Attention Deficit Hyperactivity Disorder Carlat Reports

Expert Q&A

From The Carlat Psychiatry Report, ADHD

Topics: ADHD | attention | Attention Deficit Hyperactivity Disorder | Complimentary Medicine | natural treatments

TCPR: What’s missing in how we treat ADHD? Dr. Brown: Even with stimulant treatment, patients can still have a lot of executive dysfunction. Many have comorbid conditions like dyslexia or processing disorders that stimulants do not treat. TCPR: How do you screen for those problems? Dr. Brown: Neuropsychological testing is not necessary for di

Clinical Update

Atomoxetine for Children and Adolescents: An Update

From The Carlat Child Psychiatry Report, Assessment in Children and Adolescents

Topics: ADHD | Atomoxetine (ATX) | Attention Deficit Hyperactivity Disorder

Atomoxetine (ATX, Strattera) was approved by the FDA for ADHD treatment in 2002, and since then has become a second- or third-line option (after stimulants and sometimes after central alpha-agonists) for ADHD in both children and adults. With the recent approval of another non-stimulant ADHD medication (viloxazine, brand name Qelbree), it’s a good tim

Research Update

Vitamin D for ADHD?

From The Carlat Child Psychiatry Report, Mood Disorders in Children and Adolescents

Topics: ADHD | Attention Deficit Hyperactivity Disorder | Vitamin D

Review of: Gan J et al, J Child Adolesc Psychopharmacol 2019;29(9):670–687 Many children do not respond to or tolerate standard pharmacotherapy, which drives continued interest in supplements for many conditions, including ADHD. Vitamin D plays a role in healthy brain development, and vitamin D deficiency causes neurotransmitter alterations in path

Expert Q&A

Reduced Life Expectancy in ADHD

From The Carlat Child Psychiatry Report, ADHD in Children and Adolescents

CCPR: To start, tell us about how the thinking has changed in terms of health consequences from ADHD. Dr. Barkley: In the 1970s, we saw ADHD as an educational disorder with impacts on school behavior and academic achievement. Around that same time, there was a parallel path recognizing ADHD as a social problem in family functioning and peer relationshi

Expert Q&A

Reimagining ADHD

From The Carlat Child Psychiatry Report, ADHD in Children and Adolescents

CCPR: Thanks for speaking with us today, Dr. Hallowell. Please tell us about your work. Dr. Hallowell: I’m a writer, a speaker, and a practicing psychiatrist. I have offices in Boston, New York, San Francisco, and Seattle. I went to Harvard College, Tulane Medical School, Harvard residency, and fellowship at Mass Mental Health Center. After that I wa

Research Update

Can Stimulants Prevent Crime?

From The Carlat Child Psychiatry Report, ADHD in Children and Adolescents

Review of: Mohr-Jensen C et al, J Am Acad Child Adolesc Psychiatry 2019;58(4):443–452 ADHD has long been linked to antisocial behavior leading to arrests and incarcerations. Children and young adults with ADHD are more likely to be charged with anything from traffic violations to violent crimes. However, these associations do not prove causality. I

Research Update

Methylphenidate Max Dosing

From The Carlat Child Psychiatry Report, ADHD in Children and Adolescents

Review of: Ching C et al, JAMA Pediatr 2019;173(7):630–639 Methylphenidate was one of the first stimulants prescribed for the treatment of ADHD in children, adolescents, and adults. Its efficacy is clear, and its availability in immediate release, sustained release, osmotic release oral system (OROS, brand name Concerta), and transdermal patch keep

Research Update

Crocus Sativus vs Methylphenidate for ADHD

From The Carlat Child Psychiatry Report, Autism in Children and Adolescents

Topics: ADHD | Attention Deficit Hyperactivity Disorder | Crocus Sativus | methylphenidate | Saffron

Review of: Baziar S et al, J Child Adolesc Psychopharmacol 2019;29(3):205–212 The search for an equally effective, yet better tolerated alternative to stimulant medications continues. We often hear reports on the benefits of various non-pharmaceutical supplements. Now we have a new study looking at saffron (Crocus sativus). Saffron is reported to a

