Pharmacotherapy of Adult ADHD
|
|
- Helena Nichols
- 5 years ago
- Views:
Transcription
1 Pharmacotherapy of Adult ADHD Thomas J. Spencer, MD Massachusetts General Hospital Harvard Medical School
2 Disclosures Dr. Spencer receives research support from Royalties and Licensing fees on copyrighted ADHD scales through MGH Corporate Sponsored Research and Licensing. Dr. Spencer has a US Patent Application pending (Provisional Number 61/ ), through MGH corporate licensing, on a method to prevent stimulant abuse. 2
3 Percent Change (Bmax/Kd) DVR Images Obtained with [ 11 C]Raclopride After Placebo and After Methylphenidate Control ADHD * Controls ADHD Placebo Placebo Caudate Putamen Ratio Methylphenidate Methylphenidate Volkow, ND et al., Archives of General Psychiatry, 64(8): , 2007.
4 Mechanism of Action MPH: Insights from PET Imaging Studies (Volkow et al. J Att Dis. 2002;(suppl)1) Because DA enhances task-specific neuronal signaling and decreases noise, MPH-induced increases in DA could improve attention and decrease distractibility Since DA modulates motivation, the increases in DA would also enhance the saliency of the task facilitating the interest it elicits and thus improving performance
5 Methylphenidate Increases Dorsal ACC & DLPFC in Patients with ADHD MPH-OROS Higher than Placebo at 6 Weeks damcc damcc DLPFC Parietal Bush et al. Archives of General Psychiatry. in press
6 Average Score MTA: Treatment Effects on Inattention Scores (SNAP) Average Score [MTA Group, Arch General Psychiatry, 1999] CC Beh MedMgt Comb 3 Parent 3 Teacher Assessment Point (Days)
7 Average Score Teacher SSRS Social Skills CC Beh MedMgt Comb Assessment Point (Days)
8 Pharmacotherapy of Adult ADHD N=45 Studies N=6,439 Subjects N=51 Studies N=5,488 Subjects 8 Prince, Wilens 2013
9 Methphenidate Concentration (ng/ml) Comparison of MPH Concentration Following IR-MPH and OROS-MPH OROS 18 mg IR-MPH 5 mg Time (hours)
10 Clinical Ratings of ADHD Symptoms (ADHD-RS) Week OROS-MPH mg/day Placebo mg/day P=0.04* P=0. 03 P=0.001 P<0.001 Biederman et al Biol psych 2006
11 BRIEF Impairment Stratified by Executive Function Deficit and Treatment Status at Baseline and Endpoint Biederman et al. Eur Neuropsychopharmacol 2011
12 Focalin (D-MPH)* An Isomeric Form of MPH H H H H 2 N N 2 Ph 2 COOCH 3 CH 3 OOC 2 Ph H H l (-) Methylphenidate D (+) Methylphenidate *FDA approved for ADHD. Courtesy of T. Wilens, MD.
13 SODAS d-mph: DAT Occupancy (PET) by Hour and Dose Spencer et al. In Press J Clin Psych 20 mg 30 mg 40 mg
14 Meta-analysis of Within-Subject Comparative Trials Evaluating Response to Stimulant Medications Spencer et al. Arch of Gen Psych studies N= % Best Response (Percent) % 23% 10 0 Dextroamphetamine Methylphenidate Equal response to either stimulant 14
15 Mean ADHD-RS Total Score Mixed Amphetamine Salts: Mean Total Score at Endpoint (ITT) Endpoint = LOCF Baseline Endpoint Change (Endpoint-Baseline) ** ** ** Placebo Adderall XR 20 mg **P (adjusted Dunnett s test compared with placebo following ANCOVA with baseline score as covariate) 12.9 Adderall XR 40 mg 14.4 Adderall XR 60 mg
16 Change in ADHD-RS Total Score ADHD-RS Total Score LDX in Adult ADHD: ADHD-RS Total Scores (ITT Population) Placebo mg/d LDX 50 mg/d LDX 70 mg/d LDX -16.2* -17.4* -18.6* Baseline Endpoint Change from baseline (LS mean ± SE) A more negative change in ADHD-RS total score indicates greater improvement. LS=least squares; SE=standard error of the mean. *P<.0001 (adjusted Dunnett s test compared with placebo following ANCOVA with baseline score as covariate).
