Pharmacotherapy – Attention-deficit/hyperactivity Disorder (ADHD) (Nursing)

00:01 Well, we have pharmacotherapy for ADHD. That is very effective. They are stimulants.

00:08 Norepinephrine reuptake inhibitors even for children who are over 6, not for children under 6. And we have alpha-2 agonists as well as antidepressants. All of these are used to support recovery and behavioral self-control for the person who has ADHD.

00:27 Pharmacotherapy should always be used together with psychosocial and educational supports. Both psychostimulants and non-stimulant drugs adjust the catecholaminergic neurotransmissions which have been identified as being low in persons who have ADHD.

00:49 One of the important aspects that I found with psychopharmacotherapy for kids with ADHD is there's oftentimes resistance from parents who don't want their children to be medicated. What we know about medicating a child with ADHD is that it reduces their likelihood of being bullied because they then have self-determined behavior. They are able to engage. And the medications that they take especially the psychostimulants have very short half-lives. And so what we have to remember is that a parent who decides they'll only give them, for example, Ritalin from Monday to Friday and take them off on the weekend is actually setting up their child for failure in social situations because the child's ability to focus, to engage, and to accomplish tasks is directly related to the chemical balancing in their brain which is achieved with the use of the stimulant and if you take it away, that short half-life by noon on Saturday the child has all of the same behavioral and emotional components of ADHD right back. So as I said, pharmacotherapy for ADHD, the stimulants are very effective. By increasing the dopamine levels, they boost the student's concentration and they also lessen the impulsive hyperactive behaviors. And a number of stimulants are used mostly in the amphetamine family like dextroamphetamine sulfate and methamphetamine, but these stimulants all boost that dopamine level and by doing that they increase concentration and decrease impulsive hyperactive behaviors. The norepinephrine reuptake inhibitors, those are for children who are over the age of 6. You might have heard of Strattera, atomoxetine, that blocks the presynaptic norepinephrine transporter or NET in the brain and it inhibits serotonin reuptake and that's done thru the binding to the selective serotonin transporter. We also use alpha-agonists. What do the alpha-agonists do? They decrease impulsivity, insomnia, and they increase emotional regulation and they work best when they are used in combination with a stimulant and that might be clonidine or guanfacine.