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Attention deficit hyperactivity disorder: An update

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Abstract

Attention deficit hyperactivity disorder (ADHD) is the most common neurobehavioral disorder, affecting 3% to 5% of school-aged children. Of the 3 subtypes—predominantly inattentive, predominantly hyperactive/impulsive, and a combined subtype—the latter is the most commonly represented group, accounting for 50% to 70% of all ADHD individuals. Stimulant medication is the cornerstone of management; however, stimulants with a short duration of action have been problematic for some patients. Recent technologic advances in delivery systems offer many patients the option of a once-daily dosage.

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References

  1. American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders. 4th ed (text rev), DSM-IV-TR™. Washington, DC: American Psychiatric Association; 2000:85–93.

    Google Scholar 

  2. Leung AK, Robson WL, Fagan JL, et al. Attention-deficit hyperactivity disorder: getting control of impulsive behavior.Postgrad Med. 1994;95:153–160.

    PubMed  CAS  Google Scholar 

  3. Guevara JP, Stein MT. Evidence based management of attention hyperactivity disorder.BMJ. 2001;323:1232–1235.

    Article  PubMed  CAS  Google Scholar 

  4. Leung AK, Lemay JF. How to treat patients with ADHD.Can J Diagn. 2002;19:97–110.

    Google Scholar 

  5. Brown RT, Freeman WS, Perrin JM, et al. Prevalence and assessment of attention-deficit/hyperactivity disorder in primary care settings.Pediatrics. 2001;107:e43.

    Article  PubMed  CAS  Google Scholar 

  6. Kirby K, Floriani V, Bernstein H. Diagnosis and management of attention-deficit/hyperactivity disorder in children.Curr Opin Pediatr. 2001;13:190–199.

    Article  PubMed  CAS  Google Scholar 

  7. Szymanski ML, Zolotor AL. Attention-deficit/hyperactivity disorder: management.Am Fam Physician. 2001;64:1355–1362.

    PubMed  CAS  Google Scholar 

  8. Buttross SL. Attention deficit-hyperactivity disorder and its deceivers.Curr Probl Pediatr. 2000;30:37–50.

    Article  PubMed  CAS  Google Scholar 

  9. Dunne JE. Attention-deficit/hyperactivity disorder and associated childhood disorders.Prim Care. 1999;26:349–372.

    PubMed  CAS  Google Scholar 

  10. DiScala C, Lescohier I, Barthel M, et al. Injuries to children with attention deficit hyperactivity disorder.Pediatrics. 1998;102:1415–1421.

    Article  PubMed  CAS  Google Scholar 

  11. Lou HC. Etiology and pathogenesis of attention-deficit hyperactivity disorder (ADHD): significance of prematurity and perinatal hypoxic-haemodynamic encephalopathy.Acta Paediatr. 1996;85:1266–1271.

    Article  PubMed  CAS  Google Scholar 

  12. Schweitzer JB, Cummins TK, Kant CA. Attention-deficit/hyperactivity disorder.Med Clin North Am. 2001;85:757–777.

    Article  PubMed  CAS  Google Scholar 

  13. Taylor MA. Evaluation and management of attention-deficit hyperactivity disorder.Am Fam Physician. 1997;55:887–901.

    PubMed  CAS  Google Scholar 

  14. Goldman LS, Genel M, Bezman RJ, et al. Diagnosis and treatment of attention-deficit/hyperactivity disorder in children and adolescents.JAMA. 1998;279:1100–1107.

    Article  PubMed  CAS  Google Scholar 

  15. Barr CL, Wigg KG, Bloom S, et al. Further evidence from haplotype analysis for linkage of the dopamine D4 receptor gene and attention-deficit hyperactivity disorder.Am J Med Genet. 2000;96:244–250.

