Attention-deficit/hyperactivity disorder (ADHD) is a common, chronic, and costly disorder, with an impact that can span from preschool into adulthood. There are safe and effective therapies that can manage and help prevent many of the associated negative outcomes of ADHD, but treatment rates are far from optimal and considerable obstacles exist in achieving satisfactory treatment adherence. Individuals with untreated ADHD, their families, and other caregivers must be made aware of the impact that this disorder may have on them at every stage of life and, correspondingly, the improved outcomes that can be achieved with the successful management of ADHD.
[Show abstract][Hide abstract] ABSTRACT: BACKGROUND: Medication is an important element of therapeutic strategies for ADHD. While medications for ADHD are generally well-tolerated, there are common, although less severe, as well as rare but severe adverse events AEs during treatment with ADHD drugs. The aim of this review is to provide evidence- and expert-based guidance concerning the management of (AEs) with medications for ADHD.
METHODS: For ease of use by practitioners and clinicians, the article is organized in a simple question and answer format regarding the prevalence and management of the most common AEs. Answers were based on empirical evidence from studies (preferably meta-analyses or systematic reviews) retrieved in PubMed, Ovid, EMBASE and Web of Knowledge through 30 June 2012. When no empirical evidence was available, expert consensus of the members of the European ADHD Guidelines Group is provided. The evidence-level of the management recommendations was based on the SIGN grading system.
RESULTS: The review covers monitoring and management strategies of loss of appetite and growth delay, cardiovascular risks, sleep disturbance, tics, substance misuse/abuse, seizures, suicidal thoughts/behaviours and psychotic symptoms.
CONCLUSION: Most AEs during treatment with drugs for ADHD are manageable and most of the times it is not necessary to stop medication, so that patients with ADHD may continue to benefit from the effectiveness of pharmacological treatment.
Journal of Child Psychology and Psychiatry 01/2013; 54(3). DOI:10.1111/jcpp.12036 · 6.46 Impact Factor
"Indeed, fear of severe cardiovascular effects may lead individuals with ADHD not being benefited from highly effective medications, if the potential risks are overestimated. In this case, limiting children's access to effective treatment for ADHD could have serious implications, given the substantial risks of not treating ADHD . Screening and treating iron deficiency before starting a treatment with ADHD dug(s) should help the clinician and the patient to overcome the fear of severe cardiovascular event, thus allowing the patient to benefit from effective drugs without adverse events. "
[Show abstract][Hide abstract] ABSTRACT: Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most common childhood-onset neuropsychiatric conditions. Despite extensive research, the etiopathophysiological factors underlying ADHD are not completely understood. It has been suggested that iron deficiency may contribute to ADHD symptoms severity. Whereas evidence from studies based on serum ferritin measures, a marker of peripheral iron status, is somewhat mixed, preliminary recent evidence suggests a deficiency of brain iron in individuals with ADHD. Therefore, it has been proposed that either a deficiency of peripheral iron or a dysfunction of the blood-brain barrier, in the presence of normal peripheral iron levels, may contribute to low brain iron levels, which, in turn, would increase the risk for ADHD symptoms in a subgroup of individuals with this disorder. It has also been found that individuals with ADHD may be at increased risk of severe cardiovascular events during treatment with ADHD drugs, although the extent to which this occurs in ADHD patients compared to non-ADHD individuals is still matter of investigation. Since iron depletion has been recently reported as a risk factor for adverse prognosis in heart failure, iron deficiency might contribute both to ADHD symptoms severity before treatment and to increased risk of severe cardiovascular events during treatment with ADHD drugs in a selected subgroup of patients. Therefore, we hypothesize that the effective treatment of iron deficiency might lead both to improvement of ADHD symptoms severity and to a decrease of the risk of cardiovascular events during treatment with ADHD drugs. If empirical studies confirm this hypothesis, the clinician would be advised to systematically check iron status and effectively treat iron deficiency before starting a pharmacological treatment with ADHD drugs.
Medical Hypotheses 05/2012; 79(2):246-9. DOI:10.1016/j.mehy.2012.04.049 · 1.07 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood disorders and at least one-third to one-half will continue through adolescence and adulthood. Moreover it is important the high comorbidity not only in children, but in adolescents and adults. Therefore ADHD becomes especially important when we observe it as a risk factor for the development of another psychopathology that add more complexity to the diagnosis of children and adolescents and also adults, and confers an evolutionary risk throughout the lifetime of the person who suffers from it. A correlational study with a sample of 378 patients diagnosed with ADHD in the childhood between 1988 and 2000 who had initiated treatment after been diagnosed was carried out. 88 patients were evaluated years after (2006) with ages between 18 and 33 years old. 85% of the patients in this study had had combined treatment. The data found in this study show lower comorbidity than other published studies (36.4%), as well as a lower persistence of the complete diagnosis of ADHD in the adulthood (15%). This is a treated population; the results may lead to a possible protector role of the early treatment of ADHD.
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