What is attention deficit hyperactivity disorder and how is it treated?
Attention deficit hyperactivity disorder (ADHD) is a neurological-behavioral developmental disorder beginning in childhood. It is manifested in difficulty focusing, hyperactivity, and poorly controlled impulsivity. In adults, it can also result in lowered intellect and trouble of information perception.
From the neurological point of view, ADHD is a persistent chronic syndrome without a cure. It is considered that around 30% of kids outgrow the syndrome or find a way to minimize its effect on their daily live achieving adulthood.
ADHD and its treatment have been controversial since the 1970s. The existence of the syndrome is doubted by a large number of health specialists, teachers, politics, children, and media. Others believe that the syndrome is an actual problem and that there are genetic and physiological causes for the syndrome development.
ADHD is divided into three main types and two additional:
- Predominantly inattentive presentation;
- Combined presentation;
- Other specified attention-deficit/hyperactivity disorder;
- Unspecified attention-deficit/hyperactivity disorder.
According to the statistics based on U.S.-based research, the condition affects 5-10% of people including both children and adults. The syndrome is more frequently diagnosed in boys than in girls.
When should a person go to a doctor with suspected ADHD?
It is crucial to get the right diagnosis as soon as possible and start the treatment as ADHD can significantly limit achievements at school and affect social behavior, psychology and child development. The main problem is rash reactions leading to impulsive behavior. The lack of proper diagnosis can cause a negative impact on the social, mental, and behavioral aspects.
Here you can find the main clinical symptoms that may indicate ADHD in different age groups:
- At preschool age, ADHD manifests in anxiety, lack of discipline, throwing a tantrum, the absence of desire and ability to complete tasks, absence of concentration, difficulties in obeying the rules, including in games, sometimes, over-active motility.
Sometimes children at an early age do not realize that they are a danger to themselves or to others. They try to climb high and dangerous places or run out onto the road. Due to behavioral difficulties, such children often cause irritation in adults or other children. They have a problem making friends, this makes them withdrawn, unwilling to communicate, sometimes even prone to aggressiveness towards other children.
- At the age of the elementary school, symptoms appear in impulsive reactions, outbursts of anger and isolation. Such behavior causes hostility of other children and adults, they are not accepted in the company, and therefore develop anti-social inclinations up to aggressiveness.
At school age, the syndrome manifests itself in low grades, difficulties in organizing processes, and not doing homework.
- In high school and as adults, such children can drop off school; find it difficult to work and to find work that matches their talents and expectations. It is also difficult for them to obey the laws. Sometimes they become aggressive and more than others prone to drug addiction, smoking, and alcohol abuse, as well as to illegal acts that are dangerous to themselves and others. They are more susceptible to accident hazards, including traffic accidents.
Diagnosis and appropriate treatment at an early age are crucial in order to prevent various complications of the syndrome. However, it should be remembered that there are extraordinary active children who do not suffer from ADHD, but only have a different temperament. Such children may be mistakenly diagnosed with ADHD, so you should be extremely careful in the diagnosis.
What doctor should you go to?
If you suspect that your child suffers from ADHD, you should take them to a pediatrician who will then appoint you a meeting with a child pediatric neurologist, a pediatrician specializing in child development or a child psychiatrist. A specialist doctor conducts diagnostics together with other specialists, as necessary.
How is ADHD treated?
Although many people are not happy about the perspective of giving their young children drugs for ADHD, over 45 years of drug therapy of ADHD have shown that it has much more positive than negative results. Besides, the negative consequences of not treating ADHD are much worse the potential adverse effects of the used medications.
The first-line medication for ADHD is Ritalin, a stimulant of the central nervous system (CNS) of phenethylamine and piperidine classes.
The use of the stimulant improves behavior and cognitive functions, i.e. attention, ability to focus, memory, and others helping children overcome their academic and social problems. The benefit of the medication use is observed in 70% of children diagnosed with ADHD. The improvement manifests in lowered aggressiveness, impulsivity, improved memory and focus, and so on.
As another argument pro the drug therapy of ADHD is that it doesn’t cause addiction. On the contrary, in teenagers who do not use ADHD medications, there is a higher increased propensity for illicit drug and alcohol addiction. Studies have also shown that alcoholics and drug addicts suffering from ADHD are not able to recover from addiction without undergoing parallel treatment for ADHD.
Some patients complain that the medications change their perception and personality not in a good way. It often happens at the beginning of the therapy when unusual slowing down of emotional response and motility occurs. However, these symptoms are transient, i.e. they go away over time or a person gets used to them and they cause no discomfort. Such slowing down is especially crucial for ADHD patients with predominant hyperactivity and impulsiveness above all. However, for individuals with less pronounced hyperactivity and inability to focus and learn or work, it would be wise to consider other medications.
Although Ritalin is a first-line medication, there are also other drugs with a similar effect and much shorter list of side effects, for instance, Modafinil. This medication doesn’t cause sedation at all and would be suitable in less pronounced hyperactivity and predominant attention deficit. It is a drug approved for narcolepsy as well as Ritalin, and also for shift work sleep disorder and obstructive sleep apnea in which cognitive function lowering is also observed as in ADHD. Unfortunately, Modafinil isn’t approved for ADHD yet but it is in the list for approval. Luckily, it can be bought without a prescription at an online drugstore such as ours (we offer you to buy generic Modafinil called Modalert). You can check our comparison of the two drugs and decide which medication suits you best.
Rare.
The side effects that can develop during the first days of use and then go away are:
- Headache;
- Insomnia;
- Nausea;
- Agitation.
In case of drug intolerance, allergy can develop which means that the drug use must be discontinued.
Frequent.
The most common side effects of Ritalin are a decrease in appetite and insomnia at the beginning of treatment, headaches, abdominal pain, apathy and a nervous state, and a state of depression may occur in the later stages of treatment. A less common side effect is a stop in weight gain, in some patients the symptoms of ADHD increase after the drug is stopped (rebound effect), in the late hours of the day, which is expressed in increased sensitivity, anxiety, and tearfulness. If a patient taking Ritalin suffers from tics, they may worsen. Other side effects are:
- Nausea,
- Dizziness;
- Heart symptoms;
- Vision impairment;
- Allergy (if occurs, treatment is stopped immediately).
A long-tem use in high doses sometimes can cause a delay in the growth.
The drug can cause dependence.
- Intolerance or allergy to the drug;
- Pregnancy and breastfeeding;
- Severe heart disease;
- Liver cirrhosis;
- Intolerance or allergy to the drug;
- Pregnancy and breastfeeding;
- Heart disease;
- High blood pressure
- Glaucoma;
- Pheochromocytoma;
- Use of MAO inhibitors;
- Thyroid gland dysfunction;
- Depression;
- Eating disorders;
- Psychoses;
- Mania, schizophrenia, bipolar disorder;
- Neuropathic disorders;
- Arterial occlusion;
- Brain aneurysm;
- Vascular disorders;
- Tourette syndrome or motor tics.
(Updated at Apr 14 / 2024)
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