Drugs For ADHD

Question 1

Psycho stimulants

Dexamfetamine
Lisdexamfetamine
Methylphenidate

Answer 1

Moa: psychostimulants are thought to enhance dopaminergic and noradrenergic neurotransmission

Indication:ADHD

Precautions
Treatment with it within 14 days of stopping a maoi-contraindicated
CI in hyperthyroidism and phaechromocytoma
Tourette syndrome,tics disorders
Risk factors for angle closure glaucoma
CI in severe cardiac diseases
Preg: methylphenidate may increase risk of cardiac malformations. Misuse may result in premature delivery, intrauterine growth retardation , withdrawal SX in neonates

Adr common: nausea, diarrhoea, dry mouth,loss of appetite,wt loss, anxiety, irritability, changes in BP

Dexamfetamine and lisdexamfetamine are amphetamines. Dexamfetamine is the active metabolite of lisdexamfetamine. Methylphenidate is a CNS stimulant similar to amphetamines

Avoid taking doses after early afternoon if you have trouble sleeping at night (this will make you drowsy the next day. This drug may also make you feel dizzy,do not operate or drive machinery if affected

Question 2

Dexamfetamine

Answer 2

Indication: ADHD, narcolepsy

Dose: If daily dose more than 5mg give 2-3 doses

6-12yo: initially 2.5mg in the morning for 1 week, increase daily dose by 2.5-5mg each week according to response and tolerability my max 40mg daily

Narcolepsy 10mg in the morning gradually increase to 60mg od in divided doses

Question 3

Lisdexamfetamine

Answer 3

Indication: ADHD,Binge eating (2nd line under psy care)

Dose: adult,child above 6yo, oral 20mg-30mg om if needed increase dose by 20mg at intervals of at least 1 week. Max 70mg/day. Initial tx period is 12 weeks

Swallow capsule whole or open it to mix with soft food like yogurt or in a glass of water or orange juice

Question 4

Methylphenidate

Answer 4

Indication: ADHD, Narcolepsy

Precaution: hepatic, half dose in severe impairment

Adr common: tremor

Dose
6-12yo: 5mg od-bd, max 40mg/day
More than 12yo:10mg om to max 60mg/day

Narcolepsy dose
5mg bd to a max of 60mg od

Question 5

Atomoxetine

Answer 5

Moa: selectively inhibits presynaptic noradrenaline reuptake in the CNS

Indication: ADHD

precautions
- Rx with or within 14 days of stopping a mao
-phaechromocytoma
-Risk factors for open angle glaucoma
-hx of seizures

Adr
Nausea,vomiting
Doser