Cancer S ety, American Ctrilege of Surgeons ADH antidiuretic hormone ADHD attention-deficit hyperactivity disorder ADR adverse drug reaction AE adverse events AF atrial fibrillation AHA American Heart Association Al aluminum... 

Symptoms of Fragile X syndrome include cognitive impairment, autism, seizures, and hyperactivity. 

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. 

Tourette s syndrome, a heterogeneous behavioral disorder associated with motor and vocal tics of variable form and severity, can be effectively treated with haloperidol. Antipsychotics can also be employed to control disturbed behavior in senile dementia or Alzheimer s disease, since they decrease confusion, agitation, and hyperactivity. Most of these drugs also exhibit a strong antiemetic effect and can sometimes be used clinically for this purpose. 

The continued use of opioids results in the development of physical dependence, as demonstrated by the appearance of a characteristic abstinence syndrome upon interruption or cessation of use. The symptoms of withdrawal include hyperactivity, anxiety, restlessness, yawning, diarrhea, vomiting, chills, fever, lacrimation, and runny nose. Piloerection (gooseflesh or cold turkey), mydriasis, increased blood pressure and heart rate, and hyperpyrexia may be observed. Tremors, abdominal cramps, and muscle and joint pain may be present. Drug craving is an important feature of opioid withdrawal. In contrast to some other drugs of abuse, withdrawal is not life threatening. 

Alcoholism is among the major health problems in most countries. Dependence on ethanol, as with other addictive drugs, is expressed as drug-seeking behavior and is associated with a withdrawal syndrome that occurs after abrupt cessation of drinking. The ethanol withdrawal syndrome is characterized by tremors, seizures, hyperthermia, hallucinations, and autonomic hyperactivity. 

D. These are classic features of opioid abstinence syndrome. The abstinence syndrome in chronic alcohol or barbiturate users consists of hallucinations, tremors, hyperthermia, and autonomic hyperactivity. The abstinence syndrome for users of cocaine and amphetamine is not as stereotyped as for opioids or CNS depressants, such as alcohol and barbiturates. 

Unlabeled Uses Treatment of attention-deficit hyperactivity disorder, autism, behavioral syndromes in dementia... 

In addition to tics, individuals with tic disorders may present with a broad array of behavioral difficulties including disinhibited speech or conduct, im-pulsivity, distractibility, motoric hyperactivity, and obsessive-compulsive symptoms (Leckman and Cohen, 1998). Alternatively, a sizable portion of children and adolescents with tics will be free of coexisting developmental or emotional difficulties. Scientific opinion has been divided on how broadly to conceive the spectrum of maladaptive behaviors associated with Tourette s syndrome (TS) (Comings, 1988 Shapiro et al., 1988). 

Chappell, P.B., Riddle, M.A., Scahill, L., Lynch, K.A., Schultz, R., Arnsten, A., Leckman, J.E, and Cohen, D.J. (1995) Guanfacine treatment of comorbid attention-deficit hyperactivity disorder and Tourette s syndrome preliminary clinical experience. / Am Acad Child Adolesc Psychiatry 34 1140—1146. 

Feigin, A., Kurlan, R., McDermott, M.P., Beach, J., Dimitsopulos, T, Brower, C.A., Chapieski, L., Trinidad, K., Como, P., and Jan-kovic, J. (1996) A controlled trial of deprenyl in children with Tourette s syndrome and attention deficit hyperactivity disorder. Neurology 46 965-968. 

Singer, S., Brown, J., Quaskey, S., Rosenberg, L., Mellits, E., and Denckla, M. (1994) The treatment of attention-deficit hyperactivity disorder in tourette s syndroms a double-blind placebo-... 

Spencer, X, Biederman, J., Kerman, K., Steingard, R., and Wilens, X (1993a) Desipramine in the treatment of children with tic disorder or Xourette s syndrome and attention deficit hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 32 354-360. 

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