What are ADHD symptoms and treatment options for ADHD? - New Age Psychiatry

What are ADHD symptoms and treatment options for ADHD?

What are ADHD symptoms and treatment options?

ADHD Symptoms

New Age Psychiatry offers ADHD treatment in Fort Lauderdale, FL and all over the state of Florida. We will talk about what is ADHD is and how to get ADHD treatment in Fort Lauderdale.

  • ADHD symptoms or attention deficit disorder appears to be due to alteration in dopaminergic activity to the prefrontal cortex (PFC)
    • PFC is critical in regulating behavior, attention, and cognition.
    • Lesions to PFC can lead to symptoms such as distractibility, forgetfulness, impulsivity, poor planning, and locomotor hyperactivity (all prominent in ADHD)
    • PFC requires optimal levels of norepinephrine and dopamine for regulation and function (ADHD, 2017).
  • According to the CDC treatment options for adhd include stimulants which work to augment or increase deficient dopaminergic (or norepinephrine) systems.

Dopamine’s Implications on ADHD symptoms

  • In addition to its involvement in the PFC, dopamine is also a major transmitter in the nucleus accumbens (NAc), a major area for pleasure and reward in the brain.
  • Dopamine augmentation in the NAc by stimulants likely accounts for the emotional stimulation, pleasure response, and attractiveness of these drugs that leads to compulsive abuse (ADHD, 2017).
     ADHD IN CHILDHOOD     ADHD IN ADOLESCENSE    ADHD IN ADULTHOOD
Hyperactivity Easily distracted/Inattentive Inattentiveness
Low Frustration Tolerance Easily Bored Poor organization of time and money
Aggression Impatience Missing deadlines or appointments
Easily Distracted Emotionally immature compared to peers Poor bill tracking
Difficulty Developing Routines Shifts activities Restlessness
Impulsiveness Poor driving Reactive anxiety or depression

Stimulant Options for ADHD symptoms

  • Stimulant medication is one of the most broadly effective drug therapies
  • 60-80% of children and adults with ADHD show improved impulsivity and learning ability
  • Stimulants alone often make little or no improvement in functional impairments, collaboration with other mental health or educational services is warranted to implement behavior modification such as a therapist with specialized training in ADHD (Nylander, 2021).
  • Short vs Long Acting Stimulant Medications for the treatment of ADHD or ADD symptoms
    • Requires trial and error for the best tolerated and most effective treatment for ADHD (ADHD, 2017).
    • Typically adults with ADHD or ADD prefer long acting medications such as Adderall XR due to the slower release, often not experiencing as significant “crash feeling”.
    • Short acting medications require being taken twice a day due to the short half-life of the medication (ADHD, 2017).
    • Some treatment plans include use of a single medication but taken in two different types of pills; a combination of both a long-acting medication and short acting medication.

Considerations or Side Effects of Stimulants

  • Potential considerations in adults
    • New/worsening behavior and thoughts
    • New/worsening bipolar illness
    • New/worsening aggressive or hostility problems
    • Unmasks tic disorder or neurological symptoms
    • Cardiac complications or even death
  • Potential Considerations in children
    • New/worsening behavior and thoughts
    • New/worsening bipolar illness
    • New/worsening aggressive or hostility problems
    • Unmasks tic disorder
  • In children and teenagers: new psychiatric symptoms
    • Depression, anxiety, hyperactivity, mood swings, insomnia, worsening of ADHD symptoms
  • Potential to cause psychosis and aggression
    • Unlikely or rare, typically aggression or anxiety may be caused by taking too high of a dose of a stimulant.
  • Worsening or new-onset Tourette’s or tic disorders
    • Methylphenidate may decrease the incidence
  • Seizures
    • Simulants may lower seizure threshold
    • Stimulants are often avoided in patients with underlying seizure or other neurological disorder

Proven Benefit of Stimulants for ADHD or ADD Adults

  • Do ADHD adults do better on medication?
    • 5 year follow up study concluded a benefit in symptom control from prior to treatment for ADHD symptoms (Nylander, 2021)
    • Concluded that stimulant treatment decreased the risk for subsequent comorbid psychiatric disorders (Nylander, 2021)

Effective Medications for ADHD

  • Stimulants: Methylphenidate, Amphetamines
  • Atomoxetine
  • Alpha agonists
  • Guanfacine extended release (GXR) (Intuniv)
  • Clonidine extended release (Capvey)
  • Combinations therapy: alpha agonists & stimulants
  • Antidepressants (no FDA approval): bupropion & TCA
  • Modafinil (efficacy data; no FDA approval)

C. F. (2017). ADHD, Treatment, Medication, Neuroimaging, Psychopharmacology. Journal of Developmental & Behavioral Pediatrics, 38(9), 775.

Nylander, E., Floros, O., Sparding, T., Rydén, E., Hansen, S., & Landén, M. (2021). Five‐year outcomes of ADHD diagnosed in adulthood. Scandinavian Journal of Psychology, 62(1), 13–24. https://doi.org/10.1111/sjop.12692