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Drug treatments for attention-deficit hyperactivity disorder in young people

  • Gordon Bates
Summary

The central role of medication in the treatment of attention-deficit hyperactivity disorder (ADHD) in children and adolescents is the focus of controversy once more. Questions about the safety and appropriateness of medication have arisen both within and without the medical community. This coincides with the disappointing results for long-term ADHD treatment, illustrated recently by the first major outcome study to be published. Clinicians have had to contend with a number of public health scares following on from the actions of drug regulatory bodies, in addition to misinformation and misunderstanding from the media. Ironically, this comes at a time when we have an ever-widening range of medications and formulations available to us, and better-quality studies to inform treatment decisions. The recently published National Institute for Health and Clinical Excellence guidelines address some of these issues and provide a welcome summary and reference point for beleaguered clinicians.

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Copyright
Corresponding author
Dr Gordon Bates, Huntercombe Hospital, Ivetsy Bank, Whaton Aston, Stafford ST19 9QT, UK. Email: gordon.bates@fshc.co.uk
Footnotes
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The use of these drugs in adults is discussed by Bradley Ng & Angela O'Brien in their article ‘Beyond ADHD and narcolepsy: psychostimulants in general psychiatry’, which will appear in the next issue of Advances. Ed.

Declaration of Interest

G.B. has participated in drug company sponsored research into ADHD and has received honoraria from Eli Lilly and Janssen.