    Article  Google Scholar 

  16. Comings DE, Gonzalez N, Wu S, et al. Studies of the 48 bp repeat polymorphism of the DRD4 gene in impulsive, compulsive, addictive behaviors: Tourette Syndrome, ADHD, pathological gambling, and substance abuse.Am J Med Genet. 1999;88:358–368.

    Article  PubMed  CAS  Google Scholar 

  17. Wilens TE, Biederman J, Spencer TJ. Attention deficit/hyperactivity disorder across the lifespan.Ann Rev Med. 2002;53:113–131.

    Article  PubMed  CAS  Google Scholar 

  18. Mercugliano M. What is attention-deficit/hyperactivity disorder?Pediatr Clin North Am. 1999;46:831–843.

    Article  PubMed  CAS  Google Scholar 

  19. Simms MD. Attention deficit hyperactivity disorder. In: Behrman RE, Kleigman RM, Jenson HB, eds.Nelson Textbook of Pediatrics. Philadelphia, Pa: W.B. Saunders; 2004:107–110.

    Google Scholar 

  20. Filipek PA, Semrud-Clikeman M, Steingard RJ, et al. Volumetric MRI analysis comparing subjects having attention-deficit hyperactivity disorder with normal controls.Neurology. 1997;48:589–601.

    PubMed  CAS  Google Scholar 

  21. Hynd GW, Hern KL, Novey ES, et al. Attention deficit hyperactivity disorder and asymmetry of the caudate nucleus.J Child Neurol. 1993;8:339–347.

    PubMed  CAS  Google Scholar 

  22. Mostofsky S, Reiss AL, Lockhart P, et al. Evaluation of cerebellar size in attention-deficit hyperactivity disorder.J Child Neurol. 1998;13:434–439.

    PubMed  CAS  Google Scholar 

  23. Zametkin AJ, Liebenaurer LL, Fitzgerald GA, et al. Brain metabolism in teenagers with attention-deficit hyperactivity disorder.Arch Gen Psychiatry. 1993;50:333–340.

    PubMed  CAS  Google Scholar 

  24. Ernst M, Zametkin AJ, Matochik JA, et al. DOPA decarboxylase activity in attention deficit hyperactivity disorder adults: a [fluorine-8] fluorodopa positron emission tomographic study.J Neurosci. 1998;18:5901–5907.

    PubMed  CAS  Google Scholar 

  25. Dougherty DD, Bonab AA, Spencer TJ, et al. Dopamine transporter density in patients with attention deficit hyperactivity disorder.Lancet. 1999;354:2132–2133.

    Article  PubMed  CAS  Google Scholar 

  26. McGough JJ, McCracken JT. Assessment of attention deficit hyperactivity disorder: a review of recent literature.Curr Opin Pediatr. 2000;12:319–324.

    Article  PubMed  CAS  Google Scholar 

  27. Morgan A, Hynd G, Riccio C, et al. Validity of DSM-IV ADHD predominantly inattentive and combined types: relationship to previous DSM diagnosis/subtype differences.J Am Acad Adolesc Psychiatry. 1996;35:325–333.

    Article  CAS  Google Scholar 

  28. Hechtman L. Assessment and diagnosis of attention-deficit/hyperactivity disorder.Child Adolesc Psychiatr Clin North Am. 2000;9:481–498.

    CAS  Google Scholar 

  29. Jensen PS, Martin BA, Cantwell DP. Comorbidity in ADHD: implications for research, practice, and DSM-IV.J Am Acad Child Adolesc Psychiatry. 1997;36:1065–1079.

    PubMed  CAS  Google Scholar 

  30. Owens JA, Maxim R, Nobile C, et al. Parental and self-report of sleep in children with attention-deficit/hyperactivity disorder.Arch Pediatr Adolesc Med. 2000;154:549–555.

    PubMed  CAS  Google Scholar 

  31. Robson WL, Jackson HP, Blackhurst D, Leung AK. Enuresis in children with attention-deficit hyperactivity disorder.South Med J. 1997;90:503–505.

