Stimulant Drugs and ADHD

Taylor JR, Jentsch JD (2001) Stimulant effects on striatal and cortical dopamine systems involved in reward-related behavior and impulsivity. In Solanto MV, Arnsten AFT, Castellanos FX (eds) Stimulant drugs and ADHD, Oxford University Press, pp 104-133... 

Ferguson, S.A. (2001) A review of rodent models of ADHD. In So-lanto, M.V., Arnsten, A.F.T., and Castellanos, F.X., eds. Stimulant Drugs and ADHD-.Basic and Clinical Neuroscience. New York Oxford University Press, pp. 209-220. 

Solmto MV, Amsten AF, Castellanos FX. Stimulant Drugs and ADHD Basic and Clinical Neuroscience. New York Oxford University Press, 2001... 

GreenhUl L. L. 2001. Clinical effects of stimulant medication in ADHD, in Stimulant drugs and ADHD Basic and clinical neuroscience, (Solanto M. V, Amsten A. F. T. and Castellanos F. X., eds), pp. 31-71. Oxford University Press, New York Hausknecht K. A., Acheson A., Farrar A. M., Kieres A. K., Shen R. Y., Richards J. B. and Sabol K. E. 2005. Prenatal alcohol exposure causes attention defidts in male rats. Behav. Neurosci. 119 302-310... 

Children are given stimulant drugs for ADHD during a period of time in which they are developing their psychological and social skills, and, indeed, their very identity. What does it mean to a child, and later to the grown adult, to be told that his or her brain has crossed wires or a biochemical imbalance What are the repercussions of children hearing that... 

Substance-Induced Anxiety Disorder. Numerous medicines and drugs of abuse can produce panic attacks. Panic attacks can be triggered by central nervous system stimulants such as cocaine, methamphetamine, caffeine, over-the-counter herbal stimulants such as ephedra, or any of the medications commonly used to treat narcolepsy and ADHD, including psychostimulants and modafinil. Thyroid supplementation with thyroxine (Synthroid) or triiodothyronine (Cytomel) can rarely produce panic attacks. Abrupt withdrawal from central nervous system depressants such as alcohol, barbiturates, and benzodiazepines can cause panic attacks as well. This can be especially problematic with short-acting benzodiazepines such as alprazolam (Xanax), which is an effective treatment for panic disorder but which has been associated with between dose withdrawal symptoms. 

Atomoxetine is the first non-stimulant drug approved for the treatment of ADHD. It is classified as a norepinephrine reuptake inhibitor and is approved for use in children, adolescents, and adults. However, its efficacy has not been studied in children under six years old. 

Drugs such as amphetamine and methylphenidate act to enhance the release and/or inhibit the reuptake of both DA and NE. An extensive review of stimulant actions and their relevance to ADHD can be found in Solanto et al. (2001). Methylphenidate can improve PFC working memory function in healthy adult humans and animals (Mehta et ah, 2000). It is likely that these improvements are due to both DA and NE beneficial actions in PFC, as well as stimulation of posterior association cortices. Some of the ideas regarding the sites of stimulant therapeutic actions in the brain are illustrated in Figure 8.2. 

Whereas some drug studies have been done in children with normal IQ who have conduct disorder, there are very few studies involving children with MR and disruptive behavior problems. We are not aware of any studies of psychostimulants primarily to manage conduct problems in children with MR. However, most studies of children with both MR and ADHD have observed improvements on subscales assessing conduct problems, especially as rated by teachers (Aman et al., 1991, Aman et al., 1993). Given the low toxicity and well-tolerated side effects of the stimulants, they should at least be considered for treating conduct disorder in children and adolescents with MR, especially if they have ADHD. 

Castellanos, F.X., Gulotta, G., and Rapoport, J. (1992) Superior Intellectual functioning and stimulant drug response in ADHD. Poster at May 26-29, 1992 New Clinical Drug Evaluation Unit (NCDEU) meeting, Boca Raton, Florida. 

Attentiveness and on-task behavior. More specifically, stimulant drugs improve the ability of children with ADHD to sustain both attention and... 

Some of these drugs, such as Dexedrine, are derivatives of the illegal stimulant amphetamine. Some drugs, such as Adderall , are also used to treat narcolepsy and ADHD and actually contain a mixture of dextroamphetamine and amphetamine. 

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