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.

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.

Stimulant Medication Use by Primary Care Physicians in the Treatment of Attention Deficit Hyperactivity Disorder

PEDIATRICS ◽  
1990 ◽  
Vol 86 (1) ◽  
pp. 95-101
Author(s):  
Mark L. Wolraich ◽  
Scott Lindgren ◽  
Ann Stromquist ◽  
Richard Milich ◽  
Charles Davis ◽  
...  
Keyword(s):  
Primary Care ◽  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Primary Care Physicians ◽  
Stimulant Medication ◽  
Medication Use ◽  
The United States ◽  
Hyperactivity Disorder ◽  
Family Practitioners ◽  
Behavioral Treatments

Treatment of attention deficit hyperactivity disorder (ADHD), one of the most common behavioral disorders in children in the United States, remains controversial because of concern about stimulant medication use. Extending a previous study of pediatricians, the present study surveyed a random national sample of family practitioners and then directly screened 457 patients of 10 pediatricians and family practitioners in two small midwestern cities. Responses to the national survey indicated that stimulant medication remains the main treatment prescribed by primary care physicians for children with ADHD. In the direct patient screening, the prevalence of ADHD diagnoses was 5.3% (pediatricians) and 4.2% (family practitioners) of all elementary-schoolaged children screened. Eighty-eight percent of these children were treated with methyiphenidate. Although medication was considered an effective treatment by the parents of 85% of the children given the medication, efficacy was unrelated to the accuracy of diagnosis. When explicit DSM-III-R criteria were used, only 72% of those assigned a diagnosis of ADHD by the physicians would have received that diagnosis based on a structured psychiatric interview with the parents and only 53% received that diagnosis based on teacher report of symptoms, even when the child was not receiving medication. Although the majority of physicians (in both the surveys and the direct screenings) reported using at least some behavioral treatments with their patients, parents reported infrequent use of nonpharmacologic forms of therapy, such as behavior modification. These data thus indicate a relatively modest rate of stimulant medication use for ADHD, but a serious underuse of systematic behavioral treatments in primary care.

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.

Attention Deficit Disorders and Depression

PEDIATRICS ◽  
1989 ◽  
Vol 84 (4) ◽  
pp. 748-748
Author(s):  
GUY LORD ◽  
RICHARD P. BARTHEL
Keyword(s):  
Attention Deficit ◽  
Attention Deficit Disorder ◽  
Side Effect ◽  
Self Esteem ◽  
Valuable Contribution ◽  
Attention Deficit Disorders ◽  
Subjective Distress ◽  
Stimulant Medications

Kelly et al drew attention to the subjective distress and low self-esteem experienced by many children with attention deficit disorder. This is a valuable contribution, in that it is all too easy to simply respond to the distress that such children cause in others (parents, teachers) as opposed to the unhappiness of the child him- or herself. Our concerns relate to the fact that the word "depression" is used only once, as a side effect of stimulant medications. Recent studies indicate a considerable overlap between the problems of children with attention deficit disorder and those in whom depression is diagnosed.

scholarly journals Postoperative Lyme Arthritis in the Orthopaedic Patient

2019 ◽  
Vol 11 (4) ◽  
pp. 350-354
Author(s):  
Matthew C. Hess ◽  
Zachary Devilbiss ◽  
Garry Wai Keung Ho ◽  
Raymond Thal
Keyword(s):  
United States ◽  
Lyme Disease ◽  
Postoperative Complication ◽  
Joint Pain ◽  
English Language ◽  
The United States ◽  
Lyme Arthritis ◽  
Level Of Evidence ◽  
Pubmed Database ◽  
Level 3

Context:Lyme disease is the most common tick-borne illness in North America and Europe, and Lyme arthritis is a frequent late-stage manifestation in the United States. However, Lyme arthritis has rarely been reported as a postoperative complication.Evidence Acquisition:The PubMed database was queried through June 2018, and restricted to the English language, in search of relevant articles.Study Design:Clinical review.Level of Evidence:Level 3.Results:A total of 5 cases of Lyme arthritis as a postoperative complication have been reported in the literature.Conclusion:These cases highlight the importance for providers practicing in Lyme-endemic regions to keep such an infection in mind when evaluating postoperative joint pain and swelling. We propose herein an algorithm for the workup of potential postoperative Lyme arthritis.Strength of Recommendation Taxonomy (SORT):C

Classroom Social Interactions of Attention Deficit Disorder with Hyperactivity Children as a Function of Stimulant Medication

1987 ◽  
Vol 12 (1) ◽  
pp. 61-76 ◽  
Author(s):  
Jan L. Wallander ◽  
Stephen R. Schroeder ◽  
Joseph A. Michelli ◽  
C. Thomas Gualtieri
Keyword(s):  
Social Interactions ◽  
Attention Deficit ◽  
Attention Deficit Disorder ◽  
Stimulant Medication

scholarly journals Effect of Stimulant Medication on Children with Attention Deficit Disorder: A “Review of Reviews”

1993 ◽  
Vol 60 (2) ◽  
pp. 154-162 ◽  
Author(s):  
James M. Swanson ◽  
Keith McBurnett ◽  
Tim Wigal ◽  
Linda J. Pfiffner ◽  
Marc A. Lerner ◽  
...  
Keyword(s):  
Attention Deficit ◽  
Attention Deficit Disorder ◽  
Stimulant Medication ◽  
Symptomatic Improvement ◽  
University Of California ◽  
Average Effect ◽  
General Audience ◽  
Literature Synthesis ◽  
Review Of Reviews ◽  
The University

The University of California, Irvine ADD Center recently conducted a synthesis of the literature on the use of stimulants with children with attention deficit disorder (ADD), using a unique “review of reviews” methodology. In this article, we compare three reviews from each of three review types (traditional, meta-analytic, general audience) and illustrate how coding variables can highlight sources of divergence. In general, divergent conclusions stemmed from variations in goal rather than from variations in the sources selected to review. Across quantitative reviews, the average effect size for symptomatic improvement (.83) was twice that for benefits on IQ and achievement measures (.35). A summary of what should and should not be expected of the use of stimulants with ADD children, derived from the literature synthesis, is provided.

The Risks Associated With Stimulant Medication Use in Child and Adolescent Populations Diagnosed With Attention-Deficit/Hyperactivity Disorder

2012 ◽  
Vol 14 (1) ◽  
pp. 5-14
Author(s):  
Jeanne M. Stolzer
Keyword(s):  
United States ◽  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Developmental Stages ◽  
Stimulant Medication ◽  
Medical Model ◽  
Child And Adolescent ◽  
The United States ◽  
Hyperactivity Disorder ◽  
Chemical Imbalance

Throughout human history, psychiatric dysfunction in child and adolescent populations has been rare. However, over the last 2 decades, psychiatric diagnoses have reached epidemic proportions—particularly in the United States. Currently, attention-deficit/hyperactivity disorder (ADHD) is the most commonly diagnosed psychiatric illness in child and adolescent populations with an estimated 10–12 million children diagnosed in the United States. Over the last 2 decades, behavior patterns that were once perceived as typical, normative developmental stages have been systematically redefined by those promoting the mass labeling and drugging of children as a “chemical imbalance of the brain.” Grounded in bioevolutionary theory, this article will challenge the existing medical model and will explore in-depth the risks associated with the ADHD label and the use of stimulant medication in pediatric populations. In addition, this article will examine the cultural, physical, neurological, psychological, and social correlates as they relate to the diagnosis of ADHD in America.

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