The gold standards of treatment for ADHD are the stimulants amphetamine and methylphenidate. They are old friends, having been used for decades, and there is a wealth of patient experience with them. Although we use them all the time, an occasional review of the tools in our toolbox is always helpful.
Researchers have often found an association between television viewing and higher rates of attention problems over time, though not all studies have supported this link.
Dosing stimulants is never easy. There are various rules of thumb—for example, 0.5 mg/kg for amphetamine preparations and 1 mg/kg for methylphenidate preparations—but these have not been empirically validated.
Guanfacine, an alpha-2 agonist, is sometimes prescribed off-label for ADHD and has now received official FDA approval in a new, extended-release formulation. Shire will soon market the drug under the brand name Intuniv. So how well does it work?
A recent follow-up of the Multisite Treatment Study of Children with ADHD (MTA) study investigated the long-term course of ADHD and the impact of short-term treatment on long-term outcomes.
On February 21, 2007, the FDA directed all manufacturers of stimulants to develop Medication Guides for patients, spelling out, in non-technical language, the dangers of taking these medications.
On February 23, the FDA approved Shire and New River’s Vyvanse (lisdexamfetamine dimesylate) for the treatment of ADHD in children. Vyvanse is the molecule dextroamphetamine (trade names Dexedrine and Dextrostat) attached to the amino acid lysine.
