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1.
Medicina (B Aires) ; 80 Suppl 2: 72-75, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32150718

RESUMO

Attention deficit and hyperactivity disorder (ADHD) is a neurobiological disorder frequent in childhood. The main symptoms are attention disorder and/or impulsivity and/or hyperactivity. There are different subtypes of ADHD according to the degree of presence of these three symptoms. There are different therapeutic approaches with high proved effectiveness. Methylphenidate, a stimulant that acts through the dopaminergic and adrenergic pathways, is commonly used for the treatment of ADHD. The Strengths and Difficulties Questionnaire (SDQ) is a brief behavioural screening instrument internationally used for the screening of mental health problems in children and adolescents. It consists in a 25 items questionnaire with 5 different scales: emotional symptoms, conduct problems, hyperactivity / inattention, peer relationship problems and prosocial behaviours. The SDQ score was collected in a sample of ADHD patients with an age between 7 and 12 years. The score obtained before starting treatment with methylphenidate was compared before and after starting treatment, every 3-6 months and up to a period of 2 years. Statistical processing was performed using R, which is a free program for statistical and graphical analysis, that allows temporary analysis. The results indicate that hyperactivity improves throughout the first year of treatment, emotional symptoms and behavioral problems improve during the first 6 months of treatment, pro-social symptoms slowly improve over 2 years. Problems with partners do not improve in the analyzed time.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Inibidores da Captação de Dopamina/uso terapêutico , Metilfenidato/uso terapêutico , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Criança , Progressão da Doença , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Visita a Consultório Médico , Análise de Regressão , Inquéritos e Questionários , Fatores de Tempo , Resultado do Tratamento
2.
Laeknabladid ; 106(3): 131-138, 2020.
Artigo em Islandês | MEDLINE | ID: mdl-32124736

RESUMO

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder among children but symptoms may persist into adulthood. At Landspitali - the National University Hospital an interdisciplinary unit is responsible for ADHD-diagnosis and for commencing treatment of adult ADHD. The aim of this study is to evaluate the effectiveness of pharmaceu-tical treatment provided by the unit and the effects of psychiatric comorbidities. METHODS: The study is retrospective and includes all individuals ≥18 years of age who received pharmaceutical treatment in the adult ADHD unit at Landspitali 2015-2017. Individuals who had previously received treatment by the unit or were already on medication for ADHD were excluded. Information on symptoms and wellbeing before and after treatment were obtained from three questionnaires, an ADHD rating scale, DASS and QOLS. RESULTS: Of 211 patients who met inclusion criteria 144 (68%) completed the treatment provided by the unit on average 143 days. Impulsivity/hyperactivity predicted treatment failure with OR=0.96 (p=0.015). There was a statistically significant difference in all key response variables before and after pharmaceutical treatment (p<0.001). The Cohen's d effect size for ADHD variables were 3.18 for attention-deficit and 1.40 for impulsivity/hyperactivity. The effect size for quality of life was 1.00 and among the DASS subscales the maximum effect size was 1.43 for stress. Increased quality of life correlated with decreased symptoms as rated by DASS and the ADHD rating scale. Treatment success rates were significantly -higher for DASS but not for attention-deficit, impulsivity/hyperactivity and quality of life among individuals with psychiatric comorbidities alongside ADHD. Gender did not affect treatment effectiveness. CONCLUSIONS: Those who complete treatment within the ADHD unit achieve good results with decreased psychiatric symptoms and improved quality of life. Treatment discontinuation is a challenge.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Estimulantes do Sistema Nervoso Central , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Estimulantes do Sistema Nervoso Central/uso terapêutico , Hospitais Universitários , Humanos , Qualidade de Vida , Estudos Retrospectivos , Falha de Tratamento , Resultado do Tratamento
5.
Autoimmun Rev ; 19(1): 102439, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31734401

