Getting Help for Attention Deficit Disorder
ADHD Secrets Uncovered
Announcing an important message for parents. Has Your Child Been Diagnosed With ADHD Is Coping With Your Child's Behavior Wearing You Out Are You Tired of Searching For Answers
The term ADHD is not included in the ICD-10 but is comparable to the so-called hyperkinetic disorders which are represented in its various forms (either single or in combination with other disorders) in the F9x chapter of the ICD-10. The diagnosis of a hyperkinetic disorder requires severe symptoms of inattention (for example concentration problems), hyperactivity (for example extensive restlessness) and impulsivity (for example an inability to wait) for at least six months which are present in two separate contexts (e.g. at school and at home). Symptoms need to be present before the age of six (cf. Section 184.108.40.206).
Enhancement of sensory functions is well accepted because we usually presume that prosthetic interventions only improve natural functions or replace impaired functions without changing the personality. What about psychopharmacological agents changing attention and behaviour in school, school success etc. The use of stimulants in children and adolescents not only for the treatment of ADHD but also for cognitive enhancement during examination periods appears to be growing, especially in the United States (Fegert et al. 2002 McCabe et al. 2005). The President's Council on Bioethics in its study Beyond Therapy - Biotechnology and the Pursuit of Happiness summarises - Psychostimulants like Methylphenidate, Amphetamine and Modafinil are used for the treatment of children with attention deficit hyperactivity disorder.
Mal models but in real life situations, can answer these questions and provide a reliable evidence base for treatment decisions. In contrast, the current discussions of evidence based treatments centre on pharmaco-economic considerations with respect to effectiveness rather than to safety and not at all on long-term safety. It is clear that the industry has no direct motivation for studying the long-term safety of their compounds (Vitiello et al. 2004), particularly if they are being widely used. When drugs manufactured by different patent holders are combined, there are no commercial sponsors willing to study the consequences of the combinations. It is clear that the state or health insurance systems must sponsor research in this field in order to protect patients from risks of novel interventions. Another question that is related to the potential harm of stimulants is the question of whether the burden of illness justifies any pharmacological intervention. Comparing the diagnostic...
In contrast to safety issues, there is an overwhelming body of data proving the efficacy and even long-term effectiveness of stimulant use in ADHD. The effect sizes of stimulants for ADHD are high (larger than one) the numbers needed to treat are small, and placebo effects are also small for this indication. On the other hand, SSRIs are not only a problem because of the safety issues but especially because of a lack of superiority over placebo in many trials. Only Fluoxetine has proven consistently superior to placebo in all trials amongst children and adolescents with depression. Placebo rates are high in children with mild depression, which depression trials tend to study. That means that these children respond very well just to the attention of a study doctor and that sometimes the addition of medication may bring little benefit in comparison to this psychosocial effect. The lesson to learn from the SSRI debacle is that positive effects are usually over-reported and overestimated...
At first glance it may appear as if the acute drug challenge model has severe limitations for examining the effects of chronic drug changes. Such changes are of crucial importance for understanding receptor dynamics in situations often encountered clinically. Two important examples stand out. The first is the effects of chronic administration of antipsychotic medications in schizophrenic populations. Drugs such as haloperidol, olanzapine, or clozapine often require a period of time before attaining full efficacy. A second salient example comes from the study of chronic abusers of drugs such as cocaine or ecstasy. It is well known that abusers often experience a tolerance to the effects of these drugs, implying changes in receptor populations that modulate the pharmacology of the drug of abuse. Thus, it would appear as if the acute drug challenge may not provide an adequate model for examining receptor dynamics. However, there are many ways to construe the acute drug challenge model....
Growth and weight gain, activity pattern, psychosocial economic issues, smoking, medical history (celiac disease, nephropathy, hyperllpidemia, eating disorder, high blood pressure, asthma, attention deficit disorder, hypothyroidism, and other autoimmune diseases), insulin regimen, oral glucose-lowering medications, blood glucose monitoring schedule
We include this syndrome, though generally thought of as a condition of middle age, because it may present in childhood as an attention deficit disorder (95) and hence the possibility of misdiagnosis as absence epilepsy. Recognition is worthwhile as it tends to be exquisitely dopa sensitive (96). It is seen in children with leukemia, often as a consequence of chemothera-peutic agents, and in this situation may be responsive to benzodiazepines. In children with renal failure, it is important that iron deficiency is treated.
