Effectiveness of Psychostimulant and Non-Psychostimulant Drug Therapy in the Attention Deficit Hyperactivity Disorder

Attention Deficit Hyperkinetic Disorder (ADHD) is a neurobiological behavioral disorder of the child, adolescent, and adult characterized by problems of concentration, hyperactivity, and impulsivity caused by an imbalance of chemical neurotransmitters in the brain—dopamine and noradrenaline. ADHD first-line drugs are divided in psychostimulant, as Methylphenidate and Amphetamines and non-psychostimulant medications-Atomoxetine (the only representative non-psychostimulant medication approved in our country in children and adolescents). The purpose of our research was to assess the clinical evolution of patients with ADHD based on the drug treatment that is administered: psychostimulant or non-psychostimulant. Both psychostimulant—Methylphenidate, and non-psychostimulant therapy—Atomoxetine, proved to significantly improve the symptoms of attention deficit hyperkinetic disorder. There was a significant reduction in the severity of ADHD symptoms at six months and at one year from the start of treatment in the case of the psychostimulant group, whereas in the non-psychostimulant group, the significant reduction in severity of symptomatology occurs only at six months after the start of treatment. We can conclude that both types of drugs are effective in reducing the severity of symptoms and in improving the clinical condition of patients with ADHD, but the comparative analysis of the two groups demonstrated that significantly better results are obtained with psychostimulant treatment.

L-dopa: main drug induced dyskinesia

Introduction: 3,4-dihydroxy-L-phenylalanine (L-dopa) is the gold standard drug for the treatment of Parkinson’s disease (PD). This disease causes degeneration of dopaminergic cells, L-dopa supplies the lack of dopamine, being effective in its treatment. The average time for the onset of this hyperkinetic disorder is usually 6.5 years and the young age at the beginning of the disease. This pathology may present with chorea, dystonia, myoclonus and stereotypes. Diskinesia-inducing L-dopa (LID) remains one of the most challenging unmet needs in the treatment of PD and other neurodegenerative diseases. Methodology: This is an integrative review, using the MedLine, Cochrane and PubMed databases with the descriptors “drug induced”, “dyskinesia” and “L- dopa”. Articles published in the last 10 years; in English; clinical trial articles and original articles were included. Results: The prevalence for the development of LID was 50% for those who started PD at 40-59 years of age, compared to 16% at 70 years of age. The incidence of LID is about 90% after 9 years, but the main cause is related to the dose of levodopa and the duration of the disease. The risk factors for the development of LID are modifiable (levoodopa dose and body weight) and non- modifiable (age, sex, duration, progress and severity of the disease). Conclusion: With this, it can be concluded that doctors who deal with PD need to be aware of the risk factors for LID and know how to manage it.

Clinical and biochemical features of anxiety in children with hyperkinetic disorder

Clinical and biochemical features of anxiety in children with a hyperkinetic disorder, also known as a combined type of ADHD, have not been studied, although these data are extremely necessary for therapeutic intervention in cases of comorbidity of hyperkinetic and anxiety disorders.Objective: to study pathogenetic mechanisms and the role of anxiety level in the formation of the main symptoms of the disorder.Materials and methods. We examined 182 children with hyperkinetic disorder and 60 peers from control group aged 6–10 years. After clinical examination we studied the content of monoamines, their precursors, and metabolic products in daily urine. Assessment of the main clinical symptoms (inattention, hyperactivity, impulsivity) was carried out on the SNAP-IV scale. An assessment of the level of anxiety was carried out according to the questionnaire Lavrentieva G.P. and Titarenko T.M. Patients with hyperkinetic disorder were divided into subgroups according to the nature of the monoaminergic “profile”.The results of the study support the hypothesis that pathological and steady increase in anxiety level leads to increase in the impulsivity level in children with hyperkinetic disorder. And the main role in this process is played by the noradrenergic system and the weakening of the inhibitory effect of serotonin, causing an increase of anxiety level and aggravating the imbalance of the activity of monoamine systems.

Core dimensions of attention-deficit/hyperactivity disorder

This chapter presents an account of the clinical picture of attention-deficit/hyperactivity disorder (ADHD) and the severe form hyperkinetic disorder. They are disabilities that change with development and are often accompanied by other problems that can mask it or themselves be masked by it. Clinical and standardized ways of making the diagnosis are described. Inattentiveness and impulsive hyperactivity are rewarding challenges for diagnosis and treatment in adulthood, as well as during childhood and adolescence.