ADD and ADHD

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ADD, ADHDor just full of Energy?

• Colleen Finegan, Ph.D.
• Wright State University
• Montgomery County
• Child and Family Services
• Jan 27, 2005

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What is it?
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Imagine..

• Imagine living in a fast-moving kaleidoscope,
  where sounds, images, and thoughts are
  constantly shifting.
• Feeling easily bored, yet helpless to keep
  your mind on tasks you need to complete.

http//www.nativeremedies.com/focus_for_adhd.shtml
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Imagine

• Distracted by unimportant sights and
  sounds, your mind drives you
  from one thought or activity to the
  next.
• Perhaps you are so wrapped up
  in a Collage of thoughts and
  images that you don't notice
  when someone speaks to you.

http//www.nativeremedies.com/focus_for_adhd.shtml
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Imagine

• For many, this is what it's like to have
  Attention Deficit Hyperactivity Disorder, or
  ADHD.
• They may be unable to sit still, plan ahead,
  finish tasks, or be fully aware of what's going
  on around them.

http//www.nativeremedies.com/focus_for_adhd.shtml
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Imagine

• To their family, classmates or coworkers, they
  seem to exist in a whirlwind of disorganized or
  frenzied activity.
• Unexpectedly--on some days and in some
  situations--they seem fine, often leading others
  to think the person with ADHD can actually
  control these behaviors.

http//www.nativeremedies.com/focus_for_adhd.shtml
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Imagine

• As a result, the disorder can mar the person's
  relationships with others in addition to
  disrupting their daily life, consuming energy,
  and diminishing self-esteem.

http//www.nativeremedies.com/focus_for_adhd.shtml
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Definition
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Diagnostic and Statistical Manual of Mental
Disorders (DSM-IV)

• The DSM-IV includes standardized diagnostic
  criteria for many psychiatric disorders.
• The following are the current diagnostic criteria
  for ADHD from the DSM-IV.
• It should be used only for informational purposes
  and is not intended for self-diagnosis or for use
  by anyone other than a qualified health
  professional.

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AD/HD - Diagnostic Criteria

• A. Either (1) or (2)
• 1. six (or more) of the following symptoms of
  inattention have persisted for at least 6 months
• to a degree that is maladaptive and inconsistent
  with developmental level

http//www.psychologynet.org/add.html
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AD/HD - Diagnostic Criteria

• often fails to give close attention to details or
  makes careless mistakes in schoolwork, work, or
  other activities
• often has difficulty sustaining attention in
  tasks or play activities

http//www.psychologynet.org/add.html
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AD/HD - Diagnostic Criteria

• often does not seem to listen when spoken to
  directly
• often does not follow through on instructions and
  fails to finish schoolwork, chores, or duties in
  the workplace
• (not due to oppositional behavior or
  failure to understand instructions)

• http//www.psychologynet.org/add.html

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AD/HD - Diagnostic Criteria

• often has difficulty organizing
  tasks and activities
• often avoids, dislikes, or is reluctant to engage
  in tasks that require sustained mental effort
• (such as schoolwork or homework)

http//www.psychologynet.org/add.html
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AD/HD - Diagnostic Criteria

• often loses things necessary for tasks
  or activities (e.g., toys, school assignments,
  pencils, books, or tools)
• is often forgetful in daily activities
• is often easily distracted by extraneous stimuli

http//www.psychologynet.org/add.html
15
AD/HD - Diagnostic Criteria

• 2. six (or more) of the following symptoms of
  hyperactivity-impulsivity have persisted for at
  least 6 months
• to a degree that is maladaptive and inconsistent
  with developmental level

http//www.psychologynet.org/add.html
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AD/HD - Diagnostic Criteria

• Hyperactivity
• often fidgets with hands or feet or squirms in
  seat
• often leaves seat in classroom or in other
  situations in which remaining seated is expected
• often has difficulty playing or engaging in
  leisure activities quietly

http//www.psychologynet.org/add.html
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AD/HD - Diagnostic Criteria

• Hyperactivity
• often runs about or climbs excessively in
  situations in which it is inappropriate (in
  adolescents or adults, may be limited to
  subjective feelings of restlessness)

http//www.psychologynet.org/add.html
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AD/HD - Diagnostic Criteria

