Stimulant treatment for children and adolescents with ADHD - An update on efficacy and safety issues

2011 ◽  
Vol 26 (S2) ◽  
pp. 2144-2144
Author(s):  
T. Banaschewski
Keyword(s):  
Children And Adolescents ◽  
Pharmacological Treatment ◽  
Treatment Plan ◽  
Comprehensive Treatment ◽  
Efficacy And Safety ◽  
Pharmacological Management ◽  
Stimulant Treatment ◽  
Safety Issues ◽  
Group A ◽  
Long Acting

Pharmacological management for children and adolescents with ADHD should be part of a comprehensive treatment plan including psychological, behavioural, and educational advice and interventions. If pharmacological treatment is appropriate, stimulant medications and atomoxetine are the most effective medications for ADHD. The European ADHD Guidelines Group (a panel of ADHD experts from several European countries) has developed guidelines for the diagnosis and treatment of ADHD and published algorithms on the use of long-acting medications. Recently, the Guidelines Group has conducted a comprehensive review of the published literature on adverse effects of the drugs that are licensed in Europe, and most commonly used, for the treatment of ADHD or hyperkinetic disorder. This presentation will summarize those results and give an update on efficacy and safety issues concerning the pharmacological treatment of children and adolescents with ADHD.

scholarly journals Effectiveness and Tolerability of Methylphenidate in Children and Adolescents with Attention Deficit Hyperactivity Disorder

2011 ◽  
Vol 3 ◽  
pp. CMT.S6615
Author(s):  
Caroline Bodey
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Side Effects ◽  
Children And Adolescents ◽  
Attention Deficit ◽  
Treatment Plan ◽  
Immediate Release ◽  
Height Velocity ◽  
Comprehensive Treatment ◽  
Hyperactivity Disorder ◽  
Cardiovascular Side Effects

Attention deficit hyperactivity disorder (ADHD) is a common condition and important for the affected individual, their family and society. It manifests with pervasive symptoms of hyperactivity, impulsivity and inattention. In many children with ADHD these symptoms persist into adolescence and adulthood. Drug treatment with psychostimulants, including methylphenidate, is an important part of a comprehensive treatment plan for children with severe ADHD that includes psychosocial, behavioural and educational advice and interventions. Methylphenidate is a central nervous system stimulant, whose mechanism of action is thought to be due to an increase in catecholamines in areas of the brain concerned with motivation and reward. Methylphendiate is available in short acting (immediate release) and longer acting (modified release) forms. Pharmacotherapy for ADHD is in three stages: initiation, maintenance and termination. The efficacy of methylphenidate in terms of reducing core symptoms is 70% as compared to placebo. This efficacy is maintained for at least 24 months. Methylphenidate generally has a favourable side effect profile. The most significant side effects include appetite suppression with an initial deceleration in height velocity, cardiovascular side effects that are not clinically significant in children with no adverse cardiac history, and tics. Methylphenidate is generally well tolerated and liked by children and adolescents with ADHD, who appreciate the benefits that medication has on their behaviour.

ADHD treatment

2018 ◽  
Author(s):  
Alessandro Zuddas ◽  
Tobias Banaschewski ◽  
David Coghill ◽  
Mark A. Stein
Keyword(s):  
Treatment Plan ◽  
Symptom Improvement ◽  
Comprehensive Treatment ◽  
Short Term ◽  
Serious Adverse Events ◽  
Stimulant Treatment ◽  
Medication Treatment ◽  
Adhd Treatment ◽  
Adolescents And Adults

Stimulants are effective medications and should be used as one of the main pharmacological options for the management of ADHD in children, adolescents, and adults. They all inhibit catecholamine uptake, but they differ for specific aspects of the mechanism of action, pharmacokinetics, as well as on efficacy for specific patients. Short-term efficacy in reducing ADHD symptoms is well established, as is the safety profile for these agents. There is increasing evidence that ADHD symptom improvement generally translates or corresponds to improved functioning and quality of life. Stimulant treatment should be based on a comprehensive assessment and diagnosis, including full medical history and physical examination, and it should always be part of a comprehensive treatment plan that includes psychological, behavioural, and educational advice and interventions. Medication treatment should be closely monitored for both common and unusual (but potentially serious) adverse events.

