The Novelty of Bupropion As a Dopaminergic Antidepressant for the Treatment of Adult Attention Deficit Hyperactive Disorder

2018 ◽  
Vol 20 (2) ◽  
pp. 210-219 ◽  
Author(s):  
Kanit Tha Deang ◽  
Hatta Sidi ◽  
Hazli Zakaria ◽  
Raja Lope Adam ◽  
Srijit Das ◽  
...  
Keyword(s):  
Attention Deficit ◽  
Adult Adhd ◽  
Medical Condition ◽  
Attention Deficit Hyperactive Disorder ◽  
Hyperactivity Disorder ◽  
Arduous Task ◽  
Adhd Treatment ◽  
Dopamine Reuptake Inhibitor ◽  
High Level ◽  
High Index Of Suspicion

Attention deficit hyperactive disorder (ADHD), a hyperactivity disorder prevalent among children may continue as an adulthood attention deficit. To date, treating an individual with an adult ADHD may be an arduous task as it involves numerous challenges, which include a need for high index of suspicion to diagnose this medical condition. Many psychiatric disorders masquerade as ADHD and delay the necessary assessment and proper treatment for this debilitating medical disorder. Adult ADHD is often misdiagnosed (or under diagnosed) due to the fact that this medical condition is being masked by the patients’ high level of intellectual achievement. As the ADHD in adult persists, it may end-up with impairment in the personal-social-occupational function in which the management becomes a great challenge. The treatment of ADHD can be optimized by using various drugs targets agents like norepinephrine-dopamine reuptake inhibitor (NDRI), with or without psycho stimulants like methylphenidate, which is marketed as Ritalin. Bupropion, an NDRI has a novel effect on ADHD as the molecule exerts its effects by modulating the reward-pleasure mesolimbic dopaminergic system and at the same time regulates the elevating mood dimension of the noradrenergic neurotransmission. The role of Bupropion in the neural and psychopharmacological perspective treatment of ADHD was deliberated. The present review highlights the novel effects of Bupropion in ADHD treatment, together with the help of other successful bio-psycho-social measures. This may be of immense benefit to the psychiatrists for treating their patients.

Attention deficit hyperactivity disorder (ADHD): perspective of the general adult psychiatrist

2018 ◽  
Vol 35 (3) ◽  
pp. 247-249
Author(s):  
D. Murray ◽  
P. Devitt
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Ad Hoc ◽  
Neurodevelopmental Disorder ◽  
Psychiatric Services ◽  
Hyperactivity Disorder ◽  
Adhd Treatment

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder with onset in childhood. In Ireland adult ADHD treatment is drifting in an ad hoc manner into general adult psychiatric services. We propose this process should be halted in favour of a delivering a carefully planned adult ADHD service.

scholarly journals Insomnia Disorder in Adult Attention-Deficit/Hyperactivity Disorder Patients: Clinical, Comorbidity, and Treatment Correlates

2021 ◽  
Vol 12 ◽  
Author(s):  
Christian Fadeuilhe ◽  
Constanza Daigre ◽  
Vanesa Richarte ◽  
Lara Grau-López ◽  
Raul F. Palma-Álvarez ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Rating Scales ◽  
Clinical Severity ◽  
Hyperactivity Disorder ◽  
Insomnia Disorder ◽  
Adhd Treatment

