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By Faye Kehler Family Physician and GP Anesthetist since 1987 interested in all aspects of Medicine
Jeffrey H Newcorn
Several pharmacotherapeutic options, both FDA-approved and off-label, exist for the treatment of adult ADHD. The most commonly used agents include several stimulants and atomoxetine, which have demonstrated significant, though similar, efficacy for ADHD versus placebo. Treatment should be selected according to patient comorbidity profiles, cardiovascular risks, and risk of abuse of prescription medications. In this activity, treatments for ADHD with and without comorbidity are discussed, including mechanisms of action, safety risks, and the potential for substance abuse...
March 2011: Journal of Clinical Psychiatry
Yuval Bloch, Shai Aviram, Aviv Segev, Uri Nitzan, Yechiel Levkovitz, Yoram Braw, Aviva Mimouni Bloch
OBJECTIVE: We hypothesized that patients with ADHD were typified by distress more than by functional difficulties. Thus, a decline in state anxiety while performing a cognitive task when taking methylphenidate would discriminate between ADHD patients and controls. METHOD: State anxiety and cognitive performance on a continuous performance test were assessed in ADHD patients and controls with and without taking methylphenidate. RESULTS: State anxiety and cognitive performance improved from baseline in 36 ADHD adults after taking methylphenidate...
January 2017: Journal of Attention Disorders
Margaret H Sibley, Luis A Rohde, James M Swanson, Lily T Hechtman, Brooke S G Molina, John T Mitchell, L Eugene Arnold, Arthur Caye, Traci M Kennedy, Arunima Roy, Annamarie Stehli
OBJECTIVE: Adolescents and young adults without childhood attention deficit hyperactivity disorder (ADHD) often present to clinics seeking stimulant medication for late-onset ADHD symptoms. Recent birth-cohort studies support the notion of late-onset ADHD, but these investigations are limited by relying on screening instruments to assess ADHD, not considering alternative causes of symptoms, or failing to obtain complete psychiatric histories. The authors address these limitations by examining psychiatric assessments administered longitudinally to the local normative comparison group of the Multimodal Treatment Study of ADHD...
February 1, 2018: American Journal of Psychiatry
Terrie E Moffitt, Renate Houts, Philip Asherson, Daniel W Belsky, David L Corcoran, Maggie Hammerle, HonaLee Harrington, Sean Hogan, Madeline H Meier, Guilherme V Polanczyk, Richie Poulton, Sandhya Ramrakha, Karen Sugden, Benjamin Williams, Luis Augusto Rohde, Avshalom Caspi
OBJECTIVE: Despite a prevailing assumption that adult ADHD is a childhood-onset neurodevelopmental disorder, no prospective longitudinal study has described the childhoods of the adult ADHD population. The authors report follow-back analyses of ADHD cases diagnosed in adulthood, alongside follow-forward analyses of ADHD cases diagnosed in childhood, in one cohort. METHOD: Participants belonged to a representative birth cohort of 1,037 individuals born in Dunedin, New Zealand, in 1972 and 1973 and followed to age 38, with 95% retention...
October 2015: American Journal of Psychiatry
Shari L Hutchison, Jaswinder K Ghuman, Harinder S Ghuman, Irina Karpov, James M Schuster
Attention-deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed mental health disorders and is associated with higher incidence of comorbid oppositional or conduct, mood, anxiety, pervasive developmental, and substance-use disorders. Comorbid mental health conditions may alter the presence of symptoms and treatment of ADHD. Atomoxetine (ATX), a nonstimulant medication for the treatment of ADHD, may be prescribed for individuals with ADHD and comorbid conditions despite some risk for certain undesirable side effects and lower effectiveness for the treatment of ADHD than stimulants...
October 2016: Therapeutic Advances in Psychopharmacology
Ying Li, Jie Gao, Shu He, Yan Zhang, Qiwei Wang
Attention deficit hyperactivity disorder (ADHD) is one of the most common neurobehavioral disorders. We carried out this comparison of multiple treatments based on sufficient data in attempt to evaluate the efficacy and safety of ADHD medication for children and adolescents. PubMed, Embase and the Cochrane Database were used to search for relevant articles. Changes in the ADHD Rating Scale (ADHD-RS) scores and the Conners' Parent Rating Scale-Revised (CPRS) scores were used as outcomes for efficacy. Withdrawals due to all-cause, adverse effects and lack of efficacy were defined as primary outcomes evaluating the safety of such medications...
