Advances and Considerations in Attention-Deficit/Hyperactivity Disorder Pharmacotherapy
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a highly heritable neuropsychiatric disorder associated with significant impairments in occu¬pational, academic, neuropsychological, and social functioning. Central nervous system (CNS) stimulants are recommended as first-line medication therapy for children. CNS stimulants include formulations of methylphenidate and amphetamine derivatives and are available in a large variety of immediate- and extended-release preparations. Extended-release preparations are often preferred to limit drug administration during school or work and may help to limit side effects associated with rapid fluctuations in serum concentration. Stimulant medication is by far the most commonly used treatment in managing children with ADHD, 10-20% of those who take such medication do now show clinically significant improvements in their primary ADHD symptom. Even when a favorable response is obtained, some children experience side effects that are of sufficient occurrence and severity to prevent continued use of stimulant medication. In such instances or when families are unwilling to consider a stimulant, non-stimulant medications may be appealing. This review focuses on etiology, assessment and treatment of ADHD with various stimulant and non-stimulant agents.
Pliszka S; AACAP Work Group on Quality Issues. Practice parameter for the assessment and treatment of children and adolescents with attentiondeficit/ hyperactivity disorder. J Am Acad Child AdolescPsychiatry 2007;46(7):894-921.
Cormier E. Attention deficit/hyperactivity disorder: areview and update. J Pediatr Nurs 2008;23(5):345-57.
American Psychiatric Association. American Psychiatric Association Diagnostic and Statistical Manual for Mental Disorders DSM IV-TR. 4th ed. (Text Revision). American Psychiatric Press: Washington DC, 2000.
Fox AM, Mahoney WJ. Children with School Problems. Ottawa, ON: Canadian Paediatric Society, 1998.
American Academy of Pediatrics. Clinical practice guideline: diagnosis and evaluation of the child with attention-deficit/hyperactivity disorder. Pediatrics 2000;105(5):1158-70.
Barkley RA. Attention Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment. 2nd ed. New York: Guilford Press; 1998.
Goldman LS, Genel M, Bezman RJ, Slanetz PJ. Diagnosisand treatment of attention-deficit/hyperactivity disorder in children and adolescents. Council on Scientific Affairs, American Medical Association. JAMA 1998;279(14):1100-7.
Mercugliano M. What is attention-deficit/hyperactivity disorder? Pediatr Clin North Am 1999;46(5):831-43.
Spencer T, Biederman J, Wilens T. Attentiondeficit/ hyperactivity disorder and comorbidity. Pediatr Clin North Am 1999;46(5):915-27, vii.
Root RW, Resnick RJ. An update on the diagnosis and treatment of attention-deficit/hyperactivity disorder in children. Prof Psycho Res Prac 2003;34(1):34-41.
Owens J, Hoza B. Diagnostic utility of DSM-IV-TR symptoms in the prediction of DSM-IV-TR ADHD subtypes and ODD. J Atten Disord 2003;7(1):11-27; discussion 29.
Staller J, Faraone SV. Attention-deficit hyperactivity disorder in girls: epidemiology and management. CNS Drugs 2006;20(2):107-23.
Gaub M, Carlson CL. Gender differences in ADHD: a meta-analysis and critical review. J Am Acad Child Adolesc Psychiatry 1997;36(8):1036-45.
Biederman J, Faraone SV, Mick E, Williamson S, Wilens TE, Spencer TJ, Weber W, Jetton J, Kraus I, Pert J, Zallen B. Clinical correlates of ADHD in females: findings from a large group of girls ascertained from pediatric and psychiatric referral sources. J Am Acad Child Adolesc Psychiatry 1999;38(8):966-75.
Nadeau K, Littman EB, Quinn PQ. Understanding girls with attention deficit hyperactivity disorder. New York: Bruner/Mazel; 2000.
American Psychiatric Association. Diagnostic and Statistical Manual for Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.
