ADD - ADHD
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ADD - ADHD
NIH - Attention Deficit Hyperactivity Disorder
"According to the most recent version of the Diagnostic and Statistical Manual of Mental Disorders2 (DSM-IV-TR), there are three patterns of behavior that indicate ADHD. People with ADHD may show several signs of being consistently inattentive. They may have a pattern of being hyperactive and impulsive far more than others of their age. Or they may show all three types of behavior. This means that there are three subtypes of ADHD recognized by professionals. These are the predominantly hyperactive-impulsive type (that does not show significant inattention); the predominantly inattentive type (that does not show significant hyperactive-impulsive behavior) sometimes called ADD—an outdated term for this entire disorder; and the combined type (that displays both inattentive and hyperactive-impulsive symptoms)."
Highlighted Article
Supplementation with flax oil and vitamin C improves the outcome of Attention Deficit Hyperactivity Disorder (ADHD). (Prostaglandins Leukot Essent Fatty Acids. 2006)
"Supplementation with flax oil and vitamin C improves the outcome of Attention Deficit Hyperactivity Disorder (ADHD). (Prostaglandins Leukot Essent Fatty Acids. 2006) "This pilot study evaluates the effect of alpha linolenic acid (ALA)-rich nutritional supplementation in the form of flax oil and antioxidant emulsion on blood fatty acids composition and behavior in children with ADHD. Post-supplementation levels of RBC membrane fatty acids were significantly higher than pretreatment levels as well as the levels in control. There was significant improvement in the symptoms of ADHD reflected by reduction in total hyperactivity scores of ADHD children derived from ADHD rating scale."
Notes
The Guidelines section will contain the 2006 and certain 2005 updated published guidelines. To view Guidelines from previous years, view year 2005 InfoMedlinks (Articles section) or our Monthly Online Newsletter (under the Guidelines section).
Attention Deficit Disorder and Attention Deficit Hyperactivity Disorder
Daily Treatment Report
Cognitive Therapy-CBT-Psychotherapy
Behavioral Training of Parents Reduces Office Visits and Need for Polypharmacy in ADHD "Children with attention deficit–hyperactivity disorder (ADHD) require fewer office visits and are less likely to be taking multiple medications if their parents receive behavioral training … "
Drug Side-Effects and Interactions
Methylphenidate (Ritalin)-associated Cataract and Glaucoma. (J Chin Med Assoc. 2006) "Large dose of methylphenidate may cause cataract and glaucoma. The mechanism remains unclear. Doctors should be aware of the possible ocular side effects of methylphenidate."
FDA Safety Changes: Daytrana, Oncaspar, Alimta "The US Food and Drug Administration (FDA) has approved drug safety labeling revisions to advise of the potential for methylphenidate transdermal therapy to increase the risk for cardiovascular events and exacerbate psychotic symptoms in certain patients; the risk for serious thrombotic events in patients receiving pegaspargase therapy; and dose-limiting myelosuppression in patients receiving treatment with pemetrexed injection."
Isolated atomoxetine (Stratteratrade mark) ingestions commonly result in toxicity. (J Emerg Med. 2006) "Supratherapeutic ingestions of atomoxetine can result in transient tachycardia, vomiting, and cognitive disturbances."
[ADHD drugs and cardiovascular risk] (Ned Tijdschr Geneeskd. 2006)
FDA calls for new warnings on ADHD drugs "The drugs, which include GlaxoSmithKline Plc's Dexedrine and Novartis AG's Ritalin, must include a warning about the possible risk of sudden death and serious heart problems."
Dexedrine (dextroamphetamine sulfate)
Medications for attention deficit hyperactivity disorder: cardiovascular concerns.
Avoid ADHD Drugs, Canada Tells Heart Patients "Canada's health ministry on Friday warned individuals with hypertension, heart disease or abnormalities, arthrosclerosis or hyperthyroidism not to take drugs used to manage attention deficit hyperactivity disorder (ADHD)."
Study: ADHD Drugs Send Thousands to ERs
ADHD drugs should carry warning, FDA committee recommends
ADHD Drugs and Cardiovascular Risk (NEJM 2006)
Long-Term Stimulant Medication Treatment of Attention-Deficit/Hyperactivity Disorder: Results from a Population-Based Study (J Dev Behav Pediatr. 2006) "Dextroamphetamine and methylphenidate were equally likely to be associated with a favorable response, but dextroamphetamine was more likely to be associated with side effects. These results demonstrate that the effectiveness of stimulant medication treatment of ADHD provided throughout childhood is comparable to the efficacy of stimulant treatment demonstrated in clinical trials."