17 Effect Size Stimulant Tx of Executive Function Lisdexamfetamine in Adult ADHD + GEC > 65 Adler et al. JCP
18 Score Controlled Trial of Lisdexamfetamine Collisions * TX Group Placebo Baseline 2nd Simulation
19 Adverse Effects of Stimulants Adverse effects (AEs) are similar for all stimulants Decreased appetite Insomnia Headache Stomachache Irritability/rebound phenomena Rates of these AEs may be high prior to any medical intervention; thus, baseline levels should always be obtained Wilens T, Spencer T. In: Child and Adolescent Psychiatric Clinics of North America. Philadelphia, Pa: Saunders Press; 2000:
20 Concerns Associated with Use of Stimulants Substance abuse Diversion Tics Growth Cardiovascular risk
21
22 Screening for Cardiac Risk: AHA Guidelines Medical history Personal congenital or acquired cardiac disease history Family history of cardiac disease (<50 years of age) Palpitations, chest pain, fainting, seizures, post-exercise symptoms Ask about other medications (including OTC) Routine medical exam Monitor BP and pulse at baseline and follow-up, especially in adults ECG is reasonable but not mandatory Routine check of Holter, ECHO is not necessary Gutgesell H, et al. Circulation. 1999:99: Schubiner H, et al. J Atten Disord. 2006;10:
23 Medication for ADHD and Criminality (Lichtenstein et al. NEJM 2012: 367: ) Women-41% reduction Men- 32% reduction Swedish national registers (N= 25,656 with ADHD-about 50% on medications) Ca. 40% of convictions related to drug offenses (Tx OR=0.6). No difference in type of ADHD medication (stimulants, nonstimulants) or level of crime.
24 Norepinephrine Effects Attentional Systems Posterior Resulting Activity Disengage from stimuli Change focus to new stimuli Engage attention to new stimuli Posterior Anterior Anterior Working memory Analyze data Prepare for response Pliszka SR, et al. J Am Acad Child Adolesc Psychiatry. 1996;35(3): Mefford IN, Potter WZ. Med 24 Hypotheses. 1989;29(1):33-42.
25 fmri of Atomoxetine: MSIT shows activation of dorsolateral prefrontal, parietal, cerebellum Bush, et al. Psychiatry Research. Volume 211, Issue 1, 30 January 2013
26 Mean CAARS Change Atomoxetine: Long-term Efficacy in Adults (34 Weeks) Discontinuation Phase Acute Phase Extension Phase Placebo Atomoxetine Atomoxetine-EXT Atomoxetine-EXT Weeks N = 384; Adler L et al. J Clin Psych
27 Improvement Least Squares Mean Change Atomoxetine Treatment in Adults with ADHD and Comorbid Social Anxiety Disorder Adler et al. Depression Anxiety * ** Placebo Atomoxetine ** ** *** Week *p<.05 **p<.01 ***p<.001 Overall tx effect p<.001
28 Atomoxetine in Adults with ADHD: Common Side Effects* Side Effect Atomoxetine (%) Placebo (%) Dry mouth 21 7 Insomnia 21 9 Nausea 12 5 Decreased appetite 12 3 Decreased libido 7 2 Erectile difficulty 10 1 Dizziness 6 2 Increased BP (systolic, diastolic): 1-3 mm Hg Increased HR: 5 bpm Michelson *All significant D, et versus al. Biol placebo. Psychiatry. 2003;53:
29 Atomoxetine: Black Box Warnings Hepatotoxicity Two cases in 4 million exposures of elevated liver enzymes (one had autoimmune disease); no clinical predictors Symptoms: Abdominal pain and jaundice Resolved with discontinuation of medication No screening or blood tests necessary Suicidal ideation/behavior is a concern in children only and is extremely rare 2004 Strattera Safety Guide: Revised Label. FDA MedWatch Web site.
30 Medications that are not FDA approved for ADHD
31 Bupropion XL (Wellbutrin XL ) in Adults With ADHD: Percent Responders % of Responders Placebo n = 81 Bupropion XL n = 81 * * * Time in Study (Weeks) *P.01, P<.05, 30% reduction from baseline. Wilens et al. Biol Psych 2005
32 Armodafinil Intrasynaptic Dopamine (Rt Caudate) by Dose Spencer et al. Biol Psych 2010 Volkow et al. JAMA 2009 Volkow 200/400 mg modafinil nucleus accumbens Volkow 200/400 mg modafinil caudate
33 Memantine: Clinical ADHD Rating (AISRS) Surman et al. Annual Meeting AACAP 2010
34 Summary: Pharmacotherapy of ADHD Efficacy in adults consistent with efficacy in children A variety of effective drugs Commonality: dopaminergic or noradrenergic mechanism of action Preliminary evidence of cholinergic mechanism
Pharmacotherapy of ADHD Across the Lifecycle: Stimulants
Pharmacotherapy of ADHD Across the Lifecycle: Stimulants Thomas J. Spencer, MD Massachusetts General Hospital Harvard Medical School Percent Change (Bmax/Kd) DVR Images Obtained with [ 11 C]Raclopride
More informationStimulant Treatment of ADHD
Stimulant Treatment of ADHD Thomas J. Spencer, MD Massachusetts General Hospital Harvard Medical School Disclosures Shire Laboratories Department of Defense FDA Alcobra Lundbeck Inc. Consultant Research
More informationPharmacotherapy of ADHD with Non- Stimulants
Pharmacotherapy of ADHD with Non- Stimulants Timothy E. Wilens, M.D. Chief, Division of Child and Adolescent Psychiatry, (Co)Director of Center for Addiction Medicine, Massachusetts General Hospital Massachusetts
More informationPsychopharmacology of ADHD. Copyright 2006 Neuroscience Education Institute. All rights reserved.
