An update on the pharmacotherapy of attention-deficit/hyperactivity disorder in adults

Wilens, Timothy E.; Morrison, Nicholas R.; Prince, Jefferson B.

doi:10.1586/ern.11.137

Cited by 94 publications

(82 citation statements)

References 164 publications

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“…50 However, no controlled studies have specifically assessed the effectiveness of medication treatments for ADHD in college populations. 49 Further, those studies that exist suggest that many adults treated with medication either do not experience significant reduction in ADHD symptoms or experience intolerable side effects.…”

Section: Discussionmentioning

confidence: 99%

“…49 Further, those studies that exist suggest that many adults treated with medication either do not experience significant reduction in ADHD symptoms or experience intolerable side effects. 50 Most of these studies operationalize response to medication as 30% symptom reduction; thus, even those adults for whom pharmacotherapy is "successful" often continue to experience considerable impairment related to the core symptoms of ADHD.…”

Section: Discussionmentioning

confidence: 99%

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Attention-Deficit/Hyperactivity Disorder Symptom Levels and Romantic Relationship Quality in College Students

Bruner

Kuryluk

Whitton

2015

Journal of American College Health

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Attention-Deficit/Hyperactivity Disorder Symptom Levels and Romantic Relationship Quality in College Students

Bruner

Kuryluk

Whitton

2015

Journal of American College Health

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“…Through their effects on dopamine and noradrenaline transporters, stimulants inhibit the reuptake of dopamine and noradrenaline, thereby increasing the extracellular levels of these neurotransmitters. These stimulants also inhibit monoamine oxidase, the enzyme that metabolises these catecholamines (Wilens et al 2011). Atomoxetine works as a selective reuptake inhibitor of noradrenaline leading to its increased extracellular concentration (Garnock-…”

Section: Introductionmentioning

confidence: 99%

Oxidative and nitrosative stress in ADHD: possible causes and the potential of antioxidant-targeted therapies

Lopresti

2015

ADHD Atten Def Hyp Disord

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Attention deficit hyperactivity disorder (ADHD) has a complex etiology although theories associated with disturbances in dopaminergic and noradrenergic activity are most commonly cited.The importance of these catecholamines in ADHD is supported by its effective treatment utilising stimulant and non-stimulant medications that modify their activity. Recently there has been interest in oxidative and nitrosative stress (O&NS) in ADHD and its potential to contribute to this condition. In this article, research investigating O&NS in ADHD is reviewed and its impact on catecholaminergic activity and neurological structure is discussed. Lifestyle, environmental, ADHD is most commonly treated with stimulant medications such as methylphenidate and amphetamines, non-stimulants such as atomoxetine, and alpha2-adrenergic agonists such as clonidine and guanfacine. Through their effects on dopamine and noradrenaline transporters, stimulants inhibit the reuptake of dopamine and noradrenaline, thereby increasing the extracellular levels of these neurotransmitters. These stimulants also inhibit monoamine oxidase, the enzyme that metabolises these catecholamines (Wilens et al. 2011). Atomoxetine works as a selective reuptake inhibitor of noradrenaline leading to its increased extracellular concentration (Garnock- Jones and Keating 2009).While effective, these medications are associated with several adverse effects. These include loss of appetite, growth delay and sleep disturbances (Cortese et al. 2013). It is important to note that despite their widely accepted short-term efficacy, the long-term effectiveness of pharmacological treatments on social, educational and occupational functioning in people with ADHD continues to be debated (Huang and Tsai 2011;Langberg and Becker 2012;Nijmeijer et al. 2008). On a positive note, recent analyses using the Swedish national registrar suggests that long-term stimulant use in people with ADHD is associated with reduced rates of substance use, criminality, and serious traffic accidents (Chang et al. 2014a;Chang et al. 2014b;Lichtenstein et al. 2012).Despite wide appreciation of catecholaminergic theories associated with ADHD, there has been increased research into other biological mechanisms associated with ADHD. For example, in psychiatry there has been interest in immune-inflammatory pathways and oxidative and nitrosative stress (O&NS). In particular, it has been confirmed through recent meta-analyses that depression is Increased O&NS has also been found in bipolar disorder (Andreazza et al. 2008;Brown et al. 2014),

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“…The standard treatment of ADHD is with psychostimulants, particularly methylphenidate (Wilens, Morrison, & Prince, 2011). The potential risks of misuse and generating addiction to these drugs have been raised.…”

Section: Drug Treatmentmentioning

confidence: 99%

Trastorno por déficit de atención con hiperactividad y dependencia de sustancias depresoras. Una revisión

et al. 2013

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Resumen AbstractThe comorbidity between attention deficit hyperactivity disorder (ADHD) and substance use disorders is very common. A review of literature addressing prevalence, clinical features and treatment of the comorbidity between ADHD and CNS depressants was conducted. The prevalences found have a wide range (4.5% to 58%). ADHD has been associated with greater severity of addiction, early onset of consumption and addiction, more psychiatric comorbidity and more chronicity. In drug-dependent patients the diagnosis is a complex process because the frequent overlap of symptoms. The screening instruments should be used with caution.Drug therapy has shown efficacy in reducing ADHD symptoms, but there is no consensus regarding their influence on substance use.However, results should be interpreted cautiously, because the samples are small. Psychoeducational interventions are relevant, but treatment outcomes have not been described or studied systematically.Key Words: ADHD, addictions, alcohol, cannabis, opioids.Existe una elevada comorbilidad entre el trastorno por déficit de atención con hiperactividad (TDAH) y los trastornos por uso de sustancias. Se revisa la literatura sobre la prevalencia, características clínicas y tratamiento de la comorbilidad del TDAH con la dependencia de sustancias depresoras del SNC. Las prevalencias encontradas presentan amplia variabilidad (4,5% a 58%). El TDAH se asocia a una mayor gravedad de la adicción, menor edad de inicio del consumo y de la adicción, mayor presencia de otros trastornos psicopatológicos y mayor cronicidad. En pacientes drogodependientes el diagnóstico es un proceso complejo por el frecuente solapamiento de síntomas. Los instrumentos de cribado se deben utilizar con precaución.El tratamiento farmacológico ha mostrado eficacia en la reducción de los síntomas del TDAH y no hay consenso respecto a su influencia sobre el consumo. Sin embargo, los resultados se deben interpretar con cautela, porque las muestras son pequeñas. Las intervenciones psicoeducativas son relevantes, pero no se han descrito, ni estudiado sistemáticamente los resultados de este tipo de intervenciones.

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An update on the pharmacotherapy of attention-deficit/hyperactivity disorder in adults

Cited by 94 publications

References 164 publications

Attention-Deficit/Hyperactivity Disorder Symptom Levels and Romantic Relationship Quality in College Students

Attention-Deficit/Hyperactivity Disorder Symptom Levels and Romantic Relationship Quality in College Students

Oxidative and nitrosative stress in ADHD: possible causes and the potential of antioxidant-targeted therapies

Trastorno por déficit de atención con hiperactividad y dependencia de sustancias depresoras. Una revisión

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