Attention Deficit Hyperactivity Disorder in Teens (cont.)
John Mersch, MD, FAAP
Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.
Roxanne Dryden-Edwards, MD
Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
In this Article
- ADHD in teens introduction
- What causes ADHD in teens?
- How is ADHD in teens diagnosed?
- What are the symptoms of ADHD in teens?
- How does ADHD in teens affect executive function?
- What kinds of difficulties do teens with ADHD face?
- What are non-medical treatment strategies for teen ADHD?
- What stimulant medications are available to treat ADHD in teens?
- What are the potential side effects of stimulant medications?
- What non-stimulant medications are available to treat ADHD in teens?
- What alternative treatments are available for ADHD in teens?
- Find a local Doctor in your town
What stimulant medications are available to treat ADHD in teens?
Several studies have clearly established that pharmacologic (drug) therapy for ADHD is superior to behavioral therapy or cognitive behavioral therapy alone. Combining medication and behavioral therapy is less likely to improve behavioral outcomes over medication alone unless patients are also experiencing anxiety or oppositional defiant disorder. The first category of therapeutic medications is chemically classified as "stimulants." Studies have established that 80% of patients with ADHD will have a positive response to their use and this therapy is generally well tolerated. Medications come in short- (3 to 4 hour), medium- (5 to 6 hour), and long- (8 to 10 hour) lasting formulations. The two most common medications are: 1) methylphenidate (for example, Ritalin, Concerta) and 2) amphetamine (for example, Adderall, Vyvanse). Stimulant medications that are in liquid or in patch form (Quillivant-XR and Daytrana, respectively) are now available, allowing children who have difficulty swallowing pills to benefit from the medication. Both the methylphenidate and amphetamine classes of stimulants are felt to positively affect the neurochemical transmitters of the brain that moderate attention, arousal, and impulse control.
What are the potential side effects of stimulant medications?
Side effects may include appetite suppression, irritability, inhibited personality, depression, and sleep issues. Rarely, patients may develop tics and very rarely patients develop hallucinations while taking stimulant medications. Studies show that short-term use of stimulants (up to 3 years) may contribute to a mild slowing of the rate of height acquisition; however, the ultimate acquired height when considering long-term use is not thought to be affected. Recently, there have been concerns regarding the risk of sudden cardiac death in patients treated with stimulants. A recent policy statement from the American Academy of Pediatrics suggests that several elements be evaluated prior to initiating therapy with stimulant medications. These include:
- Patient and family cardiac history of structural or functional heart disease, sudden death, unexplained death in children through young adults, and history of hereditary heart disease (cardiomyopathy and/or long QT syndrome). Concerns of these issues warrant evaluation by a pediatric cardiologist.
- Routine EKG or echocardiogram studies are not thought to be necessary for most patients.
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