harmacological Treatment
timulants
How do stimulants help ADHD?
ADHD is the neurological disorder that is result from low level of neurotransmitter in brain. Neurotransmitter is the chemical substance that help to transmit signals between nerve cells. Stimulant work by stimulating specific cell to produce neurotransmitter in the brain. Stimulants are the first-choice medication in ADHD treatment.
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Dopamine and norepinephrine responsible for regulating attention and executive function (planning, prioritizing, organizing, paying attention, memorizing ability, and control emotion). Stimulants make these neurotransmitters more available, therefore improving activity and communication in those parts of the brain which operate on dopamine and norepinephrine and signal for specific tasks.
DISadvantages
advantages
Stimulant can help manage ADHD symptoms:
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Short attention span
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Impulsive behavior
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Hyperactivity
Doses that used to treat ADHD in children and teens are not tend to cause or encourage addiction. However, there is potential for abuse and addiction with any stimulant medication and it is high risk in person who had a history of substance abuse and addiction.
Their misuse, including overdose, can also lead to psychosis, anger, paranoia, heart, nerve, and stomach problems. These issues could lead to a heart attack or seizures. Stimulant misuse can lead to severe addiction, even when used as prescribed by a doctor. Withdrawal symptoms (physical reaction upon stopping to take an addictive drug) include fatigue, depression, and sleep problems.
Methylphenidate
blocking neurotransmitter (dopamine and norepinephrine) reuptake by neurons and thus increasing neurotransmitter in nerve cells.
How it works?
Improve distractibility, short attention span, hyperactivity, emotional lability, and impulsivity.
How it acts?
What are the side effects?
Headache, decreased appetite, stomach ache, nervousness, difficulty sleeping, mood swings, sweating, shaking, fever, weight loss, and dizziness.
Amphetamine
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increases the release of dopamine and norepinephrine from their storage sites into junction between nerve cells thus speed up the messages travelling in brain.
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blocks the reuptake neurotransmitter in nerve cells.
How it works?
Stabilizing distractibility, short attention span, hyperactivity, emotional lability, and impulsivity. Improve brain development and nerve growth in children with ADHD.
How it acts?
What are the side effects?
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Significant weight loss, stomach upset/pain, nausea/vomiting, dizziness, headache, diarrhea, fever, trouble sleeping.
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It is also found to slow growth in child.
ADHD-specific non-stimulant target to increase the neurotransmitter (norepinephrine) in nerve cell and enhancing the information transfer in brain.
How do non-stimulants help ADHD?
on-stimulants
advantages
Nonstimulants don’t tend to cause agitation, sleeplessness, or lack of appetite. They also don’t cause tendency of substance abuse or addiction. In addition, they have long-lasting and smoother effect than many stimulants, which can take effect and wear off abruptly
DISadvantages
Tendency to have suicidal thought and liver problem for ADHD-specific non-stimulant.
ATOMOXETINE
FDA approved for treatment of ADHD in adults and children over the age of 6 years old.
GUANFACINE
Atomoxetine
FDA approved for treatment of ADHD in adults and children over the age of 6 years old.
ADHD-Specific Non-Stimulants
It should be considered or preferred for ADHD patients with an active substance abuse problem, those with severe side effects to stimulants, tics, Tourette's disorder, mood lability and comorbid anxiety.
inhibit the reuptake of neurotransmitter (noradrenaline) in nerve cells.
How it works?
How it acts?
It increases a person's attention span and lessen their impulsive behavior and hyperactivity.
What are the side effects?
stomach-ache, nausea, vomiting, dizziness, fatigue, dry mouth, increased heart rate and blood pressure, agitation, and irritability.
Atomoxetine may increase the suicidal thinking which may occur during the first few months of treatment, therefore patients and parents should be aware of this risk.
Guanfacine
Anti-Hypertensive Drugs
Approved for children ages 6 to 17. Doctors also prescribe them to adults. They do not appear to be as effective in improving symptoms of inattention and are usually only used to treat ADHD when you can't tolerate or don't respond to Strattera or stimulants.
How it acts?
They lower distractibility and improve attention, working memory, and impulse control.
What are the side effects?
headache, fatigue, dizziness, and sleepiness.
Therefore, which medication is the best for ADHD?
In short, there’s no way to know which stimulant medication will work “best” for any one person’s ADHD. It’s often related to your history, your genetics, and your or your child’s unique metabolism.
Table of comparison between stimulants and non-stimulants.