Psychopharmacology of ADHD Persistence (Predicted Value) Persistence of ADHD Into Adulthood 90 80 70 60 50 40 30 20 10 0 NA 10 15 20 25 30 Age at Follow-Up Syndromatic Persistence Symptomatic Persistence
More informationPharmacotherapy of ADHD with Non-Stimulants
Pharmacotherapy of ADHD with Non-Stimulants Timothy E. Wilens, M.D. Chief, Division of Child and Adolescent Psychiatry, (Co)Director of Center for Addiction Medicine, Massachusetts General Hospital Massachusetts
More informationDrug Class Review. Pharmacologic Treatments for Attention Deficit Hyperactivity Disorder
Drug Class Review Pharmacologic Treatments for Attention Deficit Hyperactivity Disorder Final Update 5 Report July 2015 The purpose of reports is to make available information regarding the comparative
More informationADHD: A Focus On Drug Therapy
ADHD: A Focus On Drug Therapy MARY WORTHINGTON, PHARM.D., BCPS MCWHORTER SCHOOL OF PHARMACY BIRMINGHAM, ALABAMA SEPTEMBER 13, 2013 Outpatient Prescription Drug Utilization in US Children, 2002-2010 90
More informationAD/HD is a mental disorder, and it often lasts from
short version10 WHAT WE KNOW Managing Medication for Adults with AD/HD AD/HD is a mental disorder, and it often lasts from childhood into adulthood. Medication is the basic part of treatment for adults.
More informationThe Use of ADHD Medication in the Pediatric Population
The Use of ADHD Medication in the Pediatric Population Shirin Madzhidova, PharmD Pediatric Pharmacotherapy Fellow Nova Southeastern University Objectives Discuss the importance of treatment with medications
More informationMRCPsych Pharmacology of ADHD treatment. Dr Xanthe Barkla, Consultant Child and Adolescent Psychiatrist
MRCPsych Pharmacology of ADHD treatment Dr Xanthe Barkla, Consultant Child and Adolescent Psychiatrist 04 01 17 Curriculum mapping MRCPsych Paper A(ii) covers clinical psychopharmacology MRCPsych Syllabus:
More informationPHYSICIAN S REFERENCE: TREATMENT & MEDICATIONS RESEARCH: CURRENT CONCEPTS & FUTURE DEVELOMENTS By David W. Goodman, MD
PHYSICIAN S REFERENCE: TREATMENT & MEDICATIONS RESEARCH: CURRENT CONCEPTS & FUTURE DEVELOMENTS By David W. Goodman, MD PHARMACOTHERAPY OF ADULT ATTENTION DEFICIT / HYPERACTIVITY DISORDER Program Overview
More informationEffectively Recognizing and Managing ADHD in Adolescents. Educational Objectives
Educational Objectives After completing this activity, the participant should be better able to: Explain how the proper recognition and management of ADHD in adolescents by MCOs can improve clinical outcomes
More informationADHD and Substance Use Disorders: An Intoxicating Combination
ADHD and Substance Use Disorders: An Intoxicating Combination Timothy E. Wilens, MD Chief, Division of Child & Adolescent Psychiatry Director, Center for Addiction Medicine Massachusetts General Hospital
More informationJeffrey H. Newcorn 1 Peter Nagy. Brian Yan 5 Steven Pliszka
CNS Drugs DOI 10.1007/s40263-017-0468-2 ORIGINAL RESEARCH ARTICLE Randomized, Double-Blind, Placebo-Controlled Acute Comparator Trials of Lisdexamfetamine and Extended-Release Methylphenidate in Adolescents
More informationPresented by the National Resource Center on ADHD
Presented by the National Resource Center on ADHD Timothy E. Wilens, M.D. Massachusetts General Hospital Harvard Medical School Save 25% if you join/rejoin CHADD Use Promo Code: JANA14 If you are currently
More informationPrevious Study Return to List Next Study
A service of the U.S. National Institutes of Health Trial record 1 of 1 for: 42603ATT3013 Previous Study Return to List Next Study A Study to Evaluate Effectiveness and Safety of Prolonged Release OROS
More informationPerspective Truth on ADHD & Medications. Thomas L. Matthews, M.D. Associate Dean of Student Affairs Professor of Psychiatry
Perspective Truth on ADHD & Medications Thomas L. Matthews, M.D. Associate Dean of Student Affairs Professor of Psychiatry Disclosures National Institute of Health ADHD and Aggression Study Co- Investigator
More informationDose Range. Dose Schedule. Child: 5-60 mg Over 50 kg:5-100 mg Focalin, child: mg Over 50 kg: mg. Focalin: 4-5 hrs.