    PubMed  CAS  Google Scholar 

  32. Heffron WM, Martin CA, Welsh RJ, et al. Hyperactivity and child abuse.Can J Psychiatry. 1987;32:384–386.

    PubMed  CAS  Google Scholar 

  33. Hechtman L, Weiss G. Controlled prospective fifteen year follow-up of hyperactives as adults: non-medical drug and alcohol use and anti-social behavior.Can J Psychiatry. 1986;31:557–567.

    PubMed  CAS  Google Scholar 

  34. Barkley RA, Murphy KR, Kwasnik D. Motor vehicle driving competencies and risks in teens and young adults with attention deficit hyperactivity disorder.Pediatrics. 1996;98:1089–1095.

    PubMed  CAS  Google Scholar 

  35. Levy F, Ward PB. Neurometrics, dynamic brain imaging and attention deficit hyperactivity disorder.J Paediatr Child Health. 1995;31:279–283.

    PubMed  CAS  Google Scholar 

  36. American Academy of Pediatrics, Committee on Quality Improvement and Subcommittee on Attention-Deficit/Hyperactivity Disorder. Clinical practice guidelines: treatment of the school-aged child with attention deficit/hyperactivity disorder.Pediatrics. 2001;108:1033–1044.

    Article  Google Scholar 

  37. MTA Cooperative Group. Moderators and mediators of treatment response for children with attention-deficit/hyperactivity disorder: the multimodal treatment study of children with ADHD.Arch Gen Psychiatry. 1999;56:1088–1096.

    Article  Google Scholar 

  38. Efron D, Jarman F, Barker M. Side effects of methylphenidate and dextroamphetamine in children with attention deficit hyperactivity disorder: a double-blind, crossover trial.Pediatrics. 1997;100:662–666.

    Article  PubMed  CAS  Google Scholar 

  39. Valentine J, Zubrick S, Sly P. National trends in the use of stimulant medication for attention deficit hyperactivity disorder.J Paediatr Child Health. 1996;32:223–227.

    PubMed  CAS  Google Scholar 

  40. Barkley RA, Murphy JV. Treating attention-deficit hyperactivity disorder: medication and behavior management training.Pediatr Ann. 1991;20:256–266.

    PubMed  CAS  Google Scholar 

  41. Elia J, Ambrosini PF, Rapoport JL. Treatment of attention-deficit-hyperactivity disorder.N Engl J Med. 1999;340:780–788.

    Article  PubMed  CAS  Google Scholar 

  42. Wolraich ML, Baumgaertel A. The practical aspects of diagnosing and managing children with attention deficit hyperactivity disorder.Clin Pediatr. 1997;36:497–504.

    Article  CAS  Google Scholar 

  43. Greenhill LL, Findling RL, Swanson JM, et al. A double-blind, placebo-controlled study of modified-release methylphenidate in children with attention-deficit/hyperactivity disorder.Pediatrics. 2002;109:e39.

    Article  PubMed  Google Scholar 

  44. Pelham WE, Gnagy EM, Burrows-Maclean L, et al. Once-a-day Concerta methylphenidate versus three-times-daily methylphenidate in laboratory and natural settings.Pediatrics. 2001;107:e105.

    Article  PubMed  CAS  Google Scholar 

  45. Wilens T, Pelham W, Stein M, et al. ADHD treatment with once-daily OROS methylphenidate: interim 12-month results from a long-term open-label study.J Am Acad Child Adolesc Psychiatry. 2003;42:424–433.

    Article  PubMed  Google Scholar 

  46. Wolraich ML, Greenhill LL, Pelham W, et al. Randomized controlled trial of OROS methylphenidate once a day in children with attention-deficit/hyperactivity disorder.Pediatrics. 2001;108:883–892.

    Article  PubMed  CAS  Google Scholar 

  47. Adesman AR. New medications for treatment of children with attention-deficit/hyperactivity disorder: review and commentary.Pediatr Ann. 2002;31:514–522.