Pharmacological treatment of sex offenders

2016 ◽  
Vol 33 (S1) ◽  
pp. S43-S43
Author(s):  
F. Thibaut
Keyword(s):  
Sex Offenders ◽  
Sexual Violence ◽  
Pharmacological Treatment ◽  
Treatment Plan ◽  
Comprehensive Treatment ◽  
Gnrh Analogue ◽  
Gnrh Analogues ◽  
Competing Interest ◽  
Serial Rapists ◽  
And Behavior

Most people recognize that incarceration alone will not solve sexual violence. Indeed, treating the offenders is critical in an approach to preventing sexual violence and reducing victimization. In most cases, a diagnosis of paraphilia is associated with sexual violence. This review is intended to present and summarize the first recently published international guidelines about pharmacological treatment of paraphilias. Pharmacological interventions should be part of a more comprehensive treatment plan including psychotherapy and, in most cases, behavior therapy. Antiandrogens, and mostly GnRH analogues, significantly reduce the intensity and frequency of deviant sexual arousal and behavior. GnRH analogue treatment constitutes the most promising treatment for sex offenders at high risk of sexual violence, such as pedophiles or serial rapists, however informed consent is necessary. SSRIs remain an interesting option in adolescents, in patients with depressive or OCD disorders, or in mild paraphilias such as exhibitionism.Disclosure of interestThe author has not supplied his declaration of competing interest.

scholarly journals Trichotillomania: What Do We Know So Far?

2021 ◽  
pp. 1-7
Author(s):  
Daniel Fernandes Melo ◽  
Caren dos Santos Lima ◽  
Bianca Maria Piraccini ◽  
Antonella Tosti
Keyword(s):  
Selective Serotonin Reuptake Inhibitors ◽  
Behavioral Therapy ◽  
Treatment Plan ◽  
Interdisciplinary Approach ◽  
Comprehensive Treatment ◽  
Reversal Training ◽  
Pharmacological Management ◽  
Related Disorder ◽  
Pull Out ◽  
Habit Reversal Training

Trichotillomania is defined as an obsessive-compulsive or related disorder in which patients recurrently pull out hair from any region of their body. The disease affects mainly female patients, who often deny the habit, and it usually presents with a bizarre pattern nonscarring patchy alopecia with short hair and a negative pull test. Trichoscopy can reveal the abnormalities resulting from the stretching and fracture of hair shafts, and biopsy can be necessary if the patient or parents have difficulties in accepting the self-inflicted nature of a trichotillomania diagnosis. Trichotillomania requires a comprehensive treatment plan and interdisciplinary approach. Physicians should always have a nonjudgmental, empathic, and inviting attitude toward the patient. Behavioral therapy has been used with success in the treatment of trichotillomania, but not all patients are willing or able to comply with this treatment strategy. Pharmacotherapy can be necessary, especially in adolescents and adult patients. Options include tricyclic antidepressants, selective serotonin reuptake inhibitors, and glutamate-modulating agents. Glutamate-modulating agents such as N-acetylcysteine are a good first-line option due to significant benefits and low risk of side effects. Physicians must emphasize that the role of psychiatry-dermatology liaison is extremely necessary with concurrent support services for the patient and parents, in case of pediatric patients. In pediatric cases, parents should be advised and thoroughly educated that negative feedback and punishment for hair pulling are not going to produce positive results. Social support is a significant pillar to successful habit reversal training; therefore, physicians must convey the importance of familial support to achieving remission. This is a review article that aims to discuss the literature on trichotillomania, addressing etiology, historical aspects, clinical and trichoscopic features, main variants, differential diagnosis, diagnostic clues, and psychological and pharmacological management.

scholarly journals Clinical Evaluation of Preoperative Embolization, Vertebroplasty, and Decompression in the Treatment of Aggressive Vertebral Hemangiomas

