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Does Childhood Treatment of ADHD With Stimulant Medication Affect Substance Abuse in Adulthood?

American Journal of Psychiatry (Impact Factor: 12.3). 06/2008; 165(5):553-5. DOI: 10.1176/appi.ajp.2008.08020237
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Available from: James Swanson, Dec 24, 2014
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    • "Supporting this line of argument, neuroimaging data in ADHD and obese subjects report commonality in brain structural abnormalities, including in the frontal cortex [33], [34], [35], [36], a locus considered to be important for self-regulation and EFs. In addition, ADHD subjects have been shown to have reduced DA receptor binding capacity in the hypothalamus, which controls for satiety and hunger [76]. "
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    ABSTRACT: Attention-Deficit/Hyperactivity Disorder (ADHD) is a complex and heterogeneous childhood disorder that often coexists with other psychiatric and somatic disorders. Recently, a link between ADHD and body weight dysregulation has been reported and often interpreted as impaired self-regulation that is shared between the two conditions. The objective of this study is to investigate the relation between body weight/BMI and cognitive, emotional and motor characteristics in children with ADHD. 284 ADHD children were stratified by weight status/BMI according to WHO classification and compared with regard to their neurocognitive characteristics, motivational style, and motor profile as assessed by a comprehensive battery of tests. All comparisons were adjusted for demographic characteristics of relevance including, socioeconomic status (SES). Both Obese and overweight ADHD children exhibited significantly lower SES compared to normal weight ADHD children. No significant differences were observed between the three groups with regards to their neurocognitive, emotional and motor profile. Our findings provide evidence that differences in weight/BMI are not accounted for by cognitive, motivational and motor profiles. Socio-economic characteristics are strongly associated with overweight and obesity in ADHD children and may inform strategies aimed at promoting healthier weight.
    Full-text · Article · Jan 2013 · PLoS ONE
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    • "There is concern that the use of stimulant medications to treat ADHD may play a role in the development of drug addiction [111]. However, when taken in clinical doses and within a clinical context there appears to be very little abuse potential [51, 103]. "
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    ABSTRACT: Attention-deficit/hyperactivity disorder (ADHD), one of the most common neuropsychiatric conditions of childhood, often has a chronic course and persists into adulthood in many individuals. ADHD may have a clinically important impact on health-related quality of life in children, a significant impact on parents' emotional health and interfere with family activities/cohesion. To date, the main targets of ADHD treatment have focused on reducing the severity of symptoms during the school day and improving academic performance. However, the treatment of ADHD should reach beyond symptom control to address the issues of social competencies and improvement of health-related quality of life from the perspectives of individuals with ADHD and their families, to support them in reaching their full developmental potential. Methylphenidate (MPH) is recognised as the first-line choice of pharmacotherapy for ADHD in children and adolescents. This paper focuses on the importance and benefits to child development of ADHD symptom control beyond the school day only, i.e. extending into late afternoon and evening and uses the example of an extended-release MPH formulation (OROS((R)) MPH) to demonstrate the potential benefits of active full day coverage (12 h) with a single daily dose. Concerns of long-term stimulant treatment are also discussed.
    Full-text · Article · Oct 2009 · European Child & Adolescent Psychiatry
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    • "addressing the issue whether psychostimulant treatment leads to substance-use disorders (Faraone & Wilens, 2003). These and more recently published findings failed to show an elevated risk for substance abuse (Biederman et al. 2008;Mannuzza et al. 2008;Volkow & Swanson, 2008). While non-stimulant medications (as whole) in our meta-analysis were somewhat less efficacious than stimulants, they produced robust improvements compared to placebo. "
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    ABSTRACT: Our objective was to conduct a meta-analysis of therapeutic efficacy of pharmacological treatment of adult ADHD based on data from controlled clinical trials. We used the search engines PubMed and Medline to identify relevant clinical trials. Short-term studies with double-blind parallel-group design were selected for the analysis. Altogether, we identified 11 trials that met the criteria, and investigated a total of 1991 subjects, 694 and 1297 of whom were treated with placebo or active medication, respectively. In order to pool efficacy data from studies with different characteristics, including different number of participants, different trial duration and measures of efficacy, the statistical effect sizes for each study had to be calculated. Our findings showed that the pooled effect size across all treatments was in the medium-to-high range (Cohen's d=0.65, p<0.0001 vs. placebo), and the effect size for stimulants (Cohen's d=0.67, p<0.0001 vs. placebo) was somewhat higher than for non-stimulant medications (Cohen's d=0.59, p<0.0001 vs. placebo). The current database of controlled trials for adult ADHD is relatively small, and does not include data for many of the potentially important agents. In addition, effect-size estimates for different classes of medications (i.e. stimulant and non-stimulant medications) were based on separate studies; head-to-head comparisons of various agents are severely lacking. Nonetheless, results of this meta-analysis across all ADHD medications in adult subjects demonstrated statistically significant and clinically robust improvement in symptom severity compared to placebo treatment.
    Full-text · Article · Aug 2009 · The International Journal of Neuropsychopharmacology
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