Attention Deficit-Hyperactivity Disorder

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Overview

Prescribing for ADHD is increasing in all age groups, particularly adolescents and young adults. Between 1998 and 2005, prescriptions for teenagers and pre-teenagers increased 133% for amphetamine products and 52% for methylphenidate products; 80% for both. With increased prescribing, safety, misuse and abuse have emerged as the biggest therapeutic dilemmas in the treatment of ADHD.

Drug therapy and behavioral therapy are the most beneficial and well-studied treatments for all age groups. Stimulants are the first-line treatment for ADHD because they are the most effective medications and have good tolerability overall. Nonstimulant medications are available but vary greatly in onset, effectiveness, and side effects. This issue summarizes the benefits and risks of treatment based on severity of patient symptoms, coexisting conditions, and preferences. ADHD treatments are compared with regard to effectiveness, tolerability, dosing, monitoring, and counseling.

Publication Date: Apr-1-10
Expiration Date: Apr-1-13
CE Credit: 1.5 (.15 CEU)
Type of activity: Knowledge-based

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Programs developed by The Rx Consultant are written by health care providers with expertise in the topic area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure that every program presents information that is current, accurate, relevant to "real world" health care providers, and written in an easy reading, "plain English" style.

Authors

Julie A. Dopheide, Pharm.D., BCPP, Associate Professor of Clinical Pharmacy Psychiatry and the Behavioral Sciences, University of Southern California Schools of Pharmacy and Medicine. Dr. Dopheide has specialized expertise in child/adolescent psychiatric disorders. She works with children and adults with psychiatric illnesses in the hospital and clinic settings, and teaches at the Los Angeles County+University of Southern California Medical Center.

Disclosure Statement

Dr. Dopheide reports no financial or personal relationship with any commercial interest producing, marketing, reselling, or distributing a product or service that appears in this issue.

Editorial and Review Board

Editor and CE Administrator Terry M. Baker, PharmD Associate Editor and CE Coordinator Tracy Farnen, PharmD Associate Editors James Chan, PharmD, PhD Pharmacy Quality and Outcomes Coordinator Kaiser Permanente Oakland, CA Associate Clinical Professor School of Pharmacy University of California San Francisco San Francisco, CA Ron Finley, RPh Lecturer Department of Clinical Pharmacy University of California San Francisco San Francisco, CA Associate Member of the UCSF Memory and Aging Center Alzheimer's Research Center Consultant Pharmacist to the Institute on Aging-On Lok Senior Health Institute on Aging Alzheimer's Day Care Center Angie S. Graham, PharmD Drug Information Coordinator Stanford Hospital and Clinics Stanford University Medical Center Stanford, CA Julio R. Lopez, PharmD, FCSHP Chief of Pharmacy Service VA Northern California Health Care System Adjunct Clinical Professor College of Pharmacy Touro University Vallejo, CA Assistant Clinical Professor School of Pharmacy University of California, San Francisco San Francisco, CA

Adjunct Professor Thomas J. Long School of Pharmacy University of the Pacific Stockton, CA Visiting Associate Professor and Lecturer Nursing School Samuel Merritt University Oakland, CA Pamela Mausner, MD Joshua J. Neumiller, PharmD, CDE, CGP, FASCP Assistant Professor Department of Pharmacotherapy College of Pharmacy Washington State University And Elder Services of Spokane Spokane, WA Candy Tsourounis, PharmD Professor of Clinical Pharmacy Medication Outcomes Center Department of Clinical Pharmacy School of Pharmacy University of California, San Francisco San Francisco, CA Senior Editorial Advisor Gerard Hatheway, PharmD, PhD Editorial Advisors Jocelyn Chan, PharmD Belinda M. Danielson, RPh Christopher M. DeSoto, PharmD Cynthia Chan Huang, PharmD, MBA Fred Plageman, PharmD Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners Emily K. Meuleman, RN, C, MS

Accreditation Statements

The Rx Consultant is a publication of Continuing Education Network, Inc.

About the Rx Consultant

The Rx Consultant is a monthly publication dedicated to providing health care professionals with the information they need to educate patients about drugs and manage drug therapy. The reader is responsible for confirming the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.

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Target Audience

This accredited program is targeted to pharmacists and nurses.

Exam and Credit Statement Procedures

Upon successful completion of this program and the post test (70%), 1.5 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and program evaluation.

Educational Goals and Objectives

At the conclusion of this program, participants will be able to:

1. Describe the clinical signs and symptoms of ADHD and explain how ADHD can affect functioning across the life span.
2. Compare treatment options with regard to efficacy, tolerability and appropriate monitoring parameters.
3. Counsel patients, families and caregivers on the appropriate dosing and monitoring of medications for managing symptoms of ADHD.