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

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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 | 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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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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Article

Adolescents With ADHD and Substance Use Disorders: A Primer

Topics: Addiction | ADHD | Child Psychiatry | Registered Articles | Substance Abuse

You are evaluating a 16-year-old boy referred for mandated substance use treatment by his high school, where he was found drinking alcohol and smoking cannabis with a friend in the restroom. As you gather his history, he says, “One doctor told me I have ADHD. That’s why I smoke pot—it helps me focus. But I think I’d do better with some Adderall.

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Article

Differentiating ADHD From Anxiety: Tips for Clinicians

Topics: ADHD | Anxiety | Child Psychiatry | Practice Tools and Tips

When parents bring in their kids for concentration, attention, and learning issues, it’s common to assume a provisional diagnosis of ADHD. In many children, however, anxiety can be the real cause of these problems. Studies have long shown that about two-thirds of children and adolescents who present for ADHD evaluation have comorbid conditions, inc

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Research Update

Does Methylphenidate Use in Children and Young Adults Increase Risk of Suicide?

Topics: ADHD | Child Psychiatry | Research Updates

Review Of: Man KKC et al, JAMA Psychiatry 2017;74(10):1048–1055 Some studies have indicated that patients with ADHD may be at an increased risk of suicide. While these studies have shown associations between methylphenidate use and suicide, it is not clear whether the stimulant actually causes suicidality or whether patients taking stimulants are s

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Article

An Integrative Approach to Attention Deficit Hyperactivity Disorder

Topics: ADHD | Child Psychiatry | Psychotherapy

Integrative approaches to treating ADHD have become increasingly sought after by parents, especially those who are concerned about the side effects and potential overuse of psychostimulant medication. Surveys report that over 60% of child psychiatry patients are employing integrative tools on their own such as vitamins, specific diets, and herbal remedi

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Article

Official 2017 Carlat ADHD Pediatric Stimulant Comparison Table

Topics: ADHD | Child Psychiatry

Our official 2017 Carlat ADHD Stimulant Comparison table, an easy-to- use reference that you’ll find handy. Table: Official 2017 Carlat ADHD Pediatric Stimulant Comparison Table (Click here to view as full-sized PDF.)

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Expert Q&A

Choosing Medications for ADHD

Topics: ADHD | Child Psychiatry

CCPR: Can you tell us about your current practice? Dr. Buchanan: I am responsible for pediatric ER and floor consults, I supervise the school crisis walk-in clinic, and I am responsible for high-risk intakes in the clinic.   CCPR: We hear a lot about overdiagnosis of ADHD. What are your thoughts? Dr. Buchanan: We all hear that the prob

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Research Update

Is Modafinil an Effective Alternative for the Treatment of ADHD?

Topics: ADHD | Child Psychiatry | Research Update

Review of: Wang SM et al, J Psychiatr Res 2017;84:292–300. Modafinil (Provigil) is FDA-approved for narcolepsy, obstructive sleep apnea, and shift work sleep disorder, but not for ADHD. Given that it has some of the same stimulating properties of psychostimulants, it should theoretically be effective. Wang and colleagues identified five randomized

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