Psychiatry-ADHD Flashcards
3 types of ADHD
Inattentive (ADD), hyperactive and combined type
Why do we prescribe stimulants for hyperactive people with ADHD?
Dopamine, NE and ACh are all dumped into they synaptic cleft with stimulants. This increases the executive function of the frontal lobe, which is decreased in people with ADHD.
Criteria for diagnosis of ADHD?
6+ monthsof 6/9 symptoms. Clear evidence that the symptoms interfere with or reduce the quality of social, academic or occupational functioning. Several symptoms present before age 12, symptoms in 2+ settings and not due to other conditions.
Confounders of ADHD
Parenting styles, teaching styles, sensory deficits and other psychiatric issues (depression, anxiety, bipolar etc)
What labs do you want to run for a prospective kid that will be taking ADHD stimulants?
Height/weight (can retard growth), vitals (HTN), EKG (family history of early cardiac death), LFT, CBC
Most popular ADHD rating scale.
Conner’s: has forms for parent and teacher to feel out. Levels above 65% strongly suggests medication will help ADHD.
How does medical management of ADHD compare with behavioral management?
Medical is way more effective.
Contraindications for ADHD medications
Glaucoma, HTN, psychotic disorders, bipolar disorders and hyperthyroidism
First line agents for ADHD
Methylphenidate (dextroamphetamine), dextroamphetamine (adderall)
Most serious side effect of ADHD
Dependence. No evidence that it stunts growth
Drug more likely to cause depression and suicidal ideation when stopped.
Dextroamphetamine. When taking this drug you also have a risk for anorexia or weight loss.
Third line ADHD drug that can cause liver failure?
Cylert
Stimulant that is approved for narcolepsy
Provigil
Stimulant that is an alpha-2 agonist used to treat ADHD that does not have side effects of stimulants.
Clonidine
Drugs chemically related to stimulants that takes 8-12 weeks to kick in
Wellbutrin and Effexor
