Attention-deficit hyperactivity disorder medical therapy
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The mainstay of therapy for ADHD is the administration of such stimulants as Ritalin and Adderall. While there is no cure for ADHD, currently available treatments can help reduce symptoms and improve functioning. Other treatment options include psychotherapy, education and training, or a combination of therapies.
Measurement-based care may help.
Several different types of medications may be prescribed to mitigate the symptoms associated with ADHD.
- Stimulants, such as Methylphenidate (Ritalin) and amphetamine salts (dextroamphetamine and amphetamine; Adderall), are used to increase the patient’s supply of the brain chemicals dopamine and norepinephrine, which play essential roles in thinking and attention. Ritalin is safe and effective in preschool-aged children suffering from ADHD so long as they are closely monitored while taking the drug.
- Lisdexamfetamine is a prodrug of dextroamphetamine. It may be dosed once a day and is less likely to be abused.
- Atomoxetine (Strattera) is a selective norepinepherine reuptake inhibitor (SNRI) approved for the management of ADHD. It is effective in adult ADHD and is often favored due to lack of abuse potential. Atomoxetine carries a black box warning as there is an increase risk of suicidal ideation in adolescents. While it is non-inferior to methylphenidate in children, its adverse effects in children and adolescents render it a less favorable treatment option.
- Non-stimulants such as extended release Guanfacine and Clonidine (both alpha-2 adrenergic agonists) are also used to treat ADHD.
- Other drugs, including anti-depressants, may also be prescribed in cases of ADHD depending on the patient’s co-morbidities.
|Standard mean difference (SMD)* for
|Amphetamines (dexamphetamine, lisdexamfetamine, mixed amphetamine salts)||-0.51 (95% CI -0.75 to -0.28)||2.69|
|Bupropion||-0.50 (95% CI -0.86 to -0.15)||1.20|
|* Interpretation of standard mean difference (SMD):|
0.2 represents a small effect
0.5 a moderate effect
0.8 a large effect
- National Institute of Mental Health (NIH). (2016). "Attention Deficit Hyperactivity Disorder."
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- Southammakosane, Cathy (August 2015). [www.pediatrics.aappublications.org/content/136/2/351 "Pediatric Psychopharmacology for Treatment of ADHD, Depression, and Anxiety"] Check
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- Castells X, Blanco-Silvente L, Cunill R (2018). "Amphetamines for attention deficit hyperactivity disorder (ADHD) in adults". Cochrane Database Syst Rev. 8: CD007813. doi:10.1002/14651858.CD007813.pub3. PMC 6513464 Check
|pmc=value (help). PMID 30091808.
- Verbeeck W, Bekkering GE, Van den Noortgate W, Kramers C (2017). "Bupropion for attention deficit hyperactivity disorder (ADHD) in adults". Cochrane Database Syst Rev. 10: CD009504. doi:10.1002/14651858.CD009504.pub2. PMC 6485546. PMID 28965364.