Attention Deficit/Hyperactive Disorder (ADHD)

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Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common childhood-onset psychiatric conditions, occurring in 5% of children. ADHD can persist into adulthood affecting behaviour and development. ADHD is extensively studied and ADHD literature is plentiful, however, ADHD pathophysiology is still not completely known. The lack of a direct cause and mechanism of disease complicates treatment for many individuals. Finding an ideal treatment is often the result of a “trial and error” process. The current understanding of ADHD and the use of stimulant medications as treatment is presented.
DESCRIPTION
Attention Deficit/Hyperactivity Disorder (ADHD) is a disorder that affects the brain, causing structural and functional abnormalities1
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However, as Rastmanesh’s review article states, “DA-deficit theory of ADHD is insufficient to cover critical aspects of ADHD pathology and medication”.9 Further research has also indicated that other neurotransmitter systems such as the adrenergic, serotoninergic, nicotinergic and cholinergic systems may be involved.10
The accepted disease mechanism of ADHD among most researchers is low levels of dopamine.11 Dopamine pathways are directly responsible for cognitive control of behaviour, motivation, reward perception and motor function, collectively called “executive functions”.12 Dopamine is a neurotransmitter that sends signals between nerve cells, a deficiency results in impaired signals and thus impaired cognitive control, specifically the executive function, causing the symptoms of
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There are several cases under which stimulants are contraindicated. Due to the nature of stimulants and possible side effects, patients with any of the following conditions should not use stimulants as a treatment: history of alcoholism/substance abuse, anxiety, arteriosclerosis, cardiac disease, glaucoma, allergies (to methylphenidate, amphetamine or fructose/glucose/galactose/sucrose intolerance or deficiencies), hyperthyroidism or Tourette’s syndrome.16
The prognosis for ADHD is commonly very positive. Although no cure exists for ADHD, those affected can take advantage of the wide range of treatments including: medication, behavioural therapy and creating a structured school/home life. Those affected by ADHD often learn how to best live with their disease and accommodate as they mature.16
ALTERNATIVE

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