American Academy of Pediatrics. Clinical practice guideline: diagnosis and evaluation of the child with attention-deficit/hyperactivity disorder. Pediatrics 2000;105(5):1158-70.
Tannock R. Attention deficit hyperactivity disorder: advances in cognitive, neurobiological, and genetic research. J Child Psychol Psychiatry 1998;39(1):65-99.
Pliszka SR, McCracken JT, Maas JW. Catecholamines in attention-deficit hyperactivity disorder: current perspectives. J Am Acad Child Adolesc Psychiatry 1996;35(3):264-72.
Waldman ID, Rowe DC, Abramowitz A, Kozel ST, Mohr JH, Sherman SL, Cleveland HH, Sanders ML, Gard JM, Stever C. Association and linkage of the dopamine transporter gene and attention-deficit hyperactivity disorder in children: heterogeneity owing to diagnostic subtype and severity. Am J Hum Genet 1998;63(6):1767-76.
Mick E, Biederman J, Faraone SV, Sayer J, Kleinman S. Case-control study of attention-deficit hyperactivity disorder and maternal smoking, alcohol use, and drug use during pregnancy. J Am Acad Child Adolesc Psychiatry 2002;41(4):378-85.
Linnet KM, Dalsgaard S, Obel C, Wisborg K, Henriksen TB, Rodriguez A, Kotimaa A, Moilanen I, Thomsen PH, Olsen J, Jarvelin MR. Maternal lifestyle factors in pregnancy risk of attention deficit hyperactivity disorder and associated behaviors: review of the current evidence. Am J Psychiatry 2003;160(6):1028-40.
American Academy of Pediatrics. Subcommittee on Attention-Deficit/Hyperactivity Disorder and Committee on Quality Improvement. Clinical practice guideline: treatment of the school-aged child with attentiondeficit/ hyperactivity disorder. Pediatrics 2001;108(4): 1033-44.
Noorbala AA, Akhondzadeh S. Attentiondeficit/ hyperactivity disorder: etiology and pharmacotherapy. Arch Iran Med 2006;9(4):374-80.
Mohammadi MR, Akhondzadeh S. Pharmacotherapy of attention-deficit/hyperactivity disorder: nonstimulant medication approaches. Expert Rev Neurother 2007;7(2):195-201.
May DE, Kratochvil CJ. Attention-deficit hyperactivitydisorder: recent advances in paediatric pharmacotherapy. Drugs 2010;70(1):15-40.
Greenhill LL, Pliszka S, Dulcan MK, Bernet W, Arnold V, Beitchman J, Benson RS, Bukstein O, Kinlan J, McClellan J, Rue D, Shaw JA, Stock S; American Academy of Child and Adolescent Psychiatry. Practice parameter for the use of stimulant medications in the treatment of children, adolescents, and adults. J Am Acad Child Adolesc Psychiatry 2002;41(2 Suppl):26S-49S.
Angold A, Erkanli A, Egger HL, Costello EJ. Stimulant treatment for children: a community perspective. J Am Acad Child Adolesc Psychiatry 2000;39(8):975-84; discussion 984-94.
American Academy of Pediatrics. Subcommittee on Attention-Deficit/Hyperactivity Disorder and Committee on Quality Improvement. Clinical practice guideline: treatment of the school-aged child with attentiondeficit/ hyperactivity disorder. Pediatrics 2001;108(4): 1033-44.
Greenhill LL, Pliszka S, Dulcan MK, Bernet W, Arnold V, Beitchman J, Benson RS, Bukstein O, Kinlan J, McClellan J, Rue D, Shaw JA, Stock S; American Academy of Childand Adolescent Psychiatry. Practice parameter for the use of stimulant medications in the treatment of children, adolescents, and adults. J Am Acad Child Adolesc Psychiatry 2002;41(2 Suppl):26S-49S.
