ADHD Flashcards
What is the prevalence of ADHD
2%-7%
What risks are increased in children with ADHD
Accidental injuries
Poor relationship with peers and parents
Worse quality of life
Impaired school performance
which gender is more likely to be diagnosed with ADHD and why
Boys
As they show more hyperactivity whist females
How is ADHD diagnosed
Symptoms must
- Meet DSM-5 or ICD-10
- Causes moderate physiological, social, educational or occupational impairment
- Must occur in 2 or more important settings
- assess persons needs and co-existing conditions
According to DSM-5 how many symptoms of inattention, Hyperactivity and impulsivity need to be present in children and adults for a diagnosis of ADHD to be made
Children up to 16: six or more
Adults from the age of 17: five or more
How long do the symptoms need to be presents
At least 6 months
According to DSM-5 what other conditions need to be meet for a ADHD diagnosis
1- Inattentively, hyperactive and impulsive symptoms must be present before age 12
2- setting are present in two or more settings: school/ work or with friends or relatives
3- Clear evidence that symptoms interfere with quality of social, school and work functionality
4- symptoms not explained by another mental disorder
5- Does not happen only during SCH or psychotic disorder
What are the 3 types of ADHD presentation
1-Combined
2- Predominantly inattentive presentation
3- Predominantly Hyperactive-Impulsive presentation
Which brain regions are involved in ADHD
Prefrontal cortex
Basal ganglia:
Cerebellum
Is ADHD hereditary
ADHD inheritable: TRUE OR FALSE?
True: 74% inheritability
What dopamine pathways are involved in ADHD
DAT
DRD4
DRD5
TAAR1
MAOA
COMT
DBH
Which serotonin pathways are involved ADHD
SERT
5HT1B
TPH2
Which Noradrenaline pathways are involved ADHD
ADRA2A
In terms of NT, why does inattention occur
Partially due to Noradrenaline deficit in PFC neurons
which neurotransmitter pathway causes hyperactivity and impulsivity
Mesocorticolimbic dopamine pathway
- Ventral tegmental dopaminergic neurons
- Ventral Striatum
List the medication used in children over 5
Methylphenidate
Lisdexamfetamine
Dexamfetamine
Atomoxetine
Guanfacine
Describe the mechanism of action of Methylphenidate
Inhibits the transporters of NA and DA
Increases the amount in the PFC
What are the side effects of Methylphenidate
-Small increase in BP and heart rate
-Loss of appetite leading to weight loss or poor weight gain
-Trouble sleeping
-Headaches
-Stomach aches
-Feeling aggressive, irritable, depressed, anxious or tense
Pharmacology of Lisdexamphetamine
-Prodrug
-Converted into dextroamphetamine and L-lysine
-Slow onset
-Longer duration of action
-Reduced abuse potential
What are the side affects of Lisdexamphetamine
Decreased appetite
Aggression
Drowsiness
Dizziness
Headaches
Diarrhoea
Nausea and vomiting
MOAs of Dextroamphetamine
- Bind to Monoamine transporter DAT and NAT, decreasing their reuptake
- Cause Trace amine-associated receptor 1 to phosphorylate DAT.
- The new P-DAT is internalised into the presynaptic neuron which decreases removal of DA
- Enters the presynaptic monoamine vesicle and cause the release of NA and DA TOWARDS THE SYBAPES
MOA of Atomoxetine
Binds to norepinephrine transporter and inhibits the retake of NA and DA
Benefit of Atomoxetine
Not in other reward Circuit so had less abuse potential
