ADHD

Research Update

The MTA Turns 21: Implications for ADHD Treatment

Topics: ADHD | Behavioral treatment | medications | MTA

REVIEW OF: The MTA Cooperative Group, Arch Gen Psychiatry 1999;56(12):1073–1086    The Multimodal Treatment Study of Children with ADHD (MTA) published its first and most important results 21 years ago, answering fundamental questions about the roles for medicine and behavioral treatment in childhood ADHD. Funded by NIMH, the study enrolled

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Research Update

Vitamin D for ADHD?

Topics: ADHD | Attention Deficit Hyperactivity Disorder | Vitamin D

Review of: Gan J et al, J Child Adolesc Psychopharmacol 2019;29(9):670–687 Many children do not respond to or tolerate standard pharmacotherapy, which drives continued interest in supplements for many conditions, including ADHD. Vitamin D plays a role in healthy brain development, and vitamin D deficiency causes neurotransmitter alterations in path

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Issue Highlights

Highlights From This Issue

Topics: ADHD | adolescents | Child Psychiatry | Teen | teens

The long-term effects of ADHD on longevity support assertive treatment in childhood and adolescence. Most reading programs that are heavily marketed do not have direct research demonstrating their efficacy; however, we can learn the important principles and offer families guidance. There are many practical strategies to help families manage AD

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Article

Are Target Symptoms More Important Than Diagnosis?

Topics: ADHD | adolescents | Research | Teen | teens

Recently I evaluated Caroline, a 15-year-old patient who presented with symptoms of depression, including insomnia, poor appetite, loss of interest in friends and activities, and inability to focus on her schoolwork. In addition, Caroline described a sad, dark view of herself, the state of the world, and her future. It seemed clear that I needed to addr

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Expert Q&A

Reduced Life Expectancy in ADHD

Topics: ADHD | attention | Attention Deficit Hyperactivity Disorder | Life coaching | Life expectancy | Longevity | Medication | methylphenidate | Mortality | stimulant | Teen | teens

CCPR: To start, tell us about how the thinking has changed in terms of health consequences from ADHD. Dr. Barkley: In the 1970s, we saw ADHD as an educational disorder with impacts on school behavior and academic achievement. Around that same time, there was a parallel path recognizing ADHD as a social problem in family functioning and peer relationshi

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Expert Q&A

Reimagining ADHD

Topics: ADHD | attention | Attention Deficit Hyperactivity Disorder | Relationships | Teen | teens

CCPR: Thanks for speaking with us today, Dr. Hallowell. Please tell us about your work. Dr. Hallowell: I’m a writer, a speaker, and a practicing psychiatrist. I have offices in Boston, New York, San Francisco, and Seattle. I went to Harvard College, Tulane Medical School, Harvard residency, and fellowship at Mass Mental Health Center. After that I wa

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Research Update

Can Stimulants Prevent Crime?

Topics: ADHD | attention | Attention Deficit Hyperactivity Disorder | Crime | Criminal behavior | Learning & Developmental Disabilities | Medication | stimulant | Teen | teens

Review of: Mohr-Jensen C et al, J Am Acad Child Adolesc Psychiatry 2019;58(4):443–452 ADHD has long been linked to antisocial behavior leading to arrests and incarcerations. Children and young adults with ADHD are more likely to be charged with anything from traffic violations to violent crimes. However, these associations do not prove causality. I

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Research Update

Methylphenidate Max Dosing

Topics: ADHD | attention | Attention Deficit Hyperactivity Disorder | Medication | methylphenidate | stimulant | Teen | teens

Review of: Ching C et al, JAMA Pediatr 2019;173(7):630–639 Methylphenidate was one of the first stimulants prescribed for the treatment of ADHD in children, adolescents, and adults. Its efficacy is clear, and its availability in immediate release, sustained release, osmotic release oral system (OROS, brand name Concerta), and transdermal patch keep

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Research Update

Heart Rate Changes Linked to ­Emotional Dysregulation

Topics: ADHD | Anxiety | attention | Conduct Disorder | Depression | Dysregulation | Emotional dysregulation | Heart rate

Review of: Deutz MH et al, J Am Acad Adolesc Psychiatry 2019;58(6):589–599 Can we use heart rate to assess and track psychopathology? Child psychiatrists associate lower resting heart rate (HR-rest) and heart rate reactivity (HR-reactivity) with externalizing behaviors such as disruptive behaviors and aggression (“under-arousal”) and elevations

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Research Update

Crocus Sativus vs Methylphenidate for ADHD

Topics: ADHD | Attention Deficit Hyperactivity Disorder | Crocus Sativus | methylphenidate | Saffron

Review of: Baziar S et al, J Child Adolesc Psychopharmacol 2019;29(3):205–212 The search for an equally effective, yet better tolerated alternative to stimulant medications continues. We often hear reports on the benefits of various non-pharmaceutical supplements. Now we have a new study looking at saffron (Crocus sativus). Saffron is reported to a