MEDICATIONS FOR ADHD Group Main Use Medication Brand/ Form Dose Schedule Dose Range Most Common Side Effects for Group Pros for Group Cautions for Group methylphenidate Methylin Focalin (dexmethylphenidate)
More information2013 Virtual AD/HD Conference 1
Medication for ADHD & Coexisting Conditions Dr. Kenny Handelman Child, Adolescent & Adult Psychiatrist Halton Healthcare Adjunct Professor of Psychiatry, University of Western Ontario www.drkenny.com www.adhdpodcast.com
More informationPractical Psychopharmacology for More Complex Mental Health Presentations
MINISTRY OF CHILDREN AND YOUTH SERVICES Practical Psychopharmacology for More Complex Mental Health Presentations Part 1: Stimulants Dr. Ajit Ninan & Joel Lamoure 1 Practical Psychopharmacology for More
More informationTimothy E. Wilens, M.D. ADHD & Substance Use Disorders
Timothy E. Wilens, M.D. ADHD & Substance Use Disorders Chief, Division of Child & Adolescent Psychiatry; (Co) Director, Center for Addiction Medicine Massachusetts General Hospital Harvard Medical School
More informationADHD Medications: Basics. David Benhayon MD, PhD
ADHD Medications: Basics David Benhayon MD, PhD Goals & Objectives Understand basic classes of stimulants and equivalents Be exposed to role of nonstimulant alternatives Discuss the role of therapy in
More information2013 Virtual AD/HD Conference 1
Medication for & Coexisting Conditions Part 2 Dr. Kenny Handelman Child, Adolescent & Adult Psychiatrist Halton Healthcare Adjunct Professor of Psychiatry, University of Western Ontario www.drkenny.com
More informationDRUGS FOR ADHD: ADOLESCENTS TO ADULTS
DRUGS FOR ADHD: ADOLESCENTS TO ADULTS DISCLOSURE Natasha Rodney-Cail, Pharmacist, Drug Evaluation Unit Has no conflicts of interest Dr. James Chandler, MD, FRCPC Has no conflicts of interest STEVEN Age
More informationOH, Adolescents and Attention Deficit Hyperactivity Disorder (ADHD) How do you deal with them? Presented By: Todd Twogood MD, FAAP
OH, Adolescents and Attention Deficit Hyperactivity Disorder (ADHD) How do you deal with them? Presented By: Todd Twogood MD, FAAP Teenagers Time of Transformation Allergy to Parents The Real Self Looks
More informationEvaluation and Treatment of ADHD An Overview
Evaluation and Treatment of ADHD An Overview Kevin Ware, M.D. Vice Chairman, Dept. of Psychiatry Mount Carmel Medical Center Columbus, Ohio Objectives Describe the prevalence and characteristics of ADHD
More informationImproving the Recognition and Management of ADHD in Adults
Improving the Recognition and Management of ADHD in Adults Provided by Integrity Continuing Education, Inc. Supported by an educational grant from Shire. 1 Faculty Affiliation Oren Mason, MD Assistant
More informationBackground. Alain Joseph 1 Rajeev Ayyagari 2 Meng Xie 2 Sean Cai 3 Jipan Xie 3 Michael Huss 4 Vanja Sikirica 5
DOI 10.1007/s00787-017-0962-6 REVIEW Comparative efficacy and safety of attention deficit/hyperactivity disorder pharmacotherapies, including guanfacine extended release: a mixed treatment comparison Alain
More informationPresented by the. National Resource Center on ADHD
Presented by the National Resource Center on ADHD www.help4adhd.org (800) 233-4050 Daniel Cox, PhD Director of the Virginia Driving Safety Laboratory Professor of Psychiatric & Internal Medicine, University
More informationCase Study Activity: Management of Attention-Deficit/Hyperactivity Disorder Answers to Interactive Questions and Resources
Case Study Activity: Management of Attention-Deficit/Hyperactivity Disorder Answers to Interactive Questions and Resources Case 3. Risk of Abuse of ADHD Medications Provider: American Pharmacists Association
More informationAttention Deficit Hyperactivity Disorder (ADHD) in Children under Age 6
in Children under Age 6 Level 0 Conduct comprehensive assessment and provide psychoeducation about ADHD, including clearly defined treatment expectations. Consider co-morbid developmental language disorder,
More informationAtomoxetine (First known as Tomoxetine) (Adopted by the CCG until review and further notice)
New Medicine Report Document Status Atomoxetine (First known as Tomoxetine) (Adopted by the CCG until review and further notice) Post Suffolk D&TC Traffic Light Decision RED Date of Last Revision 12.07.04
More informationHolistic approach in management of ADHD
Holistic approach in management of ADHD Outline Historic timeline Prevalence ADHD development Treatment modalities Current guidelines for management ADHD Historical Timeline Described in 19 th century
More informationStudy Center(s): The study was conducted at 39 study sites in Japan.