    PubMed  Google Scholar 

  48. Auiler JF, Liu K, Lynch JM, et al. Effect of food on early drug exposure from extended-release stimulants: results from the Concerta, Adderall XR food evaluation (CAFÉ) study.Curr Med Res Opin. 2002;18:311–316.

    Article  PubMed  CAS  Google Scholar 

  49. Dirksen SJ, D’Imperio JM, Birdsall D, et al. A postmarketing clinical experience study of Metadate CD.Curr Med Res Opin. 2002;18:371–380.

    Article  PubMed  CAS  Google Scholar 

  50. Biederman J, Lopez FA, Boellner SW, et al. A randomized, double-blind, placebo-controlled, parallel-group study of SL1381 (Adderall XR) in children with attention-deficit/hyperactivity disorder.Pediatrics. 2002;110:258–266.

    Article  PubMed  Google Scholar 

  51. McCough JJ, Biederman J, Greenhill LL, et al. Pharmacokinetics of SL1381 (Adderall XR), an extended-release formulation of Adderall.J Am Acad Child Adolesc Psychiatry. 2003;42:684–691.

    Article  Google Scholar 

  52. McCracken JT, Biederman J, Greenhill LL, et al. Analog classroom assessment of a once-daily mixed amphetamine formulation, SL1381 (Adderall XR), in children with ADHD.J Am Acad Child Adolesc Psychiatry. 2003;42:673–683.

    Article  PubMed  Google Scholar 

  53. Adesman AR, Morgan AM. Management of stimulant medications in children with attention-deficit/hyperactivity disorder.Pediatr Clin North Am. 1999;46:945–963.

    Article  PubMed  CAS  Google Scholar 

  54. Rasbury WC. Attention deficit disorder: an overview.Henry Ford Hosp Med J. 1988;36:212–216.

    PubMed  CAS  Google Scholar 

  55. Mannuzza S, Klein RG, Bonagura N, et al. Hyperactive boys almost grow up: V. Replication of psychiatric status.Arch Gen Psychiatry. 1991;48:77–83.

    PubMed  CAS  Google Scholar 

  56. Zametkin AJ, Ernst M. Problems in the management of attention-deficit-hyperactivity disorder.N Engl J Med. 1999;340:40–46.

    Article  PubMed  CAS  Google Scholar 

  57. Tan G, Schneider SC. Attention-deficit hyperactivity disorder: pharmacotherapy and beyond.Postgrad Med. 1997;101:201–222.

    PubMed  CAS  Google Scholar 

  58. Biederman J, Baldessarini RJ, Wright V, et al. A double-blind placebo-controlled study of desipramine in the treatment of ADHD: I. Efficacy.J Am Acad Child Adolesc Psychiatry. 1989;28:777–784.

    Article  PubMed  CAS  Google Scholar 

  59. Hunt RD, Paguin A, Payton K. An update on assessment and treatment of complex attention-deficit hyperactivity disorder.Pediatr Ann. 2001;30:162–172.

    PubMed  CAS  Google Scholar 

  60. Reitz SJ. Attention-deficit/hyperactivity disorder: focus on pharmacologic management.J Pediatr Health Care. 1997;11:78–83.

    Article  PubMed  CAS  Google Scholar 

  61. Riddle MA, Geller B, Ryan N. Another sudden death in a child treated with desipramine.J Am Acad Child Adolesc Psychiatry. 1993;32:792–797.

    Article  PubMed  CAS  Google Scholar 

  62. Snyder R, Turgay A, Aman M, et al. Effects of risperidone on conduct and disruptive behavior disorders in children with subaverage IQ.J Am Acad Child Adolesc Psychiatry. 2002;41:1026–1036.