We urge the beginning of such a debate in both academia and society at large. It is especially necessary in light of the increasing exposure of children to cognition enhancing drugs, like Methylphenidate, which deeply influence the physical structure of the brain, as we are now well aware of. According to the legal standards sketched above, this current practice is, to a large extent, illicit. We believe that it is presently tolerated only on grounds of (1) collectively closing our eyes on the physical, viz. neuronal, effects of such drugs, and of (2) a tacitly growing medicalisation of heretofore normal, if unde-sired, variants of children's behaviour. The expansion of the concepts of both disease and treatment to include formerly normal mental features of children is problematic in various respects. It is reinforced by the conceptual vagueness of mental disease , which considerably exceeds definitional ambiguities in the purely somatic sphere. Is a fidgety child a milder case of...
Attention deficit-hyperactivity disorder (ADHD) is difficult to diagnose because many of its symptoms overlap or coexist with other behavioral disorders. ADHD commonly begins in childhood and is characterized by attention problems, easy boredom, impulsive behavior, and hyperactivity. ADHD has been correlated with alterations from the norm in brain structure and metabolism. It is treated with stimulant drugs, primarily methylphenidate (Ritalin).
Treatment decisions in children are always difficult because the standard dyadic relationship in the informed consent contract between patient (who gives informed consent) and physician (who provides information and offers the medication) is replaced by a triangulated relationship between parent(s), doctor, and child. This can lead to some complications. For example, in the case of stimulant treatment of preschool or primary school children with ADHD, the child does not usually see a problem from his or her perspective, but the parents and teachers do. They want the child's behaviour to change. Parents may decide that the child should take pills to reduce educational conflicts. At the same time it is these parents who both define the problem and give consent on their child's behalf. Could they really represent the child's wishes and his or her best interests in that case Classically, many patients with ADHD stop medication when they reach the age of puberty
The example of stimulant treatment of attention deficit hyperactivity disorder and the possible use of stimulants for enhancement served to underline that psychopharmacological interventions can be applied not only for treatment but also for enhancement purposes. Reliable diagnostic instruments are urgently needed to distinguish between healthy people, who want to enhance their normal cognitive functions, and people suffering from a cognitive deficit or, more general, from a condition that can be regarded a psychiatric disease or disorder.
Either CPSs or true absence can be accompanied by automatisms such as eye fluttering, lip smacking, or hand wringing (72,74). In children, these epileptic seizures, especially absence, may be difficult to distinguish from lapses of attention commonly seen with attention deficit disorders (ADD ADHD).
Amphetamines are used to manage attention deficit hyperactivity disorder (ADHD) in children. Children with this disorder exhibit a short attention span, hyper-activity, impulsiveness, and emotional lability. The condition is more prevalent in boys than in girls and poses a problem with school and learning, although these children are usually of normal or above average intelligence. How amphetamines, which are CNS stimulants, calm the hyperactive child is unknown. These drugs reduce motor restlessness, increase mental alertness, provide mood elevation, produce a mild sense of euphoria, and reduce the sense of fatigue. In addition to taking a CNS stimulant, the child with ADHD may also need psy-chotherapeutic counseling.
Eight-year-old Sarah was brought to the Behavioral Paediatrics Program Clinic for 'behavior problems'. These included picking on her 7-year-old sister and 5-year-old brother, disruptive behaviors at after-school day care, and defiance and anger outbursts almost daily in interactions with parents. She met criteria for a diagnosis of Oppositional Defiant Disorder, and had no ADHD or learning difficulties. Therapy for Sarah and her family included primarily behavioral management including family meetings and negotiation. For her angry outbursts, Sarah was taught self-hypnosis which included
Some conditions previously regarded as diseases are now thought of as normal states of the mind or body. Others that were previously perceived as variations of normality are now regarded as diseases. Homosexuality is an example of the former, attention deficit hyperactivity disorder of the latter. (Hansson 2005)