News of Note

FDA Approves Adhansia XR

From The Carlat Child Psychiatry Report, Depression in Children and Adolescents

We are always in need of a new formulation of stimulant medication that might capture a few more of our patients who just do not quite tolerate or respond well enough to the many existing formulations. So whenever a new one is released, we try to set aside our natural skepticism and take a look at the stated facts before judging its merit. Adhansia X

News of Note

First Non-Drug Treatment Approved by FDA for Treating Children With ADHD

From The Carlat Child Psychiatry Report, Depression in Children and Adolescents

NeuroSigma made a splash by announcing that the FDA has granted medical device approval for its external Monarch Trigeminal Nerve Stimulation (eTNS) System for treating kids with ADHD ages 7–12 who are not currently taking medications. What does medical device approval mean? The FDA reviewed the Monarch eTNS System through the de novo pre-market

Clinical Update

How to Treat ADHD in Bipolar Disorder

From The Carlat Psychiatry Report, Bipolar Disorder

Topics: | | | | | | | | | | | | | | | | | | ADHD Alpha Agonists Amphetamines ArModafinil Atomoxetine Attention Deficit Hyperactivity Disorder Bipolar Disorder Bipolar II Comorbidity Guanfacine methylphenidate Modafinil Nuvigil Pharmacology Provigil Psychopharmacology Psychopharmacology Tips stimulant Stimulants

Patients with bipolar disorder often present with cognitive complaints. Our October 2021 issue laid out a diagnostic plan for these symptoms, and in this article, I’ll cover some treatment approaches for patients with a DSM-based ADHD-bipolar comorbidity (ie, the ADHD symptoms began in childhood and persist after the mood episodes have stabilized).

Research Update

Viloxazine for ADHD

From The Carlat Psychiatry Report, Bipolar Disorder

Review of: Nasser A et al, Int J Clin Pract 2021;75(8):e14330 Study type: Meta-analysis of randomized controlled trials Viloxazine (Qelbree) just got FDA approval in 2021 for the treatment of ADHD in children and adolescents, and the FDA is reviewing data in adult ADHD. Viloxazine has a long history of use as an antidepressant in Europe. Like atomoxet

Clinical Update

How to Diagnose ADHD in Bipolar Disorder

From The Carlat Psychiatry Report, Mood Disorders

Hailey is a 24-year-old woman with bipolar II disorder who has recently come out of a mixed episode. Although her mood symptoms have resolved, she is distracted easily, has difficulty organizing her work, and often forgets important tasks. She read about ADHD online and asks if she can have a stimulant to help her focus. ADHD and hypomania share many

Clinical Update

Stimulants and Creativity

From The Carlat Psychiatry Report, Stopping Psych Meds Part 1

Your patient is a 25-year-old music teacher with ADHD. Though her organizational skills have improved with methylphenidate, she complains that it impairs her performance as a jazz musician: “I feel self-conscious, like a robot.” Popular lore holds that creative people have ADHD traits and that ADHD bestows advantages in creative thinking. Stock c

Research Update

Guanfacine ER for Adults With ADHD?

From The Carlat Psychiatry Report, Mood and Menopause

Review of: Iwanami A et al, J Clin Psychiatry 2020;81(3):19m12979 Study type: Randomized, double-blind, placebo-controlled trial Stimulants are rapid, safe, and effective first-line treatments for many adults with ADHD. However, there are inevitably patients for whom stimulants are not indicated or tolerated—those with arrhythmias or stimulant use d

Article

Stimulants as Cognitive Enhancers

From The Carlat Psychiatry Report, Adult ADHD

Depending on your practice setting, you are likely to encounter adults who seek stimulants for various “non-medical” uses, from cognitive enhancement to recreational abuse to outright diversion. Abuse and diversion are easier to detect these days with the controlled substance databases available in most states. Abuse of stimulants is relative