November 2017: Molecular Neurobiology
T E Wilens, T J Spencer, J Biederman, K Girard, R Doyle, J Prince, D Polisner, R Solhkhah, S Comeau, M C Monuteaux, A Parekh
OBJECTIVE: Despite the increasing recognition of attention deficit hyperactivity disorder (ADHD) in adults, there is a paucity of controlled pharmacological trials demonstrating the effectiveness of compounds used in treatment, particularly nonstimulants. The authors report results from a controlled investigation to determine the anti-ADHD efficacy of bupropion in adult patients with DSM-IV ADHD. METHOD: This was a double-blind, placebo-controlled, randomized, parallel, 6-week trial comparing patients receiving sustained-release bupropion (up to 200 mg b...
February 2001: American Journal of Psychiatry
Thomas E Brown, Philipp C Reichel, Donald M Quinlan
OBJECTIVES: To demonstrate that high IQ adults diagnosed with ADHD suffer from executive function (EF) impairments that: a) can be identified with a combination of standardized measures and self-report data; and b) occur more commonly in this group than in the general population. METHOD: 157 ADHD adults with IQ >/= 120 were assessed with 8 normed measures of EF- 3 index scores from standardized tests of memory and cognitive abilities, and 5 subscales of a normed self-report measure of EF impairments in daily life...
September 2009: Journal of Attention Disorders
K M Antshel, S V Faraone, K Maglione, A E Doyle, R Fried, L J Seidman, J Biederman
BACKGROUND: To examine the association between psychological tests of executive functioning and functional outcomes among high-IQ adults with attention deficit hyperactivity disorder (ADHD). METHOD: Subjects were high-IQ adults with (n=64) and without ADHD (n=53). Subjects were administered a battery of neuropsychological tests assessing executive functioning. RESULTS: High-IQ adults with ADHD performed less well than those without ADHD on several psychological tests of executive functioning, including the Wisconsin Card Sorting Test (WCST), Stroop Color and Word Test, Rey-Osterrieth Complex Figure Test (ROCF), California Verbal Learning Test (CVLT) and an auditory continuous performance test (CPT)...
November 2010: Psychological Medicine
Helena Rohlf, Viola Jucksch, Caterina Gawrilow, Michael Huss, Jakob Hein, Ulrike Lehmkuhl, Harriet Salbach-Andrae
Compared to the high number of studies that investigated executive functions (EF) in children with attention-deficit/hyperactivity disorder (ADHD), a little is known about the EF performance of adults with ADHD. This study compared 37 adults with ADHD (ADHD(total)) and 32 control participants who were equivalent in age, intelligence quotient (IQ), sex, and years of education, in two domains of EF--set shifting and working memory. Additionally, the ADHD(total) group was subdivided into two subgroups: ADHD patients without comorbidity (ADHD(-), n = 19) and patients with at least one comorbid disorder (ADHD(+), n = 18)...
January 2012: Journal of Neural Transmission
Chieko Kanai, Ryuichiro Hashimoto, Takashi Itahashi, Masayuki Tani, Takashi Yamada, Haruhisa Ota, Akira Iwanami, Nobumasa Kato
The cognitive profile differences between adult patients with autism spectrum disorder (ASD) and those with attention-deficit/hyperactivity disorder (ADHD) are not well characterized. We examined the cognitive profiles of adults having either ASD (n=120) or ADHD (n=76) with no intellectual disabilities (IQ≥70) using the Wechsler Intelligence Scale III (WAIS-III). Verbal Intelligence (VIQ) - Performance Intelligence (PIQ) difference discrepancies were detected between the two groups. Information subtest scores of the Verbal Comprehension index and Arithmetic and Digit Span subtests of the Freedom from Distractibility index were significantly higher in ASD than in ADHD, while the Picture Completion subtest was significantly lower in ASD...
February 2017: Research in Developmental Disabilities
K M Antshel, S V Faraone, K Maglione, A Doyle, R Fried, L Seidman, J Biederman
BACKGROUND: Because the diagnosis of attention deficit hyperactivity disorder (ADHD) in higher education settings is rapidly becoming a contentious issue, particularly among patients with high IQs, we sought to assess the validity of diagnosing ADHD in high-IQ adults and to further characterize the clinical features associated with their ADHD. METHOD: We operationalized high IQ as having a full-scale IQ120. We identified 53 adults with a high IQ who did not have ADHD and 64 adults with a high IQ who met diagnostic criteria for ADHD...
August 2009: Psychological Medicine
Blair A Johnston, David Coghill, Keith Matthews, J Douglas Steele
Methylphenidate (MPH) is established as the main pharmacological treatment for patients with attention deficit hyperactivity disorder (ADHD). Whilst MPH is generally a highly effective treatment, not all patients respond, and some experience adverse reactions. Currently, there is no reliable method to predict how patients will respond, other than by exposure to a trial of medication. In this preliminary study, we sought to investigate whether an accurate predictor of clinical response to methylphenidate could be developed for individual patients, using sociodemographic, clinical and neuropsychological measures...
