Management of attention deficit hyperactivity disorder information
Practices with established treatment efficacy for ADHD
Attention deficit hyperactivity disorder management options are evidence-based practices with established treatment efficacy for ADHD.
The American Academy of Pediatrics (AAP) recommends different treatment paradigms depending on the age of the person being treated. For those aged 4–5, the AAP recommends evidence-based parent- and/or teacher-administered behavioral interventions as first-line treatment, with the addition of methylphenidate if there is continuing moderate-to-severe functional disturbances. For those aged 6–11, the use of medication in combination with behavioral therapy is recommended, with the evidence for stimulant medications being stronger than that for other classes. For adolescents aged 12–17, use of medication along with psychosocial interventions are recommended.[1] Clinical picture of ADHD can be corrected if rehabilitation interventions are started from the early preschool age, when the compensatory capabilities of the brain are great and a persistent pathological stereotype has not yet formed. If symptoms persist at a later age, as the child grows, defects in the development of higher brain functions and behavioral problems worsen, which subsequently lead to difficulties in schooling.[2]
There are a number of stimulant and non-stimulant medications indicated for the treatment of ADHD. The most commonly used stimulant medications include methylphenidate (Ritalin, Concerta), dexmethylphenidate (Focalin, Focalin XR), Serdexmethylphenidate/dexmethylphenidate (Azstarys), mixed amphetamine salts (Adderall, Mydayis), dextroamphetamine (Dexedrine, ProCentra), methamphetamine (Desoxyn), and lisdexamfetamine (Vyvanse). Non-stimulant medications with a specific indication for ADHD include atomoxetine (Strattera), viloxazine (Qelbree), guanfacine (Intuniv), and clonidine (Kapvay). Other medicines which may be prescribed off-label include bupropion (Wellbutrin), tricyclic antidepressants, SNRIs, or MAOIs.[3][4][5] The presence of comorbid (co-occurring) disorders can make finding the right treatment and diagnosis much more complicated, costly, and time-consuming. So it is recommended to assess and simultaneously treat any comorbid disorders.[6]
A variety of psychotherapeutic and behavior modification approaches to managing ADHD including psychotherapy and working memory training may be used. Improving the surrounding home and school environment with parent management training and classroom management can improve behavior and school performance of children with ADHD.[7][8] Specialized ADHD coaches provide services and strategies to improve functioning, like time management or organizational suggestions.[9] Self-control training programs have been shown to have limited effectiveness.[citation needed]
^Wolraich ML, Hagan JF, Allan C, Chan E, Davison D, Earls M, et al. (October 2019). "Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents". Pediatrics. 144 (4): e20192528. doi:10.1542/peds.2019-2528. PMC 7067282. PMID 31570648.
^Khaletskaya OV. Синдром дефицита внимания и гиперактивности в детском возрасте.
^Stein MA (July 2004). "Innovations in attention-deficit/hyperactivity disorder pharmacotherapy: long-acting stimulant and nonstimulant treatments". American Journal of Managed Care. 10 (4 Suppl): S89–98. PMID 15352535.
^Hazell P (October 2005). "Do adrenergically active drugs have a role in the first-line treatment of attention-deficit/hyperactivity disorder?". Expert Opinion on Pharmacotherapy. 6 (12): 1989–98. doi:10.1517/14656566.6.12.1989. PMID 16197353. S2CID 13346726.
^Waxmonsky J (October 2003). "Assessment and treatment of attention deficit hyperactivity disorder in children with comorbid psychiatric illness". Current Opinion in Pediatrics. 15 (5): 476–482. doi:10.1097/00008480-200310000-00006. PMID 14508296. S2CID 36186879.
^Cite error: The named reference AAP2001 was invoked but never defined (see the help page).
^Tresco KE, Lefler EK, Power TJ (2010). "Psychosocial Interventions to Improve the School Performance of Students with Attention-Deficit/Hyperactivity Disorder". Mind & Brain: The Journal of Psychiatry. 1 (2): 69–74. ISSN 2042-468X. PMC 2998237. PMID 21152355.
^Ahmann E, Tuttle LJ, Saviet M, Wright SD (2018). "A Descriptive Review of ADHD Coaching Research: Implications for College Students" (PDF). Journal of Postsecondary Education and Disability. 31 (1): 17–39.
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