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 […]
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 […]
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 […]
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 […]
Tags: add, adhd, guanfacine, intuniv
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 […]
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 […]
Tags: add, adhd, concerta, methylphenidate, ritalin
ADHD Medications and School Performance
The Wall Street Journal recently published an article casting doubt about the ability of ADHD medications to improve school grades and achievement. Actually, casting doubt might be a little soft as the title was “ADHD Drugs Don’t Boost Grades.” In the article, the author runs through a number of studies (some not published) that find […]
Tags: add, adhd, grades, school performance
Who Should Evaluate and Treat ADHD? The AAP’s Nudge
In October, the journal Pediatrics, based right here in Vermont, published updated guidelines from the American Academy of Pediatrics (AAP) regarding the assessment and treatment of ADHD. Since its publication, what has clearly generated the most media discussion about these new guidelines is the inclusion of preschool children (age 4 and above) in the recommendations. […]
Tags: add, adhd, mental health, psychiatry
New NEJM Study Shows No Increased Cardiovascular Risk with ADHD Medications
by John Koutras, MD The use of ADHD drugs was not associated with an increased risk of serious cardiovascular events in children and young adults. This was the overall finding of a new study published in the New England Journal of Medicine. ADHD medications are prescribed for more than 2.7 million children in the US […]