Reviews : Pharmacotherapy of adolescent attention deficit hyperactivity disorder: challenges, choices and caveats

  title={Reviews : Pharmacotherapy of adolescent attention deficit hyperactivity disorder: challenges, choices and caveats},
  author={E. Jane Garland},
  journal={Journal of Psychopharmacology},
  pages={385 - 395}
  • E. Garland
  • Published 1 July 1998
  • Psychology
  • Journal of Psychopharmacology
A recent increase in stimulant treatment of adolescents with attention deficit hyperactivity disorder (ADHD) has been documented. Challenges in treating adolescent ADHD with methylphenidate or dextroamphetamine include compliance with frequent dosing, abuse potential and wear-off or rebound effects. Co-morbid anxiety, occurring in at least 30 percent of ADHD youths, is associated with lower rate of response to stimulants. The effective alternatives, tricyclic antidepressants or pemoline, are… 
Emerging drugs for attention-deficit/hyperactivity disorder
  • R. Weisler
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    Expert opinion on emerging drugs
  • 2007
Recent advances have lengthened the duration of effectiveness, which has increased compliance and eliminated the need for additional medication dosing during the school or work day, and additional safe, well-tolerated, long-acting medications with further reduced potential for diversion and abuse are needed.
Switching from Neurostimulant Therapy to Atomoxetine in Children and Adolescents with Attention-Deficit Hyperactivity Disorder
It is concluded that patients with ADHD can be switched from neurostimulants, specifically methylphenidate, to atomoxetine, and may benefit from symptom improvement, and is shown to be effective in relapse prevention.
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  • J. Nash
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Neurotherapy for ADHD offers an effective alternate for patients whose treatment is limited by side effects, poor medication response and in cases in which the patients and/or their parents refuse to consider medications.
Clinical Suggestions for Management of Stimulant Treatment in Adolescents
Management of ADHD in adolescence requires specific accommodations, which include providing adolescents with as much control over treatment as possible, so that they perceive treatment to be widening their autonomy rather than limiting it.
Treating attention-deficit/hyperactivity disorder beyond symptom control alone in children and adolescents: a review of the potential benefits of long-acting stimulants
The importance and benefits to child development of ADHD symptom control beyond the school day only are focused on, i.e. extending into late afternoon and evening and an extended-release MPH formulation (OROS® MPH) is used to demonstrate the potential benefits of active full day coverage (12 h) with a single daily dose.
Long-Term Effects of Stimulant Treatment for ADHD: What Can We Tell Our Patients?
When administered properly with careful titration, follow-up, and dose adjustment, stimulants are a safe and effective treatment for ADHD with minimal long- term risk and possible long-term benefit.
Adherence, persistence, and medication discontinuation in patients with attention-deficit/hyperactivity disorder – a systematic literature review
Although there was a lack of consistency in the measurement of adherence and persistence, these findings indicate that drug adherence and retention are generally poor among patients with ADHD.
Efficacy and Safety of Modafinil Film–Coated Tablets in Children and Adolescents With Attention-Deficit/Hyperactivity Disorder: Results of a Randomized, Double-Blind, Placebo-Controlled, Flexible-Dose Study
Intention-to-treat analysis (ITT) showed that compared with placebo, treatment with modafinil significantly improved the core symptoms of ADHD as shown by greater reductions in the ADHD-RS-IV School Version total scores from baseline to final visit.
[The effectiveness of atomoxetine in children, adolescents, and adults with ADHD. A systematic overview].
The existing results indicate that atomoxetine is promising for the treatment of ADHD in children, adolescents, and adults.


Pharmacotherapy of adult attention deficit/hyperactivity disorder: a review.
The literature appears to support the use of robust doses of both stimulants and antidepressants for ADHD in adults, and controlled studies applying stringent diagnostic criteria and outcome methodology are necessary to define the range of pharmacotherapeutic options.
Nicotine and attention in adult attention deficit hyperactivity disorder (ADHD).
Results indicate the need for a longer clinical trial and a comparison with other stimulants in adult ADHD treatment, and indicate significant clinician-rated global improvement, self-rated vigor and concentration, and improved performance on chronometric measures of attention and timing accuracy.
An open trial of pemoline in drug-dependent delinquents with attention-deficit hyperactivity disorder.
Preliminary data indicate that pemoline may be a useful treatment for ADHD in substance-dependent delinquents; the authors propose a controlled trial of p emoline in such youths.
Controlled stimulant treatment of ADHD and comorbid Tourette's syndrome: effects of stimulant and dose.
A substantial minority of comorbid subjects had consistent worsening of tics on stimulants, although the majority experienced improvement in ADHD symptoms with acceptable effects on tics, and MPH was better tolerated than DEX.
An open trial of venlafaxine in adult patients with attention deficit hyperactivity disorder.
Data suggest that controlled trials should be conducted with venlafaxine for ADHD, and patients who could tolerate the medication and showed a good response that was well maintained are suggested.
Equivalent effects of stimulant treatment for attention-deficit hyperactivity disorder during childhood and adolescence.
Stimulant medication is equally effective with children and adolescents with ADHD if they are engaged in similar activities and treatment providers should rigorously examine environmental causes to problems before prescribing higher doses of stimulants to adolescents who exhibit a worsening in functioning.
Efficacy of methylphenidate for attention-deficit hyperactivity disorder in children with tic disorder.
Methylphenidate appears to be a safe and effective treatment for attention-deficit hyperactivity disorder in the majority of children with comorbid tic disorder.
School Observations of Children with Attention‐Deficit Hyperactivity Disorder and Comorbid Tic Disorder: Effects of Methylphenidate Treatment
The findings support the conclusions that methylphenidate suppresses ADHD behaviors in the classroom and aggressive behavior in all settings and that a low dose may have a weak exacerbation effect on the frequency of motor tics; but, in general, the majority of youngsters do not experience clinically significant tic worsening with a MED.
Carbamazepine use in children and adolescents with features of attention-deficit hyperactivity disorder: a meta-analysis.
There is preliminary evidence that CBZ may be an effective alternate treatment in children with features of ADHD, and a meta-analysis of reports concerning the efficacy of carbamazepine revealed it was significantly more effective than placebo at controlling target symptoms.
Treatment of attentional and hyperactivity problems in children with sympathomimetic drugs: a comprehensive review.
Questions remain concerning development of tolerance in children, ways to define subgroups of disordered children who may respond uniquely to stimulants, the efficacy of medication in combination with other treatments, and possible long-term negative consequences of medication.