ADHD or attention deficit hyperactive disorder is characterized by restlessness, inattentiveness and impulsive behavior. Children affected by this disorder are at risk of developing severe learning difficulties, behavioral problems, social problems, substance abuse issues and criminality. However, there are various ways to treat ADHD. Usually several treatment methods can be combined to get a satisfactory outcome. e.g. Drug treatment and behavioral parent therapy.
What are the drugs used for ADHD?
Amphetamines
Amphetamines are types of drugs that cause central nervous system stimulation. However ironically they were found to be quite effective in hyperactive disorders such as Attention Deficit Hyperactive Disorder (ADHD) (1, 2 and 3). In addition it must be noted that common “drugs of abuse” such as Ecstasy are in the Amphetamines group.
Amphetamines are supposed to work by increasing naturally occurring norepinephrine, dopamine and epinephrine neurotransmitter levels in certain areas of the brain. This action stimulates inhibitory areas of the brain, which results in reduction in unnecessary hyperactivity. Therefore it ultimately helps the child to concentrate more and suppress the hyperactive urges. In fact number of clinical trials performed in many different countries has found that ADHD can be effectively treated with Amphetamines.
Common Amphetamines used in ADHD are Methylphenidate (Ritalin®, Addwize, Concerta®, Metadate® Methylin®), Lisdexamfetamine (Vyvanse®) and Dextroamphetamine (Dexedrine®, DextroStat®, LiquADD®, ProCentra®).
Stimulant medications such as Amphetamines improve academic performance, mathematical skills, word discovery skills and word retrieval. (4, 5, 6, 7 and 8)
Methylphenidate is absorbed readily from the gut and rapidly cross the blood brain barrier. In addition they have short half-life and the effect only lasts around 1 -4 hours. But drug effect will be seen within 30mins. Therefore the drug should be taken frequently. Sustained release preparations are developed to counteract this problem. e.g. Ritalin SR 10mgs. However, these sustained released preparations take around three hours to act.
Usually Amphetamines are considered the first line of treatment for ADHD. However some children with ADHD may not respond to stimulant medications such as Amphetamines.
What are non-stimulant medications prescribed for ADHD?
Tricyclic antidepressants
They are effective for behavioral problems associated with ADHD. However, TCAs are not usually effective for cognitive problems associated with ADHD such as memory impairment, lack of attention and inability to concentrate (9). Therefore they essentially treats only hyperactive component of the disease (This disease has both Attention deficit and hyperactive elements).
Clonidine and Guanfacine
These drugs are categorized as weak alpha 2 noradrenalin stimulators. However, evidence from Randomized double-blind clinical trials are lacking in this regard. Clonidine usually treats behavioural disturbances associated with ADHD. In addition Guanfacine is found to be somewhat effective in treating children with ADHD.
Summary
ADHD or attention deficit hyperactive disorder is usually treated with stimulant drugs, Tricyclic anti-depressants, clonidine and Guanfacine. They are usually given as part of a comprehensive treatment plan.
Sources
1. Spencer, T., Biederman, J., Wilens, T., Harding, M., O'Donnell, D., and Griffin, S. (1996). Pharmacotherapy of attention-deficit hyperactivity disorder across the life cycle Journal of the American Academy of Child and Adolescent Psychiatry, 35, 409–32.
2. Kavale, K. (1982). The efficacy of stimulant drug treatment for hyperactivity: a meta-analysis. Journal of Learning Disabilities, 15, 280–9.
3. Swanson, J.M., McBurnett, K., Wigal, T., et al. (1993). Effects of stimulant medication on children with attention deficit disorder: a ‘review of reviews'. Exceptional Children, 60, 154–62.
4. Douglas, V.I., Barr, R.G., Desilets, J., and Sherman, E. (1995). Do high doses of stimulants impair flexible thinking in attention-deficit hyperactivity disorder? Journal of the American Academy of Child and Adolescent Psychiatry, 34, 877–85.
5. Milich, R., Licht, B.G., Murphy, D.A., and Pelham, W.E. (1989). Attention-deficit hyperactivity disordered boys' evaluations of and attributions for task performance on medication versus placebo. Journal of Abnormal Psychology, 98, 280–4.
6. Milich, R., Carlson, C.L., Pelham, W.E., Jr, and Licht, B.G. (1991). Effects of methylphenidate on the persistence of ADHD boys following failure experiences. Journal of Abnormal Child Psychology, 19, 519–36.
7. Rapport, M.D., Denney, C., DuPaul, G.J., and Gardner, M.J. (1994). Attention deficit disorder and methylphenidate: normalization rates, clinical effectiveness, and response prediction in 76 children. Journal of the American Academy of Child and Adolescent Psychiatry, 33, 882–93.
8. Douglas, V.I., Barr, R.G., O'Neill, M.E., and Britton, B.G. (1986). Short term effects of methylphenidate on the cognitive, learning and academic performance of children with attention deficit disorder in the laboratory and the classroom. Journal of Child Psychology and Psychiatry and Allied Disciplines, 27, 191–211.