• Hyperactivity
• often talks excessively
• is often "on the go" or often acts as
  if "driven by a motor"

http//www.psychologynet.org/add.html
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AD/HD - Diagnostic Criteria

• Impulsivity
• often blurts out answers before questions have
  been completed
• often has difficulty awaiting turn
• often interrupts or intrudes on others (e.g.,
  butts into conversations or games)

http//www.psychologynet.org/add.html
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AD/HD - Diagnostic Criteria

• B. Some hyperactive-impulsive or inattentive
  symptoms that caused impairment were present
  before age 7 years.
• C. Some impairment from the symptoms is present
  in two or more settings (e.g., at school or
  work and at home).

http//www.psychologynet.org/add.html
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AD/HD - Diagnostic Criteria

• D. There must be clear evidence of clinically
  significant impairment in social, academic, or
  occupational functioning.

http//www.psychologynet.org/add.html
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AD/HD - Diagnostic Criteria

• E. The symptoms do not occur exclusively during
  the course of a
• Pervasive Developmental Disorder Schizophrenia 
• or other Psychotic Disorder

http//www.psychologynet.org/add.html
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AD/HD - Diagnostic Criteria

• and are not better accounted for by another
  mental disorder such as a/an
• Mood
  Disorder
• Anxiety Disorder
• Dissociative Disorder
• Personality Disorder

http//www.psychologynet.org/add.html
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AD/HD-Specific Types

• Attention-Deficit/Hyperactivity Disorder,
  Combined Type if both Criteria A1 and A2 are met
  for the past 6 months

http//www.psychologynet.org/add.html
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AD/HD-Specific Types

• Attention-Deficit/Hyperactivity Disorder,
  Predominantly Inattentive Type if Criterion A1
  is met but Criterion A2 is not met for the past 6
  months

http//www.psychologynet.org/add.html
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AD/HD-Specific Types

• Attention-Deficit/Hyperactivity Disorder,
  Predominantly Hyperactive-Impulsive Type if
  Criterion A2 is met but Criterion A1 is not met
  for the past 6 months

http//www.psychologynet.org/add.html
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AD/HD-Specific Types

• Note For individuals (especially adolescents and
  adults) who currently have symptoms that no
  longer meet full criteria, "In Partial Remission"
  should be specified.

http//www.psychologynet.org/add.html
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AD/HD and Academic Achievement

• Up to 80 of students with AD/HD exhibit academic
  performance problems.
• adolescents with AD/HD have a much higher
  history of grade retention, special ed
  placement, and school-drop out relative to their
  peers.
• If diagnosed as having AD/HD, the impact on
  children's educational success is often
  profound.
•  
• http//www.helpforadd.com/2003/february.htm

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AD/HD and Academic Achievement

• among children without a formal ADHD
  diagnosis, attention problems frequently have a
  tremendously adverse impact on children's
  academic achievement.
• Among children who meet full ADHD diagnostic
  criteria, and who thus have attention problems
  that are often quite severe, the impact is likely
  to be profound.
• http//www.helpforadd.com/2003/february.htm

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AD/HD and Reading Achievement

• attention problems observed in K were found
  to predict diminished reading achievement in
  fifth grade even among children who had no
  evidence of any primary reading disability. 
• children with higher levels of teacher rated
  attention problems during first grade made
  significantly less progress in reading over the
  year than other children.
• http//www.helpforadd.com/2003/february.htm

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Prevalence

• ADHD, once called hyperkinesis or minimal brain
  dysfunction, is one of the most common mental
  disorders among children.
• It affects 3 to 5 percent of all children,
  perhaps as many as 2 million American children.

http//www.nativeremedies.com/focus_for_adhd.shtml
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Prevalence

• Two to three times more boys than girls are
  affected.
• On the average, at least one child in every
  classroom in the United States needs help for the
  disorder.
• ADHD often continues into adolescence and
  adulthood, and can cause a lifetime of frustrated
  dreams and emotional pain.

http//www.nativeremedies.com/focus_for_adhd.shtml
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Prevalence

• Varies by gender, age, social class and
  urban-rural
• 1-3 of children (DSM-III or III-R)
• 2-8 of children (DSM-IV) (Average 3-5)
• 4.7 of adult population (DSM-IV-all types)
• 31 malesfemales (community samples)
• 51 - 91 (clinical samples)