RESUMO

INTRODUCTION: Methylphenidate (Ritalin) is a CNS stimulant, and is a common treatment for children and adults with ADHD. It has been associated with Raynaud's phenomenon (RP) but not with Systemic Sclerosis (SSc). We report a case series of patients pointing out the connection between Methylphenidate and SSc. CASES: We identified three patients in a single Rheumatology clinic in Israel, who developed SSc following treatment with CNS stimulants for ADHD. All three cases had Raynaud's phenomenon, skin changes, pathological capillaroscopy and positive ANA. Symptoms appeared and worsened over months following the use of methylphenidate and subsided after its cessation. CONCLUSION: This is the first report in the literature of a causative relation between methylphenidate and the development of SSc, a serious, life-threatening condition. Patients treated with CNS stimulants should be followed closely for side-effects such as RP and skin changes.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Estimulantes do Sistema Nervoso Central/efeitos adversos , Escleroderma Sistêmico/induzido quimicamente , Adulto , Estimulantes do Sistema Nervoso Central/uso terapêutico , Feminino , Humanos , Israel , Doença de Raynaud/induzido quimicamente , Adulto Jovem
6.
Lancet Psychiatry ; 6(12): 995-1010, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31672337

RESUMO

BACKGROUND: Medicinal cannabinoids, including medicinal cannabis and pharmaceutical cannabinoids and their synthetic derivatives, such as tetrahydrocannabinol (THC) and cannabidiol (CBD), have been suggested to have a therapeutic role in certain mental disorders. We analysed the available evidence to ascertain the effectiveness and safety of all types of medicinal cannabinoids in treating symptoms of various mental disorders. METHODS: For this systematic review and meta-analysis we searched MEDLINE, Embase, PsycINFO, the Cochrane Central Register of Controlled Clinical Trials, and the Cochrane Database of Systematic Reviews for studies published between Jan 1, 1980, and April 30, 2018. We also searched for unpublished or ongoing studies on ClinicalTrials.gov, the EU Clinical Trials Register, and the Australian and New Zealand Clinical Trials Registry. We considered all studies examining any type and formulation of a medicinal cannabinoid in adults (≥18 years) for treating depression, anxiety, attention-deficit hyperactivity disorder (ADHD), Tourette syndrome, post-traumatic stress disorder, or psychosis, either as the primary condition or secondary to other medical conditions. We placed no restrictions on language, publication status, or study type (ie, both experimental and observational study designs were included). Primary outcomes were remission from and changes in symptoms of these mental disorders. The safety of medicinal cannabinoids for these mental disorders was also examined. Evidence from randomised controlled trials was synthesised as odds ratios (ORs) for disorder remission, adverse events, and withdrawals and as standardised mean differences (SMDs) for change in symptoms, via random-effects meta-analyses. The quality of the evidence was assessed with the Cochrane risk of bias tool and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. This study is registered with PROSPERO (CRD42017059372, CRD42017059373, CRD42017059376, CRD42017064996, and CRD42018102977). FINDINGS: 83 eligible studies (40 randomised controlled trials, n=3067) were included: 42 for depression (23 randomised controlled trials; n=2551), 31 for anxiety (17 randomised controlled trials; n=605), eight for Tourette syndrome (two randomised controlled trials; n=36), three for ADHD (one randomised controlled trial; n=30), 12 for post-traumatic stress disorder (one randomised controlled trial; n=10), and 11 for psychosis (six randomised controlled trials; n=281). Pharmaceutical THC (with or without CBD) improved anxiety symptoms among individuals with other medical conditions (primarily chronic non-cancer pain and multiple sclerosis; SMD -0·25 [95% CI -0·49 to -0·01]; seven studies; n=252), although the evidence GRADE was very low. Pharmaceutical THC (with or without CBD) worsened negative symptoms of psychosis in a single study (SMD 0·36 [95% CI 0·10 to 0·62]; n=24). Pharmaceutical THC (with or without CBD) did not significantly affect any other primary outcomes for the mental disorders examined but did increase the number of people who had adverse events (OR 1·99 [95% CI 1·20 to 3·29]; ten studies; n=1495) and withdrawals due to adverse events (2·78 [1·59 to 4·86]; 11 studies; n=1621) compared with placebo across all mental disorders examined. Few randomised controlled trials examined the role of pharmaceutical CBD or medicinal cannabis. INTERPRETATION: There is scarce evidence to suggest that cannabinoids improve depressive disorders and symptoms, anxiety disorders, attention-deficit hyperactivity disorder, Tourette syndrome, post-traumatic stress disorder, or psychosis. There is very low quality evidence that pharmaceutical THC (with or without CBD) leads to a small improvement in symptoms of anxiety among individuals with other medical conditions. There remains insufficient evidence to provide guidance on the use of cannabinoids for treating mental disorders within a regulatory framework. Further high-quality studies directly examining the effect of cannabinoids on treating mental disorders are needed. FUNDING: Therapeutic Goods Administration, Australia; Commonwealth Department of Health, Australia; Australian National Health and Medical Research Council; and US National Institutes of Health.


