ADD - ADHD
- Adult ADD
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- General Information
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- Internet Sites
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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predominantly inattentive type (that does not show significant hyperactive-impulsive behavior) sometimes called ADD—an outdated term for this entire disorder; and the combined type (that displays both inattentive and hyperactive-impulsive symptoms)."
NHS - Attention deficit hyperactivity disorder (ADHD) “Symptoms of ADHD in children and adolescents The symptoms of ADHD in children and adolescents are well defined. The main symptoms of each behavioural problem are detailed below. Inattentiveness • a very short attention span, • being very easily distracted, • being unable to stick at tasks that are tedious, or time consuming, • being unable to listen to, or carry out, instructions, • being unable to concentrate, and • constantly changing activity, or task. Hyperactivity • being unable to sit still, especially in calm or quiet surroundings, • constantly fidgeting, • being unable to settle to tasks, and • excessive physical movement. Impulsiveness • being unable to wait for a turn, • acting without thinking, • breaking any set rules, and • little or no sense of danger. If your child has ADHD, their symptoms usually become noticeable at around the age of five. ADHD can cause many problems in your child's life, and can often lead to underachievement at school, poor social interaction with other children and adults, and problems with discipline.“
Highlighted ArticlesIdentifying, Evaluating, Diagnosing, and Treating ADHD in Minority Youth (Journal of Attention Disorders 2008) “Untreated ADHD carries greater risk for substance abuse, impulsive behavior, and legal conflicts, whereas overdiagnosing and overtreating risk stigma associated with mental disorder, growth limitation, and tachycardia or hypertension. This dichotomy is even more perplexing for minority youth, many of whom are disadvantaged and lack access to care. Stressful living circumstances increase the likelihood a minority child will be diagnosed with ADHD (Barbarin & Soler, 1993). Fearing their child will be labeled, minority parents may hesitate to ask for help. … Cultural awareness during the assessment and history gathering is critical for the evaluation of minority youth. There are ADHD scales more appropriate for minority children. In addition, we are learning that children of diversity may not respond to all medications the same way Caucasian children do. The more we learn about genetic variations, the more we are likely to understand why medication alone is not effective in all cases and should not be considered the only treatment tool. Prosocial skills training, psychotherapy for the children, and support for the parents are all key if we want these children to truly succeed.”
ADHD in Children With Comorbid Conditions: Diagnosis, Misdiagnosis, and Keeping Tabs on Both (2007) "There is a complex interplay between ADHD and its commonly occurring comorbid psychiatric disorders, such as oppositional defiant disorder (ODD), conduct disorder (CD), anxiety, depression, bipolar disorder (BPD), and substance abuse. Comorbidity greatly influences presentation, diagnosis, and prognosis; complicates treatment; and significantly increases the morbidity and disease burden of ADHD.[6] When ADHD is comorbid with another psychiatric disorder, it is often the first disorder to develop, and children with severe ADHD symptoms have a higher likelihood of developing other psychiatric disorders.[1] When evaluating for comorbid conditions, the clinician should attempt to determine whether one "primary" condition can fully account for the most disabling and distressing symptoms. If a primary condition can fully explain such symptoms, then the other condition should not be diagnosed. For example, if a patient has ADHD symptoms only during episodes of bipolarity, ADHD would not be diagnosed. "
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Notes
The Guidelines section will contain 2008 and some 2007 updated published guidelines. To view Guidelines from previous years, view the Guideline sections or the Article sections or our Monthly Online Newsletter (under the Guidelines section).
Attention Deficit Disorder and Attention Deficit Hyperactivity Disorder
Treatment Report
Cognitive Therapy-CBT-Psychotherapy
Methylphenidate Disrupts Social Play Behavior in Adolescent Rats. (Neuropsychopharmacology. 2008) “These data show that methylphenidate selectively blocks the most vigorous part of the behavioral repertoire of adolescent rats through a noradrenergic mechanism. We suggest that the effect of methylphenidate on social play is a reflection of its therapeutic effect in ADHD, that is, improved behavioral inhibition. However, given the importance of social play for development, these findings may also indicate an adverse side effect of methylphenidate.”
Evaluation of Group Cognitive Behavioral Therapy for Adults With ADHD. (J Atten Disord. 2008)
Drug Side-Effects and Interactions
[Drug-Induced Psychosis after Intake of a Modified - Release Formulation of Methylphenidate.] (Psychiatr Prax. 2008)
Meta-Analysis of Suicide-Related Behavior Events in Patients Treated With Atomoxetine. (J Am Acad Child Adolesc Psychiatry. 2008) “CONCLUSIONS:: Although uncommon, suicidal ideation was significantly more frequent in pediatric ADHD patients treated with atomoxetine compared to those treated with placebo. Retrospective analysis has limitations in ascertaining intent.”
