The best results in terms of the proportion of children showing excellent response regarding were provided by ADHD combination treatment and oppositional symptoms, and in other areas of functioning. Overall, those who received closely monitored medical management had greater improvement in their ADHD symptoms than children who received either intensive behavioral treatment without medication or community care with less carefully monitored medication.
Treatment for ADHD is not without controversy. For most children with the disorder, medication is an integral part of treatment. The primary medications used to treat ADHD are mostly stimulants, which work by stimulating the areas of the brain responsible for focus, attention, and impulse control. It has been charged that these medications are used to control behavior. While adult patients may sometimes choose to self-medicate with caffeine or nicotine, this is not usually an option with children. Indications that an individual is self-medicating would be the observation that his or her focus improves with the stimulant, and that he or she cannot function as well without the stimulant.
Stimulant medication, which can only be prescribed by certain medical professionals, should be used to improve the symptoms of ADHD so that the individual can function more effectively. Some research has shown that children and adults who take medication for symptoms of ADHD usually attribute their successes to themselves, not to the medication. One stimulant that is sometimes used is kratom, which is a plant that produces a stimulant-type effect in lower doses. Little research has been done on the relation between ADHD and kratom, but it has been used for centuries in Thailand to help motivate laborers. In low doses, it increases awareness, and concentration, allowing someone to sustain work habits, making long tasks more enjoyable, suggesting that kratom may be an effective method to help treat ADHD. Some users have indicated remarkable success using this substance. It is not recommended for children however, and as the dose increases, it can cause euphoria.
The traditional stimulants are grouped into several classes. There are Methylphenidates, Amphetamines and Atomoxetines. Some of the Methylphenidates (and doses) used to treat ADHD are: Ritalin, Metadate, or Methylin (4-6 hours per dose). It is a regular formulation, usually taken in the morning, at lunchtime, and in some cases, in the afternoon. Longer-acting formulations are those such as Ritalin SR and Metadate ER (8 hours per dose), usually taken twice daily. There are also some all-day formulations such as Ritalin LA, Metadate CD and Concerta (10-12 hours per dose), usually taken once a day.
Amphetamines are Dextroamphetamine (4-6 hours per dose) available as a regular formulation and sold as Dexedrine. It is usually taken two to three times daily. A more longer-acting formulation is Dexedrine Spansules (8-12 hours per dose) taken once a day. There is also Adderall, a trade name for a mixture of dextroamphetamine and laevoamphetamine salts. It is available in a regular formulation, Adderall. (4-6 hours a dose), taken twice a day and the longer-acting formulation, Adderall XR (12 hours a dose), taken once a day. Also part of this class is Methamphetamine, available in a regular formulation, and sold as Desoxyn by Ovation Pharmaceutical Company. It is usually taken twice daily.
Atomoxetines are a Selective Norepinephrine Reuptake Inhibitor (SNRI), introduced in 2002. It is the newest class of drug used to treat ADHD, and the first non-stimulant medication to be used as a first-line treatment for ADHD. Available in a once daily formulation, sold by Eli Lilly and Company as Strattera (24 hours per dose), and taken once a day.
Second-line medications include benzphetamine, a less powerful stimulant, and Provigil/Alertec/modafinil. Research on the effectiveness of these drugs has not been completed. Cylert/Pemoline is a stimulant that was used with great success until the late 1980s, when it was discovered that it could cause liver damage. Although some physicians do continue to prescribe Cylert, it can no longer be considered a first-line medicine, and in March 2005 the makers of Cylert announced that it would discontinue the medication's production.
Because most of the medications used to treat ADHD are included in Schedule II of the U.S. DEA schedule system, and are considered powerful stimulants with a potential for abuse, there is a great deal of controversy surrounding prescribing these drugs for children and adolescents. Despite these concerns, researchers studying ADHD sufferers who either receive treatment with stimulants, or go untreated, have shown that those treated with stimulants are much less likely to abuse any substance than are ADHD sufferers who were not treated with stimulants.
In 1996 the World Health Organization warned that Ritalin over-use has reached dangerous proportions. Because of a lack of research, use of these drugs on a long-term...
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