Late Onset ADHD? Usually Not

Primary care clinicians who work with adolescents and adults are seeing increasing numbers of patients presenting for an ADHD evaluation in which the symptoms didn’t develop until later in childhood or even in adulthood.  These “late onset” cases have traditionally been viewed as being atypical, although there has not been a great deal of systematic […]

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Your ADHD Treatment Plan

When someone presents for evaluation and treatment of ADHD, what does your treatment plan look like?  Sure medications are often considered, and hopefully also some parent behavioral coaching too.  Anything else?   A new meta-analysis, recently published in the Journal of the American Academy of Child and Adolescent Psychiatry, provides some strong evidence about the […]

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Long Term Stimulant Treatment Associated with 1 inch Reduction in Height

When considering stimulant treatment for ADHD, one concern that is often voiced by parents is about height loss associated with long-term use.  Answering this question has been difficult, in part because the available literature has been inconsistent.  Some long term studies have shown no differences while other show reductions in over an inch. To help […]

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Higher Guanfacine Doses Found Effective for Adolescent ADHD

While stimulants generally remain first-line medication for ADHD, alternatives are often needed due to side effects or ineffectiveness.   Of the non-stimulant medications, guanfacine and its more recent extended release preparation (trade name Intuniv) is one possible alternative.  Current FDA guidelines specify 4mg per day as the maximum dose, although much of this recommendation is based on […]

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Very High Rates of Psychotic Symptoms Linked to Stimulant Medications

(Note: portions of this review were recently published in an article in Clinical Psychiatry News) While it is known that stimulant medications used to treat ADHD might occasionally to lead to psychotic symptoms, this side effect is considered to be rare and usually associated with either medication abuse or very high dosages.  A report just released today […]

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Autism Diagnosis Made Later For Children with ADHD

Autism and ADHD can share many common features, and both disorders are being diagnosed more frequently compared to previous decades.  Making matters more complicated is the accumulating evidence that the two disorders may share some underlying genetics and neurobiology.  While autism is optimally diagnosed when children are around two years of age, many are not […]

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Energy Drinks, Sugary Beverages, and ADHD Behaviors

As the Vermont legislature debates the possibility of a tax on sweetened beverages, a recent study from the journal Academic Pediatrics adds a new wrinkle to the discussion.  This paper looks not only at traditional sugary beverages like soda but also energy drinks, which are becoming increasingly popular among youth and contain high amounts of […]

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What Happened to Concerta?

There is quite a bit of confusion out there about the supply and availability of one of the staple ADHD medications, Concerta, which is the brand name of a long acting preparation of methylphenidate that uses a novel delivery system called OROS (Osmotic [Controlled] Release Oral [Delivery] System) to deliver the medication gradually throughout the […]

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ADHD as a Brain Maturation Delay

Despite a wealth of evidence, the diagnosis of ADHD remains controversial, particularly outside of the medical community.  Some research has suggested that ADHD might be better conceptualized as a delay in brain maturation rather than a “disease state” per se.   However, more research is needed to support this hypothesis. The brain imaging literature has increasingly […]

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How Well are ADHD Medications (or any Drug) Tested Prior to FDA Approval?

ADHD medications are some of the most common drugs given to children and adolescents. Most clinicians prescribe them within approved FDA indications.  Moreover, the existence of an FDA approval often provides some comfort to the prescribing clinician that the medication has received rigorous testing for efficacy and safety.  But has it?  A recent study in […]

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