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Attention Deficit Hyperactivity Disorder

Alternate Names

  • ADHD

Definition

Attention deficit hyperactivity disorder, or AD/HD, is a disorder in which an individual consistently shows certain behaviors over time. The three categories for these behaviors are inattention, hyperactivity, and impulsivity.

What is going on in the body?

In people who have ADD, the parts of the brain areas that control attention use less glucose than in other individuals. This indicates that the areas are less active. The lower activity level seems to cause inattention. No one knows for sure why these brain areas are less active.

Risks

What are the causes and risks of the condition?

No one knows the exact cause of AD/HD. Most experts believe that the following factors may play a role in causing AD/HD:
  • environmental toxins, such as lead
  • genetics
  • smoking or alcohol use by the mother during pregnancy
  • use of illegal drugs, such as cocaine, by the mother during pregnancy

Prevention

What can be done to prevent the condition?

Many times, AD/HD cannot be prevented. The following measures may be helpful:
  • obtaining good prenatal care beginning in the first trimester of pregnancy
  • avoiding pregnancy risk factors, such as drugs, alcohol, and smoking
  • taking steps to avoid lead poisoning in the environment

Diagnosed

How is the condition diagnosed?

Diagnosis of AD/HD begins with a medical history and physical exam. The healthcare provider will look for behaviors that are typical of AD/HD. In order to diagnose AD/HD, the provider must determine that the behaviors have certain characteristics:
  • They are more frequent or severe than in other people of the same age group.
  • They create significant disability in at least two areas such as school, home, work, or social settings.
  • They started early in life, before the age of 7.
  • They have been constant for at least 6 months.
The healthcare provider may order tests to rule out other disorders. These tests may include:
  • allergy tests
  • blood and urine tests
  • cranial CT scan
  • cranial MRI

Long Term Effects

What are the long-term effects of the condition?

Without effective treatment, AD/HD can cause serious problems at school, home, work, and social settings.

Other Risks

What are the risks to others?

ADHD is not contagious. It poses no risk to others. There may be a genetic component to the disorder.

Treatments

What are the treatments for the condition?

Treatment for AD/HD usually involves medicine along with one or more other strategies. The most common medicine for AD/HD is a stimulant called methylphenidate. This medicine is available in a number of name-brand products, such as Ritalin, Concerta, or Metadate.

Other medicines used to treat AD/HD include the following:
  • amphetamines, such as Adderall, Dexedrine, or Dextrostat
  • antidepressants, such as desipramine (i.e., Norpramin) or bupropion (i.e., Wellbutrin)
  • medicines normally used to treat high blood pressure, such as clonidine (i.e., Catapres)
Medicines are often used together with other treatment strategies, such as:
  • cognitive behavioral therapy
  • emotional counseling
  • practical support for activities of daily living
  • psychotherapy
  • social skills training for the individual
  • stress management training
  • support groups

Side Effects

What are the side effects of the treatments?

Side effects from medicines can include the following:
  • headache
  • involuntary muscle movements
  • loss of appetite
  • mood changes as medicine wears off
  • sleep disorders
  • weight management problems
A person who is receiving any form of therapy may show an initial increase in negative behavior. This may last until new behaviors become routine.

After Treatment

What happens after treatment for the condition?

Treatment and monitoring of AD/HD can be lifelong for many patients, although for some, the symptoms seem to reduce or go away over time.

Monitor

How is the condition monitored?

Any new or worsening symptoms should be reported to the healthcare provider.

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