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Andreana MacIvor posted Mar 22, 2022 3:31 PM
Attention deficit hyperactivity disorder (ADHD) is characterized by a pattern of behavior that is characteristic of symptoms such as poor concentration, impulsivity, and disorganization. Clinical presentation is the basis for diagnosis (DynaMed, 2022). Behavioral therapy is to be utilized first to help patients learn to control their behavior and improve their ability to concentrate and resist impulsive urges (American Psychiatric Association, 2017). If there is still significant functional impairment after a trial of behavioral therapy, then stimulant medication is utilized as the first-line pharmacological treatment. The lowest effective dose should be utilized with controlled-released formulas preferred, due to decreased likelihood of abuse potential. Amphetamines and methylphenidate have efficacy in treating the symptoms of ADHD. Common side effects include anorexia, headache, hypertension, tachycardia, and insomnia. Non-stimulant atomoxetine can be prescribed for ADHD in patients who are intolerant to stimulant side effects (DynaMed, 2022). Amphetamines and methylphenidate inhibit dopamine and norepinephrine transport, inhibit monoamine oxidate activity, and inhibit vesicular monoamine transporter 2 (Faraone, 2018). It is common for tic disorders to be comorbid with ADHD. Evidence is conflicting as to whether psychostimulants exacerbate or precipitate tics. There is evidence to support methylphenidate and dexamphetamine as treatments for tics and comorbid ADHD. The priority of treatment should be addressing tics over ADHD symptomology. Psychoeducation and behavioral management may be beneficial in curbing tics. Evidence also supports the administration of atomoxetine, clonidine, guanfacine, and aripiprazole for severe tics (Ogundele & Ayyash, 2018).

References

American Psychiatric Association. (2017). What is ADHD. https://www.psychiatry.org/patients-

families/adhd/what-is-adhd

DynaMed. (2022). Attention deficit hyperactivity disorder (ADHD) in adults.

https://www.dynamed.com/condition/attention-deficit-hyperactivity-disorder-adhd-in-adults

Faraone, S.V. (2018). The pharmacology of amphetamine and methylphenidate: Relevance to the

neurobiology of attention-deficit/hyperactivity disorder and other psychiatric comorbidities. Neuroscience & Biobehavioral Reviews, 87: 255-270. https://doi.org/10.1016/j.neubiorev.2018.02.001

Ogundele, M.O. & Ayyash, H.F. (2018). Review of the evidence for the management of co-

morbid tic disorders in children and adolescents with attention deficit hyperactivity disorder. World Journal of Clinical Pediatrics, 7(1): 36-42. https://doi.org/10.5409/wjcp.v7.i1.36


 

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