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News of Note

FDA Approves Adhansia XR

Topics: Adhansia XR | ADHD | adolescents | Attention Deficit Hyperactivity Disorder | Child Psychiatry | children | extended-release | methylphenidate | News of Note | pediatric | teens | treatment

We are always in need of a new formulation of stimulant medication that might capture a few more of our patients who just do not quite tolerate or respond well enough to the many existing formulations. So whenever a new one is released, we try to set aside our natural skepticism and take a look at the stated facts before judging its merit. Adhansia X

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News of Note

First Non-Drug Treatment Approved by FDA for Treating Children With ADHD

Topics: ADHD | adolescents | Attention Deficit Hyperactivity Disorder | Brain Devices | Child Psychiatry | children | efficacy | eTNS | News of Note | pediatric | safety | teens | treatment | Trigeminal Nerve Stimulation

NeuroSigma made a splash by announcing that the FDA has granted medical device approval for its external Monarch Trigeminal Nerve Stimulation (eTNS) System for treating kids with ADHD ages 7–12 who are not currently taking medications. What does medical device approval mean? The FDA reviewed the Monarch eTNS System through the de novo ­pre-market

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Research Update

Risk of Psychosis With Stimulants in ADHD Patients

Topics: ADHD | adolescents | amphetamine | Child Psychiatry | children | Free Articles | Medication | methylphenidate | pediatric | Psychosis | Research Update | stimulant | teens

Review of: Moran LV et al, N Engl J Med 2019;380(12):1128–1138 In 2007, the FDA required stimulant manufacturers to warn of possible psychosis with stimulants. But what is the real incidence? This study set out to find and discern if there is a difference between methylphenidate and amphetamine classes of medications. Drawing from two large comm

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Article

Psychostimulants: Bringing Order out of Chaos

Topics: ADHD

There are now no fewer than 14 FDA-approved psychostimulants… and counting. This does not include the many generics, the new non-stimulant Straterra or the off-label ADHD meds Wellbutrin (bupropion) and desipramine. Yes, capitalism is in full swing in the stimulant world. But who’s complaining? Now we have multiple options from which to pick and

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Article

Straterra: A Safer Desipramine?

Topics: ADHD

The Eli Lilly reps are almost delirious about their new ADHD “miracle drug”, Straterra (atomoxetine). This is not surprising. No pharmaceutical firm has survived the conversion of a blockbuster from brand to generic (as happened to Prozac in 2001) without sustaining a buyout or merger, and while it may be hard to drum up sympathy for a multi-billion

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Article

Adult ADHD: Is it Real?

Topics: ADHD

They have been flooding into your office: grown-ups who believe that they have ADHD. Some are referred to you by their exasperated spouses (“my wife gave me an ultimatum…”), some recognize themselves in their hyperactive children (“I tried his ritalin one day, and I’ve never been more focused in my life”), and some are swept into treatment b

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Expert Q&A

Dr. Jefferson Prince on Treating ADHD

Topics: ADHD

TCR: Dr. Prince, you have done innumerable evaluations of children and adults with ADHD. These days, psychiatrists in the community are besieged by patients wanting treatment for ADHD, and the pressure is on to come up with a diagnosis and treatment during a single 45 minute session. Is this possible? Dr. Prince: That’s a great question, and with kid

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Anecdotes From The Field

Stimulant Abuse

Topics: ADHD | Substance Abuse

David Sorenson, M.D., is medical director of the Anna Jaques Hospital Child Psychiatry Inpatient Unit in Amesbury, Massachusetts. His experiences with patients misusing ADHD medications should give us pause. “Many psychiatrists are naive about stimulants. I’ve heard a lot of stories about what kids are actually doing with their medications by lis

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Clinical Update

A Closer Look at Alpha-2 Agonists for ADHD

Topics: ADHD | Alpha Agonists

The alpha-2 agonists guanfacine ER (Intuniv) and clonidine ER (Kapvay) were approved for ADHD in 2010–2011, but three things have held back their use: They are less effective than stimulants (effect size of 0.5 vs. 0.8) They are only approved in children and adolescents Cost Recently, the ER versions went generic and the first major trial in a

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Clinical Update

Stimulants and Creativity

Topics: ADHD | Amphetamines | ArModafinil | Attention Deficit Hyperactivity Disorder | Creativity | methylphenidate | Modafinil | Provigil | Side Effects | stimulant | Stimulants

Your patient is a 25-year-old music teacher with ADHD. Though her organizational skills have improved with methylphenidate, she complains that it impairs her performance as a jazz musician: “I feel self-conscious, like a robot.” Popular lore holds that creative people have ADHD traits and that ADHD bestows advantages in creative thinking. Stock cha

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