Cautions Issued on Use Of Psychiatric Drugs "Newborns whose mothers took antidepressants such as Prozac, Paxil and Zoloft in the last trimester of pregnancy had six times the risk of suffering oxygen deprivation after birth compared with newborns whose mothers had not taken the drugs … adults taking medications such as Adderall and Ritalin to treat attention-deficit hyperactivity disorder might be at higher risk of sudden death and other serious side effects, especially if they have high blood pressure."
FDA report details 25 ADHD drug deaths
Influence of Methylphenidate on brain development - an update of recent animal experiments (Behavioral and Brain Functions 2006) "…this short review updates the influence of MPH on brain development, since recent human and animal studies suggest that MPH alters the dopaminergic system with long-term effects beyond the termination of treatment. Animal studies imply that the effects of MPH may depend on the neural responder system: Whereas structural and functional parameters are improved by MPH in animals with psychomotor impairments, they remain unaltered or get worse in healthy controls."
Drugs
Low-Dose Atomoxetine May Be Effective as ADHD Maintenance Treatment in Children
Preschoolers with ADHD Improve with Low Doses of Medication
Efficacy and Safety of Immediate-Release Methylphenidate Treatment for Preschoolers With ADHD. (J Am Acad Child Adolesc Psychiatry. 2006)
Methylphenidate-induced improvements of various measures of attention in adults with Attention Deficit Hyperactivity Disorder. (J Neural Transm. 2006) "The present findings indicate that adults with ADHD are not differentially impaired in attentional processes but may suffer from a more global deficit of attention. Although MPH treatment has been found to be effective in the treatment of the attention deficit of adults with ADHD, additional treatment appears to be necessary."
Effects of methylphenidate on subtypes of attention-deficit/hyperactivity disorder. (J Am Acad Child Adolesc Psychiatry. 2006)
Viewpoint: Atomoxetine Used Differently Than Stimulants for ADHD
Adult ADHD: Effective Treatment Strategies
Atomoxetine Versus Stimulants for Treatment of Attention Deficit/Hyperactivity Disorder (The Annals of Pharmacotherapy 2006) ”CONCLUSIONS: Based on available evidence, psychostimulants are regarded as first-line pharmacologic treatment for children and adolescents with ADHD, as the efficacy and safety of these agents have been well established based on clinical trials and extensive naturalistic use. Adverse effects in some patients and abuse potential have led to the search for new treatments. Atomoxetine represents an alternative treatment for ADHD and is unlikely to be associated with abuse; however, long-term safety data are needed to further establish its place in therapy."
Long-term outcomes of stimulant medication in attention-deficit hyperactivity disorder. (Expert Rev Neurother. 2006) "Stimulant medication may slightly elevate the blood pressure and possibly increase susceptibility to seizures and to tics and Tourette syndrome. Starting treatment with stimulant medication is usually associated with weight loss and a transient slowing of the height velocity, although it is believed that most children catch up during puberty. No studies were found that listed strokes or heart attacks as potential or actual complications, although one individual from a group of normal controls died suddenly of cardiac arrest in adolescence. It would appear that the medical complications associated with amphetamine addiction are not relevant to the therapeutic use of stimulant medication in the treatment of ADHD, although there is limited information on extended periods of treatment lasting 10 years or more."
FDA OKs First Attention Deficit Patch
[Benefit of the extended-release methylphenidate formulations: a comparative study in childhood.] (Arch Pediatr. 2006) "Methylphenidate (MPH) is a potential therapeutic tool for Attention Deficit with Hyperactivity Disorders (ADHD). In addition to the immediate-release formulation, Ritalin((R)), two extended-release formulations, Ritalin((R)) LA(TM) and Concerta((R)) are available and allow a once-daily administration. We compared the respective benefits of both formulations for the patients and their family in terms of efficacy, handling and tolerance. … CONCLUSIONS: MPH therapy in ADHD carries an excellent risk/benefit ratio without addictive induced behaviours. The extended-release MPH formulations provide an improvement for the patients in keeping with Ritalin((R)) efficacy through a once-daily administration. Regardless of its formulation, MPH indications and guidelines must be respected."