2020 ◽  
Author(s):  
Derong Xu ◽  
Yongming Xi ◽  
Chuanli Zhou ◽  
Kai Zhu ◽  
Xuexiao Ma
Keyword(s):  
Treatment Plan ◽  
Treatment Strategies ◽  
Preoperative Embolization ◽  
Efficacy And Safety ◽  
Operative Blood Loss ◽  
Operative Duration ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Vertebral Hemangiomas

Abstract Background: Symptomatic aggressive vertebral hemangioma often requires clinical treatment; however, there is great controversy over the treatment plan. We aimed to evaluate the efficacy and safety of different methods including preoperative emobilization, vertebroplasty, decompression and internal fixation in the treatment of aggressive hemangioma.Methods: A retrospective clinical review of patients diagnosed with aggressive vertebral hemangiomas was conducted. All the patients were assigned to 3 groups according to the treatment strategies: patients in Group A underwent embolization before decompression, patients in Group B underwent decompression with vertebroplasty, patients in Group C received all three treatments. Clinical indexes were compared within 3 groups.Results: There were 6 patients received embolization and decompression (Group A), 9 patients underwent decompression with vertebroplasty (Group B) and 6 patients in Group C. The operative duration of patients in group A (198.33±38.43 min) were less than another two groups (P=0.001). The intra-operative blood loss of patients in group C was 713.33±165.13ml, which was significantly less than group A and group B (P=0.045). Patients in group C exhibited the lowest volume of drainage on POD 1 (178.33±66.76ml), which showed significant difference compared with group A (368.33±191.15ml, P=0.01). There was no significant difference of pre-operative and post-operative VAS and JOA score among 3 groups, as well as drainage on POD 2, total volume and hospital duration.Conclusion: The treatment strategy of combined embolization, vertebroplasty and decompression fixation is efficient and safe. For special patients, if such a strategy cannot be adopted, simple embolization plus decompression or vertebroplasty plus decompression is also competent.

scholarly journals Tiotropium: efficacy and safety in pediatric bronchial asthma

2021 ◽  
pp. 175-180
Author(s):  
Natalia G. Kolosova ◽  
Irina V. Grebeneva ◽  
Veronika D. Denisova
Keyword(s):  
Children And Adolescents ◽  
Bronchial Asthma ◽  
Adjunctive Therapy ◽  
Randomized Clinical Trials ◽  
Inhaled Corticosteroids ◽  
Symptom Control ◽  
Asthma Treatment ◽  
Efficacy And Safety ◽  
Chronic Lung Diseases ◽  
Long Acting

Bronchial asthma is one of the most common chronic lung diseases observed in children. According to the international and Russian guidelines, the long-term objectives of asthma treatment in children and adolescents are to achieve good symptom control, minimize the risk of asthma exacerbations, reduce hospital admissions, decrease the use of short-acting bronchodilators, reduce restrictions in the airflow and side effects, and ensure that normal activity levels are maintained. The asthma treatment is based on the use of inhaled corticosteroids as a backbone therapy and addition of adjunctive therapy if the disease control is poor or worsening. Tiotropium bromide is the first anticholinergic drug that has been approved for children and adults with poorly controlled asthma and is currently used as a treatment option for moderate to severe bronchial asthma. Randomized clinical trials in children and adolescents with persistent bronchial asthma showed high efficacy and safety of tiotropium. The addition of tiotropium in the form of 2 inhalations of 2.5 μg once a day to the bronchial asthma therapy in children over 6 years old, including medium doses of inhaled corticosteroids, is a preferred and safe option to increase the therapy coverage compared to an increase of a dose of inhaled corticosteroids to high levels, regardless of the disease phenotype (In atopic, non-atopic bronchial asthma, bronchial asthma with obesity, etc.). Tiotropium adjunctive therapy may also be a therapeutic option for children using inhaled corticosteroids, who have asthma that does not respond well to long-acting β2-agonist therapy, or for those, who are worried about the safety of long-acting β2-agonists.

scholarly journals Efficacy of Chloroquine and Lopinavir/Ritonavir in mild/general COVID-2019: a prospective, open-label, multicenter randomized controlled clinical study

