ADHD (Attention deficit hyperactivity disorders)

Question 1

Background/Summary

Answer 1

Behavioural syndrome which includes - Hyperactivity, Impulsivity, Inattention
- These symptoms co exist but 1 can be dominate.
Shows in child 3-7 yrs but not recognised after 7 yrs.
ADHD can carry on to adulthood

Question 2

Treatment

Answer 2

1st line - Methylphenidate or Lisdexamfetamine
- No improvement after 6 weeks switch to ALT 1st line.
2nd line (if 1st fails) - Atomoxetine
- ALT - Guanfacine

NOTE: If PT is working on Lisdexamfetamine but cant tolerate long duration of action - use Dexamfetamine

Specialist - Bupropion, Modafinil, Venlafaxine

Atomoxetine preferred in drug misuse PTs

Question 3

Drugs key info (EXAM Q)

Answer 3

Avoid abrupt withdrawal.

Affects driving/Skilled tasks. - drowsiness

Atomoxetine - Doses r BW dependent
BUT ADULT MAX IS 120mg/day

• AEs: When starting monitor for agitation, irritability, suicidal thoughts, self harm, unusual behaviours in initial months of treating/DOSE change.

Methylphenidate
- Equasym/Medikinet (brands) - can be sprinkled on TBS of apple sauce
Caution when switching brands as there formulations differ.