As a rule, treatment of ADHD in children and adults begin to receive stimulants that regulate the two neurotransmitters: norepinephrine and dopamine.
Stimulants are short acting and depot. More recent long-acting stimulants can be taken before school. If in a week does not come better, your doctor may try to change the dosage. If improvements are still not replaced by another psychostimulant.
For a long time enjoyed the popularity of Methylphenidate (Ritalin). Unfortunately, the drug is addictive and dependence because of their pharmacological properties of the drug similar to cocaine. Single of the stimulant, which is not addictive - Atomoxetine (Strattera). This drug acts on the neurotransmitter norepinephrine, whereas other stimulants, primarily impact on dopamine. More than 70% of children with ADHD, taking Strattera, a marked improvement in symptoms. In 2004, the FDA required the manufacturer Eli Lily put on a label warning of possible adverse effects of the drug on the liver.
Most of the side effects is small, and usually correlates with the dose of the drug taken. High doses provoke a more serious side effects. Here are the most common of these are: loss of appetite, insomnia, increased anxiety and / or irritability. Some children complain of mild abdominal pain and headaches.
Appetite is usually reduced in the middle of the day, and restored to the dinner. Therefore, by this time, as the appetite improves, the child should receive adequate amounts of nutritious foods. If the baby does not sleep, you can try to give the medicine well before bedtime to reduce the dose or add a small dose of an antidepressant. Some children during treatment with tics occur. In this case, the reduced dose. Very few children different individual intolerance of psychostimulants, regardless of dosage. In such cases, the child is prescribed an antidepressant instead of the stimulant.
Antidepressants are considered as second-line drugs treatment. Tricyclic antidepressants are the older generation are used from time to time, as they, like the stimulants, affect norepinephrine and dopamine.Venlafaxine (Effexor), a new antidepressant, is also used because it affects norepinephrine. Bupropion (Wellbutrin), which is an indirect effect on the antidepressant neurotransmitters dopamine, has proven effective in clinical trials for the treatment of ADHD in children and adults. He even has a bonus: it reduces the need for smoking.
Sometimes the doctor may prescribe a small child a drug that is approved by the FDA for use in adults or older children. Such use of the drug is called "off label". Many of the newer drugs that provide care for children with mental disorders are assigned this way, because the safety and efficacy of some of them has been systematically studied in children. Drugs that do not pass this test, the instructions are marked that "safety and effectiveness in children have not been proved."
Lisdexamfetamine (Vyvanse) - a prodrug, which has no therapeutic effect until metabolized in the body and becomes a dextroamphetamine. In clinical studies conducted to determine the duration of exposure, Vyvanse demonstrated significant efficacy for the whole day, until 6:00 pm, inclusive. The pharmaceutical company New River developed Vyvanse as a new drug for the treatment of ADHD with low potential for dependence. This drug opens a new era in the treatment of ADHD.
In September 2009, the pharmaceutical company Shire Pharmaceuticals Group announced that the FDA approved Guanfacine (Intuniv) - delayed release tablets for the treatment of children and adolescents aged 6 to 17 years. Medicine is not a stimulant and does not threaten addiction. The exact mechanism of drug action has not yet been studied, but assumed that it acts directly on receptors in the prefrontal cortex. It is believed that this region is associated with the occurrence of ADHD. Use of the drug improves memory and ability to concentrate, and also reduces the appearance of other behavioral problems in children with ADHD.Adverse reactions are moderate. The most common side effect is sedation. It also marked drowsiness, headache, fatigue, abdominal pain.
Some people respond better to one drug, some - on the other. It is important to work with your doctor for the selection of the correct drug and correct dosage. For many people, stimulants dramatically reduce hyperactivity and impulsivity and improve the ability to focus, work and learn. These drugs may also improve the coordination of movements, which is necessary for writing and sports.
The FDA recommends that children, adolescents and adults who take medication to treat ADHD, developed in conjunction with a physician care plan, which includes a complete history and evaluation of health status, in particular, look at the cardiovascular and psychiatric problems (including assessment of family history of these problems). It is caused by the fact that the review conducted by FDA reports of serious cardiovascular adverse events in patients taking usual doses of drugs to treat ADHD, has revealed cases of sudden death in patients with serious heart problems or defects and heart attack in adults with certain risk factors. Another FDA review of the established, showed that only slightly (approximately 1 in 1000) increased the risk of mental disorders. There have been cases where patients have not previously had mental problems, heard voices, unfounded suspicions displayed, which can be easily turned into a mania.
According to the materials by the FDA and drugs.com
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