ADHD

Question 1

1st line medication for ADHD in children?

Answer 1

methylphenidate

Question 2

1st line medication for ADHD in adults ?

Answer 2

methylphenidate or lisdexamfatamine

Question 3

2nd line medication for ADHD in children ?

Answer 3

lisdexfetamine

Question 4

if patients respond to lisdexfetamine but can’t tolerate side effects, what drug would you switch to ?

Answer 4

dexafetamine

Question 5

criteria for diagnosis of ADHD ?

Answer 5

impaired attention
overactivity
early onset < 6yrs
present in 2 or more domains (i.e. school, home, clinic)
diagnosis of anxiety, mood affective disorder, pervasive developmental disorder and schizophrenia must be excluded

Question 6

how would you first manage a patient who you thought had ADHD in primary care?

Answer 6

10 week trial of watch and wait

if symptoms persisted then refer to secondary care (paediatrician with special interests or psychiatrist)

Question 7

side effects of methylphenidate ?

Answer 7

abdominal pain 
dyspepsia
nausea
appetite suppression 
weight loss 
sedation

Question 8

how are patients monitored who are on methylphenidate ?

Answer 8

weight and height 6 monthly

baseline ECG

Question 9

what is the main complication associated with ADHD medications ?

Answer 9

cardiotoxic
perform baseline ECG
refer to cardiology if significant PMH or FH or any doubt

Question 10

what is the minimum age methylphenidate can be prescribed ?

Answer 10

5 years old and above