ADHD

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

Read More
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

Read More
Research Update

Risk of Psychosis With Stimulants in ADHD Patients

Topics: ADHD | adolescents | amphetamine | Child Psychiatry | children | 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

Read More
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

Read More
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

Read More
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

Read More
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

Read More
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

Read More
Highlights

Highlights From This Issue

Topics: ADHD | Adult ADHD | Micronutrients | Narcolepsy | Schizophrenia

Micronutrients are vitamins and minerals that play an essential role in human physiology. They have promising studies in a host of psychiatric disorders, and Dr. Rucklidge explains why. Adult-onset ADHD has been proposed as a new diagnosis, but the data supporting it point in a different direction. Light therapy is one of few natural treatments with

Read More
Article

Stimulants as Cognitive Enhancers

Topics: ADHD | Amphetamines | Attention Deficit Hyperactivity Disorder | Cognition | Cosmetic pharmacology | methylphenidate

Depending on your practice setting, you are likely to encounter adults who seek stimulants for various “non-medical” uses, from cognitive enhancement to recreational abuse to outright diversion. Abuse and diversion are easier to detect these days with the controlled substance databases available in most states. Abuse of stimulants is relative

Read More
Research Update

Amphetamines Stand Out in ADHD

Topics: ADHD | Amphetamines | Research Update

Review of: Cortese S et al, Lancet 208;5:727–738 Type of study: Meta-analysis With so many medications available to treat ADHD, wouldn’t it be nice to know if some are better than others? In this comprehensive meta-analysis, researchers sought to compare the relative efficacy and tolerability of both stimulant (methylphenidate and am

Read More
Research Update

How Helpful Is Computerized Testing for ADHD?

Topics: ADHD | Child Psychiatry | Research Update | Technology

Review of: Hollis C et al, J Child Psychol Psychiatry 2018;59(12):1298–1308 With busy clinic schedules and the ever-burgeoning load of documentation, computerized diagnostic aids are in more demand than ever. For ADHD, the gold standard is still a clinical assessment with information from parents and teachers, but those reports are difficult to obt

Read More
Research Update

Would Treating Kids With ADHD Help Their Mothers?

Topics: ADHD | Child Psychiatry | Research Update | Working With Families

Review of: Gokcen C et al, J Child Adolesc Psychopharm 2018;28(5):350–353 Parenting a child with ADHD can be challenging. Parents often report feeling stressed, burned out, or depressed while caring for their children with ADHD. When ADHD medications lead to significant improvements in a child’s behavior, can that alleviate symptoms in parents? A

Read More
Article

New Stimulants: From Remixed Amphetamines to Bedtime Ritalin

Topics: ADHD | Psychopharmacology Tips

You may have noticed that a confusing array of new stimulants has been approved in the last few years. Since 2012, there have been five new amphetamines and two new methylphenidates. What are these preparations? Are any of them worth prescribing to your patients? To prepare you for the promotional downpour that’s likely to accompany all this repackagi

Read More
Article

Note From the Editor-in-Chief

Topics: ADHD | Child Psychiatry

In this issue we tackle a range of challenges, including differentiating ADHD from bipolar disorder, understanding suicide risk in college students, managing assertions about the safety of weed, and assessing and treating violent behavior in our patients. How do we think about the future of kids with ADHD? Dr. Mark Katz offers a hopeful approach. We als

Read More
Article

Evaluating and Treating Co-Occurring ADHD and Bipolar Disorder

Topics: ADHD | Bipolar Disorder | Child Psychiatry

Early into the evaluation of a 10-year-old boy, you note the following symptoms: inattention, hyperactivity, impulsivity, sleep problems, racing thoughts, and moodiness. The boy’s parents came to your office convinced that their son has ADHD, but thinking through the case, you recognize that the same symptoms could signal bipolar disorder (BD). You ha

Read More
Expert Q&A

Becoming Successful Despite ADHD

Topics: ADHD | Psychotherapy | Registered Articles

CCPR: Dr. Katz, how did you get interested in this topic? Dr. Katz: There’s a body of research exploring the lives of those who overcame a range of adverse childhood experiences, including learning-related challenges. I’ve always been interested in this work. Parents at our center are often surprised to learn that successful adults in every prof

Read More
News of Note

Jornay PM Nighttime Stimulant for Next-Morning Effect

Topics: ADHD | News of Note | Sleep Disorders

Prescribing bedtime stimulants sounds like a recipe for a bad night’s sleep. But the FDA recently approved Jornay PM, which is an extended release (ER) formulation of methylphenidate that is, in fact, dosed at night. Approved for kids age 6 and older, Jornay PM has an extremely delayed onset of effect of 10 hours. This means kids can take it at aro

Read More
Research Update

Amphetamine Extended Release Oral Suspension for ADHD

Topics: ADHD | Research Update

Review of: Childress AC et al, J Child Adolesc Psychopharmacol 2017;28(5):306–313 In 2015, the FDA approved Dyanavel XR (amphetamine extended release oral suspension), which was the first long-acting liquid version of amphetamine on the market. To provide some context, Quillivant XR, a long-action liquid methylphenidate formulation, was approved in

Read More
Research Update

Mindfulness Therapy for Adult ADHD

Topics: ADHD | Research Update

Review of: Janssen L et al, Psychological Medicine 2018;28:1–11 Medications are the first-line treatment for adult ADHD, and the efficacy of psychosocial therapies is less well-defined. Mindfulness-based therapy showed promise for adult ADHD in a recent meta-analysis, but there were flaws and significant differences between the included studies (Ja

Read More