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Does childhood treatment of ADHD with stimulant medication affect substance abuse in adulthood?

American Journal of Psychiatry (Impact Factor: 13.56). 06/2008; 165(5):553-5. DOI: 10.1176/appi.ajp.2008.08020237
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    ABSTRACT: Background Methylphenidate (MPH) is a stimulant prescribed to treat attention-deficit/ hyperactivity disorder. Its primary mechanism of action is in the dopamine system, alterations of which are associated with vulnerability to alcohol abuse. There are concerns that juvenile MPH treatment may influence adult drinking behavior. This study examined the interaction of MPH treatment and environmental rearing conditions, which are known to independently influence ethanol (EtOH) drinking behavior, on anxiety-like behavior and vulnerability to alcohol abuse in a juvenile rodent model.Methods Male Sprague–Dawley rats were housed in enriched, standard, or isolated conditions for 4 weeks, starting at postnatal day 21. Rats were concurrently treated with 8 mg/kg/d MPH or saline, delivered via osmotic minipump. Anxiety-like behavior was determined at the end of the treatment session, and 5 weeks later. After MPH treatment, rats were exposed to a 2-bottle choice EtOH drinking procedure that lasted 3 weeks.ResultsEarly life chronic MPH treatment was associated with greater EtOH intake and greater EtOH preference, but only in socially isolated animals. Isolated animals had greater levels of anxiety-like behavior than standard-housed or enriched animals after 4 weeks of exposure to the housing conditions, a difference that persisted even after all animals had been individually housed for an additional 5 weeks and exposed to EtOH.Conclusions These results suggest that early life MPH treatment may increase vulnerability to EtOH drinking in adulthood in a subset of the population. Additionally, this study highlights the importance of early rearing condition for establishing long-lasting behavioral phenotypes. Environmental histories should be considered when prescribing MPH treatment to young children.
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    ABSTRACT: Sažetak Problem dece sa hiperkinetičkim poremećajem, odnosno ADHD dijagnozom, sve je više prisutan u svakodnevnom životu. Prema meta-analističkim studijama, kojima je pokušano da se objedine rezultati iz svih delova sveta o prevalenciji ovog poremećaja, od 3% do 5% dece u nižim razredima osnovne škole je sa ovim poremećajem, što ga čini jednim od najčešćih psihopatoloških entiteta na dečjem uzrastu. Kako bi se pravovremeno i na odgovarajući način pristupilo tretmanu hiperkinetičkog poremećaja, neophodno je ispravno dijagnostikovati isti. Prilikom dijagnostikovanja, u obzir se uzimaju podaci iz različitih izvora. Tek nakon što su prikupljeni podaci od roditelja, samog deteta, učitelja/nastavnika, nakon obavljene procene psihologa i defektologa, pregleda dečijeg neurologa i psihijatra i analize razultata primenjenih skala procene, dijagnostikuje se hiperkinetički poremećaj, ili se, po potrebi, preporučuju dodatne procedure procene drugih stručnjaka. Poseban značaj u postupku procene imaju podaci koji se dobijaju skalama procene, jer mogu da se prikupljaju od različitih procenjivača, uzimajući u obzir različita okruženja i različite vremenske okvire. U zavisnosti od težine kliničke slike, preovlađujućih simptoma, od toga u kakvim uslovima dete odrasta, te kakvu podršku ima, odlučuje se, kroz zajednički rad multidisciplinarnog tima, o vrsti tretmana – psihosocijalni i/ili medikamentozni tretman. Multidisciplinarni pristup jeste nužan i kada je u pitanju sprovođenje tretmana jer hiperkinetički poremećaj podrazumeva smetnje na području motorike, pažnje, emocija, socijalnih odnosa, na perceptivno-motoričkom planu i u vezi sa kognitivnim funkcijama.
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    ABSTRACT: Methylphenidate (MPD) is used to treat ADHD and as a cognitive enhancement and recreationally. MPD's effects are not fully understood. One of the sites of psychostimulant action is the ventral tegmental area (VTA). The VTA neuronal activity was recorded from freely behaving rats using a wireless system. 51 animals were divided into groups: saline, 0.6, 2.5, and 10.0 mg/kg MPD. The same repetitive MPD dose can elicit either behavioral sensitization or tolerance; thus the evaluation of the VTA neuronal activity was based on the animals' behavioral response to chronic MPD exposure: animals exhibiting behavioral tolerance or sensitization. Acute MPD elicits dose-related increases in behavioral activity. About half of the animals exhibited behavioral sensitization or tolerance to each of the MPD doses. 361 units were recorded from the VTA and exhibited similar spike shape on experimental day 1 (ED1) and on ED10. 71, 84, and 79 % of VTA units responded to acute 0.6, 2.5, and 10.0 mg/kg MPD, respectively. The neuronal baseline activity at ED10 was significantly modified in 94, 95, and 100 % of VTA units following 0.6, 2.5 and 10.0 mg/kg MPD, respectively. Following chronic MPD exposure, 91, 98, and 100 % exhibit either electrophysiological tolerance or sensitization of 0.6, 2.6, or 10.0 mg/kg MPD, respectively. In conclusion, the chronic administration of the same dose of MPD caused some animals to exhibit behavioral sensitization and other animals to exhibit tolerance. The VTA units recorded from animals exhibiting behavioral sensitization responded significantly differently to MPD from animals that exhibited behavioral tolerance.
    Journal of Neural Transmission 11/2013; 121(3). DOI:10.1007/s00702-013-1101-2 · 2.87 Impact Factor

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