Drug - Kent



Pros and cons of medication:

Why use medication?

Behavioral treatments for ADHD can be difficult to implement if the child is unable to attend to the lesson at hand. Medications have been shown to increase focus on tasks, as well as calming children who seem to be unable to sit still long enough to finish a task completely. Using medications can help to decrease the intensity of a behavioral treatment, and to help the child attend to the therapy more effectively.

Drawbacks to medication:

Stimulant medication is extremely unpredictable and getting the proper dosage can take time and various trials. Long term effects of medications can be serious, and medications should constantly be evaluated to determine if they are doing the job they are intended to do. Extra caution should be exercised whenever there is more than one medication used on the same child. Also, medication alone cannot possibly substitute for the proper teaching and modeling required to help a child learn to regulate their own behaviors.

Some Facts about ADHD treatments

• Medications can be reduced 50-75% when combined with behavior therapy.

• Behavioral Treatments are less intensive when combined with medical treatment.

• The two treatments compliment each other in their effects.

• Medication alone does not teach the alternate behaviors that are appropriate in place of the problematic behavior

• A combined program is easier for parents and teachers to maintain due to less medication

• There is a 93-97% improvement rate, compared to 50-79% for each treatment alone

Other Resources:

- ADHD online family community

- Official Site of the Attention Deficit Disorder Association

- Information on ADHD from

References:

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•

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• Safer, Daniel J., Are Stimulants Overprescribed for Youths with ADHD? Annals of Clinical Psychiatry Vol. 12, Issue 1, March 2000. pp. 55-62.

• Pelham, William E. Jr. and Gnagy, Elizabeth M., Psychosocial and Combined Treatments for ADHD, Mental Retardation and Developmental Disabilities Research Reviews, Vol. 5, 1999, pp. 225-236.

ADHD

(Attention Deficit Hyperactivity Disorder)

Medication options

Information on:

• Medical Treatments

• Benefits

• Drawbacks

• General Facts

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Pamphlet created by Misty Sommers-Tackett

Kent State University – School Psychology Dept.

Drug |Potential Benefits |Form

(sug. dose) |Duration |Possible Side Effects |Precautions/ Comments | |RITALIN

methylphenidate

|Works quickly, Good safety record. Works on at least 70% of patients. Works on many people who do not respond to dextroamphetamine. Reduces restlessness, increases focus and self monitoring, decreases impulsiveness… |Tablets

(10 mg) |3-4 hrs |Insomnia, decreased appetite, weight loss, stomach ache - usually disappear after using for a few weeks. |Not recommended for patients with anxiety, motor tics. Together with dextroamphetamine is usually the first line medication with the highest success rate in improving ADHD type behaviors. | |DEXEDRINE

dextroamphetamine |Works quickly. Works on many people who do not respond to methylphenidate. Good safety record. |Tablets

(5 mg) |3-6 hrs |Insomnia, decreased appetite, irritability, weight loss - usually disappear after use for a few weeks. |Not recommended for patients with anxiety, motor tics. See above. Cheaper than Ritalin, drug of first choice in Australia. | |ADDERALL

(combination of amphetamine salts) |Lasts longer than Ritalin. It is absorbed less quickly, and could eliminate the need for a mid-day dose of medication, which is sometimes intrusive and embarrassing.

|Tablets (5,10,20 & 30 mg) |8-12 hrs |Decreased appetite, stomachache, difficulty falling asleep, and irritability. (Other side effects seen with the amphetamine class of drug, the active ingredient in ADDERALL XR, include nausea, vomiting, dizziness, tics, allergic reactions, weight loss, increased blood pressure, and psychosis (abnormal thinking or hallucinations). ) |Abuse of amphetamines can lead to dependence. Slower weight gain and/or growth in height have been reported with long-term use of amphetamine in children, although there appears to be a “catch-up” over time. | |CYCLERT

Pemoline

|Decreases impulsivity/distractability/hyperactivity/ emotionality. |Tablets

(37.5 mg) |3-6 hrs |convulsive seizures; hallucinations; dyskinetic movements of the tongue, lips, face and extremities; mild depression; dizziness; increased irritability; headache; and drowsiness, insomnia, weight loss, nausea, stunted growth. |Because of its association with life threatening hepatic (liver) failure, CYLERT should NOT ordinarily be considered as first line therapy for ADHD. | |CATAPRES clonadine hydrochloride |Decreases impulsivity/aggression/improves sleep |Tablets

(100 mg) |3-6 hrs |Little affect on attention. Causes sedation. Slight concern with cardiac deaths. |Overdose dangerous. Withdraw medication gradually | |TOFRANIL

imipramine hydrocloride |Decreases hyperactivity and probably impulsivity/more beneficial to sleep than stimulants/ improves mood particularly if depressed or anxious. Lasts throughout the day. |Tablets

(10 & 25 mg) |12-24 hrs |Limited affect on attention. Dry mouth, fuzzy head or dizziness. Causes sedation. Constipation. Decreased appetite. |Some concerns with cardiac death. Accidental poisoning can cause death/ a trycyclic antidepressant May take 2-4 weeks for clinical response. Usually considered a second line medication. | |NORPRAMIN desipramine hydrochloride |Similar to above. Helpful for ADHD patients with comorbid depression/ anxiety |Tablets

(10 mg) |12-24 hrs |Similar to imipramine |More commonly used than imipramine in the USA/ a trycyclic antidepressant | |AURORIX moclobemide |Reduces restlessness/ disturbing behavior/ increases attention span. |Tablets

(150 mg) | |Considered about 1/3 as effective as stimulant medication. Sleep disturbance, light -headedness, nausea, headaches. |Usually considered a 3rd/4th line medication. Can react with other medications. Do not administer with stimulants, cold medicines, anti-depressants | |STRATTERA norepinephrine reuptake inhibitor |Strattera is anon-stimulant medication and works by selectively blocking the reuptake of norepinephrine, by certain nerve cells in the brain which increases the availability of norepinephrine, which is thought to regulate impulse control, organization and attention. |Oral capsule

(NA) |Once a day |Since this is a newer medication being used for ADHD, there is not reliable information available at this time.

The precise mechanism by which Strattera works on ADHD is not known. |Decreased appetite, nausea, vomiting, fatigue, dyspepsia, dizziness, weight loss and mood swings. Use caution in patients with hypertension, hypotension, tachycardia, or cardiovascular or cerebrovascular disease. Long-term effects unknown. | |Data provided by: ADDnet at and ADDerall XR at and and

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