Stimulant Medications in Adults with Attention Deficit Disorder

1984 ◽  
Vol 29 (5) ◽  
pp. 435-440 ◽  
Author(s):  
M. Gauthier
Keyword(s):  
Attention Deficit ◽  
Prospective Studies ◽  
Attention Deficit Disorder ◽  
Stimulant Medication ◽  
Case Reports ◽  
Firm Conclusion ◽  
Double Blind ◽  
Stimulant Medications ◽  
Persistent Disability

The long-term prospective studies done in the last two decades on children suffering from attention deficit disorder with hyperactivity (ADD-H) give evidence of persistent disability in a majority of them when they reach adulthood. The literature on the use of stimulant medication in adults suffering from attention deficit disorder, residual type (ADD-R), is critically reviewed. After optimistic case reports two controlled double-blind studies have recently showed contradictory results. Some adults appear clearly to be helped by stimulant medication, but more investigations, especially with children diagnosed in childhood and followed-up, are needed before any firm conclusion can be made about the usefulness or non-usefulness of stimulants in ADD-R. There, as it is the case in childhood, medication might be insufficient by itself and might have to be associated with other forms of treatment.

Responses to Methylphenidate and Varied Doses of Caffeine in Children with Attention Deficit Disorder

1981 ◽  
Vol 26 (6) ◽  
pp. 395-401 ◽  
Author(s):  
D. Garfinkel Barry ◽  
D. Webster Christopher ◽  
Leon Sloman
Keyword(s):  
Attention Deficit ◽  
Attention Deficit Disorder ◽  
Low Dose ◽  
Stimulant Medication ◽  
High Dose ◽  
Day Hospital ◽  
Double Blind ◽  
Treatment Conditions ◽  
Hospital Patients ◽  
Low Dosage

Six children with the diagnosis of Attention Deficit Disorder were treated as day hospital patients, using different stimulant medication. They were studied in a double-blind crossover experiment in which they received caffeine in low dose or in a high dose. Methylphenidate was added to both dosages, as well as administered alone. Results indicated that caffeine in low dosage when added to methylphenidate was superior to all other treatment conditions. Caffeine in low dosage could not be differentiated from 10 mg of methylphenidate. High dosage caffeine was not different from placebo or no-drug conditions. This study offers evidence to support a curvilinear pattern of dose-response for caffeine, in attenuating the behavioural manifestations of this syndrome.

Dramatic Favorable Responses of Children with Learning Disabilities or Dyslexia and Attention Deficit Disorder to Antimotion Sickness Medications: Four Case Reports

1991 ◽  
Vol 73 (3) ◽  
pp. 723-738 ◽  
Author(s):  
Harold N. Levinson
Keyword(s):  
Learning Disabilities ◽  
Quantitative Study ◽  
Attention Deficit ◽  
Attention Deficit Disorder ◽  
Case Reports ◽  
Learning Disabled ◽  
Disabled Children ◽  
Double Blind ◽  
Clinical Method

Responses of four learning disabled children who showed dramatic improvements to one or more antimotion-sickness-antihistamines and -stimulants are described qualitatively. These cases were selected from a prior quantitative study in which three antihistamines (meclizine, cyclizine, dimenhydrinate) and three stimulants (pemoline, methylphenidate, dextroamphetamine) were tested in variable combinations (using a specific clinical method) for favorable responses by 100 children characterized by diagnostic evidence of learning disabilities and cerebellar-vestibular dysfunctioning. Pending validation in double-blind controlled studies, these qualitative results suggest that the “cerebellar-vestibular (CV) stabilizing” antimotion-sickness medications, Piracetam included, and their combinations may be shown to be therapeutically useful in treating children with learning disabilities or dyslexia and attention deficit disorder.

