ADHD

Question 1

What are the 4 types of ADHD?

Answer 1

• combined
• inattentive
• hyperactive/impulsive
• other specified

Question 2

What types of symptoms need to be present for a diagnosis of ADHD?

Answer 2

6 inattention symptoms

6 hyperactive/impulsive symptoms

Question 3

When does ADHD most often become apparent?

Answer 3

at young age when age appropriate norms arent met for paying attention and delaying gratification
the more inattentive types might not be noticed until later in life when there are greater demands

Question 4

Is ADHD heritable?

Answer 4

yes, 76% heritability

Question 5

Which genes might be linked to ADHD?

Answer 5

DA system, NE system and neurotransmission and neuronal plasticity

Question 6

Which are of the brain is different in ADHD and how is it different?

Answer 6

ACC-hypoactive in ADHD

Question 7

How is NE and DA firing different in ADHD?

Answer 7

decreased tonic firing in PFC–>treat by increasing DA and NE

Question 8

What are some environmental factors that might contribute to the development of ADHD?

Answer 8

cigarette/alcohol use in pregnancy
lead poisoning
head injury
high sugar
food color additives

Question 9

What is the differential diagnosis for ADHD?

Answer 9

• Autism
• Learning disability
• Substance Use Disorder
• Personality Disorder
• Bipolar Disorder

Question 10

Which other psychiatric disorder is most commonly co-morbid with ADHD?

Answer 10

Anxiety (others include depression, substance use and bipolar)

Question 11

Which class of medications in commonly used to treat ADHD?

Answer 11

stimulants

Question 12

How do the stimulants and what are some of the downfalls of them?

Answer 12

• work by promoting increased activity of dopamine and NE
• risk of addiction
• paranoia in misuse
• stunt growth, weight loss, possible cardiac issues

Question 13

What are the positives and negatives of using non-stimulants instead?

Answer 13

positives-no addiction risk, might lower BP

negatives-less efficacy, often sedating, might lower BP

Question 14

What types of psychotherapy are used for treating ADHD?

Answer 14

behavioral modification and training

Question 15

How are methylphenidate and amphetamines different?

Answer 15

methylphenidate-antagonizes DAT reuptake pump and NET reuptake pump
amphetamines-also inhibit reuptake pumps but can also reverse the DAT–>greater transmission and more side effects

Question 16

How does Atomoxetine work?

Answer 16

NET inhibitor only

Question 17

How do Guanfacine ER and Clinidine ER work?

Answer 17

agonist at a-2 autoreceptor

-improves signal to noise ratio

Question 18

How is the prognosis for ADHD?

Answer 18

• wide range
• tend to have less school, less powerful jobs, lower self esteem, greater antisocial behavior, greater addiction rates, greater divorce rates
• *equal rates of medical illness**