Biederman J. Practical considerations in stimulant drug selection for the attention-deficit/hyperactivity disorder patient-efficacy, potency, and titration. Today’s Therapeutic Trends 2002;20(4):311-28.
Akhondzadeh S, Stone TW. Interaction between adenosine and GABAA receptors on hippocampal neurones. Brain Res 1994;665(2):229-36.
Akhondzadeh S. Hippocampal synaptic plasticity and cognition. J Clin Pharm Ther 1999;24(4):241-8.
Tuerck D, Wang Y, Maboudian M, Wang Y, Sedek G, Pommier F, Appel-Dingemanse S. Similar bioavailability of dexmethylphenidate extended (bimodal) release, dexmethyl-phenidate immediate release and racemic methylphenidate extended (bimodal) release formulations in man. Int J Clin Pharmacol Ther 2007;45(12):662-8.
Davids E, Zhang K, Tarazi FI, Baldessarini RJ. Stereoselective effects of methylphenidate on motor hyperactivity in juvenile rats induced by neonatal 6- hydroxydopamine lesioning. Psychopharmacology (Berl) 2002;160(1):92-8.
Greenhill LL, Muniz R, Ball RR, Levine A, Pestreich L, Jiang H. Efficacy and safety of dexmethylphenidate extended-release capsules in children with attentiondeficit/ hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 2006;45(7):817-23.
Teo SK, Stirling DI, Thomas SD, Khetani VD. Neurobehavioral effects of racemic threo-methylphenidate and its D and L enantiomers in rats. Pharmacol Biochem Behav 2003;74(3):747-54.
Connor DF, Steingard RJ. New formulations of stimulants for attention-deficit hyperactivity disorder: therapeutic potential. CNS Drugs 2004;18(14):1011-30.
Prince JB. Pharmacotherapy of attention-deficit hyperactivity disorder in children and adolescents: update on new stimulant preparations, atomoxetine, and novel treatments. Child Adolesc Psychiatr Clin N Am 2006;15(1):13-50.
Markowitz JS, Straughn AB, Patrick KS. Advances in the pharmacotherapy of attention-deficit-hyperactivity disorder: focus on methylphenidate formulations. Pharmacotherapy 2003;23(10):1281-99
Wolraich ML, Greenhill LL, Pelham W, Swanson J, Wilens T, Palumbo D, Atkins M, McBurnett K, Bukstein O, August G. Randomized, controlled trial of oros methylphenidate once a day in children with attentiondeficit/ hyperactivity disorder. Pediatrics 2001;108(4):883-92.
Findling RL, Bukstein OG, Melmed RD, López FA, Sallee FR, Arnold LE, Pratt RD. A randomized, double-blind, placebo-controlled, parallel-group study of methylphenidate transdermal system in pediatric patients with attention-deficit/hyperactivity disorder. J Clin Psychiatry 2008;69(1):149-59.
Jasinski DR, Krishnan S. Abuse liability and safety of oral lisdexamfetamine dimesylate in individuals with a history of stimulant abuse. J Psychopharmacol 2009;23(4):419-27
Wigal SB, Kollins SH, Childress AC, Squires L; 311 Study Group. A 13-hour laboratory school study of lisdexamfetamine dimesylate in school-aged children with attention-deficit/hyperactivity disorder. Child Adolesc Psychiatry Ment Health 2009;3(1):17.
Banaschewski T, Roessner V, Dittmann RW, Santosh PJ, Rothenberger A. Non-stimulant medications in the treatment of ADHD. Eur Child Adolesc Psychiatry 2004;13 Suppl 1:I102-16.
Akhondzadeh S, Tavakolian R, Davari-Ashtiani R, Arabgol F, Amini H. Selegiline in the treatment of attention deficit hyperactivity disorder in children: a double blind and randomized trial. Prog Neuropsychopharmacol Biol Psychiatry 2003;27(5):841-5.