Russell Barkley - ADHD Workshop cincinnati 9/14/01
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Etiology- Neurological

• Prenatal Injuries (10-15)
• Post Natal Brain Damage (3-5)
• Post-Natal Infection
• Smaller Less Developed Brian Regions
• Suspected Neuro-Chemical Dependancy

Russell Barkley - ADHD Workshop cincinnati 9/14/01
35
Executive Function Deficits

• The brain is believed to be responsible for
  managing processes needed to solve problems and
  attain future goals
• These processes may include

• Organizational skills
• planning,
• future-oriented behavior,
• set-maintenance,
• set regulation

selective attention, maintenance of attention or
vigilance, inhibition, creativity.
http//web.uccs.edu/lthede/executiv.htm
36
Evidence for Executive
Deficits

• Deficits on Executive Function Tests
• Less frontal Electrical Activity
• Reduced Blood flow to the frontal and striatal
  regions
• Dimished frontal and straital metabolic activity
• Smaller Frontal-Basal Gangalia-Cerebellular areas

Russell Barkley - ADHD Workshop cincinnati 9/14/01
37
Etiology - Heredity / Genetics

• Family Aggregation of Disorder
• Twn Studies of Heritability
• Molecular Genetics

Russell Barkley - ADHD Workshop cincinnati 9/14/01
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Diagnosis is Difficult
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• A common problem in determining ADHD lies within
  the fact that many symptoms trace to symptoms of
  other disorders.
• Depression and anxiety contain symptoms
  analogous with those
  of ADHD.
• Also, a majority of teenagers require
  extraneous focus on
  schoolwork and
  exhibit disorganization.

http//www.floridatoday.com/news/verge/stories/200
3/may/051803cp.htm
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Co-Morbitity

• AD/HD shares the symptoms and characteristics
  with many other disorders
• Bipolar Disorder
• Conduct Disorder
• Anxiety Disorder
• Oppositional Defiant Disorder (ODD)
• Learning Disabilities

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Co-Morbitity - Bipolar Disorder

• Separation Anxiety
• Rages Explosive Temper Tantrums (lasting up to
  several hours)
• Marked Irritability
• Oppositional Behavior
• Frequent Mood Swings
• Distractibility
• Hyperactivity
• Impulsivity
• Restlessness/Fidgetiness
• Silliness, Goofiness, Giddiness
• Racing Thoughts

• Aggressive Behavior
• Grandiosity
• Carbohydrate Cravings
• Risk-Taking Behaviors
• Depressed Mood
• Lethargy
• Low Self-Esteem
• Difficulty Getting Up in the Morning
• Social Anxiety
• Oversensitivity to Emotional or Environmental
  Triggers  

http//add.about.com/cs/comorbidcondition/a/coexis
ting.htm
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Co-Morbitity - Conduct Disorder

• Bullies, threatens or intimidates others
• Initiates physical fights
• Physically cruel to people or animals
• Forces someone into sexual activity
• Fire setting
• Destruction of property
• Stealing, Lying, Deceitfulness
• Runs away from home
• Truant from school
• Stays out at night,
• despite parental objections or punishment  

http//add.about.com/cs/comorbidcondition/a/coexis
ting.htm
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Co-Morbitity - Anxiety Disorder

• Worry about everything, big and small
• Headaches or other aches and pains for no
  apparent reason
• Trouble Relaxing
• Trouble concentrating on one thing
• Trouble falling asleep or wake up often during
  the night
• Have hot flashes
• Feel nauseous when worried  

http//add.about.com/cs/comorbidcondition/a/coexis
ting.htm
44
Co-Morbitity - Depression

• Feeling Sad or Empty
• Appears Tearful
• In children can be irritable
• Diminished interest in all or almost all
  activities
• Weight loss without dieting
• Decrease in appetite
• Insomnia or hypersomnia
• Loss of energy
• Thoughts of suicide  

http//add.about.com/cs/comorbidcondition/a/coexis
ting.htm
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Co-Morbitity - Oppositional Defiant Disorder

