ADHD

Expert Q&A

Practical Issues with Prescribing ADHD Meds

Topics: Adhansia | ADHD | Aptensio | Contempla | Dyanaval | Evekeo | Jornay PM | Mydayis | Qelbree | Quillivant | Stimulant treatment | Zenzedi and ProCentra

We spoke with Dr. Buchanan about choosing medications for ADHD in 2017, and she is back now with an update. In addition to this interview, check out the table below for an overview of ADHD medications over the past decade. CCPR: Thanks for talking with us, Dr. Buchanan. Please help us make sense of the many new ADHD medications. Dr. Buchanan: Sure.

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Clinical Update

Talking with Parents about Stimulant Treatment

Topics: ADHD | Collaboration | Parents | Stimulant Medications

  After a thorough assessment, you diagnose your 16-year-old patient Alex with ADHD and recommend a trial of stimulant medication. Alex wants to try the medication, but his mother feels he just needs tips and skills to improve his focus and doesn’t need to “take pills for the rest of his life.” ADHD is one of the most treatable conditio

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Research Update

Methylphenidate Improves Mood and Boredom in Children with ADHD

Topics: ADHD | Boredom | Depression | methylphenidate | Mood

REVIEW OF: Golubchik P et al, J Child Adolesc Psychopharmacol 2021;31(4):310–314 TYPE OF STUDY: Open label, ­uncontrolled We are always looking for new angles to understand the conditions we treat. ADHD leads to significant academic and social impairments and is highly comorbid with depression and “boredom.” This study examines these associatio

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Research Update

The Evidence Base for Polypharmacy in ADHD

Topics: ADHD | aggression | Central Alpha Agonists | Combined Pharmacotherapy | Divalproex | polypharmacy | Risperidone | Stimulants

REVIEW OF: Baker M et al, J Child Adolesc Psychopharmacol 2021;31(3):148–163 TYPE of Study: Literature review Psychotropic polypharmacy is increasingly the norm in clinical practice. We use it to address persistent symptoms or to target comorbid conditions, though we do so at the risk of increased side effects, more drug interactions, and worsened p

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Clinical Update

Atomoxetine for Children and Adolescents: An Update

Topics: ADHD | Atomoxetine (ATX) | Attention Deficit Hyperactivity Disorder

Atomoxetine (ATX, Strattera) was approved by the FDA for ADHD treatment in 2002, and since then has become a second- or third-line option (after stimulants and sometimes after central alpha-agonists) for ADHD in both children and adults. With the recent approval of another non-stimulant ADHD medication (viloxazine, brand name Qelbree), it’s a good tim

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Expert Q&A

Unpacking Aggression Associated with ADHD

Topics: ADHD | aggression | Risperidone | Stimulants | Valproate

CCPR: You recently did a study on stepped treatment for ADHD and aggressive behavior (Blader JC et al, J Am Acad Child Adolesc Psychiatry 2021;60(2):236–251). It is riveting in its relevance to everyday practice. I am thinking of one school-age child who came to me after multiple trials of stimulants and mood stabilizers who was still very impulsively

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Clinical Update

Using Equine-Assisted Psychotherapy

Topics: ADHD | Anxiety Disorder | Autism Spectrum Disorder | Equine Assisted Psychotherapy | Equine therapy | Free Articles | PTSD | Trauma

  Sylvia is 7 years old, referred for long-standing school refusal after CBT proved ineffective. You confer with her therapist about trying a different approach. When patients are not amenable to usual therapy, equine-assisted psychotherapy (EAP) might be a good option. In this article we’ll talk about working with horses as an alternative

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Research Update

Dash Diet for Childhood ADHD

Topics: ADHD | DASH diet | diet | Dietary Approaches to Stop Hypertension (DASH) | Non-pharmacologic | treatment

REVIEW OF: Khoshbakht Y et al, Eur J Nutr 2021;60(7):3647–3658 Dietary approaches for controlling ADHD in children have been studied over many decades, but none have been found to be clearly effective. In a recent study, researchers examined the Dietary Approaches to Stop Hypertension (DASH) diet, which includes several interventions that could be

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Research Update

Self-Harm in Adolescents With ADHD

Topics: ADHD | affective disorders | alcohol abuse | alcohol dependence | co-morbidities | Non-suicidal self-injury | psychotic disorders | Suicidality

REVIEW OF: Balázs J et al, BMC Psychiatry 2018;18(1):34 What is the relationship between ADHD and self-harm and what can we do about it? ADHD is quite common, affecting 4%–6% of children and adolescents, and non-suicidal self-injury (NSSI) is also common, affecting about 5% of all people in the community and up to 80% of people with psychiatric di

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Research Update

ADHD Prevalence in the US Black Population

Topics: ADHD | Black youth | Diagnosis | Disparities | prevalence

REVIEW OF: Cénat JM et al, JAMA Psychiatry 2021;78(1):21–28 STUDY TYPE: Meta-analysis In the general population, the reported prevalence of ADHD is about 10%, with estimates varying from around 5% to 15%. Black individuals are typically underrepresented in these studies, and with fewer data, it is no surprise that the estimates are less precise

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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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