Assuntos
Ansiedade/tratamento farmacológico , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Canabinoides/uso terapêutico , Depressão/tratamento farmacológico , Transtornos de Estresse Pós-Traumáticos/tratamento farmacológico , Síndrome de Tourette/tratamento farmacológico , Austrália , Dor Crônica/tratamento farmacológico , Humanos
7.
Expert Opin Drug Metab Toxicol ; 15(11): 937-974, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31581854

RESUMO

Introduction: Long-acting stimulant formulations are recommended as first-line pharmacotherapy for attention-deficit/hyperactivity disorder (ADHD). Over the past 20 years, extended-release (ER) methylphenidate (MPH) and amphetamine (AMP) formulations have evolved to include varying drug delivery technologies, enantiomers/salts, and dosage forms. All formulations are characterized by a unique pharmacokinetic profile that is closely mirrored by pharmacodynamic response allowing clinicians to individualize therapy based on their patient's clinical needs and dosing preferences.Areas covered: This review provides an update on the pharmacokinetic properties of approved and investigational ER MPH and AMP formulations and highlights pharmacokinetic features that clinicians should consider when selecting a long-acting stimulant.Expert opinion: Since there are no reliable biomarkers that can predict individualized response to long-acting stimulants, clinicians need to consider their distinctive pharmacokinetic properties, including the pharmacokinetic profile, rate and extent of absorption, variability, dose proportionality, bioequivalence, and potential for accumulation. Clinicians also need to understand that certain factors can contribute to increased variability in pharmacokinetics and potentially affect outcomes. Less invasive, high-throughput techniques and novel time-based scales are being developed to advance research on the pharmacokinetic-pharmacodynamic relationships of stimulants. Model-based pharmacokinetic-pharmacodynamic approaches can be applied to aid the development of novel formulations and individualize therapy with existing drugs.


Assuntos
Anfetamina/administração & dosagem , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Metilfenidato/administração & dosagem , Anfetamina/farmacocinética , Estimulantes do Sistema Nervoso Central/administração & dosagem , Estimulantes do Sistema Nervoso Central/farmacocinética , Preparações de Ação Retardada , Relação Dose-Resposta a Droga , Sistemas de Liberação de Medicamentos , Desenvolvimento de Medicamentos , Humanos , Metilfenidato/farmacocinética , Modelos Biológicos , Medicina de Precisão
8.
Artigo em Inglês | MEDLINE | ID: mdl-31618876

RESUMO

Background: Cocaine use disorder (CUD) is a growing public health concern, but so far no effective pharmacotherapies have been demonstrated. Stimulant medications have proved to be promising in CUD treatment. The self-medication hypothesis (SMH) can help to explain this phenomenon better, especially in cases where CUD co-occurs with adult attention deficit hyperactivity disorder (A-ADHD). Methods: In the present retrospective study, a sample of 20 consecutive patients (aged from 18 to 65 years) with dual disorder (A-ADHD/CUD), under treatment with methylphenidate (MPH) or atomoxetine (ATM) medications, was followed to study the effects of A-ADHD treatment on cocaine use. Patients were followed for a mean period of 7 months (minimum 1, maximum 30 months). All individuals were assessed with standardized questionnaires to evaluate diagnosis, treatment efficacy, and clinical improvement. Results: the results showed that behaviors reflecting cocaine addiction were sharply reduced during the stimulant treatment of A-ADHD, and were not correlated with age, gender, familiarity, length of treatment, or medication used. CUD improvement was closely correlated with the A-ADHD improvement. This study supports the validity of the SMH in ADHD patients with co-occurring CUD.