• Short temper
• Argumentative with adults / authority figure
• Deliberately annoys others
• Angry
• Resentful
• Vindictive
• Blames others for misbehavior
• Defiance of rules
• Has difficulty in accepting authority figures
    

http//add.about.com/cs/comorbidcondition/a/coexis
ting.htm
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Co-Morbitity - Learning Disabilities

• The term Learning Disability can mean many
  different things.  There are 3 categories of
  learning disabilities
• Developmental speech and language disorders
• Academic skills disorder
• Other  

http//add.about.com/cs/comorbidcondition/a/coexis
ting.htm
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Co-Morbitity - Giftedness

• Traits of gifted children which may lead to false
  ADHD diagnosis include
• off task behavior,
• less need for sleep,
• questioning of rules and traditions,
• power struggles, and
• resistance to repetitive tasks.
•  

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Co-Morbitity - Giftedness

• Suggestions to help differentiate ADHD and
  giftedness
• Unlike gifted children, those with ADHD exhibit
  problem behavior in virtually all settings.
• Gifted students will concentrate on what
  interests them regardless of desires of parents
  and teachers, but ADHD students have brief
  attention spans in virtually all situations.
• Both ADHD and gifted students may question
  rules, but gifted students may create their own
  complex rules and expect others to follow them.
• Gifted students perform well with teachers or
  subjects they like, while ADHD students are
  inconsistent in virtually all areas of
  performance.

http//members.aol.com/svennord/ed/adhd.htm
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Diagnosis
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AD/HD - Diagnosis

• Checklists
• ADD Evaluation Scale
• ADHD Rating Scale-IV
• ADD-H Comprehensive
  Teacher/Parent Rating Scales
• Informal Checklists

http//add.about.com/cs/comorbidcondition/a/coexis
ting.htm
51
AD/HD-Other Forms of Diagnosis

• SPECT
• Using a nuclear medicine technique called "single
  photon emission computed tomography" (SPECT), Dr.
  Daniel G. Amen presents a
  compelling case for the existence of
  attention deficit disorder (AD/HD)
  through hard, visual data

http//www.amenclinic.com/ac/
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AD/HD-Other Forms of Diagnosis

• If we agree that mental disorders and difficult
  behaviors may be related to functional problems
  in the brain,
• and that brain SPECT imaging is a reliable
  measure of regional cerebral blood flow and thus
  activity patterns,
• then it follows that we should take advantage of
  this powerful tool when faced with complex
  situations or with patients unresponsive to
  treatment

http//www.amenclinic.com/ac/whyspect.asp
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Intervention for Academic Problems
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Intervention for Academic Problems

• Tutoring

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AD/HD - Is Tutoring Helpful?

• tutoring provided significant benefitsfor
  children who had been poor readers to start
  with.
• tutoring was less helpful for children with
  attention problems.  As children's level of
  attention problems increased, the benefits of
  tutoring steadily declined.
• http//www.helpforadd.com/2003/february.htm

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AD/HD - Is Tutoring Helpful?

• among children whose attention problems
  approached a clinically elevated range, there was
  virtually no discernible benefit of tutoring.
• tutoring may need to be more intensive, and/or
  specifically targeted to the special needs of
  children who are inattentive. 
• http//www.helpforadd.com/2003/february.htm

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If tutoring isnt beneficial then

• There is a critical need to develop systematic
  procedures within schools for students whose
  attention problems are resulting in academic
  problems. 
• http//www.helpforadd.com/2003/february.htm

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Specialized Instructional Procedures

• Although there are specialized instructional
  procedures for inattentive students that appear
  promising, research demonstrating that such
  interventions are associated with long-term gains
  in academic achievement is currently lacking.
• http//www.helpforadd.com/2003/february.htm

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Instructional Modification

• Instructional modifications, although helpful
  and important, try to compensate for a child's
  attention problems rather than alleviating those
  problems directly.
• http//www.helpforadd.com/2003/february.htm

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Medication Treatment

• This is also true for the impact of medication
  treatment on the long-term academic success of
  students with ADHD. 
• Although medication treatmenthas been shown to
  be profoundly helpful in many areas, there is
  currently little evidence that it results in
  substantially better academic outcomes

http//www.helpforadd.com/2003/february.htm
62
Medication Treatment

• Medication, although clearly yielding important
  short-term gains in attention for many children,
  does not produce any enduring gains in a child's
  ability to focus and attend.

