ADHD

Question 1

ADHD treatment for children >5 and young people

Answer 1

1st = methylphenidate
2nd = lisdexamfetamine (if 6 week trial of methylphenidate didn’t benefit)
3rd = dexamfetamine (if responding to lis but can’t tolerate longer effect profile)
4th = atomoxetine or guanfacine (if intolerant/unresponsive to lis and methylphenidate)

Question 2

ADHD treatment for adults

Answer 2

1st = methylphenidate or lisdexamfetamine
2nd = atomoxetine

Question 3

guanfacine side-effects

Answer 3

somnolence (Tiredness)
Overdose = hypotension

Question 4

atomoxetine side-effects

Answer 4

hepatic impairment and suicidal ideation

Question 5

why are MR preparations preferred In ADHD

Answer 5

• adherence
• reduced stigma
• reduced need to give in school
• lower risk of stimulant misuse
• pharmacokinetic profile
  *must be prescribed as brand only

Question 6

methylphenidate side-effects

Answer 6

GI: diarrhoea, vomiting, abdominal pain, dry mouth, anorexia
cardio: hypertension, arrhythmia, tachycardia
nervous system: dizziness, insomnia, irritation, aggression, headache, movement disorders

Question 7

methylphenidate monitoring

Answer 7

• height and weight, HR and BP every 6 months
• assess for tics, sexual dysfunction, seizures, sleep and worsened behaviours

Question 8

dexamfetamine and lisdexamfetamine cautions

Answer 8

• caution in patients with CVD
• similar side-effects and monitoring to methlyphenidate

Question 9

ADHD meds overdose signs

Answer 9

• initially excessive activity, paranoia, hallucinations and hypertension
• followed by exhaustions, convulsions, hyperthermia and coma