Assuntos
Cloridrato de Atomoxetina/uso terapêutico , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Estimulantes do Sistema Nervoso Central/uso terapêutico , Transtornos Relacionados ao Uso de Cocaína/tratamento farmacológico , Cocaína/administração & dosagem , Metilfenidato/uso terapêutico , Adolescente , Adulto , Idoso , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtornos Relacionados ao Uso de Cocaína/epidemiologia , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
9.
Artigo em Inglês | MEDLINE | ID: mdl-31658722

RESUMO

The emerging literature reports that children with Attention-Deficit/Hyperactivity Disorder (ADHD) show deficits in executive functioning. To date, the combination of drug therapy with certain evidence-based non-medication interventions has been proven to be the most effective treatment for ADHD. There is a gap in the literature regarding comparing the executive functions (EF) of treatment naïve and medicated children with ADHD with both each other and typically developing children. Altogether, 50 treatment naïve and 50 medicated children with ADHD and 50 typically developing children between the ages of six and 12 were enrolled. The Mini International Neuropsychiatric Interview for Children and Adolescents (Mini Kid) and the Test of Attentional Performance for Children (KiTAP) measures were employed. Treatment naïve children with ADHD showed weaker performance on most executive function measures (12 out of 15) than either the medicated ADHD group or the controls. There were no significant differences between the medicated ADHD children and typically developing children in most KiTAP parameters (10 out of 15). Executive function impairments were observable in treatment naïve ADHD children, which draws attention to the importance of treating ADHD. Future studies should focus on the specific effects of stimulant medication on executive functions.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Atenção , Estimulantes do Sistema Nervoso Central/uso terapêutico , Função Executiva , Criança , Desenvolvimento Infantil , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Resultado do Tratamento
10.
Lakartidningen ; 1162019 Sep 17.
Artigo em Sueco | MEDLINE | ID: mdl-31529419

RESUMO

Emerging evidence supports a prevalence overlap between ADHD and bulimia nervosa/binge eating disorder. A high degree of ADHD symptoms may have a negative impact on recovery in eating disorders with loss of control over the eating, bingeing and purging. Screening/diagnostic evaluation of ADHD in all persons with loss of control over the eating/bingeing/purging eating disorders is required. For patients diagnosed with ADHD, treatment with stimulants can be tested and evaluated for both eating disorders and ADHD symptoms. While there is evidence that lisdexamfetamine reduces symptoms of binge eating disorder, rigorous studies evaluating ADHD treatment, including medication, for bulimia nervosa are still missing.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtornos da Alimentação e da Ingestão de Alimentos/complicações , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Transtorno da Compulsão Alimentar/complicações , Transtorno da Compulsão Alimentar/tratamento farmacológico , Bulimia Nervosa/complicações , Bulimia Nervosa/tratamento farmacológico , Estimulantes do Sistema Nervoso Central/uso terapêutico , Transtornos da Alimentação e da Ingestão de Alimentos/tratamento farmacológico , Humanos , Dimesilato de Lisdexanfetamina/uso terapêutico
11.
Expert Rev Clin Pharmacol ; 12(10): 965-971, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31526076

RESUMO

Introduction: Attention-deficit/hyperactivity disorder (ADHD) is a common neurobehavioral disorder known to respond to amphetamine (AMPH). Multiple AMPH formulations have been developed during the past two decades and have focused mainly on extending the duration of effect. AMPH extended-release oral suspension, Dyanavel XR, (AMPH EROS) was developed to address the unmet needs of patients who have difficulty swallowing intact extended-release (ER) tablets and capsules. Areas covered: The pharmacokinetic profile of the AMPH EROS in children and adults is discussed along with the technology responsible for its release profile. Efficacy data from two clinical trials are presented and AMPH EROS is compared with other marketed AMPH ER formulations in the United States. Expert opinion: Multiple AMPH ER formulations that do not require ingestion of an intact tablet or capsule have been developed. Initial products allowed for sprinkling or dissolving of capsule contents. Recently, oral disintegrating tablets, chewable tablets, and oral suspensions have been marketed. Each formulation has positive attributes. Tablets may be more portable. However, as a suspension, AMPH EROS dosing can differ depending on daily requirements. Dose can also be titrated with a single prescription. Despite its convenience, AMPH EROS is a branded product, so price may be prohibitive for some patients.


