Prepare a response to this paper about one or more medication and some of the side effects or adverse effects of a medication.

Pharmacotherapy for ADHD

Prepare a response to this paper about one or more medication and some of the side effects or adverse effects of a medication.

Challenges of ADHD treatment in school-age children and adolescents

Attention-Deficit Hyperactivity Disorder (ADHD) is not only one of the most common neurobehavioral disorders of childhood but it has a great impact on children and adolescent’s academic achievement, well-being, and social interactions (Rowland et al., 2002) (Wolraich et al., 2019). ADHD has become a public health concern. The worldwide epidemiologic demonstrated that boys are four times more likely to be diagnosed with ADHD compared to their counterparts (Adherence Challenges With Medications in Patients With ADHD, n.d.). Although the cause of ADHD is not well understood, the etiologies of ADHD strongly correlate to genetic composition, environmental factors, including mothers who smoke during pregnancy, urban vs. rural living, male vs female (Wolraich et al., 2019). Diagnosing Attention-Deficit Hyperactivity Disorder is not as simple as once thought.

The DSM-V criteria certainly have limited much confusion in regard to diagnosing, but other psychological disease processes could mimic and confuse ADHDs symptoms. At current diagnosis criteria, one needs to exhibit six of either A or B symptoms for the 6 months, and within the type A or B, there are three subtypes: Combined, Predominantly Inattentive, and Predominantly Hyperactive-Impulsive type. Correct diagnosis in the early phase of utmost paramount to provide these children and adolescents correct treatment and adherence to medication intake.

Treatments for ADHD include psychotherapy, education, and pharmacotherapy (Adherence Challenges With Medications in Patients With ADHD, n.d.). Stimulants such as amphetamine (Adderall) is a drug of choice. It works at the two dopaminergic sites. At the dopamine transporter, it is linked to impulsivity. At the dopamine receptor genes, Adderall is linked to inattention (Rowland et al., 2002). It has the least adverse effects compared to other stimulants. Strict dosing is advisable. Individuals taking Adderall must be carefully monitored for any cardiac aberrance, including baseline heart rate and blood pressure.
Adherence is defined as “the extent to which a person’s behavior corresponds with the agreed recommendation from a clinician.”

(Charach & Fernandez, 2013)   Pediatric ADHD adherence to taking Adderal is 64%, with poor compliance. In Kamimura, Brinkman, & Froehlich, 2019, they listed predictors of decreased adherence and strategy to improve adherence. Influencing factors to the achievement of Adderal adherence and non-adherence include, but not limited to beliefs of symptoms not due to neurobiological disorder, lack of knowledge and treatment, increased-child care conflict, caregiver mental health, age at which individual is diagnosed, comorbid disorders (oppositional defiant disorder or conduct disorder). Adherence to these factors includes patient/family education, behavior strategies, including BPT, PCIT, COPE, Parenting Program, and health disparity-reducing interventions (Charach & Fernandez, 2013) .

Adherence to Adderall is much higher when prescribed by Psychiatrists as opposed to Internists(Charach & Fernandez, 2013). Furthermore, parents, teachers, the community, and patients must be educated on the importance of understanding the diagnosis. Patients must be included in their treatment. Preteens and teens want to “fit in”. Their personality can change and they may want to discontinue their medication. Hence, peer- influence can be most effective in adherence. Adults, including, parents, teachers, and professionals must afford the time to hear their concerns, give them the autonomy to participate in their treatment. Educating patients, parents, teachers, and the community, along with medication, and therapy are vital components in warring off Attention-Deficit Hyperactive Disorder, a neurobiological disorders that can lead these patients to a life filled with challenges, including increased risk of depression, anxiety, drug abuse, and alcoholism.

Reference

Rowland, A. S., Lesesne, C. A., & Abramowitz, A. J. (2002). The epidemiology of attention-deficit/hyperactivity disorder (ADHD): A public health view. In Mental Retardation and Developmental Disabilities Research Reviews (Vol. 8, Issue 3, pp. 162–170). Ment Retard Dev Disabil Res Rev. https://doi.org/10.1002/mrdd.10036

Adherence Challenges With Medications in Patients With ADHD. (n.d.). Retrieved June 14, 2021, from https://www.psychiatrictimes.com/view/adherence-challenges-medications-patients-adhd

Charach, A., & Fernandez, R. (2013). Enhancing ADHD medication adherence: Challenges and opportunities topical collection on attention-deficit disorder. Current Psychiatry Reports, 15(7). https://doi.org/10.1007/s11920-013-0371-6
Wolraich, M. L., Hagan, J. F., Allan, C., Chan, E., Davison, D., Earls, M., Evans, S. W., Flinn, S. K., Froehlich, T., Frost, J., Holbrook, J. R.,

Lehmann, C. U., Lessin, H. R., Okechukwu, K., Pierce, K. L., Winner, J. D., & Zurhellen, W. (2019). Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics, 144(4). https://doi.org/10.1542/peds.2019-2528

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