ATTENTION DEFICIT HYPERACTIVITY DISORDER
Brief Summary
Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder most diagnosed in children with an average age of diagnosis of 7. According to the Centers for Disease Control and Prevention Trusted Source, male individuals are more than twice as likely to be diagnosed with the disorder compared than females. Moreover, adults can also demonstrate symptoms and be diagnosed as well. The disease was originally called hyperkinetic impulse disorder and in the late 1960s, the American Psychiatric Association (APA) decided to formally recognize ADHD as one of the mental disorders.
Frequency
Worldwide, ADHD affects approximately 5 percent of children and 3 percent of adults
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In the Philippines, it affects an estimated 3 to 5% of the population aged 0 to 14.
Inheritance
The mode of inheritance for ADHD remains unclear, but ADHD from cytogenetic locations' 4p16.1 and 11p15.5 is inherited as an autosomal dominant pattern.
ADHD was first mentioned in 1902 by Sir George Still, a British pediatrician who recognized it as “an abnormal defect of moral control in children." Certain children affected were discovered to lack the ability of controlling their actions as a typical child might. However, they are still intelligent.
A series of tests should be done in order to diagnose an individual with ADHD. However, a specialist of your choice can make an accurate diagnosis after a detailed assessment that suits the needs of the patient. The assessment may include: a series of physical examinations, which can help rule out other possible causes for the symptoms and a series of interviews with the patient.
History of Disease
Pathogenesis
Achondroplasia is caused by a mutation in the FGF3 gene in chromosome 4 at 4p 16.3. This mutation causes a decreased production of fibroblast growth factor receptor 3 which is crucial in the conversion of cartilage into bone which is vital in the proper development of a person. This mutation is inherited in an autosomal dominant manner. More than 80 percent of people with achondroplasia have parents with normal characteristics and are born with achondroplasia due to a recent (de novo) gene modification (mutation).
Pathogenesis
ADHD can be observed in families, and the genes you inherit from your parents are considered to be an important factor in the development of the disorder (nervous system) in most cases, and are passed on to your lineage for generations. Research suggests that it is more likely that parents and siblings of a child with ADHD have ADHD themselves.
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A recent 2010 analysis of genome-wide studies found that there is only one confirmed location on chromosome 16 that has been repeatedly linked to ADHD.
The disorder has a worldwide prevalence of ∼5%. Attention deficit hyperactivity disorder (ADHD) has become one of the most recorded common psychiatric disorders. Zhang et al. (2012), explained that the polygenic nature of ADHD indicates that multiple genes jointly contribute to the development of this complex disease.
Symptoms
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constantly fidgeting
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excessive physical movement
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predominantly inattentive
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predominantly hyperactive-impulsive presentation
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Social Concerns
Individuals with ADHD often find themselves experiencing social difficulties, social rejection, and interpersonal relationship problems. This is because of their inattention, impulsivity, and hyperactivity. Such negative interpersonal outcomes cause emotional pain and suffering which affects their mental health. They are also known to contribute to the development of comorbid mood and anxiety disorders to individuals with ADHD. In this case, an individual's case may vary depending on the attention or management of their disorder.
Treatment
The Central nervous system (CNS) stimulants are the most prescribed class of ADHD drugs. These drugs regulate the amounts of the brain chemicals by increasing the dopamine and norepinephrine levels. The effect of these drugs significantly improves concentration and helps them focus better.
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Common CNS stimulants used to treat ADHD include:
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amphetamine-based stimulants (Adderall, Dexedrine, Dextrostat)
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dextromethamphetamine (Desoxyn)
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dextromethylphenidate (Focalin)
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methylphenidate (Concerta, Daytrana, Metadate, Ritalin)
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Non-stimulant medications
Various nonstimulant medications work by increasing levels of norepinephrine in the child’s brain. Norepinephrine is known to help with attention and memory. These non stimulant treatments include:
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atomoxetine (Strattera)
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antidepressants like nortriptyline (Pamelor)
Clinical Trials
Title:
Amphetamine Extended Release Tablets and Driving Performance in Subjects With Attention Deficit/Hyperactivity Disorder (ADHD)
Intervention:
Drug: Amphetamine Extended Release (ER) Tablet 20 mg
Other Name: Amphetamine extended-release oral tablet 20 mg
Phase:
Phase 2
Procedure:
A driving simulation is used to assess the effect on driving performance for the co-primary endpoints, study subjects' driving performance at 45 minutes and 10 hours post-dose, compared with placebo. Eligible subjects will be prescreened for ADHD but otherwise healthy, aged 18-25 years. Driving simulations that simulate common driving events to which the study subject must react. The reactions to each event will be assessed. Using a parallel-group design, subjects will be assessed while on study drug, and while on placebo. Safety assessments will include spontaneously reported treatment-emergent adverse events and vital signs at 4 hours post-dose.
Goal:
The purpose of this study is to assess the effect on driving performance of a single dose of amphetamine extended-release tablets (20 mg/tablet) compared with placebo at 45 minutes and 10 hours post-dose in young adults with ADHD.
Further details at:
Expert Directory
References
[1] ADHD. (n.d.). omim entry #143465. Retrieved from https://www.omim.org/entry/143465
[2] CHADD Organization. Living With ADHD: A Lifespan Disorder: Relationship and Social Skills. (n.d.). Retrieved from: https://chadd.org/for-adults/relationships-social-skills/
[3] Collingwood, Jane. The Genetics of ADHD. (2018, October 8). Retrieved from: https://psychcentral.com/lib/the-genetics-of-adhd/
[6] Holland, Kimberly (2018, September 29). The History of ADHD: A Timeline. Retrieved from: https://www.healthline.com/health/adhd/historys
[7] Margaret V. Austin, Ph.D., edited by C. E. Zupanick, Psy.D. ADHD: ATTENTION DEFICIT HYPERACTIVITY DISORDER PROGNOSIS AND LONG-TERM OUTCOMES (n.d.). Retrieved from: https://www.gulfbend.org/poc/view_doc.php?type=doc&id=13879&cn=3
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