Introduction: Several investigations have been performed on insomnia symptoms in adult attention-deficit/hyperactivity disorder (ADHD). However, the relationship between insomnia disorder and adult ADHD has been neglected in research. The main objective of the current study is to analyze the differences between adult ADHD patients with and without insomnia disorder, in terms of ADHD clinical severity, medical and psychiatric comorbidity, psychopharmacological treatment, and quality of life.Material and Methods: Two hundred and fifty-two adult patients with ADHD (mean age 37.60 ± 13.22 years; ADHD presentations—combined: 56.7%, inattentive: 39.7%, hyperactive/impulsive: 3.6%) were evaluated with an exhaustive clinical and psychological evaluation protocol including semistructured interviews (for comorbidities and ADHD assessment) and symptom rating scales for ADHD. The diagnosis of ADHD and insomnia disorder was made according to DSM-5 criteria. Furthermore, the Pittsburgh Sleep Quality Index, Insomnia Severity Index, and Epworth Sleepiness Scale were administered.Results: Insomnia disorder was found in 44.4% of adult ADHD patients and was more common in combined presentation (64.3%) and in patients with more ADHD severity. Comorbidities (both medical and psychiatric), especially mood disorders (42%), anxiety disorder (26.8%), personality disorder (39.3%), and any substance use disorder (11.6%), were associated with a higher insomnia disorder prevalence. ADHD stimulant treatment was related to lower insomnia disorder compared to patients without medication, as well as ADHD stable treatment. Additionally, worse health-related quality of life was associated with insomnia disorder.Conclusion: Insomnia disorder is highly prevalent in adult ADHD and is related to higher ADHD severity and more psychiatric and medical comorbidities. Some stimulants and stable pharmacological ADHD treatment are associated with better outcomes of insomnia disorder.

scholarly journals Investigating regions of shared genetic variation in attention deficit/hyperactivity disorder and major depressive disorder: a GWAS meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Victoria Powell ◽  
Joanna Martin ◽  
Anita Thapar ◽  
Frances Rice ◽  
Richard J. L. Anney
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Genetic Correlation ◽  
Attention Deficit ◽  
Meta Analysis ◽  
Major Depressive ◽  
Hyperactivity Disorder ◽  
High Level ◽  
Genomic Regions

AbstractAttention deficit/hyperactivity disorder (ADHD) demonstrates a high level of comorbidity with major depressive disorder (MDD). One possible contributor to this is that the two disorders show high genetic correlation. However, the specific regions of the genome that may be responsible for this overlap are unclear. To identify variants associated with both ADHD and MDD, we performed a meta-analysis of GWAS of ADHD and MDD. All genome wide significant (p < 5 × 10–8) SNPs in the meta-analysis that were also strongly associated (p < 5 × 10–4) independently with each disorder were followed up. These putatively pleiotropic SNPs were tested for additional associations across a broad range of phenotypes. Fourteen linkage disequilibrium-independent SNPs were associated with each disorder separately (p < 5 × 10–4) and in the cross-disorder meta-analysis (p < 5 × 10–8). Nine of these SNPs had not been highlighted previously in either individual GWAS. Evidence supported nine of the fourteen SNPs acting as eQTL and two as brain eQTL. Index SNPs and their genomic regions demonstrated associations with other mental health phenotypes. Through conducting meta-analysis on ADHD and MDD only, our results build upon the previously observed genetic correlation between ADHD and MDD and reveal novel genomic regions that may be implicated in this overlap.

Neurobiology and Genetics of ADHD in Adults

CNS Spectrums ◽  
2008 ◽  
Vol 13 (S13) ◽  
pp. 5-7 ◽  
Author(s):  
Thomas J. Spencer
Keyword(s):  
Adult Adhd ◽  
Extended Release ◽  
Treatment Strategies ◽  
Stimulant Use ◽  
Hyperactivity Disorder ◽  
Adhd Treatment ◽  
Norepinephrine Reuptake Inhibitor ◽  
Adults And Children ◽  
Core Symptoms ◽  
Adhd Medications

AbstractTreatment of attention-deficit/hyperactivity disorder (ADHD) may positively impact the neurobiology of adult patients with ADHD. Treatment may also minimize impairment from core symptoms and may alter the course of co-morbid disorders such as depression and substance use disorder. However, much of the information on stimulant use in adult ADHD comes from studies conducted in children, and it remains unclear whether there is a difference between children and adults when it comes to the side effects and tolerability of ADHD treatments. It is known that clinical presentation differs between adults and children, with adults demonstrating a higher percentage of mood disorders. Current treatments for adult ADHD include psychosocial therapies and pharmacologic therapies, the latter of which include the stimulants d-methylphenidate extended release (XR), OROS methylphenidate, lisdexamfetamine, and mixed amphetamine salts XR; and the nonstimulant atomoxetine, a selective norepinephrine reuptake inhibitor. There is need for additional study of treatment strategies for adult ADHD. Although all classes of ADHD medications are approved in adults, there are fewer approved formulations for adults than for children. Efficacy in adults is more subjective than in children, which may affect how efficacy rates for adult treatments are calculated. Adults also present a greater diversion risk than children. In addition, there are several new and emerging medication treatments worth considering.This Expert Roundtable Supplement represents part 2 of a 3-part supplement series on adult ADHD led by Lenard A. Adler, MD. In this activity, Thomas J. Spencer, MD, discusses the neurobiology and genetics of adult ADHD; Mark A. Stein, PhD, discusses stimulant therapy; and Jeffrey H. Newcorn, MD, reviews nonstimulants and psychosocial treatments.

