ADHD Treatment Flashcards
three subtypes ADHD
primary inattentive subtyle primarily hyperactive sutype combined subtype (six of each!)
ADHD symptoms
inattention (at least 6)
hyperactivity
impulsivity
other DSM criteria
symptoms present for past 6 months
onset on before 7 years of age
clinically significant impairment in 2 or more settings
not due to something else
adhd is
1 pediatric mental illness in primary care
60% of adhd
persists in toadult hood
male:female ratio
2: 1 inattentive
4: 1 combined
most common in community
inattentive
most common in clinic
combined
catecholamine hypothesis
dysregulation of dopamine or Ne neurotransmission
NE enhances relevant signal by increasing signal to noise ratio normally and DA locks out irrelevant new info and readies us for a response
reduced volumes in
fronto-cortical regions
abnormalities in adult PET scans
reduced regional glucose metabolism
–largest in superior PFC, pre-motor cortex
ADHD uses less efficient pathway to process data
anterior cingulate gyrus NOT utilized (this normally does cognitive/attentional tasks)
FDA approved medications
stimulants: methylphenidate, amphetamine
Non-stimulants: atomextine, alpha 2 agonists (guanfacine, clonidine)
off-label
immediate release alpha 2 agonists
antidepressants:tricyclics, bupropion, venlafaxine
three major classes of medication in adhd
stimulants
antidepressants
a2 adrenegic agonists (antihypertensives)
