Pharmacotherapy of Attention-Deficit Hyperactivity Disorder across the Life Cycle

Spencer, Thomas; Biederman, Joseph; Wilens, Timothy E.; Harding, Margaret; O’Donnell, Deborah A.; Griffin, Susan M.

doi:10.1097/00004583-199604000-00008

Cited by 729 publications

(379 citation statements)

References 159 publications

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“…Um total de 47 substâncias já foram ou são utilizadas no tratamento do TDAH (Jadad et al, 1999), entre essas destacando-se o uso de estimulantes do sistema nervoso central, como anfetaminas (Patrick e Markowitz, 1997;Manos et al, 1999), pemolina (Patrick e Markowitz, 1997;Andriola, 2000) e cafeína (Spencer et al, 1996); além desses, antidepressivos, como imipramina, bupropiona, fluoxetina e substâncias várias, como clonidina, etc. são também utilizados (Rohde et al, 2000).…”

Section: Discussionunclassified

Metilfenidato: influência da notificação de receita A (cor amarela) sobre a prática de prescrição por médicos brasileiros

Carlini

Nappo

Nogueira

et al. 2003

Rev. psiquiatr. clín.

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RESUMOOitocentos e noventa e dois médicos, entre eles neurologistas (463) e psiquiatras (411), responderam a um questionário sobre a prescrição do metilfenidato para o transtorno do déficit de atenção e hiperatividade (TDAH).A maioria dos médicos relatou a ocorrência esporádica de reações adversas não-sérias, tais como dor de cabeça, emagrecimento, inapetência, hiperexcitabilidade, taquicardia, etc; apenas seis médicos, entretanto, relataram casos que poderiam levar à suspeita de dependência, embora nenhum deles satisfizesse os critérios da CID-10 para tal.A grande maioria opinou que a exigência da notificação de receita A (amarela) é inadequada, criando preconceitos em relação à condição dos pacientes e amedrontando seus parentes. Relatam ainda que tal classificação dificulta a prescrição do medicamento, fazendo muitas vezes com que o metilfenidato se torne a segunda opção para o tratamento de TDAH, além de tornar o produto pouco disponível nas farmácias e dificultar o trabalho dos profissionais. Isso faz com que a adesão ao tratamento se torne mais difícil, pois, além dos vários entraves burocráticos para se adquirir o medicamento, há também o medo por parte dos familiares e do próprio paciente de estar tomando tal medicação.Neurologistas e psiquiatras argumentam que o controle do metilfenidato deve existir, mas, em se tratando de um medicamento prescrito por especialistas e de não possuir grande potencial de dependência, o receituário azul já seria suficiente para o controle adequado. A classificação do metilfenidato, juntamente com as anfetaminas e com o princípio ativo da maconha (dronabinol), é uma outra questão levantada, sendo tal fato para grande parte dos profissionais uma total incoerência. Unitermos: Metilfenidato; Prescrições; Medicamentos controlados; Transtorno do déficit de atenção e hiperatividade. ABSTRACTFour hundred and sixty three brazilian neurologists and 411 brazilian psychiatrists answered a questionnaire aimed at to obtain information on the prescription of methylphenidate for the treatment of the Attention Deficit and Hyperactivity Disorder.The majority of the doctors reported the erratic occurrence of a few non serious adverse reactions such as headache, weight loss, inapetence, hyperexcitability and tachycardia. On the other hand, only six doctors reported cases that cold raise a suspicion of drug dependence, although none of these six cases satisfied the ICD-10 criteria for dependence.The vast majority of the medical doctors manifested the opinion that the especial prescriptions the "Notifications A" of yellow color, the same used for opiates also, as demanded by the Brazilian Health Authorities, is inadequate as it raises misconceptions in relation to the real patient disease and frightens the parents and relatives. The doctors also claimed the such especial prescription form encumbers the prescription of the medicament making methylphenidate the second choice for the treatment and, for this reason, less available in pharmacies and drugstores. As a consequence the adherence to the ...

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Section: Discussionunclassified

Metilfenidato: influência da notificação de receita A (cor amarela) sobre a prática de prescrição por médicos brasileiros

Carlini

Nappo

Nogueira

et al. 2003

Rev. psiquiatr. clín.