2020 ◽  
Author(s):  
Xi Liu ◽  
Huili Chen ◽  
Yuqi Shang ◽  
Hongqiong Zhu ◽  
Gongqi Chen ◽  
...  
Keyword(s):  
Clinical Study ◽  
Treatment Plan ◽  
Antiviral Treatment ◽  
The Body ◽  
Comprehensive Treatment ◽  
Therapeutic Effects ◽  
Efficacy And Safety ◽  
Open Label ◽  
Randomized Controlled ◽  
Novel Coronavirus

Abstract Background The outbreak of novel coronavirus pneumonia is very serious, and no effective antiviral treatment has been confirmed. The fresh drug research and development cycle is too long to meet clinical emergency needs, and "old drugs and brand new applications" have a huge therapeutic potential. During our previous treatment, we found that the lopinavir/ritonavir treatment recommended in the Fifth edition of the treatment plan had little effect. Earlier studies have shown that chloroquine can inhibit coronavirus replication through multiple mechanisms. Our previous use of chloroquine to treat patients with SARS-CoV-2(novel coronavirus)-infected pneumonia has a higher negative rate of nucleic acid in throat swabs within 5 days after administration than that using lopinavir/ritonavir. However, the half-life and side effects of chloroquine vary greatly among individuals. Methods/design We plan to conduct a prospective, open-label, multicenter randomized controlled, comprehensive treatment clinical study. The study consisted of three phases: a screening period of 1-110 days, a treatment period of no more than 28 days, and a follow-up period of 1 month. Participants will be assessed at baseline and on days 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 14, 21, and 28 after the intervention begins. In this study, chloroquine and lopinavir/ritonavir tablets were used to treat patients with eligible novel coronavirus pneumonia diagnosed at various centers between February 12, 2020 and May 31, 2020. The efficacy and safety of chloroquine and lopinavir/ritonavir are to be evaluated. At the same time, explore the correlation between patient genetic polymorphisms and chloroquine steady-state concentration, therapeutic effects and adverse reactions in the body. It is an anti-virus for pneumonitis caused by novel coronavirus. The optimization and update of the antiviral treatment plan provides evidence-based evidence. Disscussion Our study is a prospective, open-label, multicenter randomized controlled, comprehensive treatment clinical study to evaluate the efficacy and safety of chloroquine phosphate and lopinavir/ritonavir in patients with mild/general COVID-2019. The results of this study will provide valuable clinical evidence for the treatment of novel coronavirus pneumonia.

scholarly journals Efficacy of Chloroquine versus Lopinavir/Ritonavir in mild/general COVID-19: a prospective, open-label, multicenter randomized controlled clinical study

2020 ◽  
Author(s):  
Xi Liu ◽  
Huili Chen ◽  
Yuqi Shang ◽  
Hongqiong Zhu ◽  
Gongqi Chen ◽  
...  
Keyword(s):  
Clinical Study ◽  
Treatment Plan ◽  
Antiviral Treatment ◽  
The Body ◽  
Comprehensive Treatment ◽  
Therapeutic Effects ◽  
Efficacy And Safety ◽  
Open Label ◽  
Randomized Controlled ◽  
Novel Coronavirus

