Treatment of Attention-Deficit/Hyperactivity Disorder: Overview of the Evidence

Brown, Ronald T.; Amler, Robert W.; Freeman, Wendy; Perrin, James M.; Stein, Martin T.; Feldman, Heidi M.; Pierce, Karen; Wolraich, Mark L.

doi:10.1542/peds.2004-2560

Cited by 277 publications

(164 citation statements)

References 75 publications

(65 reference statements)

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“…Methylphenidate, an effective and widely used treatment for ADHD (Volkow and Swanson, 2003;Brown et al, 2005), is a psychostimulant with the ability to increase the extracellular concentrations of DA and norepinephrine (NE), but not 5-HT, in the brain (Kuczenski and Segal, 1997). The mechanism of action responsible for the biochemical profile Results represent mean7SEM of locomotor counts accumulated in 10-min periods.…”

Section: Discussionmentioning

confidence: 99%

5-HT1B Receptor-Mediated Serotoninergic Modulation of Methylphenidate-Induced Locomotor Activation in Rats

Borycz

Zapata

Quiroz

et al. 2007

Neuropsychopharmacol

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Previous studies have shown that the dopamine (DA) uptake blocker methylphenidate, a psychostimulant widely used for the treatment of attention-deficit hyperactivity disorder (ADHD), prevents the neurotoxic effects of the highly abused DA releaser methamphetamine. However, there is a lack of information about the pharmacological interactions of these two drugs at the behavioral level. When systemically administered within an interval of 2 h, previous administration of methylphenidate (10 mg/kg, intraperitoneal (i.p.)) did not modify locomotor activation induced by methamphetamine. On the other hand, previous administration of methamphetamine (1 mg/kg, i.p.) markedly potentiated methylphenidate-induced motor activation. With in vivo microdialysis experiments, methamphetamine and methylphenidate were found to increase DA extracellular levels in the nucleus accumbens (NAs). Methamphetamine, but not methylphenidate, significantly increased the extracellular levels of serotonin (5-HT) in the NAs. Methamphetamine-induced 5-HT release remained significantly elevated for more than 2 h after its administration, suggesting that the increased 5-HT could be responsible for the potentiation of methylphenidate-induced locomotor activation. In fact, previous administration of the 5-HT uptake blocker fluoxetine (10 mg/kg, i.p.) also potentiated the motor activation induced by methylphenidate. A selective 5-HT 1B receptor antagonist (GR 55562; 1 mg/kg), but not a 5-HT 2 receptor antagonist (ritanserin; 2 mg/kg, i.p.), counteracted the effects of methamphetamine and fluoxetine on the motor activation induced by methylphenidate. Furthermore, a 5-HT 1B receptor agonist (CP 94253; 1-10 mg/kg, i.p.) strongly and dose-dependently potentiated methylphenidate-induced locomotor activation. The 5-HT 1B receptor-mediated modulation of methylphenidate-induced locomotor activation in rat could have implications for the treatment of ADHD.

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Section: Discussionmentioning

confidence: 99%

5-HT1B Receptor-Mediated Serotoninergic Modulation of Methylphenidate-Induced Locomotor Activation in Rats

Borycz

Zapata

Quiroz

et al. 2007

Neuropsychopharmacol

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“…Os dados são consistentes com a literatura, que apontam uma alta incidência dessas dificuldades em crianças e adolescentes, com potencial para gerar fracasso acadêmico, prejuízo social, dificuldades de relacionamento, suicídio e abuso de drogas (CASTILLO et al, 2000;COSTELLO;FOLEY;ANGOLD, 2006), o que possivelmente explique em parte por que houve tão pouco encaminhamento das escolas: sabe-se que os professores encaminham para os serviços de saúde mental mais casos associados à violência, agressividade e desobediência às regras escolares e sociais. (ANCONA-LOPEZ, 1983;BROWN et al, 2005;MELO;PERFEITO, 2006;SILVARES, 1998). Lopes (2008), em uma análise de dados de 371 encaminhamentos de escolares para serviços de psicologia devido a dificuldades pedagógicas e 105 entrevistas com professores do Rio Grande do Sul, evidenciou a diferenciação dos alunos com demanda escolar especial entre "alunos-problema", que apre-sentam dificuldades funcionais, segundo o MEC; e alunos com deficiência, que apresentam deficiência sensorial, intelectual ou física.…”

Section: Conclusãounclassified

Crianças e adolescentes com problemas emocionais e comportamentais têm necessidade de políticas de inclusão escolar?

Gauy

2016

Educ. rev.