9. Popper, C.W. (1997). Antidepressants in the treatment of attention-deficit/hyperactivity disorder. Journal of Clinical Psychiatry, 58, 14–31.
New oxford textbook of Psychiatry
What are the drugs used for ADHD?
Amphetamines
Amphetamines are types of drugs that cause central nervous system stimulation. However ironically they were found to be quite effective in hyperactive disorders such as Attention Deficit Hyperactive Disorder (ADHD) (1, 2 and 3). In addition it must be noted that common “drugs of abuse” such as Ecstasy are in the Amphetamines group.
Amphetamines are supposed to work by increasing naturally occurring norepinephrine, dopamine and epinephrine neurotransmitter levels in certain areas of the brain. This action stimulates inhibitory areas of the brain, which results in reduction in unnecessary hyperactivity. Therefore it ultimately helps the child to concentrate more and suppress the hyperactive urges. In fact number of clinical trials performed in many different countries has found that ADHD can be effectively treated with Amphetamines.
 |
| Addwize is a medication manufactured in India for ADHD |
Common Amphetamines used in ADHD are Methylphenidate (Ritalin®, Addwize, Concerta®, Metadate® Methylin®), Lisdexamfetamine (Vyvanse®) and Dextroamphetamine (Dexedrine®, DextroStat®, LiquADD®, ProCentra®).
Stimulant medications such as Amphetamines improve academic performance, mathematical skills, word discovery skills and word retrieval. (4, 5, 6, 7 and 8)
Methylphenidate is absorbed readily from the gut and rapidly cross the blood brain barrier. In addition they have short half-life and the effect only lasts around 1 -4 hours. But drug effect will be seen within 30mins. Therefore the drug should be taken frequently. Sustained release preparations are developed to counteract this problem. e.g. Ritalin SR 10mgs. However, these sustained released preparations take around three hours to act.
Usually Amphetamines are considered the first line of treatment for ADHD. However some children with ADHD may not respond to stimulant medications such as Amphetamines.
What are non-stimulant medications prescribed for ADHD?
Tricyclic antidepressants
They are effective for behavioral problems associated with ADHD. However, TCAs are not usually effective for cognitive problems associated with ADHD such as memory impairment, lack of attention and inability to concentrate (9). Therefore they essentially treats only hyperactive component of the disease (This disease has both Attention deficit and hyperactive elements).
Clonidine and Guanfacine
These drugs are categorized as weak alpha 2 noradrenalin stimulators. However, evidence from Randomized double-blind clinical trials are lacking in this regard. Clonidine usually treats behavioural disturbances associated with ADHD. In addition Guanfacine is found to be somewhat effective in treating children with ADHD.
Summary
ADHD or attention deficit hyperactive disorder is usually treated with stimulant drugs, Tricyclic anti-depressants, clonidine and Guanfacine. They are usually given as part of a comprehensive treatment plan.
Sources
1. Spencer, T., Biederman, J., Wilens, T., Harding, M., O'Donnell, D., and Griffin, S. (1996). Pharmacotherapy of attention-deficit hyperactivity disorder across the life cycle Journal of the American Academy of Child and Adolescent Psychiatry, 35, 409–32.
2. Kavale, K. (1982). The efficacy of stimulant drug treatment for hyperactivity: a meta-analysis. Journal of Learning Disabilities, 15, 280–9.
3. Swanson, J.M., McBurnett, K., Wigal, T., et al. (1993). Effects of stimulant medication on children with attention deficit disorder: a ‘review of reviews'. Exceptional Children, 60, 154–62.
4. Douglas, V.I., Barr, R.G., Desilets, J., and Sherman, E. (1995). Do high doses of stimulants impair flexible thinking in attention-deficit hyperactivity disorder? Journal of the American Academy of Child and Adolescent Psychiatry, 34, 877–85.
5. Milich, R., Licht, B.G., Murphy, D.A., and Pelham, W.E. (1989). Attention-deficit hyperactivity disordered boys' evaluations of and attributions for task performance on medication versus placebo. Journal of Abnormal Psychology, 98, 280–4.
6. Milich, R., Carlson, C.L., Pelham, W.E., Jr, and Licht, B.G. (1991). Effects of methylphenidate on the persistence of ADHD boys following failure experiences. Journal of Abnormal Child Psychology, 19, 519–36.
7. Rapport, M.D., Denney, C., DuPaul, G.J., and Gardner, M.J. (1994). Attention deficit disorder and methylphenidate: normalization rates, clinical effectiveness, and response prediction in 76 children. Journal of the American Academy of Child and Adolescent Psychiatry, 33, 882–93.
8. Douglas, V.I., Barr, R.G., O'Neill, M.E., and Britton, B.G. (1986). Short term effects of methylphenidate on the cognitive, learning and academic performance of children with attention deficit disorder in the laboratory and the classroom. Journal of Child Psychology and Psychiatry and Allied Disciplines, 27, 191–211.
9. Popper, C.W. (1997). Antidepressants in the treatment of attention-deficit/hyperactivity disorder. Journal of Clinical Psychiatry, 58, 14–31.
New oxford textbook of Psychiatry
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