Abstract Background The outbreak of novel coronavirus pneumonia is very serious, and no effective antiviral treatment has been confirmed. The fresh drug research and development cycle is too long to meet clinical emergency needs, and "old drugs and brand new applications" have a huge therapeutic potential. During our previous treatment, we found that the lopinavir/ritonavir treatment recommended in the Fifth edition of the treatment plan had little effect. Earlier studies have shown that chloroquine can inhibit coronavirus replication through multiple mechanisms. Our previous use of chloroquine to treat patients with SARS-CoV-2(novel coronavirus)-infected pneumonia has a higher negative rate of nucleic acid in throat swabs within 5 days after administration than that using lopinavir/ritonavir. However, the half-life and side effects of chloroquine vary greatly among individuals. Methods/design We plan to conduct a prospective, open-label, multicenter randomized controlled, comprehensive treatment clinical study. The study consisted of three phases: a screening period of 1-110 days, a treatment period of no more than 28 days, and a follow-up period of 1 month. Participants will be assessed at baseline and on days 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 14, 21, and 28 after the intervention begins. In this study, chloroquine and lopinavir/ritonavir tablets were used to treat patients with eligible novel coronavirus pneumonia diagnosed at various centers between February 12, 2020 and May 31, 2020. The efficacy and safety of chloroquine and lopinavir/ritonavir are to be evaluated. At the same time, explore the correlation between patient genetic polymorphisms and chloroquine steady-state concentration, therapeutic effects and adverse reactions in the body. It is an anti-virus for pneumonitis caused by novel coronavirus. The optimization and update of the antiviral treatment plan provides evidence-based evidence. Disscussion Our study is a prospective, open-label, multicenter randomized controlled, comprehensive treatment clinical study to evaluate the efficacy and safety of chloroquine phosphate and lopinavir/ritonavir in patients with mild/general COVID-2019. The results of this study will provide valuable clinical evidence for the treatment of novel coronavirus pneumonia.

Efficacy and Safety of Oral Ivermectin and Topical Permethrin in the Treatment of Scabies

2020 ◽  
Vol 33 (1) ◽  
pp. 41-47
Author(s):  
Mohsena Akhter ◽  
Ishrat Bhuiyan ◽  
Zulfiqer Hossain Khan ◽  
Mahfuza Akhter ◽  
Gulam Kazem Ali Ahmad ◽  
...  
Keyword(s):  
Skin Diseases ◽  
Close Contact ◽  
Randomized Study ◽  
Sarcoptes Scabiei ◽  
Efficacy And Safety ◽  
Common Skin ◽  
Group A ◽  
The Mean ◽  
The Difference ◽  
Group B

Background: Scabies is one of the most common skin diseases in our country. It is caused by the mite Sarcoptes scabiei var hominis, which is an ecto-parasite infesting the epidermis. Scabies is highly contagious. Prevalence is high in congested or densely populated areas. Individuals with close contact with an affected person should be treated with scabicidal which is available in both oral and topical formulations. The only oral but highly effective scabicidal known to date is Ivermectin. Amongst topical preparations, Permethrin 5 % cream is the treatment of choice. Objective: To evaluate the efficacy & safety of oral Ivermectin compared to topical Permethrin in the treatment of scabies. Methodology: This prospective, non-randomized study was conducted at the out-patient department of Dermatology and Venereology of Shaheed Suhrawardy Medical College & Hospital over a period of 6 months, from August 2016 to January 2017. The study population consisted of one hundred patients having scabies, enrolled according to inclusion criteria. They were divided into two groups. group A was subjected to oral Ivermectin and the group B to Permethrin 5% cream. Patients were followed up on day 7 and 14 for assessment of efficacy and safety. Result: The mean scoring with SD in group A (Ivermectin) and group B (Permethrin) were 8.26 ± 2.22 and 7.59 ± 2.01 respectively at the time of observation. The difference between the mean score of the two group is not significant (p=0.117) the mean scoring with SD in group A and group B were 4.54 ± 2.05 and 1.64 ± 1.84 respectively at 7thdays. The difference between the mean score of the two group is significant (p<0.001). The mean scoring with SD in group A and group B were 2.68± 2.35 and .36± 1.10 respectively at 14th day difference between the mean score of the group is significant (p<0.001). Conclusion: Topical application of permethrin 5% cream is more effective and safer than oral Ivermectin in the treatment of scabies. TAJ 2020; 33(1): 41-47

Efficacy and safety of long-acting pasireotide in acromegalic patients in the real life: The reappraisal of the first-dose follow-up visit

2020 ◽  
Author(s):  
Claudio Urbani ◽  
Francesca Dassie ◽  
Benedetta Zampetti ◽  
Di Certo Agostino Maria ◽  
Renato Cozzi ◽  
...  
Keyword(s):  
Real Life ◽  
Efficacy And Safety ◽  
The Real ◽  
Long Acting
Sign in / Sign up

Export Citation Format

Share Document