SYNOPSIS Issue Date: 20 NOVEMBER 2012 Name of Sponsor/Company Janssen Pharmaceutical K. K. Name of Finished Product CONCERTA Name of Active Ingredient(s) Methylphenidate HCl Protocol No.: JNS001-JPN-A01
More informationPharmacologic Management of ADHD
Pharmacologic Management of ADHD CHADD Presentation April 13, 2015 Peter J Chung, MD, FAAP Developmental-Behavioral Pediatrician* Assistant Clinical Professor of Pediatrics University of California Irvine
More informationADHD: Medications and Behavioral Interventions
ADHD: Medications and Behavioral Interventions PAL Conference June 23 rd 2018 Erin Dillon-Naftolin, MD Child and Adolescent Psychiatrist Psychiatry and Behavioral Medicine Seattle Children s Hospital Disclosures
More informationProfessor Alasdair Vance Head, Academic Child Psychiatry Department of Paediatrics University of Melbourne Royal Children s Hospital
Attention Deficit Hyperactivity Disorder: an update on biological risk factors and a pharmacological treatment approach Professor Alasdair Vance Head, Academic Child Psychiatry Department of Paediatrics
More informationADHD Overview and Update
ADHD Overview and Update Rebecca Barclay, MD Child and Adolescent Psychiatrist Seattle Children s Hospital Disclosures Financial: No relevant financial relationships exist. Unlabeled/unapproved uses: Off-label
More informationFocusing in on Adult ADHD
Focusing in on Adult ADHD Diagnosis, Psychopharmacology, and Therapeutic Interventions Sharon Praissman Fisher, MS, APRN-A, APRN-PMHNP Balance Point Wellness Disclosures I have no financial/professional
More informationFocusing in on Adult ADHD
Focusing in on Adult ADHD Diagnosis, Psychopharmacology, and Therapeutic Interventions Sharon Praissman Fisher, MS, APRN-A, APRN-PMHNP Balance Point Wellness Disclosures I have no financial/professional
More informationPL CE LIVE February 2011 Forum
February 2011 PL CE LIVE Kristin W. Weitzel, Pharm.D., CDE, FAPhA Associate Editor and Director of Editorial Projects Pharmacist s Letter/Prescriber s Letter Atypical Antipsychotics Atypical Antipsychotics
More informationPHARMACOLOGIC TREATMENT OF ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD) IN ADULTS FINAL SYSTEMATIC REVIEW REPORT
PHARMACOLOGIC TREATMENT OF ATTENTION DEFICIT HYPERACTIVITY DISORDER (AD) IN ADULTS FINAL SYSTEMATIC REVIEW REPORT December 2015 FINAL REPORT 2 Conflict of Interest Statement No study members report any
More informationDisclosures. Syllabi/Slides for this program are a supplement to the live CME session and are not intended for other purposes.
1:05-2:20pm ADD & ADHD in Children and Adults: Beyond Stimulants SPEAKER Daniel Press, MD ADD & ADHD in Children and Adults: Beyond Stimulants Daniel Press, M.D. Associate Professor in Neurology Beth Israel
More informationDrug Class Review Pharmacologic Treatments for Attention Deficit Hyperactivity Disorder
Drug Class Review Pharmacologic Treatments for Attention Deficit Hyperactivity Disorder Final Report Update 3 September 2009 Update 2: November 2007 Update 1: May 2006 Original Report: September 2005 The
More information7/9/2013. Psychiatric medication treatment in children and adolescents: The good, the bad and the ugly. What ADHD is
Psychiatric medication treatment in children and adolescents: The good, the bad and the ugly Gabrielle A. Carlson, MD Professor of Psychiatry and Pediatrics Director, Child and Adolescent Psychiatry Stony
More informationStudy No.: Title: Rationale: Phase: Study Period: Study Design: Centers Indication: Treatment: Objectives: Primary Outcome/Efficacy Variable:
The study listed may include approved and non-approved uses, formulations or treatment regimens. The results reported in any single study may not reflect the overall results obtained on studies of a product.
More informationPsychopharmacology for Treatment of ADHD and ADHD with other co-existing psychiatric condition
Psychopharmacology for Treatment of ADHD and ADHD with other co-existing psychiatric condition Presented by Cat Dang, D.O Medical Director - Insightful Minds, Inc. Objectives Evaluation process Pharmacology
More informationIndividuals with attention-deficit/hyperactivity
3 W H A T W E K N O W Managing Medication for Children and Adolescents with AD/HD * Individuals with attention-deficit/hyperactivity disorder (AD/HD) experience chronic problems with inattention and/or
More informationNovember 16-18, 2017 Hotel Monteleone New Orleans, LA. Sponsored by
November 16-18, 2017 Hotel Monteleone New Orleans, LA Sponsored by Managing ADHD Across the Lifespan Scott H. Kollins, PhD Duke University School of Medicine Durham, NC Scott H. Kollins, PhD Disclosures
More informationIndividuals with attention-deficit/hyperactivity
National Resource Center on AD HD A program of CHADD 3 WHAT WE KNOW Managing Medication for Children and Adolescents with AD/HD * Individuals with attention-deficit/hyperactivity disorder (AD/HD) experience
More informationClonidine extended-release tablets for the treatment of ADHD
Clonidine extended-release tablets for the treatment of ADHD Joan Daughton*, Lindsey Corr, Howard Liu & Madeline West Practice points Stimulant medications remain the first-line treatment for ADHD. Based
More informationADHD Medications Table
Stimulants are the first line treatment of choice for ADHD followed by Non-Stimulants, then off-label medications. We are providing this list of medications so that you can be familiar with the common
More informationTreating Disruptive Behavior Disorders in Children and Teens. A Review of the Research for Parents and Caregivers
Treating Disruptive Behavior Disorders in Children and Teens A Review of the Research for Parents and Caregivers e Is This Information Right for Me? This information is for you if: A health care professional*
More informationIndividuals with attention-deficit/hyperactivity
National Resource Center on AD HD A program of CHADD 3 WHAT WE KNOW Managing Medication for Children and Adolescents with AD/HD * Individuals with attention-deficit/hyperactivity disorder (AD/HD) experience
More information4/11/2018. Attention Deficit Hyperactivity Disorder. ADHD is not a real disorder. History of ADHD and Stimulants. Disclosure.
