Pharmacologic management of attention deficit hyperactivity disorder in children and adolescents: a review for practitioners

Brown, Kelly; Samuel, Sharmeen; Patel, Dilip R.

doi:10.21037/tp.2017.08.02

Cited by 65 publications

(71 citation statements)

References 30 publications

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“…In addition, the ClinicalTrials.gov database was searched using the following keywords: (ADHD and methylphenidate). This search strategy was augmented through a hand search of reference lists for eligible articles as well as relevant clinical guidelines and review articles 2,7,10,21 .…”

Section: Methodsmentioning

confidence: 99%

“…Attention-deficit/hyperactivity disorder (ADHD) can present with symptoms encompassing inattentive, hyperactivity and impulsivity domains, and is associated with significant psychosocial and academic dysfunctions 1 . ADHD is the most common neurobehavioral disorder amongst children and adolescents 2 . In addition, children with probable ADHD have been reported to have a 16-point decrease in IQ compared to those without ADHD 3 .…”

Section: Introductionmentioning

confidence: 99%

“…These findings highlight an association between ADHD and subaverage intelligence 4 . Both pharmacological and non-pharmacological treatments have shown efficacy for the management of ADHD 2,5 .…”

Section: Introductionmentioning

confidence: 99%

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Therapeutic effects of methylphenidate for attention-deficit/hyperactivity disorder in children with borderline intellectual functioning or intellectual disability: A systematic review and meta-analysis

Sun

Tseng²,

Wu³

et al. 2019

Sci Rep

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Attention-deficit/hyperactivity disorder (ADHD) frequently co-occurs with intellectual disability in children, and may further compromise learning. Methylphenidate is a first-line treatment for ADHD, however no previous meta-analysis has evaluated its overall efficacy for ADHD in children with comorbid intellectual disability (ID) or borderline intellectual functioning. The PubMed/MEDLINE, Cochrane CENTRAL and ScienceDirect databases were systematically searched from inception through 2018/7/15 for clinical studies that investigated the effects of methylphenidate in children with ADHD and ID. A random-effects model meta-analysis was used for data synthesis. Eight studies (average Jadad score = 2.5) enrolling 242 participants receiving methylphenidate and 181 participants receiving placebo were included. The meta-analysis showed that methylphenidate led to a significant improvement in ADHD symptoms relative to placebo (Hedges’ g = 0.878, p < 0.001). Meta-regression analysis pointed to an association between the dose of methylphenidate and overall improvement in ADHD severity (slope = 1.334, p < 0.001). Finally, there was no significant difference in drop-out rate [odds ratio (OR) = 1.679, p = 0.260] or rate of treatment discontinuation due to adverse events (OR = 4.815, p = 0.053) between subjects receiving methylphenidate and those taking placebos. Our study suggests that methylphenidate retains its efficacy in children with ADHD and borderline intellectual functioning or ID.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Therapeutic effects of methylphenidate for attention-deficit/hyperactivity disorder in children with borderline intellectual functioning or intellectual disability: A systematic review and meta-analysis

Sun

Tseng²,

Wu³

et al. 2019

Sci Rep

View full text Add to dashboard Cite

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“…It has been demonstrated that not only genetic factors but also environmental factors (e.g., infections, early traumas, and drugs), age, sociodemographic factors (e.g., ethnicity and socioeconomic status), and a complex interplay between these factors have a role in the pathophysiology of different psychiatric diseases, such as anxiety disorder (1, 11), bipolar disorder (5), schizophrenia (6, 12), major depressive disorder (2, 13, 14), autism spectrum disorder (15), and ADHD (16). Close association between different psychiatric disorders, such as anxiety disorder and major depressive disorder, has been demonstrated (5, 17–21).…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Potential of Exogenous Ketone Supplement Induced Ketosis in the Treatment of Psychiatric Disorders: Review of Current Literature

et al. 2019

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Globally, psychiatric disorders, such as anxiety disorder, bipolar disorder, schizophrenia, depression, autism spectrum disorder, and attention-deficit/hyperactivity disorder (ADHD) are becoming more prevalent. Although the exact pathological alterations are not yet clear, recent studies have demonstrated that widespread changes of very complex metabolic pathways may partially underlie the pathophysiology of many psychiatric diseases. Thus, more attention should be directed to metabolic-based therapeutic interventions in the treatment of psychiatric disorders. Emerging evidence from numerous studies suggests that administration of exogenous ketone supplements, such as ketone salts or ketone esters, generates rapid and sustained nutritional ketosis and metabolic changes, which may evoke potential therapeutic effects in cases of central nervous system (CNS) disorders, including psychiatric diseases. Therefore, the aim of this review is to summarize the current information on ketone supplementation as a potential therapeutic tool for psychiatric disorders. Ketone supplementation elevates blood levels of the ketone bodies: D-β-hydroxybutyrate (βHB), acetoacetate (AcAc), and acetone. These compounds, either directly or indirectly, beneficially affect the mitochondria, glycolysis, neurotransmitter levels, activity of free fatty acid receptor 3 (FFAR3), hydroxycarboxylic acid receptor 2 (HCAR2), and histone deacetylase, as well as functioning of NOD-like receptor pyrin domain 3 (NLRP3) inflammasome and mitochondrial uncoupling protein (UCP) expression. The result of downstream cellular and molecular changes is a reduction in the pathophysiology associated with various psychiatric disorders. We conclude that supplement-induced nutritional ketosis leads to metabolic changes and improvements, for example, in mitochondrial function and inflammatory processes, and suggest that development of specific adjunctive ketogenic protocols for psychiatric diseases should be actively pursued.

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“…1 Since the symptoms affect social and academic achievement and physical condition, treatment is often required; pharmacological agents, both stimulants and nonstimulants, are frequently used in its treatment. 2 Atomoxetine is a selective, presynaptic, norepinephrine reuptake inhibitor also known as a NET inhibitor. It was the first non-stimulant medication to receive FDA approval for the treatment of ADHD.…”

Section: Introductionmentioning

confidence: 99%

Atomoxetine Induced Obsessive-Compulsive Disorder

Altay

2019

Hosp Pract Res

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Introduction: Attention deficit and hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children and adolescents. Atomoxetine is a non-stimulant drug used in the treatment of ADHD. Case Presentation: In this article, a case of obsessive-compulsive disorder (OCD) which occurred in an 11-year-old boy with an increased dose of atomoxetine during ADHD treatment and disappeared with dose reduction is reported. This case is only the second OCD case resulting from the use of atomoxetine. Conclusion: The case reported herein is the second case caused by the use of atomoxetine and the first in which OCD symptoms regressed when the atomoxetine dose was reduced. OCD development due to atomoxetine consumption may occur at different doses. When OCD develops, the solution may be dose reduction, or it may be necessary to discontinue treatment with atomoxetine.

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Pharmacologic management of attention deficit hyperactivity disorder in children and adolescents: a review for practitioners

Cited by 65 publications

References 30 publications

Therapeutic effects of methylphenidate for attention-deficit/hyperactivity disorder in children with borderline intellectual functioning or intellectual disability: A systematic review and meta-analysis

Therapeutic effects of methylphenidate for attention-deficit/hyperactivity disorder in children with borderline intellectual functioning or intellectual disability: A systematic review and meta-analysis

Therapeutic Potential of Exogenous Ketone Supplement Induced Ketosis in the Treatment of Psychiatric Disorders: Review of Current Literature

Atomoxetine Induced Obsessive-Compulsive Disorder

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