Epidemiology, Impairments, and Differential Diagnosis in Adult ADHD: Introduction

CNS Spectrums ◽  
2008 ◽  
Vol 13 (S12) ◽  
pp. 4-5 ◽  
Author(s):  
Lenard A. Adler
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Differential Diagnosis ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Hyperactivity Disorder ◽  
Childhood Disorder

In the mid-1970s, attention-deficit/hyperactivity disorder (ADHD) was still believed to be a childhood disorder that disappeared with the onset of adolescence. At this time, Wender studied a cohort of adults presenting with ADHD-like symptoms, all of whom had been diagnosed with ADHD in childhood. Wender prescribed psycho-stimulants, which successfully produced a response in the adults, thus fostering research into adult ADHD.

Medical Mimics and Differential Diagnosis in Adult ADHD

CNS Spectrums ◽  
2008 ◽  
Vol 13 (S15) ◽  
pp. 14-16 ◽  
Author(s):  
Mark A. Stein
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Differential Diagnosis ◽  
Adult Patient ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Diagnostic Evaluation ◽  
Response To Treatment ◽  
Hyperactivity Disorder ◽  
Rule Out

When performing a diagnostic evaluation for an adult patient with possible adult attention-deficit/hyperactivity disorder (ADHD), clinicians must pay particular attention to possible mimics. ADHD mimics are conditions responsible for the symptoms or impairments that superficially resemble, and may be confused with ADHD. These mimics may produce symptoms and impairments similar to those seen in adults with ADHD, but differ in etiology, course, or response to treatment of ADHD. When evaluating someone for ADHD, clinicians should first rule out the possibility of medical, psychiatric, and social mimics of ADHD.

scholarly journals The Interventions for Sleep Disorders in Children with Attention Deficit and Hyperactivity Disorder: A Narrative Review

2021 ◽  
Vol 9 (T6) ◽  
pp. 164-172
Author(s):  
Risma Dwi Nur Pratiwi ◽  
Siti Yuyun Rahayu Fitri ◽  
Adelse Prima Mulya
Keyword(s):  
Sleep Disorders ◽  
Attention Deficit ◽  
Behavioral Therapy ◽  
Neurodevelopmental Disorder ◽  
Behavioral Parent Training ◽  
Narrative Review ◽  
Healthy Children ◽  
Children With Adhd ◽  
Hyperactivity Disorder ◽  
High Level

BACKGROUND: Attention deficit and hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in childhood. Children with ADHD have more frequent comorbid sleep disorders than healthy children. The current methods of treating sleep disorders in ADHD children are still focused on pharmacological interventions which in fact only provide little benefit. AIM: This study aims to identify existing studies regarding the types of nonpharmacological and complementary interventions for sleep disorders in children with ADHD using a narrative review approach. METHODS: This was a narrative review. Inclusion criteria included articles in English and Bahasa, full-text articles, primary studies, and children with ADHD aged 18 years with or without comorbidities as the research sample, and the article having been published in the last 10 years. Searches were performed in several databases: PubMed, Springer, Web of Science, and Google Scholar. RESULTS: The result showed that programs for managing sleep disorder in ADHD are behavioral therapy, behavioral parent training (BPT), behavioral sleep intervention, neurofeedback, mind-body therapy, L-theanine supplementation, horse milk supplementation, and play therapy. The programs are found to be effective in improving sleep. CONCLUSION: The program most comprehensive with a high level of ease of implementation was BPT.