Disclosure I have no conflicts of interests to disclose Attention Deficit Hyperactivity Disorder No affiliations or financial disclosures with pharmaceutical manufacturers Off-label use of drugs will be
More informationAddressing Treatment Gaps in Adult Patients with ADHD
Addressing Treatment Gaps in Adult Patients with ADHD Supported by an educational grant from Shire. Faculty Disclosure Dr. Rakesh Jain: Consultant Addrenex, Allergan, Lilly, Lundbeck, Merck, Otsuka, Pamlab,
More informationAttention Deficit Hyperactivity Disorder (ADHD) BY MARK FABER M.D.
Attention Deficit Hyperactivity Disorder (ADHD) BY MARK FABER M.D. PREVALENCE & STATISTICS 6-8% of all children have ADHD (CDC Statistical Data) Age of onset: 7 years old (Prior DSM-IV) 12 years old (Current
More informationWARNING LETTER TRANSMITTED BY FACSIMILE
DEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service Food and Drug Administration Rockville, MD 20857 TRANSMITTED BY FACSIMILE John Lechleiter, Ph.D. President & Chief Executive Officer Eli Lilly
More informationADHD: Management Update
4/5/17 Conflicts of Interest ADHD: Management Update I have no conflicts to disclose. Jennifer R. Walton, MD, MPH, FAAP April 7, 2017 ADHD: DSM-5 Definition Objectives To briefly review ADHD diagnostic
More informationIs Lisdexamfetamine Dimesylate Safe and Effective in Reducing ADHD Symptoms?
Philadelphia College of Osteopathic Medicine DigitalCommons@PCOM PCOM Physician Assistant Studies Student Scholarship Student Dissertations, Theses and Papers 12-2016 Is Lisdexamfetamine Dimesylate Safe
More informationADHD Medications & How They Work. Gail C. Rodin, Ph.D. January 21, 2008
ADHD Medications & How They Work Gail C. Rodin, Ph.D. January 21, 2008 Agenda How the (ADHD) Brain Works (or doesn t) Neurons and neurotransmitters NE & DA: the major players in ADHD Channel vs. state
More informationAbstract and Introduction
Increasingly physicians are using Atomoxetine known as Strattera as the only non-stimulant for the treatment of ADHD. Since ADHD is the most frequently diagnosed psychological disorder in children and
More informationDriving to Distraction
Driving to Distraction New Research on the Impact of ADHD and ADHD Medications on Driving performance Daniel J. Cox, Ph.D., A.B.P.P Professor, Departments of Psychiatric and Internal Medicine Director,
More informationUniversity of Texas Health Science Center at San Antonio. Pediatrics Grand Rounds 5 February History of stimulant treatment
Pharmacological Treatment of Attention Deficit Hyperactivity Disorder and its comorbidities Steven R. Pliszka, M.D. Professor and Vice Chair Chief, Division of Child and Adolescent Psychiatry Department
More informationPharmacotherapy for Attention-deficit Hyperactivity Disorder
Pharmacotherapy for Attention-deficit Hyperactivity Disorder Stephen V Faraone, 1 Michael Pucci 2 and David Coghill 3 1. Department of Psychiatry and Department of Neuroscience and Physiology, State University
More informationManaging ADHD: What Are We Missing?