January 2015: Journal of Psychopharmacology
Daniel Minahim, Luis A Rohde
OBJECTIVE: To evaluate the presence of symptoms of attention deficit and hyperactivity disorder (ADHD) in intellectually gifted adults and children. METHODS: Two cross-sectional studies were performed in children and adults whose intelligence quotient (IQ) had been previously evaluated using Raven's Progressive Matrices (RPM) test. Seventy-seven adults displaying IQ scores above the 98th percentile were assessed using the Adult Self-Report Scale (ASRS-18) for signs of ADHD and a modified Waldrop scale for minor physical anomalies (MPAs)...
October 2015: Revista Brasileira de Psiquiatria
Esther Aarts, Mieke van Holstein, Martine Hoogman, Marten Onnink, Cornelis Kan, Barbara Franke, Jan Buitelaar, Roshan Cools
Attention-deficit/hyperactivity disorder (ADHD) is accompanied by impairments in cognitive control, such as task-switching deficits. We investigated whether such problems, and their remediation by medication, reflect abnormal reward motivation and associated striatal dopamine transmission in ADHD. We used functional genetic neuroimaging to assess the effects of dopaminergic medication and reward motivation on task-switching and striatal BOLD signal in 23 adults with ADHD, ON and OFF methylphenidate, and 26 healthy controls...
February 2015: Behavioural Pharmacology
Jeanette C Mostert, A Marten H Onnink, Marieke Klein, Janneke Dammers, Anais Harneit, Theresa Schulten, Kimm J E van Hulzen, Cornelis C Kan, Dorine Slaats-Willemse, Jan K Buitelaar, Barbara Franke, Martine Hoogman
Attention Deficit/Hyperactivity Disorder (ADHD) in childhood is associated with impaired functioning in multiple cognitive domains: executive functioning (EF), reward and timing. Similar impairments have been described for adults with persistent ADHD, but an extensive investigation of neuropsychological functioning in a large sample of adult patients is currently lacking. We systematically examined neuropsychological performance on tasks measuring EF, delay discounting, time estimation and response variability using univariate ANCOVA's comparing patients with persistent ADHD (N=133, 42% male, mean age 36) and healthy adults (N=132, 40% male, mean age 36)...
November 2015: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
Caroline Skirrow, Grainne McLoughlin, Tobias Banaschewski, Daniel Brandeis, Jonna Kuntsi, Philip Asherson
Attention-deficit/hyperactivity disorder (ADHD) is associated with cognitive performance and functional brain changes that are sensitive to task conditions, indicating a role for dynamic impairments rather than stable cognitive deficits. Prominent hypotheses consistent with this observation are a failure to optimise brain arousal or activation states. Here we investigate cortical activation during different conditions. Using a sample of 41 non-comorbid adults with ADHD and 48 controls, we examine quantitative EEG activity during a resting state, a cued continuous performance test with flankers (CPT-OX) and the sustained attention to response task (SART)...
January 2015: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
Nora D Volkow, James M Swanson
Short-term trials involving adults with ADHD have shown significant improvements in symptoms with stimulants and atomoxetine; however, data on long-term benefits and risks of these medications, particularly among older persons, have been insufficient.
November 14, 2013: New England Journal of Medicine
Fred W Reimherr, Barrie K Marchant, Thomas E Gift, Tammy A Steans, Paul H Wender
Much recent research describes the importance of emotional symptoms in ADHD. While there is no accepted system for including emotionality in diagnosing ADHD, the Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS) provides a tool to facilitate this. It assesses a range of adult ADHD symptoms which load on two factors: inattentive and emotional dysregulation. The consistently high inattentive factor was used to define significant elevation on the more variable emotional dysregulation factor (which contains four WRAADDS domains: hyperactivity/restlessness, temper, affective lability, and emotional over-reactivity) allowing the definition of two ADHD diagnostic types...
June 2015: Attention Deficit and Hyperactivity Disorders
Susanne Bejerot, Eleonore M Rydén, Christina M Arlinde
BACKGROUND: Given that adults with ADHD continue to use stimulants for extended periods of time, studies on the long-term effectiveness and adverse events are warranted. The aims of this study were to investigate factors associated with persistence in treatment in an exploratory manner and to document side effects and reasons for discontinuation. METHOD: The current study describes the systematic follow-up of 133 psychiatric patients with DSM-IV-diagnosed ADHD treated with central stimulants at a specialized outpatient unit between January 1, 2001, and August 31, 2006...
December 2010: Journal of Clinical Psychiatry
2017-04-28 04:17:16
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