http//www.helpforadd.com/2003/february.htm
63
EEG biofeedback

• Promising results of EEG biofeedback in
  reducing inattentive symptoms among AD/HD
  children have also been recently reported
  (Monastra, Monastra, George, 2001) and are
  summarized at www.helpforadd.com/2003/january.htm 
  

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Interactive Metronome

• The Interactive Metronome is another new
  technology that has also shown promise in
  enhancing children's attention and academic
  functioning (http//www.interactivemetronome.com/h
  ome/index.asp)

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Inattentive but not Disruptive

• Many children who are inattentive tend to disturb
  others and are generally disruptive in the
  classroom. These are usually the first to be
  noticed, recommended for testing and identified.
• However, there are children who may be
  inattentive but do not disturb others. These
  children often go unnoticed and are not
  identified as needing special assistance.

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Inattentive but not Disruptive

• This can be true even among inattentive
  students whose problems are severe enough to
  warrant an ADHD diagnosis, and may be especially
  likely to occur for girls who are inattentive. 
• As a result, these children may fail to acquire
  critical academic skills in the early grades,
  which put them on a path of academic struggles.

http//www.helpforadd.com/2003/february.htm
67
AD/HD Coaching

• AD/HD coaching aims to nurture your ability to
  self-initiate change in your daily life. It is a
  supportive, practical, concrete process in which
  you and your coach work together to identify and
  pursue your goals.
• Coaching helps individuals with AD/HD to develop
  the structures necessary to function effectively
  and to learn practical approaches to the
  challenges of daily life.

http//www.add.org/articles/coaching/model.html
68
AD/HD Coaching

• The coach guides the process yet does not drive
  it provides structure without imposing it
  asks questions without judgment.
  
• Strategies are developed to address issues of
  time management,
• eliminate clutter in one's home or office,
• become more effective in personal and
  professional life.

http//www.add.org/articles/coaching/model.html
69
AD/HD Coaching

• The coach provides encouragement,
  recommendations,
• feedback,
• and practical techniques such as reminders,
  questions, and calendar monitoring.
• ADD coaching is not psychotherapy. Coaches are
  not licensed therapists, nor do coaches make any
  representation of such.

http//www.add.org/articles/coaching/model.html
70
AD/HD Coaching

• What is the role of the client?
• Coaching is a process that happens over time.
  Since it is a client-driven service, for coaching
  to be successful you must possess a strong desire
  for personal growth and improvement.
• Coaching focuses on your being in action towards
  self-edification, self-improvement, creating life
  balance, and reaching goals.

http//www.add.org/articles/coaching/model.html
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Medications
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(No Transcript)
78
Ritalyn Ritalyn SR (Sustained release)

• Ritalin is a dopamine transmitter blocker and
  hence it amplifies dopamine release.
• the amplification of weak dopamine signals in
  subjects with ADHD by Ritalin would enhance
  task-specific signaling
• improve attention and decrease distractibility
• ( the most common symptoms of ADHD)
• http//www.nih.gov/news/pr/jan2001/nida-16.htm

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RitalynMethylphenidate HCL

• Its onset of action is rapid 20-30 minutes.
• It has the shortest duration of action of 2-4
  hours.
• Many children only benefit for 3 hours from
  medication.
• There may be a significant "rebound" when the
  medication wears off, constituted by
  over-agitation and/or anxiety.
• http//www.healing-arts.org/children/ADHD/medicati
  ons.htmRitalin

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Ritalyn-SRMethylphenidate HCL

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Adderal

• Adderall is made by Richwood Pharmaceuticals, and
  was previously known as 'Obetral'. The dosage of
  Adderall is roughly equivalent to a comparable
  dose of Dexedrine. Adderall tablets consist of
  equal amounts of Amphetamine and
  Dextroamphetamine, with both short and
  long-acting preparations. The therapeutic effect
  is apparently more subtle and smooth than other
  preparations and the length of action is 6-9
  hours.