Assuntos
Anfetamina/administração & dosagem , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Estimulantes do Sistema Nervoso Central/administração & dosagem , Administração Oral , Adulto , Anfetamina/farmacocinética , Estimulantes do Sistema Nervoso Central/farmacocinética , Criança , Preparações de Ação Retardada , Relação Dose-Resposta a Droga , Liberação Controlada de Fármacos , Humanos , Suspensões
12.
Clin Sports Med ; 38(4): 545-554, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31472765

RESUMO

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that manifests in difficulties with sustaining attention in tasks and/or hyperactivity/impulsivity. Prevalence rates vary and difficulties in objectively diagnosing ADHD may lead to overdiagnosis or underdiagnosis. Assessment should include a comprehensive evaluation, including history, physical, psychological evaluation, and questionnaires for ADHD. Stimulant medications are effective for treatment, but their use, side effects, and potential for misuse and abuse are a concern, particularly in athletes. Athletes and physicians also need to be aware of the governing body's drug policy for the sport.


Assuntos
Atletas/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Estimulantes do Sistema Nervoso Central/uso terapêutico , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Estimulantes do Sistema Nervoso Central/efeitos adversos , Humanos
14.
Zh Nevrol Psikhiatr Im S S Korsakova ; 119(7. Vyp. 2): 58-66, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31532592

RESUMO

The authors review current data on the role of the synthetic aspartic acid analogue N-acetyaspartate (NAA) in various biochemical metabolic reactions in the CNS. Its importance as a biomarker for neuropsychiatric disorders identified using magnetic resonance spectroscopy (MRS) is noted. The authors present their own results of the use of cogitum, a synthetic analogue of NAA, in children with the effects of traumatic brain injury, mental retardation, hyperactivity disorder and in the complex therapy of schizotypal disorder. Effects of cogitum on cognitive deficit, asthenia are evaluated. The neurotrophic effect of the drug, which specifically affects cognitive and asthenic disorders in these diseases, is shown.


Assuntos
Ácido Aspártico , Transtorno do Deficit de Atenção com Hiperatividade , Ácido Aspártico/uso terapêutico , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Encéfalo , Criança , Colina , Creatina , Humanos , Espectroscopia de Ressonância Magnética , Neurologia/tendências , Psiquiatria/tendências
15.
Biomed Pharmacother ; 118: 109033, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31545235

RESUMO

Studies suggest that abnormal neurodevelopment of prefrontal striatal circuits is implicated in the pathogenesis of attention deficit hyperactivity disorder (ADHD). In the present study, we investigated the effect of catalpol, an active ingredient of Rehmanniae radix preparata, which is the most frequently used Chinese medicinal herb for the treatment of ADHD, on behavior and neurodevelopment in spontaneously hypertensive rats (SHR). SHR were divided into SHR group (vehicle, i.g.), methylphenidate (MPH) group (2 mg/kg/day, i.g.), and catalpol group (50 mg/kg/day i.g.), and Wistar-Kyoto (WKY) rats were used as control group (vehicle, i.g.). Open Field Test (OFT) and Morris water maze (MWM) test were performed to assess the effect of catalpol on behavior. Results revealed that both catalpol and MPH treatment decreased average speed, time spent in the central area, rearing times, and central area visits, increased the immobility time of SHR in OFT, and increased number of visits to the annulus, and time spent in target quadrant in the MWM test. Hematoxylin and eosin (H&E) staining showed that catalpol reduced irregular neuronal arrangement, ruptured nuclear membranes, and resulted in disappearance of the nucleolus in the prefrontal cortex (PFC) and striatum of SHR. Moreover, immuno-fluorescent staining of NeuN and myelin basic protein (MBP) indicated that catalpol ameliorated neuronal loss and contributed to myelination. Finally, western blot and immunostaining analysis suggested that several regulatory proteins involved in PFC development were up-regulated by catalpol treatment, such as brain-derived neurotrophic factor (BDNF), cyclin-dependent kinase 5 (Cdk5), p35, fibroblast growth factor (FGF) 21 and its receptor (FGFR)1. Taken together, catalpol can effectively ameliorate hyperactive and impulsive behavior, improve spatial learning and memory in SHR, likely through the neurodevelopmental pathways. Nonetheless, whether catalpol could attenuate inattention in SHR and the pathway by which catalpol reduces neuronal loss remain to be further studied.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Comportamento Animal/efeitos dos fármacos , Glucosídeos Iridoides/uso terapêutico , Atividade Motora/efeitos dos fármacos , Fármacos Neuroprotetores/uso terapêutico , Animais , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Estimulantes do Sistema Nervoso Central/uso terapêutico , Corpo Estriado/efeitos dos fármacos , Corpo Estriado/patologia , Modelos Animais de Doenças , Masculino , Aprendizagem em Labirinto/efeitos dos fármacos , Memória/efeitos dos fármacos , Metilfenidato/uso terapêutico , Neurônios/efeitos dos fármacos , Neurônios/patologia , Córtex Pré-Frontal/efeitos dos fármacos , Córtex Pré-Frontal/patologia , Ratos Endogâmicos SHR , Ratos Endogâmicos WKY
17.
Complement Ther Clin Pract ; 36: 170-175, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31383435

