Treatment strategies for ADHD: an evidence-based guide to select optimal treatment

Caye, Arthur; Swanson, James M.; Coghill, David; Rohde, Luís Augusto

doi:10.1038/s41380-018-0116-3

Cited by 203 publications

(188 citation statements)

References 197 publications

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“…Also, our findings are only partially consistent with recommendations from available guidelines or expert consensus papers. Indeed, our results are in line with:1) the guidelines from the National Institute of Clinical Care and Excellence ( 25 ) on the use of fluoxetine for moderate to severe depression; 2) the lack of endorsement for antidepressants to treat ADHD ( 26 ), PTSD ( 27 ), or core symptoms of ASD ( 28 ). However, our findings are at odds with: 1) expert guidance suggesting the use of imipramine for pediatric enuresis ( 29 ); 2) the recommendation to use fluoxetine, rather than fluvoxamine, among the SSRIs, for ADs ( 30 ); 3) the NICE guidelines recommending the use of imipramine, albeit only when enuresis has proved resistant to all other treatment options ( 31 ).…”

Section: Discussionsupporting

confidence: 86%

Antidepressants in Children and Adolescents: Meta-Review of Efficacy, Tolerability and Suicidality in Acute Treatment

et al. 2020

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Antidepressants are prescribed for the treatment of a number of psychiatric disorders in children and adolescents, however there is still controversy about whether they should be used in this population. This meta-review aimed to assess the effects of antidepressants for the acute treatment of attention-deficit/hyperactivity disorder (ADHD), anxiety disorders (ADs), autistic spectrum disorder (ASD), enuresis, major depressive disorder (MDD), obsessive-compulsive disorder (OCD), and posttraumatic stress disorder (PTSD) in children and adolescents. Efficacy was measured as response to treatment (either as mean overall change in symptoms or as a dichotomous outcome) and tolerability was measured as the proportion of patients discontinuing treatment due to adverse events. Suicidality was measured as suicidal ideation, behavior (including suicide attempts) and completed suicide. PubMed, EMBASE, and Web of Science were systematically searched (until 31 October 2019) for existing systematic reviews and/or meta-analyses of double-blind randomized controlled trials. The quality of the included reviews was appraised using AMSTAR-2. Our meta-review included nine systematic reviews/meta-analyses (2 on ADHD; 1 on AD; 2 on ASD; 1 on enuresis; 1 on MDD, 1 on OCD and 1 on PTSD). In terms of efficacy this review found that, compared to placebo: fluoxetine was more efficacious in the treatment of MDD, fluvoxamine and paroxetine were better in the treatment of AD; fluoxetine and sertraline were more efficacious in the treatment of OCD; bupropion and desipramine improved clinician and teacher-rated ADHD symptoms; clomipramine and tianeptine were superior on some of the core symptoms of ASD; and no antidepressant was more efficacious for PTSD and enuresis. With regard to tolerability: imipramine, venlafaxine, and duloxetine were less well tolerated in MDD; no differences were found for any of the antidepressants in the treatment of anxiety disorders (ADs), ADHD, and PTSD; tianeptine and citalopram, but not clomipramine, were less well tolerated in children and adolescents with ASD. For suicidal behavior/ideation, venlafaxine (in MDD) and paroxetine (in AD) were associated with a significantly increased risk; by contrast, sertraline (in AD) was associated with a reduced risk. The majority of included systematic reviews/meta-analyses were rated as being of high or moderate in quality by the AMSTAR-2 critical appraisal tool (one and five, respectively). One included study was of low quality and two were of critically low quality. Compared to placebo, selected antidepressants can be efficacious in the acute treatment of some common psychiatric disorders, although statistically significant differences do not always translate into clinically significant results. Little information was available about tolerability of antidepressants in RCTs of OCD and in the treatment of ADHD, ASD, MDD, and PTSD. There is a paucity of data on suicidal ideation/behavior, but paroxetine may increase the risk of suicidality in the treatment of AD and ven...

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Section: Discussionsupporting

confidence: 86%

Antidepressants in Children and Adolescents: Meta-Review of Efficacy, Tolerability and Suicidality in Acute Treatment

et al. 2020

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“…18 Availability of treatment may also be related to increases in the diagnosis of ADHD, as there are many effective pharmacologic and nonpharmacologic treatments that have been and continue to be developed to address ADHD symptoms and associated negative functioning. 19…”

