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ADHD MEDICATIONS Myths and Facts ADHD Awareness Day, Oct 2011 by Theresa Cerulli, M.D. Neuropsychiatrist

ADHD MEDICATIONS Myths and Facts ADHD Awareness Day, Oct 2011 by Theresa Cerulli, M.D. Neuropsychiatrist. ADHD Medication Categories 1. Stimulants. a. Methylphenidates. b. Amphetamines. 2. Non-Stimulants. ADHD Medications. Stimulants Methylphenidates -

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ADHD MEDICATIONS Myths and Facts ADHD Awareness Day, Oct 2011 by Theresa Cerulli, M.D. Neuropsychiatrist

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  1. ADHD MEDICATIONSMyths and FactsADHD Awareness Day, Oct 2011byTheresa Cerulli, M.D.Neuropsychiatrist

  2. ADHD Medication Categories1. Stimulants a. Methylphenidates b. Amphetamines 2. Non-Stimulants

  3. ADHD Medications Stimulants Methylphenidates - • Ritalin, Ritalin LA, Daytrana, Metadate ER, Metadate CD Concerta, Focalin IR, Focalin XR Amphetamines- • Adderall IR, Adderall XR, Dexedrine • Vyvanse (prodrug) Non-Stimulants • Atomoxetine • Intuniv, Kapvay Off-Label meds • Wellbutrin SR, XL • Provigil • Tenex, Clonidine • TCA’s

  4. Methylphenidate Products Ritalin, Methylin Ritalin SR Concerta Metadate ER and CD Methylin ER Ritalin LA Focalin Focalin XR Daytrana (patch) Amphetamines Dexedrine Dexedrine Spansules Adderall Adderall XR Vyvanse (Prodrug) Stimulants

  5. Short Term Stimulant Side Effects: Loss of appetite Weight loss Insomnia Headache Irritability Feeling jittery Dry mouth Anxiety Tachycardia Nausea/GI side effects Exacerbation of Tics Long Term Stimulant Side Effects: Possible Delayed Growth Spurt Possible decrease in height Possible Tic Disorders Most recent studies show no evidence of growth problems or tic disorders compared with ADHD patients who never took stimulant medications Stimulant Medication Side Effects

  6. Stimulants: FDA Warning Label

  7. Non-Stimulants FDA approved for treating ADHD - • Strattera (atomoxetine) • Intuniv (long-acting guanfacine), • Kapvay (long-acting clonidine) Off Label meds, not FDA approved for ADHD - • Provigil, Wellbutrin XL, tenex, clonidine, Tricyclic antidepressants (TCA’s)

  8. Non-Stimulant Side Effects • Strattera- Sedation, GI side effects, dizziness, liver, SI • Intuniv, Kapvay- Sedation, lightheadedness/dizziness • Wellbutrin- HA, dry mouth, sweating, nausea, decreases seizure threshold • TCA’s- Sedation, wt gain, dry mouth, postural hypotension, sexual dysfunction, cardiac (Check EKG) • Provigil- Insomnia, HA

  9. Medications Diet and Nutrition Brain Neurotransmitters Dopamine Norepinephrine Serotonin

  10. Neurotransmitters

  11. Degree of Action on Neurotransmitter Proposed mechanism of action based on animal studies

  12. Delivery Systems How is your medication released? How does your medication get to where its going?

  13. OROS Delivery System (Concerta)

  14. SODAS Delivery Adderall XR, Ritalin LA, Focalin XR

  15. ADHD Medications Adderall Intuniv Focalin Strattera How Do You Choose?

  16. Medication Considerations Consider: • Family history • Genetic subtype of ADD • Mechanism of Action of medication • Length of Action of medication • Patient’s daily schedule • FDA approval vs. off label use of medication

  17. The Upside ADHD Medications Can - • Improve Focus and Concentration • Increase productivity • Calm Hyperactivity • Increase attention to details • Improve communication/listening skills • Enhance executive functioning (organization, time management, problem solving)

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