Efficacy of methylphenidate in children with attention-deficit hyperactivity disorder and learning disabilities: a randomized crossover trial. (J Psychiatry Neurosci. 2006)
A randomized, double-blind, placebo-controlled, laboratory classroom assessment of methylphenidate transdermal system in children with ADHD. (J Atten Disord. 2006)
Pharmacotherapy of attention-deficit hyperactivity disorder in children and adolescents: update on new stimulant preparations, atomoxetine, and novel treatments. (Child Adolesc Psychiatr Clin N Am. 2006) "This article reviews data on the safety, tolerability, and efficacy of the extended-delivery stimulant preparations and atomoxetine, including nine methylphenidate formulations, five amphetamine formulations, and one norepinephrine reuptake inhibitor, now indicated for treatment of attention-deficit hyperactivity disorder (ADHD)."
A Randomized, Placebo-Controlled Trial of OROS Methylphenidate in Adults with Attention-Deficit/Hyperactivity Disorder. (Biol Psychiatry. 2005) "CONCLUSIONS: These results show that treatment with OROS MPH in daily doses of up to 1.3 mg/kg/day was effective in the treatment of adults with ADHD. Because of the potential for increases in blood pressure and heart rate, subjects receiving treatment with MPH should be monitored for changes in blood pressure parameters during treatment."
Exercise
General Information
Attention-deficit/hyperactivity disorder with obstructive sleep apnea: A treatment outcome study. (Sleep Med. 2006) "CONCLUSION: A low AHI score of >1 considered abnormal is detrimental to children with ADHD. Recognition and surgical treatment of underlying mild sleep-disordered breathing (SDB) in children with ADHD may prevent unnecessary long-term MPH usage and the potential side effects associated with drug intake."
Volumetric MRI differences in treatment-naive vs chronically treated children with ADHD. (eurology. 2006)
Study May Explain How ADHD Treatments Work
Medicine Goes to School: Teachers as Sickness Brokers for ADHD
Adult with ADHD? Try medication + psychotherapy (Current Psychiatry 2006)
[Multimodal Therapy of Children with Attention Deficit/Hyperactivity Disorder and their Parents in In-patient Rehabilitation.] (Rehabilitation (Stuttg). 2006)
The adult psychiatrist's dilemma: psychostimulant use in attention deficit/hyperactivity disorder. (J Psychopharmacol. 2006)
Guidelines
Internet Sites
Treatment Information
Treating Attention Deficit Hyperactivity Disorder
Drug-Food-Supplement Information
DrugDigest (drug interactions)
FDA - Drug Interactions: What You Should Know
NIH - Botanical Dietary Supplements: Background Information
NIH - Drug, Supplements, and Herbal Information
NIH - Herbal Supplements: Consider Safety, Too
NIH - Vitamin and Mineral Supplement Fact Sheets
Nutrition
Other
Other Treatments
Nonpharmacologic Approaches to Treating ADHD (Medscape Psychiatry & Mental Health. 2006)
Experimental
Supplements-Vitamins-CAM
Use of Complementary and Alternative Medicine among Children Diagnosed with Autism Spectrum Disorder. (J Autism Dev Disord. 2006)
Sleep Hygiene and Melatonin Treatment for Children and Adolescents With ADHD and Initial Insomnia. (J Am Acad Child Adolesc Psychiatry. 2006) "CONCLUSION:: Combined sleep hygiene and melatonin was a safe and effective treatment for initial insomnia in children with ADHD taking stimulant medication."
Supplementation with flax oil and vitamin C improves the outcome of Attention Deficit Hyperactivity Disorder (ADHD). (Prostaglandins Leukot Essent Fatty Acids. 2006) "This pilot study evaluates the effect of alpha linolenic acid (ALA)-rich nutritional supplementation in the form of flax oil and antioxidant emulsion on blood fatty acids composition and behavior in children with ADHD. Post-supplementation levels of RBC membrane fatty acids were significantly higher than pretreatment levels as well as the levels in control. There was significant improvement in the symptoms of ADHD reflected by reduction in total hyperactivity scores of ADHD children derived from ADHD rating scale."
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