Pharmacotherapy of ADHD in Adults

CNS Spectrums ◽  
2008 ◽  
Vol 13 (S8) ◽  
pp. 11-13 ◽  
Author(s):  
Timothy E. Wilens
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Therapeutic Options ◽  
Major Depressive ◽  
Children With Adhd ◽  
Hyperactivity Disorder

There is a complex overlap between major depressive disorder (MDD) and attention-deficit/hyperactivity disorder (ADHD). The different therapeutic options for adult ADHD mirror those used for children with ADHD. Both stimulant and nonstimulant medications are used to treat the disorder.

scholarly journals Shared alterations in resting-state brain connectivity in adults with attention-deficit/hyperactivity disorder and their unaffected first-degree relatives

2019 ◽  
pp. 1-11
Author(s):  
Valentino Antonio Pironti ◽  
Deniz Vatansever ◽  
Barbara Jacquelyn Sahakian
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Resting State ◽  
Adult Adhd ◽  
External Validation ◽  
Negative Consequences ◽  
Default Mode ◽  
Hyperactivity Disorder ◽  
First Degree Relatives ◽  
Human Connectome Project

Abstract Background Attention-deficit/hyperactivity disorder (ADHD) is a developmental condition that often persists into adulthood with extensive negative consequences on quality of life. Despite emerging evidence indicating the genetic basis of ADHD, investigations into the familial expression of latent neurocognitive traits remain limited. Methods In a group of adult ADHD probands (n = 20), their unaffected first-degree relatives (n = 20) and typically developing control participants (n = 20), we assessed endophenotypic alterations in the default mode network (DMN) connectivity during resting-state functional magnetic resonance imaging in relation to cognitive performance and clinical symptoms. In an external validation step, we also examined the dimensional nature of this neurocognitive trait in a sample of unrelated healthy young adults (n = 100) from the Human Connectome Project (HCP). Results The results illustrated reduced anti-correlations between the posterior cingulate cortex/precuneus and right middle frontal gyrus that was shared between adult ADHD probands and their first-degree relatives, but not with healthy controls. The observed connectivity alterations were linked to higher ADHD symptoms that was mediated by performance in a sustained attention task. Moreover, this brain-based neurocognitive trait dimensionally explained ADHD symptom variability in the HCP sample. Conclusions Alterations in the default mode connectivity may represent a dimensional endophenotype of ADHD, hence a significant aspect of the neuropathophysiology of this disorder. As such, brain network organisation can potentially be employed as an important neurocognitive trait to enhance statistical power of genetic studies in ADHD and as a surrogate efficacy endpoint in the development of novel pharmaceuticals.

Economic Burden and Disability-Adjusted Life Years (DALYs) of Attention Deficit/Hyperactivity Disorder

2019 ◽  
Vol 24 (6) ◽  
pp. 823-829 ◽  
Author(s):  
Minha Hong ◽  
Bomi Park ◽  
Sang Min Lee ◽  
Geon Ho Bahn ◽  
Moon Jung Kim ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Economic Burden ◽  
Indirect Costs ◽  
Disability Adjusted Life Years ◽  
Hyperactivity Disorder ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Adhd Treatment ◽  
The Republic

Objective: We investigated the economic burden and disability-adjusted life years (DALYs) for attention deficit/hyperactivity disorder (ADHD) in the Republic of Korea. Method: Using the National Health Insurance Service claims data for the population aged 19 years or younger, a prevalence-based approach was used to calculate the DALYs of ADHD. Direct medical costs, direct nonmedical costs, and indirect costs resulting from ADHD were estimated to calculate the economic burden of ADHD. Results: A total of 69,353 people in Korea were diagnosed with ADHD in 2012. The burden of ADHD as measured by the prevalence-based approach was 32,605 DALYs. The total economic burden of ADHD was US$47.55 million, which accounted for approximately 0.004% of Korean GDP (gross domestic product) in 2012. Conclusion: Our findings shed light on the considerable burden of ADHD, emphasizing the need for policies that can encourage ADHD treatment and enhance compliance.

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