Footnotes
References
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Allen, AJ, Kurlan, RM, Gilbert, DL et al (2005) Atomoxetine treatment in children and adolescents with ADHD and comorbid tic disorders. Neurology; 65: 1941–9.
American Academy of Child and Adolescent Psychiatry (2002) Practice parameter for the use of stimulant medications in the treatment of children, adolescents and adults. Journal of the American Academy of Child and Adolescent Psychiatry; 41: s2649.
Barkley, RA, DuPaul, GJ, McMurray, MB (1991) Attention deficit disorder with and without hyperactivity: clinical response to three dose levels of methylphenidate. Pediatrics; 87: 519–31.
Berger, S, Dhala, A, Friedberg, D (2004) Sudden cardiac death in infants, children, and adolescents. Pediatric Clinics of North America; 46: 221–34.
Biederman, J, Swanson, JM, Wigal, SB et al (2005) 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. Pediatrics; 116: e77784.
Bradley, C (1937) The behavior of children receiving benzedrine. American Journal of Psychiatry; 94: 577–85.
Brown, WA (1998) Images in psychiatry: Charles Bradley MD. Amercian Journal of Psychiatry; 155: 968.
Carlson, GA, Dunn, D, Kelsey, D et al (2007) A pilot study for augmenting atomoxetine with methylphenidate: safety of concomitant therapy in children with attention deficit/hyperactivity disorder. Child and Adolescent Psychiatry and Mental Health; 1: 10.
Chamberlain, S, del Campo, N, Dowson, J et al (2007) Atomoxetine improved response inhibition in adults with attention deficit/hyperactivity disorder. Biological Psychiatry; 62: 977–84.
Cleland, G (2007) Drugs ‘of no benefit’ to hyperactive children. Daily Telegraph; 12 November: p. 10.
Conners, CK, Levin, ED, Sparrow, E et al (2001) Multimodal treatment of ADHD in the MTA: an alternative outcome analysis. Journal of the American Academy of Child and Adolescent Psychiatry; 40: 159–67.
Duff, G (2005) Strattera (Atomoxetine) – Risk of Hepatic Disorders. Medicines and Healthcare products Regulatory Agency (http://www.mhra.gov.uk/Safetyinformation/Safetywarningsalertsandrecalls/Safetywarningsandmessagesformedicines/CON1004252).
Duff, G (2006) Strattera (Atomoxetine) – Conclusions of Risk:benefit Review. Medicines and Healthcare products Regulatory Agency (http://www.mhra.gov.uk/home/groups/comms-po/documents/websiteresources/con2023220.pdf).
Dunn, DW, Austin, JK, Harezlak, J et al (2003) ADHD and epilepsy in childhood. Developmental Medicine and Child Neurology; 45: 50–4.
Eli Lilly (2005) Straterra Prescribing Information. Eli Lilly.
Ferraro, L, Antonelli, T, Tanganelli, S et al (1999) The vigilance promoting drug modafinil increases extracellular glutamate levels in the medial preoptic area and the posterior hypothalamus of the conscious rat: prevention by local GABA receptor blockade. Neuropsychopharmacology; 20: 346–56.
Geshi, E, Kimura, T, Yoshimura, M et al (2005) A single nucleotide polymorphism in the carboxylesterase gene is associated with the responsiveness to imidapril medication and the promoter activity. Hypertension Research; 28: 719–25.
Greenhill, LL, Halperin, JM, Abikoff, H (1999) Stimulant medications. Journal of the American Academy of Child and Adolescent Psychiatry; 38: 503–12.
Gualtieri, CT (2002) Psychostimulants, dopamine agonists and amantadine. In Brain Injury and Mental Retardation: Psychopharmacology and Neuropsychiatry. Lippincott Williams and Wilkins.
Hunt, R, Minderaa, R, Cohen, D (1985) Clonidine benefits children with attention deficit hyperactivity disorder and hyperactivity: report of a double-blind placebo-crossover therapeutic trial. Journal of the American Academy of Child Psychiatry; 24: 617–29.
Jadad, AR, Boyle, M, Cunningham, C et al (1998) The Treatment of Attention Deficit/Hyperactivity Disorder: An Evidence Report. Agency for Healthcare Research and Quality, US Department of Health and Human Services.
Jensen, PS, Arnold, LE, Swanson, JM et al (2007) 3-year follow-up of the NIMH MTA study. Journal of the American Academy of Child and Adolescent Psychiatry; 46: 9891002.
Katz, R (2006) Action Memo for NDA 20-717/SE-021, for the Use of Provigil (Modafinil) Tablets in the Treatment of Pediatric Patients with Narcolepsy. Food and Drug Administration (http://www.fda.gov/cder/foi/esum/2007/020717s021_Modafinil_Clinical_BPCA.pdf).
Michelson, D, Faries, D, Wernicke, J et al (2001) Atomoxetine in the treatment of children and adolescents with attention-deficit/hyperactivity disorder: a randomized, placebo-controlled, dose response study. Pediatrics; 108: e83.
Michelson, D, Buitelaar, JK, Danckaerts, M et al (2004) Relapse prevention in pediatric patients with ADHD treated with atomoxetine: a randomized, double-blind, placebo-controlled study. Journal of the American Academy of Child and Adolescent Psychiatry; 43: 896904.
Molina, BSG, Flory, K, Hinshaw, SP et al (2007) Delinquent behavior and emerging substance in the MTA at 36 months: prevalence, course and treatment effects. Journal of the American Academy of Child and Adolescent Psychiatry; 46: 1028–40.
MTA Cooperative Group (1999a) A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. The MTA Cooperative Group. Multimodal Treatment Study of Children with ADHD. Archives of General Psychiatry; 56: 1073–86.
