A Review of the Pathophysiology, Etiology, and Treatment of Attention-Deficit Hyperactivity Disorder (ADHD)

Sharma, Alok; Couture, Justin

doi:10.1177/1060028013510699

Cited by 413 publications

(351 citation statements)

References 114 publications

(159 reference statements)

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“…An unexpected finding was the high rate of patients treated with methylphenidate or modafinil in the group of patients with steatosis hepatis. Methylphenidate is widely used in the treatment of children with attention deficit hyperactivity disorder (41) and is also used, as is modafinil, to treat secondary narcolepsy and severe daytime sleepiness in CP patients (42). Our original evaluation found 50% of our patients with steatosis hepatis were Rec.…”

Section: Discussionmentioning

confidence: 99%

Nonalcoholic fatty liver disease and fatigue in long-term survivors of childhood-onset craniopharyngioma

Hoffmann

Bootsveld

Gebhardt

et al. 2015

European Journal of Endocrinology

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Objective: Hypothalamic obesity in childhood craniopharyngioma (CP) patients carries a high risk for development of metabolic syndrome. In metabolic syndrome, the development of nonalcoholic fatty liver disease (NAFLD) is known. The aim of this study is to detect the risk for NAFLD in childhood-onset CP. Design: This cross-sectional study included liver computed tomography (CT); ultrasound analysis of abdomen; measurements of serum parameters, height, weight and body composition; and daily medication of patients with childhood-onset CP. Methods: A total of 384 patients recruited in trials HIT Endo and KRANIOPHARYNGEOM 2000 were analyzed. Ninety-four survivors were included by fulfilling the criteria of proven hypothalamic involvement (HI), a minimum time interval of 5 years between diagnosis and study, and a minimum age of 18 years at the time of evaluation. A total of 19 patients agreed to participate. To quantify the degree of steatosis hepatis, analyses of liver density were performed once by non-contrasted CT of liver sections. Results: NAFLD occurs in about 50% of CP patients with HI and is associated with elevated liver enzymes and homeostasis model assessment index. BMI is not an effective predictive factor but body fat mass measured by near-infrared spectroscopy (NIRS) is. Over half of CP patients (60%) with NAFLD are treated with stimulating agents, with risk of hepatic side effects. Conclusions: NAFLD is a major adverse late effect in childhood-onset CP. NIRS rather than BMI should be used to measure body composition and predict NAFLD. Stimulating agents for treatment of fatigue and daytime sleepiness in CP should be prescribed judiciously.

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Section: Discussionmentioning

confidence: 99%

Nonalcoholic fatty liver disease and fatigue in long-term survivors of childhood-onset craniopharyngioma

Hoffmann

Bootsveld

Gebhardt

et al. 2015

European Journal of Endocrinology

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“…Atomoxetine is considered to be particularly beneficial as an adjunct therapy in ADHD patients presenting tics and comorbid anxiety (14)(15)(16). As it is devoid of abuse potential, atomoxetine is regarded as an appropriate alternative to the drugs that are misused (17).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a Potential Metabolism-Mediated Drug-Drug Interaction Between Atomoxetine and Bupropion in Healthy Volunteers

et al. 2016

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ABSTRACT-Purpose:To evaluate the impact of bupropion on the pharmacokinetic profile of atomoxetine and its main active metabolite (glucuronidated form), 4-hydroxyatomoxetine-O-glucuronide, in healthy volunteers.Methods: An open-label, non-randomized, two-period, sequential clinical trial was conducted as follows: during Period I (Reference), each volunteer received a single oral dose of 25 mg atomoxetine, whilst during Period II (Test), a combination of 25 mg atomoxetine and 300 mg bupropion was administered to all volunteers, after a pretreatment regimen with bupropion for 7 days. Next, after determining atomoxetine and 4-hydroxyatomoxetine-O-glucuronide plasma concentrations, their pharmacokinetic parameters were calculated using a noncompartmental method and subsequently compared to determine any statistically significant differences between the two periods. Results: Bupropion intake influenced all the pharmacokinetic parameters of both atomoxetine and its metabolite. For atomoxetine, C max increased from 226±96.1 to 386±137 ng/mL and more importantly, AUC 0-∞ was significantly increased from 1580±1040 to 8060±4160 ng*h/mL, while the mean t 1/2 was prolonged after bupropion pretreatment. For 4-hydroxyatomoxetine-O-glucuronide, C max and AUC 0-∞ were decreased from 707±269 to 212±145 ng/mL and from 5750±1240 to 3860±1220 ng*h/mL, respectively. Conclusions: These results demonstrated that the effect of bupropion on CYP2D6 activity was responsible for an increased systemic exposure to atomoxetine (5.1-fold) and also for a decreased exposure to its main metabolite (1.5-fold). Additional studies are required in order to evaluate the clinical relevance of this pharmacokinetic drug interaction.

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“…Despite being one of the most extensively studied psychiatric disorders, the pathophysiology underlying ADHD symptoms remains only poorly understood (Albrecht et al 2015;Sharma and Couture 2014;Thapar et al 2013). A vast amount of research demonstrated that ADHD has strong biological underpinnings, including abnormalities in neurotransmitter systems in the brain.…”

Section: Introductionmentioning

confidence: 99%

Perception in attention deficit hyperactivity disorder

Fuermaier

Hüpen

Vries

et al. 2017

ADHD Atten Def Hyp Disord

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A large body of research demonstrated that individuals with attention deficit hyperactivity disorder (ADHD) suffer from various neuropsychological deficits. In contrast, less is known and only divergent evidence exists on perceptual functions of individuals with ADHD. This is problematic as neuropsychological and perceptual functions are closely interrelated and are often difficult to disentangle in behavioral assessments. This study presents the conduct and results of a systematic literature review on perceptual functions in children and adults with ADHD. This review considers studies using psychophysical methods (objective measurements) and self-and informant reports (subjective measurements). Results indicate that individuals with ADHD have altered perceptual functions in various domains as compared to typically developing individuals. Increased perceptual functions in individuals with ADHD were found with regard to olfactory detection thresholds, whereas reduced perceptual functions were evident for aspects of visual and speech perception. Moreover, individuals with ADHD were found to experience discomfort to sensory stimuli at a lower level than typically developing individuals. Alterations of perceptual functions in individuals with ADHD were shown to be moderated by various factors, such as pharmacological treatment, cognitive functions, and symptom severity. We conclude by giving implications for daily life functioning and clinical practice.

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A Review of the Pathophysiology, Etiology, and Treatment of Attention-Deficit Hyperactivity Disorder (ADHD)

Abstract: Published research shows the benefit of drug therapy for ADHD in children, but given the poor adverse effect and drug interaction profiles, these must be dispensed with caution.

Cited by 413 publications

References 114 publications

Nonalcoholic fatty liver disease and fatigue in long-term survivors of childhood-onset craniopharyngioma

Nonalcoholic fatty liver disease and fatigue in long-term survivors of childhood-onset craniopharyngioma

Evaluation of a Potential Metabolism-Mediated Drug-Drug Interaction Between Atomoxetine and Bupropion in Healthy Volunteers

Perception in attention deficit hyperactivity disorder

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