Use of Psychostimulant Medication: Tips for Teens—ADHD Toolkit

2007 ◽  
Vol 4 (3) ◽  
pp. 71-73
Author(s):  
Sahbal Aras ◽  
Semih Semin

Recently, the use of psychostimulant medication in children with symptoms of attention-deficit hyperactivity disorder (ADHD) has been subject to extensive debate. The problems faced while assessing and diagnosing ADHD, unnecessary prescribing of psychostimulants, the possible side-effects of psychostimulants on the developing brain, the risk of drug dependency, and the risk of stigmatising children through medicalisation of normal life events are considered among the principal objections to the use of psychostimulant medications. On the other hand, what also need to be taken into account are the increasing evidence on the genetic, biochemical and diagnostic validity of the disorder, the data showing the therapeutic effects of psychostimulants and the rarity of the above-mentioned side-effects, as well as the ethical problems created by insufficient treatment of children because of the concerns of parents. A critical evaluation of these conflicting opinions by mental health professionals might contribute to the application of ethical principles. While making this kind of evaluation, it is important to pay regard to the specific sociocultural features of the country, as well as the prevailing worldwide discussion.


2018 ◽  
Vol 49 (4) ◽  
pp. 590-597 ◽  
Author(s):  
Rachel Muster ◽  
Saadia Choudhury ◽  
Wendy Sharp ◽  
Steven Kasparek ◽  
Gustavo Sudre ◽  
...  

AbstractBackgroundWhile the neuroanatomic substrates of symptoms of attention deficit hyperactivity disorder (ADHD) have been investigated, less is known about the neuroanatomic correlates of cognitive abilities pertinent to the disorder, particularly in adults. Here we define the neuroanatomic correlates of key cognitive abilities and determine if there are associations with histories of psychostimulant medication.MethodsWe acquired neuroanatomic magnetic resonance imaging data from 264 members of 60 families (mean age 29.5; s.d. 18.4, 116 with ADHD). Using linear mixed model regression, we tested for associations between cognitive abilities (working memory, information processing, intelligence, and attention), symptoms and both cortical and subcortical volumes.ResultsSymptom severity was associated with spatial working memory (t = −3.77, p = 0.0002), processing speed (t = −2.95, p = 0.004) and a measure of impulsive responding (t = 2.19, p = 0.03); these associations did not vary with age (all p > 0.1). Neuroanatomic associations of cognition varied by task but centered on prefrontal, lateral parietal and temporal cortical regions, the thalamus and putamen. The neuroanatomic correlates of ADHD symptoms overlapped significantly with those of working memory (Dice's overlap coefficient: spatial, p = 0.003; verbal, p = 0.001) and information processing (p = 0.02). Psychostimulant medication history was associated with neither cognitive skills nor with a brain–cognition relationships.ConclusionsDiagnostic differences in the cognitive profile of ADHD does not vary significantly with age; nor were cognitive differences associated with psychostimulant medication history. The neuroanatomic substrates of working memory and information overlapped with those for symptoms within these extended families, consistent with a pathophysiological role for these cognitive skills in familial ADHD.


1998 ◽  
Vol 32 (5) ◽  
pp. 650-657 ◽  
Author(s):  
Alasdair L. A. Vance ◽  
Ernest S. L. Luk

Objective: The co-occurrence of attention deficit hyperactivity disorder (ADHD) and anxiety is a well-established clinical observation. However, its status as a clinical construct is debated. We review the prevalence of ‘ADHD and anxiety’, its definitions, and its clinical correlates and we hypothesise that neurodevelopmental deficits may be increased in ‘ADHD and anxiety’. Method: The authors identified empirical studies in the psychiatric and psychological literature. The search categories included hyperactivity, attention deficit hyperactivity disorder, attention deficit disorder and anxiety. Results: ‘ADHD and anxiety’ is considerably more common in clinical than epidemiological samples. There are a range of definitions which address the situational variation in both ADHD and anxiety symptoms and the use of categorical and continuous variables to define them. Yet the nature of the anxiety is still unclear. It is associated with a poor response to psychostimulant medication treatment, and alternative pharmacotherapy approaches have been suggested. There is a controversy about whether neurodevelopmental deficits are associated with hyperactivity alone, or anxiety, or both. Conclusions: ‘ADHD and anxiety’ is important clinically because it is common and less responsive to psychostimulant medication. Important research issues include its heterogeneity which necessitates the collection of parent, teacher, and child self-reports of symptoms' presence or absence and the hypothesis that neurodevelopmental deficits may be increased in this group of children.