Stimulant Therapy Utilization for Neurocognitive Deficits in Mild Traumatic Brain Injury

2021 ◽  
pp. 194173812110318
Author(s):  
Eric E. Coris ◽  
Byron Moran ◽  
Kevin Sneed ◽  
Gianluca Del Rossi ◽  
Bradford Bindas ◽  
...  
Keyword(s):  
Attention Deficit ◽  
Attention Deficit Disorder ◽  
English Language ◽  
Brain Injuries ◽  
Stimulant Medication ◽  
The United States ◽  
Neurocognitive Deficits ◽  
Level Of Evidence ◽  
Stimulant Use ◽  
Stimulant Medications

Context: There are 3.8 million mild traumatic brain injuries (mTBIs) that occur each year in the United States. Many are left with prolonged life-altering neurocognitive deficits, including difficulties in attention, concentration, mental fatigue, and distractibility. With extensive data on the safety and efficacy of stimulant medications in treating attention deficit, concentration difficulties and distractibility seen with attention deficit disorder, it is not surprising that interest continues regarding the application of stimulant medications for the persistent neurocognitive deficits in some mTBIs. Evidence Acquisition: Studies were extracted from PubMed based on the topics of neurocognitive impairment, mTBI, stimulant use in mTBI, stimulants, and the association between attention deficit/hyperactivity disorder and mTBI. The search criteria included a date range of 1999 to 2020 in the English language. Study Design: Literature review. Level of Evidence: Level 4. Results: Currently, there is very limited literature, and no guidelines for evaluating the use of stimulant medication for the treatment of prolonged neurocognitive impairments due to mTBI. However, a limited number of studies have demonstrated efficacy and safety of stimulants in the treatment of neurocognitive sequelae of mTBI in the adult, pediatric, military, and athletic populations. Conclusion: There is limited evidence to suggest stimulant medication may be beneficial in patients with mTBI with persistent neurocognitive symtpoms. The decision to utilize stimulant medication for mTBI patients remains physician and patient preference dependent. Given the limited encouraging data currently available, physicians may consider stimulant medication in appropriate patients to facilitate the recovery of prolonged neurocognitive deficits, while remaining cognizant of potential adverse effects.

Assessing and Treating Attention Deficit Disorder in Adolescents

1986 ◽  
Vol 149 (6) ◽  
pp. 710-715 ◽  
Author(s):  
S. P. Kutcher
Keyword(s):  
Attention Deficit ◽  
Attention Deficit Disorder ◽  
Dose Adjustment ◽  
Stimulant Medication ◽  
Daily Practice ◽  
Routine Clinical Practice ◽  
Double Blind ◽  
Research Findings ◽  
Assessment Strategies ◽  
Integrate Research

Psychiatric assessment strategies that integrate research findings with daily practice are necessary and clinically useful. This paper uses the example of an attention deficit disordered adolescent to illustrate how double-blind placebo controlled and multi-dose adjustment designs can be successfully implemented in routine clinical practice. These designs are especially valuable In evaluating the therapeutic effect of methylphenidate because of biases that may lead to clinical misuse of this stimulant medication.

Self-Esteem in Children Medically Managed for Attention Deficit Disorder

PEDIATRICS ◽  
1989 ◽  
Vol 83 (2) ◽  
pp. 211-217
Author(s):  
Patrick C. Kelly ◽  
Melvin L. Cohen ◽  
William O. Walker ◽  
Owen L. Caskey ◽  
A. W. Atkinson
Keyword(s):  
Attention Deficit ◽  
Attention Deficit Disorder ◽  
Self Esteem ◽  
Short Term ◽  
Double Blind ◽  
Long Term Follow Up ◽  
Clinically Significant ◽  
Multimodal Management

Self-esteem was measured initially in a group of 21 eight- to 12-year-old children with newly diagnosed attention deficit disorder/hyperactivity and remeasured after 1-month courses of treatment with methylphenidate and placebo given in double-blind cross-over fashion. Multimodal management of all patients included diagnosis, demystification, medication, close follow-up with supportive counseling, and referral as indicated for psychosocial and educational assistance. Long-term follow-up of 12 children who continued to receive methylphenidate was done for an average of 16 months. Initial total self-esteem was low in 30% of all subjects, intermediate in 55%, and high in 15%. No statistically significant changes occurred in self-esteem during the short-term phase of the study despite clinically significant behavioral responses to medication as assessed by serial questionnaires. At long-term follow-up, total, general, and academic self-esteem scores were improved significantly, however. These findings indicate that many preadolescents with attention deficit disorder/hyperactivity exhibit low self-esteem. Despite clinical response to medication, short-term improvement in self-esteem may not occur; however, long-term, multimodal management that includes medication does appear to improve self-esteem.

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