ADHD research exploding in recent months


2011-12-13 13:30

In recent months, researchers have published a large amount of material regarding attention deficit hyperactivity disorder (ADHD). The condition is one of the most common childhood disorders and can continue through adolescence and adulthood. It is characterized by the inability to focus or pay attention, hyperactivity and impulsive behavior. The behavior problems are so frequent that they interfere with the child's ability to adequately function on a daily basis without treatment. Symptoms include difficulty staying focused and paying attention, difficulty controlling behavior, and hyperactivity. Amphetamine (Adderall), methylphenidate (Ritalin) and other central nervous system stimulants are given to children who suffer from ADHD. Interestingly, these drugs do not have the stimulant effect observed in adults when given to children before they reach puberty. In the U.S., approximately 2.7 million children are prescribed ADHD medication, primarily to reduce impulsive behavior as well as to improve focus and attention span. In addition, more than 1.5 million adults also take the medications. Over the past decade, the use of ADHD drugs in adults has outpaced that in children.

On October 16, the American Academy of Pediatrics (AAP) released new guidelines. They provide instructions for pediatricians on diagnosing and managing ADHD in children 4 to 18. According to the new guidelines, behavioral management techniques should be the first treatment approach for preschool-age children. However, they also suggest that physicians consider prescribing Ritalin in preschool-age children with moderate to severe symptoms when behavioral intervention does not provide significant improvement. This recommendation is potentially controversial because methylphenidate is not approved by the Food and Drug Administration (FD) for use within that age group. Many ADHD medications are approved for children age six and older. The prior set of AAP guidelines, issued about a decade ago, gave recommendations for children six to 12. In addition to preschool-age children, the new recommendations also address teenagers who might not have been diagnosed at a younger age.

According to the guidelines, to correctly diagnose a child with ADHD, the overactive, impulsive behavior needs to be seen consistently for four to six months in both the home and another environment such as school. The guidelines recommend that parents undergo training to help modify behaviors associated with ADHD. Such techniques involve setting up a reward-and-punishment system and stress the consistent application of the modification techniques. Furthermore, medication should be considered for preschool-age children only if they exhibit symptoms of ADHD for at least nine months and only after behavior management techniques have been tried. For children age six through 12, the guidelines suggest a combination of behavior training and medication. Doctors stress that controlling the symptoms of ADHD in school-age children is important to boosting their chances of success in school.

They are categorized as stimulants and appear to boost and balance brain chemicals called neurotransmitters, which helps address symptoms of inattention and hyperactivity. ADHD medications have some side effects, including decreased appetite, weight loss and, sometimes, trouble sleeping. Another concern is that the medications could damage the heart. These concerns are based on the fact that they cause a modest increase in heart rate and blood pressure.

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In 2005, fears regarding a potential risk of heart damage from ADHD medications arose because of reports of about a dozen deaths from sudden cardiac arrest among young users of Adderall. As a result, the Canadian government temporarily banned the sale of Adderall; however, the suspension was later determined that the patients who had died had heart defects or other underlying heart disease.

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