Stimulants ADHD, behavioral symptoms

After antidepressants, stimulants constitute the second most widely prescribed class of therapeutic agents for children with ASD (Oswald and Sonenklar, 2007). The primary rationale for the use of stimulants in ASD is to reduce symptoms of hyperactivity and irritability, based on their effectiveness in treating behavioral symptoms of attention-deficit hyperactivity disorder (ADHD) (Findling, 2008). 

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). 

Additionally, stimulant-associated improvements in social interactions positively influence the social behavior of others in the child s environment (Cunningham et ah, 1991 Whalen and Henker, 1992). Parents, teachers, siblings, and peers are more positive toward and less critical of the treated child with ADHD. Thus, when social impairments are associated with ADHD symptoms, pharmacotherapy may be a useful treatment modality. 

Botteron and Geller (1999) listed stimulants as first-line therapies for disruptive disorders in typically developing children, followed by antipsychotics, lithium, and carbamazepine. The psychostimulants have usually been shown to provide some improvement in disruptive behavior, although ADHD symptoms have ordinarily been the main target of treatment (Arnold,... 

For a while, after the discovery of the impressive effects stimulants have on most ADHD symptoms, researchers thought stimulants themselves could be used as a test for ADHD. In other words, if the person s behavior improved while taking stimulants, then he or she had ADHD. If the person s behavior did not improve, then he or she did not have ADHD. 

The symptoms of inattention, distractibility, and/or hyperactivity that define attention-deficit/hyperactivity disorder (ADHD) improve when treated with the stimulant drug Ritalin. For long-term success, however, the behaviors associated with these symptoms can also addressed with different techniques, some of which have been described in Chapter 2. 

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