82
Adderal

• Important points to note when prescribing or
  taking Adderall
• 1. It provides therapeutic cover for a full
  school or working day.
• 2. Adderall has been used for 'impulse-control.'
• 3. Adderall has a distinct anorexic effect and
  therefore management of diet, especially in
  children, is essential.
• 4. Because Adderall has a slow onset of action
  and a sloped drop-off of action, anxiety induced
  at the onset of action and rebound at drop-off is
  reduced over other stimulants

83
Dexedrine

• Dextroamphetamine saccharate/Dextroamphetamine
  sulfate (Dexedrine)
• Dexedrine is one of the better known stimulant
  medications and is second only to Ritalin in the
  treatment of ADHD. The generic equivalent of
  Dexedrine is Dextroamphetamine Sulfate. Because
  the PDR continues to list Dexedrine under "Diet
  Control" medications, some insurance companies
  will not cover Dexedrine for the treatment of
  ADHD.

84
Dexedrine

• 4. Dexedrine 5mg is about equivalent to 10mg of
  Ritalin. In other words it is about twice as
  potent as Ritalin.
• 5. Ingestion of Vitamin C and Dexedrine
  simultaneously, e.g., taking medication with
  orange juice, may significantly reduce Dexedrine
  absorption.
• 6. Because Dexedrine in the SR form is long
  acting, it is very useful for Middle and High
  school students who forget to take their second
  or third dose. Dexedrine, however, has the
  potential side effect of reduced appetite.

85
Dexedrine

• Important things to bear in mind when prescribing
  or taking Dexedrine
• 1. The onset of action is 30 minutes, slower than
  Ritalin.
• 2. The coverage provided by Dexedrine is 3 1/2 to
  4 1/2 hours about an hour longer than Ritalin,
  especially with adult administration.
• 3. Dexedrine purportedly has a "smoother" onset
  of action and "drop-off" than Ritalin. It is
  usually almost completely absorbed and therefore
  one does not usually see the variation in onset
  of action that one sees with the use of Ritalin.

86
Dexedrine

• Important things to bear in mind when prescribing
  or taking Dexedrine
• 4. Dexedrine 5mg is about equivalent to 10mg of
  Ritalin. In other words it is about twice as
  potent as Ritalin.
• 5. Ingestion of Vitamin C and Dexedrine
  simultaneously, e.g., taking medication with
  orange juice, may significantly reduce Dexedrine
  absorption.
• 6. Because Dexedrine in the SR form is long
  acting, it is very useful for Middle and High
  school students who forget to take their second
  or third dose. Dexedrine, however, has the
  potential side effect of reduced appetite.

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Concerta
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Cylert

• Pemoline (Cylert) for ADHD
• Cylert ranks third in sales for the treatment of
  ADHD. Cylert is manufactured by Abbott no
  generic is available.
• Unlike other stimulant medications Cylert has an
  onset of action of about an hour and must be
  taken for 1-2 weeks before improvement occurs. It
  is recommended that the dosage of this medication
  be increased in increments of 18.75mg every 2-3
  days over several weeks. Cylert is more expensive
  than Ritalin or Dexedrine.

89
Cylert

• 1. Liver enzyme changes have occasionally been
  noted on patients taking Cylert. Baseline liver
  enzymes are recommended with follow ups at 3-6
  months.
• 2. Persons using alcohol are at higher risk with
  this medication. Patients with either liver or
  kidney compromise should not take this
  medication.
• 3. SSRI's affect the use of Cylert due to their
  effects on the liver P450 isoenzymes.
• 4. Cylert is a useful alternative for patients
  with cardiovascular disease as it has no effect
  on this system.
• 5. Cylert may cause insomnia, appetite
  suppression, and tics.

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Metadate
91
Self-Help Books

• Change Your Brain, Change Your Life The
  Breakthrough Program for Conquering Anxiety,
  Depression, Obsessiveness, Anger, and
  Impulsiveness by M.D. Daniel G. Amen
• Windows into the A.D.D. Mind Understanding and
  Treating Attention Deficit Disorders in the
  Everyday Lives of Children, Adolescents and
  Adults by Daniel G. Amen
• Healing ADD The Breakthrough Program
  That Allows You to See and Heal the 6 Types of
  ADD by Daniel G. Amen