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“…Amphetamine-like psychostimulants are the best-documented pharmacotherapy for attention-deficit hyperactivity disorder (ADHD) (Arnold et al, 1976;Wilens et al, 1995;Spencer et al, 1996). Amphetamines are also powerful reinforcing drugs, primarily due to their capacity to activate the mesocorticolimbic dopamine (DA) system (Wise, 1996).…”

Section: Introductionmentioning

confidence: 99%

Alpha2A-Adrenoceptors are Important Modulators of the Effects of D-Amphetamine on Startle Reactivity and Brain Monoamines

Lähdesmäki

Sallinen

MacDonald

et al. 2004

Neuropsychopharmacol

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Amphetamines are commonly used to treat attention-deficit hyperactivity disorder, but are also widely abused. They are employed in schizophrenia-related animal models as they disrupt the prepulse inhibition (PPI) of the acoustic startle response. The behavioral effects of amphetamines have mainly been attributed to changes in dopamine transmission, but they also involve increases in the synaptic concentrations of norepinephrine (NE). a 2 -Adrenoceptors (a 2 -ARs) regulate the excitability and transmitter release of brain monoaminergic neurons mainly as inhibitory presynaptic auto-and heteroreceptors. Modulation of acoustic startle and its PPI by the a 2A -AR subtype was investigated with mice lacking the a 2A -AR (a 2A -KO) and their wild-type (WT) controls, without drugs and after administration of the a 2 -AR agonist dexmedetomidine or the antagonist atipamezole. The interaction of D-amphetamine (D-amph) and the a 2 -AR-noradrenergic neuronal system in modulating startle reactivity and in regulating brain monoamine metabolism was assessed as the behavioral and neurochemical responses to D-amph alone, or to the combination of D-amph and dexmedetomidine or atipamezole. a 2A -KO mice were supersensitive to both neurochemical and behavioral effects of D-amph. Brain NE stores of a 2A -KO mice were depleted by D-amph, revealing the a 2A -AR as essential in modulating the actions of D-amph. Also, increased startle responses and more pronounced disruption of PPI were noted in D-amph-treated a 2A -KO mice. a 2A -AR also appeared to be responsible for the startlemodulating effects of a 2 -AR drugs, since the startle attenuation after the a 2 -AR agonist dexmedetomidine was absent in a 2A -KO mice, and the a 2 -AR antagonist atipamezole had opposite effects on the startle reflex in a 2A -KO and WT mice.

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“…57,60,61 Extended-release clonidine [62][63][64] and extended-release guanfacine 65,66 are also efficacious options for the treatment of ADHD, alone or in combination with stimulants. Other pharmacologic alternatives evaluated for the treatment of ADHD are modafinil, bupropion, 57 and tricyclic antidepressants, 67 but all of them have showed weaker evidence of efficacy.…”

Section: Efficacy Of Interventionsmentioning

confidence: 99%

Developments and challenges in the diagnosis and treatment of ADHD

Dias

Kieling

Graeff-Martins

et al. 2013

Rev. Bras. Psiquiatr.

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Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder, often associated with other psychiatric comorbidities, functional impairments, and poor long-term outcomes. The objective of this selected review is to describe current advances and challenges in the diagnosis and treatment of ADHD. The disorder is associated with neurobiological underpinnings and is highly heterogeneous in various aspects, such as symptom profiles, cognitive impairments, and neurobiological and genetic features. The efficacy and safety of short-term pharmacological treatments across the life cycle is well studied, but further research investigating long-term treatment, impact of treatment in preschoolers, and non-pharmacological interventions is needed. Future research is also needed to better characterize the neurodevelopmental pathways of the disorder, linking clinical and neurobiological information, less investigated populations, and new interventions.

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Pharmacotherapy of Attention-Deficit Hyperactivity Disorder across the Life Cycle

Cited by 729 publications

References 159 publications

Metilfenidato: influência da notificação de receita A (cor amarela) sobre a prática de prescrição por médicos brasileiros

Metilfenidato: influência da notificação de receita A (cor amarela) sobre a prática de prescrição por médicos brasileiros

Alpha2A-Adrenoceptors are Important Modulators of the Effects of D-Amphetamine on Startle Reactivity and Brain Monoamines

Developments and challenges in the diagnosis and treatment of ADHD

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