ADHD
A wide variety of treatment options are employed in the management of ADHD. These include both medication and the ‘talking therapies’, such as cognitive behavioural therapy
ADHD:
• Up to 30 per cent of children with aDhD may have a separate serious mood disorder like depression¹
• research suggests that child and adolescent aDhD patients in the UK may experience the longest waiting times anywhere in Europe²
• In a recent survey, 22 per cent of patients and parents of children with aDhD noted that their gP expressed doubt about whether aDhD is real³
• children with untreated or poorly controlled aDhD are more than five times more likely to participate in fights4
THE FACTS
the problem with aDhD diagnosis is that there is not one simple test. there is no blood test that can be taken and sent to a laboratory; rather it is a case of a child being assessed by a qualified healthcare professional as manifesting a ‘cluster’ of the symptoms listed above.
Unfortunately, despite positive moves being made in diagnosis and treatment of the condition, there remains something of a stigma surrounding the disorder, with some families worried about putting a label on their children and, consequently, delaying assessment: a delay, which can lead to later diagnosis and worsening of symptoms.
Treatment a wide variety of treatment options are employed in the management of aDhD. these include both medication and the ‘talking therapies’, such as cognitive behavioural therapy.
across the UK, healthcare professionals adhere to guidelines laid
down by national Institute for health and clinical Excellence (nIcE). nIcE recommends that pharmaceutical treatment should be considered for children with severe symptoms and impairment, and for children with moderate impairment, who have refused non-drug interventions, or whose symptoms have not responded sufficiently to parent training/education programmes, or to group psychological treatment.
If a child or adolescent needs treatment with medication for aDhD, then methylphenidate, atomoxetine and dexamfetamine are all recommended as possible choices. When deciding which to use, doctors should consider the following: • whether the child or adolescent has other conditions such as epilepsy
• the side effects of each medicine • factors that might make it difficult for the person to take the medicine at the right time (for example, if it is difficult to take a dose during school hours)
• the individual preference of the child or adolescent and/or their family or carer.
treatment with methylphenidate, atomoxetine or dexamfetamine should only be started after a specialist, who is an expert in aDhD, has thoroughly assessed the child or adolescent and confirmed the diagnosis. once treatment has been started, it can be continued and monitored by a gP.
References 1. chaDD. the national resource on aDhD. Depression. available at:
http://www.chadd.org/Understanding- aDhD/about-aDhD/coexisting-conditions/Dep
ression.aspx. 2. fridman m et al. access to diagnosis, treatment, and supportive services among pharmacotherapy-treated children/adolescents with aDhD in Europe: data from the caregiver Perspective on Pediatric aDhD survey. neuropsych Dis and treat 2017; 13: 947-958 3. Shire-Initiated Survey of adult Patients with aDhD and Parents/guardians of children with aDhD, Data on file. 2017 4. caci h et al. daily life impairments associated with self-reported childhood/adolescent attention- deficit/hyperactivity disorder and experiences of diagnosis and treatment: results from the European Lifetime Impairment Survey European
Psychiatry 2014; 29(5): 316-323. PharmacY In focUS - 19
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