RESUMO

BACKGROUND AND PURPOSE: Attention-deficit/hyperactivity disorder (ADHD) is one of the most common health disorders among children. Some patients do not respond to methylphenidate or cannot tolerate its side effects. Sweet almond syrup as a Persian Medicine preparation has been used for many years. This study aims to evaluate the efficacy and safety of sweet almond for ADHD children. MATERIALS AND METHODS: Fifty children aged 6-14 years with ADHD were recruited to the study. The participants were randomly assigned to two groups to receive either methylphenidate or sweet almond syrup. The outcomes were assessed using the Parent and Teacher ADHD Rating Scale every two weeks for 8 weeks. RESULTS: Results showed that the two treatments had similar effects on symptom reduction in ADHD children. No significant differences were observed between the two groups (F=2.3, df=1, p=0.13, F=0.57, df=1, p=0.47). CONCLUSION: Sweet almond may be an effective treatment for ADHD children.


Assuntos
Antioxidantes/uso terapêutico , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Estimulantes do Sistema Nervoso Central/uso terapêutico , Metilfenidato/uso terapêutico , Extratos Vegetais/uso terapêutico , Prunus dulcis , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Criança , Método Duplo-Cego , Feminino , Alimento Funcional , Humanos , Masculino
18.
Nervenarzt ; 90(9): 926-931, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31407043

RESUMO

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is a common comorbidity in adult patients with substance use disorders (SUDs). The diagnostics and treatment of ADHD with SUD are often a challenge, also with respect to the prescription of stimulants. Recently, a group of international experts developed a consensus paper on the diagnosis and treatment of comorbid ADHD and SUD. In addition, the German S3 guidelines on ADHD have been published, which also give advice on the treatment of ADHD in comorbid SUD. The German S3 guidelines on alcohol-related disorders and methamphetamine-related disorders also address ADHD as a comorbidity. METHODS: Summary of consensus and guideline recommendations, supplemented with the most recent literature. CONCLUSION: In recent years new findings on the comorbidity of ADHD in patients with SUD have emerged. A series of screening and diagnostic instruments have meanwhile been evaluated in this patient group. The consensus paper and various guidelines therefore provide clinicians with specific help in detecting ADHD in patients with SUD and in conducting further diagnostics and treatment of both disorders. For example, the importance of stimulants in the treatment of patients with SUD and ADHD has significantly changed and first studies on psychotherapeutic interventions specific to this comorbidity are now available.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Estimulantes do Sistema Nervoso Central , Transtornos Relacionados ao Uso de Substâncias , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Estimulantes do Sistema Nervoso Central/administração & dosagem , Comorbidade , Alemanha , Humanos , Transtornos Relacionados ao Uso de Substâncias/complicações
19.
Aerosp Med Hum Perform ; 90(9): 788-791, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31426894