Managing ADHD: What Are We Missing? ADHD Prevalence and Treated by Age Persistence of 30-60% Adult Treated ~60% 2.5 million Treated 10-15% 1.6 million 8% prevalence rate in US 54 million age
More informationgenerics) ER, Methylin and generic) prior authorization
ADHD Non-Stimulant Medications Step Therapy Program Policy Number: 5.01.596 Origination: 07/2014 Last Review: 07/2014 Next Review: 07/2015 Policy BCBSKC will provide coverage for brand name non-stimulant
More informationADHD Overview and Update
ADHD Overview and Update David Camenisch, MD Child and Adolescent Psychiatrist Seattle Children s Hospital Origin of ADHD Evolutionary/societal advantages? Past could risk-taking, reactivity, novelty seeking
More informationPharmacological interventions for children with Disruptive Behaviour Disorders or Conduct Disorder or Oppositional Defiant Disorder
updated 2012 Pharmacological interventions for children with Disruptive Behaviour Disorders or Conduct Disorder or Oppositional Defiant Disorder Q8: What is the effectiveness, safety and role of pharmacological
More informationADHD in the Preschool Aged Child
ADHD in the Preschool Aged Child (PATS) 11/2/2013 Stephen Meister MD, MHA, FAAP The Edmund N Ervin Pediatric Center (PATS) National Institute of Mental Health study First papers published in 2006 after
More informationManaging ADHD Across the Lifecycle
Managing ADHD Across the Lifecycle Diagnostic Issues DSM-5 ADHD Changes from DSM-IV Impairing symptoms by 12 not 7 years old Neurodevelopmental - not Disruptive Presentations not subtypes Inattentive/hyperactive-impulsive/combined
More informationADHD Non-Stimulant Medications Step Therapy Program
ADHD Non-Stimulant Medications Step Therapy Program Policy Number: 5.01.596 Last Review: 7/2018 Origination: 07/2014 Next Review: 7/2019 LoB: ACA Policy Blue Cross and Blue Shield of Kansas City (Blue
More informationATOMOXETINE. THERAPEUTICS Brands Strattera see index for additional brand names. Generic? Yes
ATOMOXETINE THERAPEUTICS Brands Strattera see index for additional brand names Generic? Yes Class Neuroscience-based Nomenclature: norepinephrine reuptake inhibitor (N-RI) Selective norepinephrine reuptake
More informationUsing Meta-analysis to Compare the Efficacy of Medications for Attention-Deficit/Hyperactivity Disorder in Youths Stephen V.
Using Meta-analysis to Compare the Efficacy of Medications for Attention-Deficit/Hyperactivity Disorder in Youths Stephen V. Faraone, PhD ABSTRACT Medications used to treat attention-deficit/hyperactivity
More informationPsychiatric medication treatment in children and adolescents:
Psychiatric medication treatment in children and adolescents: The good, the bad and the ugly Gabrielle A. Carlson, MD Professor of Psychiatry and Pediatrics Director, Child and Adolescent Psychiatry Stony
More informationADHD:Updates and Practical Suggestions
:Updates and Practical Suggestions Elizabeth Reeve MD HealthPartners Medical Group Disclosure I have no financial disclosures I may be talking about non FDA approved indications for medications Elizabeth.A.Reeve@HealthPartners.com
More informationScottish Medicines Consortium
Scottish Medicines Consortium atomoxetine capsules 10 mg to 60 mg (Strattera ) (153/05) Eli Lilly and Company Ltd No. 4 February 2005 The Scottish Medicines Consortium has completed its assessment of the
More informationADHD: Child. Gail A. Mattox, MD, FAACAP Morehouse School of Medicine Russell E. Scheffer, MD University of Kansas School of Medicine- Wichita
ADHD: Child Gail A. Mattox, MD, FAACAP Morehouse School of Medicine Russell E. Scheffer, MD University of Kansas School of Medicine- Wichita Learning Objective Implement assessment tools for accurate diagnosis
More informationSponsor. Novartis Pharmaceuticals Corporation Generic Drug Name. Agomelatine Therapeutic Area of Trial. Major depressive disorder Approved Indication
Clinical Trial Results Database Page 1 Sponsor Novartis Pharmaceuticals Corporation Generic Drug Name Therapeutic Area of Trial Major depressive disorder Approved Indication Investigational drug Study
More informationATOMOXETINE. THERAPEUTICS Brands Strattera see index for additional brand names. Generic? Yes
ATOMOXETINE THERAPEUTICS Brands Strattera see index for additional brand names Generic? Yes Class Selective norepinephrine reuptake inhibitor (NRI) Commonly Prescribed For (bold for FDA approved) Attention
More informationOptions for Medication Management: Rx and OTC/Natural Treatments AMY NEWMEYER MD CHKD DIVISION OF DEVELOPMENTAL PEDIATRICS MARCH 24, 2018.
Options for Medication Management: Rx and OTC/Natural Treatments AMY NEWMEYER MD CHKD DIVISION OF DEVELOPMENTAL PEDIATRICS MARCH 24, 2018 Disclosures I have no conflicts of interest to disclose 1 Objectives
More informationHumberto Nagera M.D. Director, The Carter-Jenkins Center Psychoanalyst, Children, Adolescents and Adults Professor of Psychiatry at USF Professor
The Carter Jenkins Center presents 1 Humberto Nagera M.D. Director, The Carter-Jenkins Center Psychoanalyst, Children, Adolescents and Adults Professor of Psychiatry at USF Professor Emeritus of Psychiatry
More informationPrevalence. Historical Timeline. Objectives. ADHD Pharmacology in Children and Adolescents APN Pharmacology Conference March 27, 2015
ADD Pharmacology in Children and Adolescents APN Pharmacology Conference March 27, 215 Richard S. Kingsley, M.D. Clinical Associate Professor of Pediatrics and Psychiatry, Sidney Kimmel Medical College
More informationA Brief Overview of Psychiatric Pharmacotherapy. Joel V. Oberstar, M.D. Chief Executive Officer
A Brief Overview of Psychiatric Pharmacotherapy Joel V. Oberstar, M.D. Chief Executive Officer Disclosures Some medications discussed are not approved by the FDA for use in the population discussed/described.
