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what is DSM IV criteria for Dx
- must meet >6 symptoms of impulsivity, inattention, and or hyperactivity
- impair social, academic or occupational function
- rule out other psych illnesses
- usually symptoms present before 6, dx between 6-7 involves 2 environments
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what are benefits of psyhchostimulants
- increased attention span
- decreased hyperactivity
- improved impulse control
- social benefits
- emotional stability
- improved motor skils
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what are adverse effects of psychostimulants
- appetite suppression
- cardiovascular
- insomnia
- headach
- nausea
- tics
- LESS COMMON--anxiety, mood changs, increased irritbaility, growth stunting not clinically significant
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what is good about once a day dosing
- improved compliance
- decreased interuptions during school
- decreaed involvment of school personel
- some patients require additional symptomcoverage with short acting formulations
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whats a non stimulant option for adhd
- atomoxetine--stratera
- ne reuptake inhibitor
- caution with renal/hepatic impairment
- ADRs--ha insomnia, gi xerostomia
- 4-6 weeks for max response
-
what are alpha 2 agonists pharamcotheapy for adhd
- clonidine or guanfacine
- decresases ne which may target impulsive behavior
- onset 2-4 weeks sedation with clonidine>guanfacine, titration of dose to multiple doses per day, usually start at bedtime nd increase slowly
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what do you use alpha 2 agonsists for
- tourette syndrom,
- aggressive syndrom
- adhd--decrese motor activity and arousal, less effect on inattention
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adverse effects of alpha two agonists
- drowsiness
- dry mouth
- hypotension
- bradycardia
- dizziness
- depression
- reboudn hypertension if stopped abrubtly
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