ADHD Drugs Flashcards
What is the most effective treatment approach for ADHD?
Medication and behavioural therapy / CBT
What two classes of drugs are used in ADHD treatment?
stimulants and
a selective norepinephrine reuptake inhibitor (SNRI)
Name the drugs used in ADHD treatment?
stimulants - methylphenidate and amphetamines
SNRI - atomoxetine
What are the brand names of the stimulants used in ADHD treatment?
methylphenidate:
- Ritalin, Ritalin SR
- Biphentin – Long acting
- Concerta – Long acting
amphetamines:
• Dexedrine/Dexedrine spansule (d-amphetamine)
• Adderall XR: Mixed salts amphetamine (d-amphetamine and amphetamine salts in a ratio of 3:1) – Long acting
• Vyvanse (Lisdexamfetamine) – Long acting: It is a pharmacologically inactive prodrug with low abuse potential. It becomes active in the body after its conversion to ‘d-amphetamine’.
What are some common side-effects of stimulants used in ADHD?
Other concerns?
- Decreased appetite
- Sleep disturbance.
- Stomach upset
- Headache
- Irritability
NB: Side effects improve with time
Other concerns with use of stimulant:
• Growth suppression
• Abuse potential
• Cardiovascular effects
therefore:
- identify FH of sudden cardiac death and take HR and BP
When is atomoxetine used in ADHD
SNRI is used when no response to other stimulants or excessive side-effects.
(no long term growth effect and no appetite suppression)
(also effective in patients with comorbid anxiety and when there is a risk of stimulant’s abuse/diversion)
Side effects and monitoring of atomoxetine SNRI?
- Increased BP and HR:
- Drug-drug interactions vis cytochrome P450 enzymes.
Monitoring • Response using rating scales (parent and teacher) • HR and BP • Height and weight on grow charts. • Suicidal ideation • Routine blood tests are not needed.
Beyond stimulants (methylphenidate and amphetamines and SNRI (atomoxetine) what other drugs can be used in ADHD?
clonidine and guanfacine
alpha-2-ADR agonists
(anti hypertensive properties too, MOA in brain unknown)