Section: Adhdmentioning

confidence: 99%

Prevalence and Trends of Developmental Disabilities among Children in the United States: 2009–2017

et al. 2019

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OBJECTIVES: To study the national prevalence of 10 developmental disabilities in US children aged 3 to 17 years and explore changes over time by associated demographic and socioeconomic characteristics, using the National Health Interview Survey. METHODS: Data come from the 2009 to 2017 National Health Interview Survey, a nationally representative survey of the civilian noninstitutionalized population. Parents reported physician or other health care professional diagnoses of attention-deficit/hyperactivity disorder; autism spectrum disorder; blindness; cerebral palsy; moderate to profound hearing loss; learning disability; intellectual disability; seizures; stuttering or stammering; and other developmental delays. Weighted percentages for each of the selected developmental disabilities and any developmental disability were calculated and stratified by demographic and socioeconomic characteristics. RESULTS: From 2009 to 2011 and 2015 to 2017, there were overall significant increases in the prevalence of any developmental disability (16.2%-17.8%, P , .001), attention-deficit/ hyperactivity disorder (8.5%-9.5%, P , .01), autism spectrum disorder (1.1%-2.5%, P , .001), and intellectual disability (0.9%-1.2%, P , .05), but a significant decrease for any other developmental delay (4.7%-4.1%, P , .05). The prevalence of any developmental disability increased among boys, older children, non-Hispanic white and Hispanic children, children with private insurance only, children with birth weight $2500 g, and children living in urban areas and with less-educated mothers. CONCLUSIONS: The prevalence of developmental disability among US children aged 3 to 17 years increased between 2009 and 2017. Changes by demographic and socioeconomic subgroups may be related to improvements in awareness and access to health care. WHAT'S KNOWN ON THIS SUBJECT: Previously, researchers found health disparities in diagnosed developmental disabilities by demographic and socioeconomic characteristics among US children. Changes in awareness, knowledge, health care services access, and improved measurement make it important to continue to monitor prevalence changes in the population. WHAT THIS STUDY ADDS: With this study, we present new nationally representative data on the prevalence of developmental disability, recent demographic trends, and estimates by urban or rural residence.

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“…Most of the action of synaptic dopamine is terminated via uptake of dopamine by the dopamine uptake transporter (DAT). The dopamine uptake transporter is one of the primary targets for medications that are used to treat ADHD (101, 102). Thus, dopamine neurotransmission plays a role in both impulsivity and psychostimulant addiction.…”

Section: Pharmacological Targets To Treat Psychostimulant-induced Cogmentioning

confidence: 99%

“…The role of noradrenaline in impulsivity is evident by use of medications that increase noradrenergic transmission in the treatment of ADHD (101, 102). Noradrenergic transmission is mediated by α (α1 and α2) and β (β1 and β2) adrenergic receptors, and the action of synaptic noradrenaline is terminated by the noradrenaline uptake transporter (NET).…”

Section: Pharmacological Targets To Treat Psychostimulant-induced Cogmentioning

confidence: 99%

Brain and Cognition for Addiction Medicine: From Prevention to Recovery Neural Substrates for Treatment of Psychostimulant-Induced Cognitive Deficits

D’Souza

2019

Front. Psychiatry

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Addiction to psychostimulants like cocaine, methamphetamine, and nicotine poses a continuing medical and social challenge both in the United States and all over the world. Despite a desire to quit drug use, return to drug use after a period of abstinence is a common problem among individuals dependent on psychostimulants. Recovery for psychostimulant drug-dependent individuals is particularly challenging because psychostimulant drugs induce significant changes in brain regions associated with cognitive functions leading to cognitive deficits. These cognitive deficits include impairments in learning/memory, poor decision making, and impaired control of behavioral output. Importantly, these drug-induced cognitive deficits often impact adherence to addiction treatment programs and predispose abstinent addicts to drug use relapse. Additionally, these cognitive deficits impact effective social and professional rehabilitation of abstinent addicts. The goal of this paper is to review neural substrates based on animal studies that could be pharmacologically targeted to reverse psychostimulant-induced cognitive deficits such as impulsivity and impairment in learning and memory. Further, the review will discuss neural substrates that could be used to facilitate extinction learning and thus reduce emotional and behavioral responses to drug-associated cues. Moreover, the review will discuss some non-pharmacological approaches that could be used either alone or in combination with pharmacological compounds to treat the above-mentioned cognitive deficits. Psychostimulant addiction treatment, which includes treatment for cognitive deficits, will help promote abstinence and allow for better rehabilitation and integration of abstinent individuals into society.

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Treatment strategies for ADHD: an evidence-based guide to select optimal treatment

Cited by 203 publications

References 197 publications

Antidepressants in Children and Adolescents: Meta-Review of Efficacy, Tolerability and Suicidality in Acute Treatment

Antidepressants in Children and Adolescents: Meta-Review of Efficacy, Tolerability and Suicidality in Acute Treatment

Prevalence and Trends of Developmental Disabilities among Children in the United States: 2009–2017

Brain and Cognition for Addiction Medicine: From Prevention to Recovery Neural Substrates for Treatment of Psychostimulant-Induced Cognitive Deficits

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