    Article  PubMed  Google Scholar 

  63. Szymanski ML, Zolotor A. Attention-deficit/hyperactivity disorder: management.Am Fam Physician. 2001;64:1355–1362.

    PubMed  CAS  Google Scholar 

  64. Turgay A, Binder C, Snyder R, et al. Long-term safety and efficacy of risperidone for the treatment of disruptive behavior disorders in children with subaverage IQ.Pediatrics. 2002;110:e34.

    Article  PubMed  Google Scholar 

  65. Pliszka SR, Greenhill LL, Crismon ML, et al. The Texas Children’s Medication Algorithm Project: Report of the Texas Consensus Conference Panel on medication treatment of childhood attention-deficit/hyperactivity disorder. Part 1.J Am Acad Child Adolesc Psychiatry. 2000;39:908–919.

    Article  PubMed  CAS  Google Scholar 

  66. Canadian Pediatric Society, Mental Health Committee. Use of methylphenidate for attention deficit hyperactivity disorder.Can Med Assoc J. 1990;142:817–818.

    Google Scholar 

  67. Safer DJ. Major treatment considerations for attention-deficit hyperactivity disorder.Curr Probl Pediatr. 1995;25:137–143.

    Article  PubMed  CAS  Google Scholar 

  68. Leung AK, Robson WL, Lim SH. Counseling parents about childhood discipline.Am Fam Physician. 1992;45:1185–1190.

    PubMed  CAS  Google Scholar 

  69. Baumgaertel A. Alternative and controversial treatments for attention-deficit/hyperactivity disorder.Pediatr Clin North Am. 1999;46:977–992.

    Article  PubMed  CAS  Google Scholar 

  70. Burgess JR, Stevens L, Zhang W, et al. Long-chain polyunsaturated fatty acids in children with attention-deficit hyperactivity disorder.Am J Clin Nutr. 2000;71:S327-S330.

    Google Scholar 

  71. Stevens LJ, Zentall SS, Deck JL, et al. Essential fatty acid metabolism in boys with attention-deficit hyperactivity disorder.Am J Clin Nutr. 1995;62:761–768.

    PubMed  CAS  Google Scholar 

  72. Boyd WD, Campbell SE. EEG biofeedback in the schools: the use of EEG biofeedback to treat ADHD in a school setting.J Neurother. 1998;2:65–71.

    Article  Google Scholar 

  73. Linden M, Gevirtz R, Isenhart R, et al. Event related potentials of subgroups of children with attention deficit hyperactivity disorder and the implications for EEG biofeedback.J Neurother. 1996;1:1–11.

    Article  Google Scholar 

  74. Baydala L, Wikman E. The efficacy of neurofeedback in the management of children with attention deficit/hyperactivity disorder.Paediatr Child Health. 2001;6:451–455.

    CAS  PubMed  Google Scholar 

  75. Voigt RG, Llorenta AM, Jensen CL, et al. A randomized, double-blind, placebo-controlled trial of docosachexaenoic acid supplementation in children with attention-deficit/hyperactivity disorder.J Pediatr. 2001;139:189–196.

    Article  PubMed  CAS  Google Scholar 

  76. Robin AL. Attention-deficit/hyperactivity disorders in adolescents: common pediatric concerns.Pediatr Clin North Am. 1999;46:1027–1038.

    Article  PubMed  CAS  Google Scholar 

  77. Swanson JM, Sergeant JA, Taylor E. Attention-deficit hyperactivity disorder and hyperkinetic disorder.Lancet. 1998;351:429–433.

    Article  PubMed  CAS  Google Scholar 

  78. Hechtman L. Predictors of long-term outcome in children with attention-deficit/hyperactivity disorder.Pediatr Clin North Am. 1999;46:1039–1052.

    Article  PubMed  CAS  Google Scholar 

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  1. Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada

    Alexander K. C. Leung MBBS, FRCPC & Jean François Lemay MD, FRCPC

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Leung, A.K.C., Lemay, J.F. Attention deficit hyperactivity disorder: An update. Adv Therapy 20, 305–318 (2003). https://doi.org/10.1007/BF02849796

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