attention deficit hyperactivity disorder ( ADHD)

Question 1

clinical features?

Answer 1

inattentive and or hyperactive/ impulsive symptoms for 6 or more months.
several symptoms appear before the age of 12.
symptoms occur in at least 2 settings ( home, school) and cause functional impairment.
subtypes: predominately inattentive, predominately hyperactive/ impulsive, combined type.

Question 2

inattentive symptoms?

Answer 2

difficulty focusing, distractible, does not listen or follow instructions, disorganized, forgetful, loses/misplaces objects.

Question 3

hyperactive/impulsive symptoms?

Answer 3

fidgety, unable to sit still, driven by a motor, hype- talkative, interrupts, blurts out answers.

Question 4

treatment?

Answer 4

stimulants [first line] ( methylphenidate, amphetamines).
non-stimulants ( atomoxetine, alpha-2 adrenergic agonists).
behavioral therapy.

Question 5

adult ADHD?

Answer 5

persists and causes significant impairment.
stimulants are the most effective tx but have potential for misuse or addiction, especially in patients with a history of substance use disorder. among nonstimulant options, the norepinephrine reuptake inhibitor atomoxetine is considered the best choice. other nonstimulant options with efficacy include bupropion and tricyclic antidepressants.