Work

Expanding medication options for pediatric ADHD.

Year: 2013

Type: article

Abstract: Molly is a nine-year-old girl who was diagnosed with Attention-Deficit Hyperactivity Disorder (ADHD) by her pediatrician and prescribed a long-acting methylphenidate formulation at a typical dose (1 mg/kg). She has tolerated long-acting methylphenidate without side effects and has had significant improvement in her academic performance and school on-task behavior. She takes methylphenidate before school at 7:00 AM and it usually wears off around 3:30 PM. Molly and her parents are pleased with her response to methylphenidate, but report that she has a lot of difficulty getting ready for school each morning due to distractibility. In the evenings she has trouble staying seated to do homework and frequently interrupts and argues with family members, but has not been able to tolerate afternoon dosing of immediate release methylphenidate due to insomnia. Attention-deficit/hyperactivity disorder (ADHD), the most common childhood neurobehavioral condition, is characterized by difficulties with sustaining attention, impulse control, and modulating activity level. The pathophysiology of ADHD is thought to involve dysregulation of brain dopamine and norepinephrine systems, which is consistent with the mechanisms of action for ADHD medications.1 Management of ADHD includes both pharmacologic and nonpharmacologic (behavioral and psychoeducational) interventions.2, 3 In the past ten years, there has been a remarkable expansion in knowledge about ADHD pharmacotherapy. This article provides an overview of the efficacy, side effects, and dosing for the three ADHD medication classes currently approved by the U.S. Food and Drug Administration (FDA) - the psychostimulants, atomoxetine, and the alpha adrenergic agonists, including guidance on choosing between as well as combining these medication classes. Special considerations, such as medication effects on tics, cardiovascular considerations, and substance abuse liability are also discussed.

Source: PubMed

Authors: Tanya E Froehlich, Sergio V Delgado, Julia S Anixt

Institutions: Cincinnati Children's Hospital Medical Center, University of Cincinnati

Language: English

Topic: Attention Deficit Hyperactivity Disorder

Subfield: Psychiatry and Mental health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: green

Funders: National Institutes of Health, National Institute of Mental Health, National Cancer Institute

Awards: Synergistic interactions between SapC-DOPS and chemotherapy for glioma, Medication Response in Children with Predominantly Inattentive Type ADHD, Cincinnati Center for Clinical and Translational Sciences and Training