2016 ◽  
Vol 33 (S1) ◽  
pp. S361-S361
Author(s):  
M. Uzbekov ◽  
E. Misionzhnik

ObjectivesPathogenetic mechanisms of hyperkinetic syndrome (HKS) or attention deficit hyperactivity disorder (ADHD) are not clear.AimTo elucidate some aspects of monoamine involvement in pathogenesis of disorder and response of monoaminergic systems to psychostimulant medication.MethodsLevels of different monoamines, their metabolites and N-methylnicotinamide (end product of kynurenine pathway) were measured in daily samples of urine from children (7–11 years old) with mild and severe HKS using fluorimetric and chromatographic methods as well as platelet monoamine oxidase (MAO) activity. Thirty children with mild HKS received psychostimulant Sydnocarb 5–15 mg daily for 1–1.5 months (for ethical reasons children with severe HKS were not included in study).ResultsHKS was accompanied by activation of dopaminergic and inhibition of noradrenergic systems. There were found metabolic differences between two forms of HKS. Compared with mild HKS, severe HKS was characterized by significant 2-fold increase of MAO activity and L-dopa, dopamine and adrenaline excretion. After sydnocarb treatment children's clinical status improved along with decrease of excretion of homovanillic, vanillylmandelic and 5-hydroxyindoleacetic acids and increase of N-methylnicotinamide.ConclusionsResults indicate that dopaminergic and noradrenergic systems play important role in pathogenesis of HKS. Clinical improvement of HKS children was accompanied by significant increase of N-methylnicotinamide excretion. It is proposed that increased urine excretion of kynurenine metabolite–N-methylnicotinamide and N-methylnicotinamide/5-hydroxyindoleacetic acid ratio can serve as potential biomarkers for evaluation of efficacy of psychostimulant medication. We hypothesize that kynurenine system plays significant role in pathogenesis of HKS/ADHD.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2000 ◽  
Vol 34 (5) ◽  
pp. 719-730 ◽  
Author(s):  
Alasdair L. A. Vance ◽  
Ernest S. L. Luk

Objective: Attention deficit hyperactivity disorder (ADHD) is a common chronic and disabling condition in children. This paper reviews the taxonomic issues and the major comorbid conditions, neurobiological correlates, treatment and public health issues associated with ADHD. Method: Pertinent recent papers are reviewed from the psychological and psychiatric literature. Results: The two major taxonomies now define a similar group of children with ADHD of a combined type/hyperkinetic disorder. Advances in the understanding and treatment of ADHD demonstrate the complex multidimensional links between neurobiology, psychology and behaviour. Careful assessment of individual factors in treatment planning and ongoing monitoring of psychostimulant medication treatment in the longer term are recommended. Conclusions: There is much still to learn about ADHD, and increased levels of clinical research and treatment resources are required.


2012 ◽  
Vol 34 (2) ◽  
pp. 110-115 ◽  
Author(s):  
Luana Freese ◽  
Luciana Signor ◽  
Cassio Machado ◽  
Maristela Ferigolo ◽  
Helena Maria Tannhauser Barros

INTRODUCTION: Methylphenidate is a psychostimulant medication used for the treatment of attention deficit hyperactivity disorder and narcolepsy. However, it has also been used for non-medical purposes, e.g. to produce euphoria, to increase self-esteem, and to achieve the so-called neurocognitive enhancement, decreasing the feeling of tiredness and increasing focus and attention. OBJECTIVE: To describe, from theoretical and contextual points of view, the potential for abuse and non-medical use of methylphenidate. METHOD: The PubMed, SciELO and Cochrane databases were searched using the following keywords in Portuguese: metilfenidato, transtorno do déficit de atenção com hiperatividade, facilitadores dos processos cognitivos or agentes nootrópicos, and abuso de substâncias; and in English: methylphenidate, attention deficit disorder with hyperactivity, cognitive enhancement or nootropic agents, and substance abuse. Studies published between 1990 and 2010 were selected for review. RESULTS: Non-medical use of methylphenidate is a relevant topic that raises important ethical and scientific questions in several areas, e.g. pharmacological and neurobiological characteristics, evidence of methylphenidate use, forms of non-medical use of methylphenidate, mechanisms of action, and therapeutic application of methylphenidate. According to the review, methylphenidate can generally influence performance as a result of its stimulatory effect. Notwithstanding, evidence does not support the conclusion that it can enhance cognitive performance. CONCLUSION: Health professionals need to acquire expert knowledge and inform patients and their families on the methylphenidate potential for abuse when used with non-medical purposes.


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