92
Self-Help Books - for Kids

• Putting on the Brakes
  Young People's Guide to
  Understanding Attention
  Deficit Hyperactivity Disorder
• AND
• The "Putting on the Brakes"
  Activity Book for Young
  People With ADHD by Patricia
  Quinn Judith Stern
• Learning to Slow Down and Pay Attention
  A Book for Kids About ADD
  by Kathleen G. Nadeau
• Sparky's Excellent Misadventures
  My A.D.D. Journal
  by Phyllis Carpenter, et al

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Self-Help Books - for YoungKids

• Shelley, the Hyperactive Turtle (Special Needs
  Collection) by Deborah M. Moss
• Jumpin' Johnny Get Back to Work! A Child's
  Guide to ADHD/Hyperactivity by Michael Gordon
• Otto Learns about His Medicine A Story about
  Medication for Children with ADHD by Matthew
  Galvin

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Herbal Remedies

• BrightSpark ADD Remedy will help you to
• Relax and calm down
• Be less impulsive
• Listen more carefully
• Follow instructions
• Concentrate better
• Be less distractible
• Achieve better results at school or work
• BrightSpark was specially formulated for children
  under 12 years of age. Adults and teenagers with
  ADD should refer to Focus ADDult
• http//www.nativeremedies.com/brightspark_for_add.
  shtml

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Herbal Remedies

• Use Focus ADDult to
• Improve focus and ability to concentrate
• Increase attention span
• Reduce distractibility
• Boost memory functioning
• Stay alert and 'sharp' while studying
• Increase motivation and energy levels
• Improve grades and increase study skills
• Boost immune functioning and protect against
  illness
• Focus ADDult was specially formulated for teens
  and adults. Children under 12 years should refer
  to Brightspark
• http//www.nativeremedies.com/brightspark_for_add.
  shtml

96
Herbal Remedies

• Use Focus to treat symptoms of ADHD naturally
  to
• Use Focus to treat symptoms of ADHD naturally to
  
• Reduce hyperactivity and restlessness
• Calm, soothe and reduce mood swings
• Improve concentration, memory and attention span
• Improve alertness and mental focus
• Calm over-active minds
• Reduce impulsiveness and aggression
• Focus is formulated for children and adults with
  ADHD. Adults with ADD (no hyperactivity) refer to
  Focus ADDult
• http//www.nativeremedies.com/brightspark_for_add.
  shtml

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Vision Therapy

• VISION THERAPY improves visual skills that allow
  a person to pay attention. These skill areas
  include visual tracking, fixation, focus change,
  binocular fusion and visualization.
• When all of these are well developed, children
  and adults can sustain attention, read and write
  without careless errors, give meaning to what
  they hear and see, and rely less on movement to
  stay alert.

http//www.add-adhd.org/attention_deficits_ADHD.ht
ml
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Occupational Therapy

• OCCUPATIONAL THERAPY for children with sensory
  integration dysfunction enhances their ability to
  process lower level senses related to alertness,
  body movement and position, and touch.
• This allows them to pay more attention to the
  higher level senses of hearing and vision.

http//www.add-adhd.org/attention_deficits_ADHD.ht
ml
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Treatment of Allergies

• TREATMENT OF ALLERGIES to pollens, molds, dust,
  foods and/or chemicals by eliminating or
  neutralizing them has also been shown to
  alleviate the identical symptoms, and without
  side effects.

http//www.add-adhd.org/attention_deficits_ADHD.ht
ml
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Abuse of AD/HD Medication

• ...When stimulants are taken as prescribed, and
  treatment is appropriately monitored, they are
  safe, effective for the vast majority of children
  and teens with ADHD, and do not increase the risk
  for developing substance abuse problems
• In factchildren with ADHD who are treated with
  stimulants are less likely to develop substance
  abuse problems than those who are not.
• http//www.helpforadd.com/2003/may.htm

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Abuse of ADHD Medication

• stimulant medication abuse is a far bigger
  problem among those who are not prescribed
  stimulants than among those who are. 
• Nonetheless, some adolescents taking medication
  to treat ADHD do misuse or abuse their
  medication, and it seems important for parents
  and professionals to be vigilant about this
  possibility. 
• it is likely that such abuse is most likely to
  occur among adolescents who have also developed
  serious conduct problems in addition to ADHD. 
• http//www.helpforadd.com/2003/may.htm

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