Mohammadi MR, Kashani L, Akhondzadeh S, Izadian ES, Ohadinia S. Efficacy of theophylline compared to methylphenidate for the treatment of attention-deficit hyperactivity disorder in children and adolescents: a pilot double-blind randomized trial. J Clin Pharm Ther 2004;29(2):139-44.
Zarinara AR, Mohammadi MR, Hazrati N, Tabrizi M, Rezazadeh SA, Rezaie F, Akhondzadeh S. Venlafaxine versus methylphenidate in pediatric outpatients with attention deficit hyperactivity disorder: a randomized, double-blind comparison trial. Hum Psychopharmacol 2010;25(7-8):530-5.
Mohammadi MR, Kazemi MR, Zia E, Rezazadeh SA, Tabrizi M, Akhondzadeh S. Amantadine versus methylphenidate in children and adolescents with attention deficit/hyperactivity disorder: a randomized, double-blind trial. Hum Psychopharmacol 2010;25(7-8):560-5. doi: 10.1002/hup.1154.
The MTA Cooperative Group. Multimodal Treatment Study of Children with ADHD. A 14-month randomized clinical trial of treatment strategies for attentiondeficit/ hyperactivity disorder. Arch Gen Psychiatry 1999;56(12):1073-86.
Wernicke JF, Kratochvil CJ. Safety profile of atomoxetine in the treatment of children and adolescents with ADHD. J Clin Psychiatry 2002;63 Suppl 12:50-5.
Witcher JW, Long A, Smith B, Sauer JM, Heilgenstein J, Wilens T, Spencer T, Biederman J. Atomoxetine pharmacokinetics in children and adolescents with attention deficit hyperactivity disorder. J Child Adolesc Psychopharmacol 2003;13(1):53-63.
Cheng JY, Chen RY, Ko JS, Ng EM. Efficacy and safety of atomoxetine for attention-deficit/hyperactivity disorder in children and adolescents-meta-analysis and metaregression analysis. Psychopharmacology (Berl) 2007;194(2):197-209.
Trzepacz PT, Williams DW, Feldman PD, Wrishko RE, Witcher JW, Buitelaar JK. CYP2D6 metabolizer status and atomoxetine dosing in children and adolescents with ADHD. Eur Neuropsychopharmacol 2008;18(2):79-86.
Olvera RL, Pliszka SR, Luh J, Tatum R. An open trial of venlafaxine in the treatment of attentiondeficit/ hyperactivity disorder in children and adolescents. J Child Adolesc Psychopharmacol 1996;6(4):241-50.
Barrickman L, Noyes R, Kuperman S, Schumacher E, Verda M. Treatment of ADHD with fluoxetine: a preliminary trial. J Am Acad Child Adolesc Psychiatry 1991;30(5):762-7.
Malhotra S, Santosh PJ. An open clinical trial of buspirone in children with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 1998;37(4):364-71.
Connor DF, Fletcher KE, Swanson JM. A meta-analysis of clonidine for symptoms of attention-deficit hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 1999;38(12):1551-9.
Hazell PL, Stuart JE. A randomized controlled trial of clonidine added to psychostimulant medication for hyperactive and aggressive children. J Am Acad Child Adolesc Psychiatry 2003;42(8):886-94.
Scahill L, Chappell PB, Kim YS, Schultz RT, Katsovich L, Shepherd E, Arnsten AF, Cohen DJ, Leckman JF. A placebo-controlled study of guanfacine in the treatment of children with tic disorders and attention deficit hyperactivity disorder. Am J Psychiatry 2001;158(7):1067-74.
Biederman J, Melmed RD, Patel A, McBurnett K, Konow J, Lyne A, Scherer N; SPD503 Study Group. A randomized, double-blind, placebo-controlled study of guanfacine extended release in children and adolescents with attention-deficit/hyperactivity disorder. Pediatrics 2008;121(1):e73-84.