More informationProfessor Alasdair Vance Head, Academic Child Psychiatry Department of Paediatrics University of Melbourne Royal Children s Hospital
Assessment and treatment of ADHD in children and adolescents In Australia: an overview Professor Alasdair Vance Head, Academic Child Psychiatry Department of Paediatrics University of Melbourne Royal Children
More informationWeek 2: Disorders of Childhood
Week 2: Disorders of Childhood What are neurodevelopmental disorders? A group of conditions with onset in the developmental period Disorders of the brain The disorders manifest early in development, often
More informationSummary ID# Clinical Study Summary: Study B4Z-MC-LYBU
CT Registry ID#7065 Page 1 Summary ID# 7065 Clinical Study Summary: Study B4Z-MC-LYBU A Randomized, Double-Blind Comparison of Atomoxetine Hydrochloride Augmented with Either Extended-Release Methylphenidate
More informationPHARMACY COVERAGE GUIDELINES ORIGINAL EFFECTIVE DATE: 3/15/18 SECTION: DRUGS LAST REVIEW DATE: 3/15/18 LAST CRITERIA REVISION DATE: ARCHIVE DATE:
DYANAVEL XR (amphetamine) extended-release oral suspension Coverage for services, procedures, medical devices and drugs are dependent upon benefit eligibility as outlined in the member's specific benefit
More informationDeficits in Emotional Regulation in ADHD
Deficits in Emotional Regulation in ADHD Joseph Biederman, MD Professor of Psychiatry Harvard Medical School Chief, Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD Massachusetts
More informationADHD and Adverse Health Outcomes in Adults
Thomas J. Spencer, MD This work was supported in part by a research grant from Shire (Dr. Spencer) and by the Pediatric Psychopharmacology Council Fund. Disclosures Dr. Spencer receives research support
More informationNorth Dakota Medicaid. Drug Utilization Review Board. Drug Class Review
North Dakota Medicaid Drug Utilization Review Board Drug Class Review Attention Deficit Hyperactivity Disorder (ADHD) Agents Prepared by Health Information Designs, Inc. 1 North Dakota Department of Social
More informationTREATMENT OF ADHD IN PATIENTS WITH SUD: NEW EVIDENCES. 4 March 2018 Frieda Matthys MD PhD
1 TREATMENT OF ADHD IN PATIENTS WITH SUD: NEW EVIDENCES 4 March 2018 Frieda Matthys MD PhD 2 An overview Where we come from Where are we now Where are we going 3 WHERE WE COME FROM The history The risk
More informationChild & Adolescent Psychiatry (a brief overview)
Child & Adolescent Psychiatry (a brief overview) Lance Feldman, MD, FAPA, MBA, BSN Vice Chair Clinical Affairs, Department of Psychiatry Affiliate Clinical Assistant Professor, University of South Carolina
More informationAttention-deficit/hyperactivity disorder (AD/HD)
10 WHAT WE KNOW Managing Medication for Adults with AD/HD Attention-deficit/hyperactivity disorder (AD/HD) is a common neurobiological condition affecting 5-8 percent of school age children 1,2,3,4,5,6,7
More informationUPDATE IN ADHD: FOCUS ON MEDICATION TREATMENTS
UPDATE IN ADHD: FOCUS ON MEDICATION TREATMENTS Learning Objectives Identify basic issues in the diagnosis of ADHD in child and adolescent patients Differentiate the spectrum of medication options available
More informationBooks, Intellectual Property Advisor/ Consultant Speakers Bureau
Source Disclosure Research Funding Books, Intellectual Property Advisor/ Consultant Speakers Bureau Employee In-kind Services (example: travel) Stock or Equity Honorarium or expenses for this presentation
More informationPsychostimulant and non-stimulant agents address the symptoms of ADHD, substantial evidence shows
Psychostimulant and non-stimulant agents address the symptoms of ADHD, substantial evidence shows Tanya E. Froehlich, MD, MS Associate Professor Department of Pediatrics Division of Developmental and Behavioral
More informationPsychiatric Medications. Positive and negative effects in the classroom
Psychiatric Medications Positive and negative effects in the classroom Teaching the Medicated Child Beverly Bryant, M.D. Hattiesburg Clinic 9/17/14 Introduction According to the National Survey of Children
More informationTREATMENT OF ADHD IN PATIENTS WITH SUD: NEW EVIDENCES. 4 March 2018 Frieda Matthys MD PhD
1 TREATMENT OF ADHD IN PATIENTS WITH SUD: NEW EVIDENCES 4 March 2018 Frieda Matthys MD PhD Faculty Disclosure Company Name Honoraria/ Expenses Consulting/ Advisory Board Funded Research Lundbeck x x x
More informationADHD Part II: Managing Comorbities
ADHD Part II: Managing Comorbities Brett Johnson, MD Staff Psychiatrist Rady Children s Behavioral Crisis Center Assistant Clinical Professor (Voluntary), UCSD January 26, 2011 Financial Disclosure I have
More information