Drugs
Large Effect from Methylphenidate, Medium Effect from Atomoxetine in ADHD Trial
[Multimodal treatment of adult attention-deficit hyperactivity disorder.] (Nervenarzt. 2008)
Safety of therapeutic methylphenidate in adults: a systematic review of the evidence. (J Psychopharmacol. 2008)
The Effects of Methylphenidate on Decision Making in Attention-Deficit/Hyperactivity Disorder. (Biol Psychiatry. 2008)
Guanfacine Extended Release for Pediatric Attention Deficit/Hyperactivity Disorder?
Atomoxetine and Osmotically Released Methylphenidate for the Treatment of Attention Deficit Hyperactivity Disorder: Acute Comparison and Differential Response. (Am J Psychiatry. 2008)
Methylphenidate significantly improves driving performance of adults with attention-deficit hyperactivity disorder: a randomized crossover trial. (J Psychopharmacol. 2008)
Modafinil improves symptoms of attention-deficit/hyperactivity disorder across subtypes in children and adolescents. (J Pediatr. 2008)
Methylphenidate Can Have Sleep Benefits In Adults With ADHD “Treatment with methylphenidate (MPH) appears to have beneficial effects on sleep parameters in adults with ADHD, including increased sleep efficiency and a feeling of improved restorative value of sleep, according to a new study.”
Exercise
General Information
Advances in ADHD Management: Maximizing Effects While Minimizing Side Effects of Treatment
Attention-deficit/hyperactivity disorder in adults: evidence-based recommendations for management. (Postgrad Med. 2008)
ADHD Stimulant Treatment May Decrease Risk Of Substance Abuse In Adolescent Girls; Results Mirror Findings In Boys “Massachusetts General Hospital (MGH) researchers have found that treatment with stimulant drugs does not increase and appears to significantly decrease the risk that girls with ADHD will begin smoking cigarettes or using alcohol or drugs.”
Substance use disorders in children and adolescents with attention-deficit/hyperactivity disorder: implications for treatment and the role of the primary care physician. (Prim Care Companion J Clin Psychiatry. 2008)
Diagnosing and managing complicated ADHD. (http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=18615163)
How Ritalin Works In Brain To Boost Cognition, Focus Attention
Evolution of the treatment of attention-deficit/hyperactivity disorder in children: A review. (Clin Ther. 2008)
Children With ADHD Should Have ECG Before Taking Stimulant Drugs “Children with attention-deficit/hyperactivity disorder (ADHD) should receive careful cardiac evaluation—including an electrocardiogram (ECG)—before starting treatment with stimulant drugs, a new American Heart Association statement recommends [1]. The statement, published online April 21, 2008 in Circulation, notes that stimulant medications used to treat ADHD can increase heart rate and blood pressure, and although these side effects are insignificant for most children with ADHD, they are an important consideration for children who have certain forms of congenital heart disease or arrhythmias with a predisposition for sudden cardiac arrest. “
ADHD Treatment For Children Different Between Specialties, Australia
Effective ADHD Treatment Found For Children With Fragile X Syndrome ““We propose that LAC be recommended as a treatment of ADHD in FXS children,” conclude the authors, “since it effectively reduces hyperactive behavior and improves social abilities without adverse side effects.” They also suggest that these results may be applicable to children with autism, who also do not easily tolerate stimulants.”
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
A randomised controlled trial into the effects of food on ADHD. (Eur Child Adolesc Psychiatry. 2008) “Comorbid symptoms of oppositional defiant disorder also showed a significantly greater decrease in the intervention group than it did in the control group (cohens's d 1.1, scale reduction 45.3%). A strictly supervised elimination diet may be a valuable instrument in testing young children with ADHD on whether dietary factors may contribute to the manifestation of the disorder and may have a beneficial effect on the children's behaviour.”
Other
Other Treatments
Experimental
Potential effects of zinc on information processing in boys with attention deficit hyperactivity disorder (Progress in Neuro-Psychopharmacology and Biological Psychiatry 2008) “The plasma zinc levels were significantly lower in both ADHD groups …”
Supplements-Vitamins-CAM
[The treatment of Attention-Deficit/Hyperactivity Disorders with polyunsaturated fatty acids - an effective treatment alternative?] (Z Kinder Jugendpsychiatr Psychother. 2008)
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