MTA Cooperative Group (1999b) Moderators and mediators of treatment response for children with attention-deficit/hyperactivity disorder. The Multimodal Treatment Study of Children with ADHD. Archives of General Psychiatry; 56: 1088–96.
National Institute for Clinical Excellence (2000) Guidance on the Use of Methylphenidate (Ritalin, Equasym) for Attention-Deficit/Hyperactivity Disorder (ADHD) in Childhood. NICE.
National Institute for Health and Clinical Excellence (2008) Diagnosis and Management of Attention-Deficit/Hyperactivity Disorder (ADHD) in Children, Young People and Adults. NICE.
Newcorn, JH, Kratochvil, CJ, Allen, AJ et al (2008) Atomoxetine and osmotically released methylphenidate for the treatment of attention deficit hyperactivity disorder: acute comparison and differential response. American Journal of Psychiatry; 165: 721–30.
Nissen, SE (2006) ADHD drugs and cardiovascular risk. New England Journal of Medicine; 354: 1445–8.
Prasad, S, Harpin, V, Poole, L et al (2007) A multi-centre, randomised, open-label study of atomoxetine compared with standard current therapy in UK children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Current Medical Research and Opinion; 23: 379–94.
Prasad, S, Steer, C (2008) Switching from neurostimulant therapy to atomoxetine in children and adolescents with attention-deficit hyperactivity disorder: clinical approaches and review of current available evidence. Pediatric Drugs; 10: 3947.
Rappley, MD, Moore, JW, Dokken, D (2006) ADHD drugs and cardiovascular risk. New England Journal of Medicine; 354: 2296.
Rapport, MD, Stoner, G, DuPaul, G et al (1985) Methylphenidate in hyperactive children: differential effects of dose on academic learning, and social behavior. Journal of Abnormal Child Psychology; 13: 227–43.
Rapport, MD, Denney, C (1997) Titrating methylphenidate in children with attention-defict/hyperactivity disorder: is body mass predictive of clinical response? Journal of the American Academy of Child and Adolescent Psychiatry; 36: 523–30.
Scottish Intercollegiate Guidelines Network (2005) Diagnosis and Management of Epilepsies in Children and Young People. SIGN.
Singer, H, Brown, J, Quaskey, S et al (1995) The treatment of attention deficit hyperactivity disorder in Tourette's syndrome: a double blind placebo-controlled study with clonidine and desimipramine. Pediatrics; 95: 7481.
Spencer, T, Biederman, J, Wilens, T et al (1993) Nortriptyline treatment of children with attention-deficit hyperactivity disorder and tic disorder or Tourette's syndrome. Journal of the American Academy of Child and Adolescent Psychiatry; 32: 205–10.
Spencer, T, Biederman, J, Heiligenstein, J et al (2001) An open-label dose ranging study of atomoxetine in children with attention deficit hyperactivity disorder. Journal of Child and Adolescent Psychopharmacology; 11: 251–65.
Spencer, TJ, Sallee, FR, Gilbert, DL et al (2008) Atomoxetine treatment of ADHD in children with comorbid Tourette syndrome. Journal of Attention Disorders; 11: 470–81.
Swanson, JM, Elliot, GR, Greenhill, LL et al (2007a) Effects of stimulant medication on growth rates across 3 years in the MTA follow up. Journal of the American Academy of Child and Adolescent Psychiatry; 46: 1015–27.
Swanson, JM, Hinshaw, SP, Arnold, LE et al (2007b) Secondary evaluations of the MTA 36-month outcomes: propensity score and growth mixture model analyses. Journal of the American Academy of Child and Adolescent Psychiatry; 46: 1003–14.
Tan, M, Appleton, R (2005) Attention deficit and hyperactivity disorder, methylphenidate, and epilepsy. Archives of Disease in Childhood; 90: 57–9.
Tourette's Syndrome Study Group (2002) Treatment of ADHD in children with tics: a randomized controlled trial. Neurology; 58: 527–36.
Vetter, VL, Elia, J, Erickson, C et al (2008) Cardiovascular monitoring of children and adolescents with heart disease receiving medications for attention deficit/hyperactivity disorder: a scientific statement from the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing. Circulation; 117: 2407–23.
Wernicke, JF, Holdridge, KC, Lin, J et al (2007) Seizure risk in patients with attention-deficit-hyperactivity disorder treated with atomoxetine. Developmental Medicine and Child Neurology; 49: 498502.
Wilens, TE (2004) Attention deficit/hyperactivity disorder and substance use disorders: the nature of the relationship, subtypes at risk and treatment issues. Psychiatric Clinics of North America; 27: 283301.
Wilens, T, McBurnett, K, Stein, M et al (2005) ADHD treatment with once-daily OROS methylphenidate: final results from a long-term open-label study. Journal of the American Academy of Child and Adolescent Psychiatry; 44: 1015–23.
Winterstein, AG, Gerhard, G, Shuster, J et al (2007) Cardiac safety of central nervous system stimulants in children with attention deficit/hyperactivity disorder. Pediatrics; 120: e1494501.
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Drug treatments for attention-deficit hyperactivity disorder in young people

  • Gordon Bates
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