Conners CK, Casat CD, Gualtieri CT, Weller E, Reader M, Reiss A, Weller RA, Khayrallah M, Ascher J. Bupropion hydrochloride in attention deficit disorder with hyperactivity. J Am Acad Child Adolesc Psychiatry 1996;35(10):1314-21.
Kahbazi M, Ghoreishi A, Rahiminejad F, Mohammadi MR, Kamalipour A, Akhondzadeh S. A randomized, double-blind and placebo-controlled trial of modafinil in children and adolescents with attention deficit and hyperactivity disorder. Psychiatry Res 2009;168(3):234-7.
Amiri S, Mohammadi MR, Mohammadi M, Nouroozinejad GH, Kahbazi M, Akhondzadeh S. Modafinil as a treatment for Attention- Deficit/Hyperactivity Disorder in children and adolescents: a double blind, randomized clinical trial. Prog Neuropsychopharmacol Biol Psychiatry 2008;32(1):145-9.
Swanson JM, Greenhill LL, Lopez FA, Sedillo A, Earl CQ, Jiang JG, Biederman J. Modafinil film-coated tablets in children and adolescents with attentiondeficit/ hyperactivity disorder: results of a randomized, double-blind, placebo-controlled, fixed-dose study followed by abrupt discontinuation. J Clin Psychiatry 2006;67(1):137-47.
Shytle RD, Silver AA, Wilkinson BJ, Sanberg PR. A pilot controlled trial of transdermal nicotine in the treatment of attention deficit hyperactivity disorder. World J Biol Psychiatry 2002;3(3):150-5.
Garber SW, Garber MD, Spizman RF. Beyond Ritalin. New York, NY: Harper Collins; 1997.
Akhondzadeh S, Mohammadi MR, Khademi M. Zincsulfate as an adjunct to methylphenidate for the treatment of attention deficit hyperactivity disorder in children: a double blind and randomized trial [ISRCTN64132371]. BMC Psychiatry 2004;4:9.
Abbasi SH, Heidari S, Mohammadi MR, Tabrizi M, Ghaleiha A, Akhondzadeh S. Acetyl-L-carnitine as an= adjunctive therapy in the treatment of attentiondeficit/ hyperactivity disorder in children and adolescents: a placebo-controlled trial. Child Psychiatry Hum Dev 2011;42(3):367-75.
Gant C. Complementary medicine approaches to ADHD. Presentation to Annual Conference, American College of Advancement in Medicine (ACAM). Orlando, FL: Laguna Hills, 1999.
Brue AW, Oakland TD. Alternative treatments for attention-deficit/hyperactivity disorder: does evidence support their use? Altern Ther Health Med 2002;8(1):68- 70, 72-4.
Pelham WE, Murphy HA. Attention deficit and conduct disorders. In: Herson M, editor. Pharmacological and Behavioral Treatment: An Integrative Approach. New York: J Wiley and Sons; 1986. p. 108-48.
Cala S, Crismon ML, Baumgartner J. A survey of herbal use in children with attention-deficit-hyperactivity disorder or depression. Pharmacotherapy 2003;23(2):222-30.
Salehi B, Imani R, Mohammadi MR, Fallah J, Mohammadi M, Ghanizadeh A, Tasviechi AA, Vossoughi A, Rezazadeh SA, Akhondzadeh S. Ginkgo biloba for attention-deficit/hyperactivity disorder in children and adolescents: a double blind, randomized controlled trial. Prog Neuropsychopharmacol Biol Psychiatry 2010;34(1):76-80.
Akhondzadeh, S, Mohammadi, MR, Momeni F. Passiflora incarnata in treatment of attention-deficit hyperactivity disorder in children and adolescents. Therapy2005;2(4):609-14.
| Files | ||
| Issue | Vol 49, No 8 (2011) | |
| Section | Original Article(s) | |
| Keywords | ||
| ADHD Non-stimulants Psychopharmacology Stimulants | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