RESUMO

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is a chronic neurological disorder characterized by persistent patterns of inattention, impulsivity, and hyperactivity. The most common treatment for this disorder is methylphenidate, which is a disqualifying medication for flight. Candidates with previous use of methylphenidate are not necessarily disqualified from the Israeli Air Force (IAF) flight academy.METHODS: Flight cadets from 12 consecutive flight courses who have used methylphenidate at least once in the past were identified according to their medical records. The graduation ratio of cadets with previous use of methylphenidate was compared with that of the rest of the cadets. A comparison was also made with regard to the causes of disqualification from the flight course. Statistical significance was assessed using the Fischer Test.RESULTS: Among the 90 flight cadets who have used methylphenidate, only 2 (2.2%) successfully graduated from the IAF flight academy. Among the 2983 flight cadets who have no history of methylphenidate use, 461 (15.4%) successfully graduated. We found no significant differences in the disqualification causes between the two groups.CONCLUSION: The IAF flight academy graduation rate was meaningfully and significantly lower among cadets who reported previous use of methylphenidate. The study design, however, limits the inference of causal relationship.Sarfati S, Nakdimon I, Tsodyks J, Assa A, Gordon B. Success rates at an air force pilot academy and its relation to methylphenidate use. Aerosp Med Hum Perform. 2019; 90(9):788-791.


Assuntos
Sucesso Acadêmico , Estimulantes do Sistema Nervoso Central/farmacologia , Cognição/efeitos dos fármacos , Metilfenidato/farmacologia , Militares/educação , Pilotos/educação , Adolescente , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Estimulantes do Sistema Nervoso Central/uso terapêutico , Uso Indevido de Medicamentos , Feminino , Humanos , Israel , Masculino , Metilfenidato/uso terapêutico , Militares/estatística & dados numéricos , Pilotos/estatística & dados numéricos , Estudos Retrospectivos , Instituições Acadêmicas/estatística & dados numéricos , Adulto Jovem
20.
Genetics ; 213(2): 633-650, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31455722

RESUMO

Knowledge of the genetic basis underlying variation in response to environmental exposures or treatments is important in many research areas. For example, knowing the set of causal genetic variants for drug responses could revolutionize personalized medicine. We used Drosophila melanogaster to investigate the genetic signature underlying behavioral variability in response to methylphenidate (MPH), a drug used in the treatment of attention-deficit/hyperactivity disorder. We exposed a wild-type D. melanogaster population to MPH and a control treatment, and observed an increase in locomotor activity in MPH-exposed individuals. Whole-genome transcriptomic analyses revealed that the behavioral response to MPH was associated with abundant gene expression alterations. To confirm these patterns in a different genetic background and to further advance knowledge on the genetic signature of drug response variability, we used a system of inbred lines, the Drosophila Genetic Reference Panel (DGRP). Based on the DGRP, we showed that the behavioral response to MPH was strongly genotype-dependent. Using an integrative genomic approach, we incorporated known gene interactions into the genomic analyses of the DGRP, and identified putative candidate genes for variability in drug response. We successfully validated 71% of the investigated candidate genes by gene expression knockdown. Furthermore, we showed that MPH has cross-generational behavioral and transcriptomic effects. Our findings establish a foundation for understanding the genetic mechanisms driving genotype-specific responses to medical treatment, and highlight the opportunities that integrative genomic approaches have in optimizing medical treatment of complex diseases.


Assuntos
Drosophila melanogaster/genética , Genômica , Locomoção/genética , Transcriptoma/genética , Animais , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Transtorno do Deficit de Atenção com Hiperatividade/genética , Drosophila melanogaster/efeitos dos fármacos , Epistasia Genética/genética , Feminino , Regulação da Expressão Gênica/efeitos dos fármacos , Estudos de Associação Genética , Variação Genética/genética , Genoma de Inseto/efeitos dos fármacos , Humanos , Locomoção/efeitos dos fármacos , Masculino , Metilfenidato/farmacologia , Transcriptoma/efeitos dos fármacos
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