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RESUMOEste trabalho teve o objetivo de avaliar o perfil de crianças encaminhadas para serviços de saúde mental e discutir o impacto dos problemas funcionais apresentados em escolares, que podem estar sendo negligenciados pelas políticas públicas brasileiras. Os dados de 160 escolares, de ambos os sexos, foram coletados em três serviços médicos de saúde mental com os respectivos cuidadores, a partir de dois instrumentos: ficha de identificação para caracterizar os participantes, os cuidadores, o perfil sociodemográfico, o responsável pelo encaminhamento e a queixa; e Inventário dos Comportamentos para Crianças e Adolescentes entre 6 e 18 anos (CBCL6/18 anos). Os dados obtidos evidenciam uma alta demanda devido a dificuldades emocionais/comportamentais, combinadas com dificuldades de aprendizagem, de relacionamento e na vida diária, denominadas pelo Ministério da Educação (MEC) como transtornos funcionais, não atendidas pelas políticas de Ensino Especial, encaminhadas por postos de saúde e médicos, e não prioritariamente pela escola, encaminhador padrão. Exceto pelo encaminhamento, os dados são consistentes com a literatura, que aponta uma alta incidência dessas dificuldades em crianças e adolescentes, geradores de barreiras acadêmicas e de problemas de alto impacto ao longo da vida acadêmica e pessoal. A esse respeito, modelos de intervenções baseadas em escola têm de forma crescente ampliado o conceito de inclusão e apontado alternativas ABSTRACTThis study had the objective of evaluating the profile of children referred to mental health services and of discussing the impact of functional problems presented at school, which may be neglected by the Brazilian public policies. Data from 160 schoolchildren, of both genders, was collected from their respective caretakers in three mental health services using two instruments: an identification form to characterize the participants, the caretakers, the social-demographic profile, the person responsible for the referral and demand; and the Child Behavior Checklist (CBCL) for children and adolescents between 6 and 18 years of age. Data obtained showed a high demand due to emotional/behavioral difficulties combined with learning, relationship and daily life difficulties named functional disorders by the Brazilian Ministry of Education and Culture (MEC) and not attended by the special education policies, which were referred by health centers and not mainly by the school, which would be the standard. Except for the referral, data is consistent with the literature, which points out a high incidence of these difficulties in children and adolescents, creating academic barriers and problems that have a great impact throughout their academic and personal lives. In this regard, intervention models based in schools have increasingly widened the concept of inclusion and offered promising alternatives of alliances between schools and mental health services, which may inspire future public policies in the area.

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“…Cases of intoxication have been described after the administration of chewed or crushed tablets at doses ranging from 2 mg/kg or 60 mg for MPH-IR to 4 mg/kg or 120 mg for MPH-ER. 42 Conversely, several studies on the clinical use of MPH attest to its effectiveness and low toxicity, 3,18,25,30 and recommend its use with a personalized medical prescription.…”

Section: Mph Adverse Effects and Risksmentioning

confidence: 99%

Non-medical use of methylphenidate: a review

Freese¹,

Signor²,

Machado³

et al. 2012

Trends Psychiatry Psychother.

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Uso não terapêutico do metilfenidato: uma revisãoNon-medical use of methylphenidate: a review Abstract Introduction: Methylphenidate is a psychostimulant medication used for the treatment of attention deficit hyperactivity disorder and narcolepsy. However, it has also been used for non-medical purposes, e.g. to produce euphoria, to increase self-esteem, and to achieve the so-called neurocognitive enhancement, decreasing the feeling of tiredness and increasing focus and attention. Objective: To describe, from theoretical and contextual points of view, the potential for abuse and non-medical use of methylphenidate. Method: The PubMed, SciELO and Cochrane databases were searched using the following keywords in Portuguese: metilfenidato, transtorno do déficit de atenção com hiperatividade, facilitadores dos processos cognitivos or agentes nootrópicos, and abuso de substâncias; and in English: methylphenidate, attention deficit disorder with hyperactivity, cognitive enhancement or nootropic agents, and substance abuse. Studies published between 1990 and 2010 were selected for review. Results: Non-medical use of methylphenidate is a relevant topic that raises important ethical and scientific questions in several areas, e.g. pharmacological and neurobiological characteristics, evidence of methylphenidate use, forms of nonmedical use of methylphenidate, mechanisms of action, and therapeutic application of methylphenidate. According to the review, methylphenidate can generally influence performance as a result of its stimulatory effect. Notwithstanding, evidence does not support the conclusion that it can enhance cognitive performance. Conclusion: Health professionals need to acquire expert knowledge and inform patients and their families on the methylphenidate potential for abuse when used with non-medical purposes.

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Treatment of Attention-Deficit/Hyperactivity Disorder: Overview of the Evidence

Cited by 277 publications

References 75 publications

5-HT1B Receptor-Mediated Serotoninergic Modulation of Methylphenidate-Induced Locomotor Activation in Rats

5-HT1B Receptor-Mediated Serotoninergic Modulation of Methylphenidate-Induced Locomotor Activation in Rats

Crianças e adolescentes com problemas emocionais e comportamentais têm necessidade de políticas de inclusão escolar?

Non-medical use of methylphenidate: a review

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