Attention deficit hyperactivity disorder management is the treatment options available to people with attention-deficit/hyperactivity disorder (ADHD).
There are several effective and clinically proven options to treat people with ADHD. Combined medical management and behavioral treatment is the most effective ADHD management strategy, followed by medication alone, and then behavioral treatment. However, these results have been questioned because the study from the multimodal treatment group faded the behavioral procedure 3 months prior to the last evaluation point but continued the medication group. Indeed, after 14 months the medication group lost its advantage to the long discontinued behavior modification group. By year eight socioeconomic status and family structure were the only predictive variable for ADHD treatment A separate study highlighted the influence that nonclinical factors such as family size may have in mediating the use of pharmacologic therapies for children with ADHD.
The most common stimulant medications are methylphenidate (Ritalin), dextroamphetamine (Dexedrine), and mixed amphetamine salts (Adderall). Atomoxetine (Strattera) and Guanfacine (Intuniv) are non-stimulant drugs approved for the treatment of ADHD. Other medications which may be prescribed off-label include certain antidepressants such as tricyclic antidepressants, SNRIs or MAOIs. The presence of comorbid (relating to two diseases that occur together, e.g. depression and ADHD) disorders make finding the right treatment and diagnosis much more costly and time consuming.
A variety of psychotherapeutic and behavior modification approaches to managing ADHD including psychotherapy and working memory therapy may be used. Improving the surrounding home and school environment with parent management training and classroom management can improve the behavior of children with ADHD. Specialized ADHD coaches provide services and strategies to improve functioning, like time management or organizational suggestions. Self-control training programs have shown to have limited effectiveness. Behaviorally based self-control does better than cognitive self-control training A meta-analysis found that the use of behavior modification for ADHD are effective.
As of 2006 there was a shortage of data regarding ADHD drugs' potential adverse effects, with very few studies assessing the safety or efficacy of treatments beyond four months, and no randomized controlled trials assessing for periods of usage longer than two years. Treatment of preschool children is not recommended. The U.S. Food and Drug Administration (FDA) found that a large number of the controlled trials required subjects who were known to respond to stimulants or who had no history of intolerance to stimulants, and this limits assumed generalizability of the trials' results.
On Wednesday, November 21, 2012, the online edition of the Peoria, Illinois-based Peoria Journal Star newspaper featured an Associated Press (AP) article by Marilynn Marchione, with AP Medical Writer Maria Cheng contributing from London. It cited a study, published in the New England Journal of Medicine, with Paul Lichtenstein, from the Karolinska Institute in Stockholm, Sweden, as lead author, which revealed that medications to treat ADHD (Ritalin, Adderall, and others) in adults (and older teens- over age 15) drastically lowered their likelihood of committing a crime (mainly burglary and theft, as opposed to truly violent crimes, like murder).
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“This we take it is the grand characteristic of our age. By our skill in Mechanism, it has come to pass, that in the management of external things we excel all other ages; while in whatever respects the pure moral nature, in true dignity of soul and character, we are perhaps inferior to most civilised ages.”
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