Attention Deficit/Hyperactivity Disorder (ADHD) paper

Attention Deficit/Hyperactivity Disorder (ADHD) is a common psychiatric disorders usually diagnosed in school age children. It is a neuropsychiatric disorder that affects preschoolers, children, adolescents and adults all over the world. It is described by a pattern of reduced persistent attention, and increased impulsivity or hyperactivity (Sadock, 2015). It is a kind of behavioral issue that has received substantial awareness in both classroom and research settings as a result of its likely adverse effects on academic products and classroom functioning (Purpura & Lonigan, 2009). The National Institute of Mental Health (NIMH) approximates that its incidence rate is between 3% and 10%, with ADHD influencing around 2 million children in the United States (Neuropsychiatric ailment and treatment, 2008).

ORDER CUSTOM, PLAGIARISM-FREE PAPER

ADHD is usually co-morbid with other psychiatric disorders including depressive and anxiety disorders, substance abuse, conduct disorder, and antisocial behaviors (Neuropsychiatric ailment and treatment, 2008). Children with untreated ADHD have higher than typical rates of accidents and injury (NIMH). Pharmacotherapy treatment for ADHD includes Stimulant and Non stimulant medications. The stimulant medications includes Methylphenidate, dextroamphetamine and Focalin (Sadock, 2015). The non-stimulant medications includes atomoxetine, Clonidine, and Guanfacine (Sadock, 2015). This paper will examine and addresses treatment options for this 8-year old Caucasian girl with Attention Deficit/Hyperactivity Disorder (ADHD) while analyzing ethical and legal implications regarding her treatment.

Decision #1

My first decision is to start chewable Ritalin (methylphenidate) IR 10 mg PO every morning.

Reason for selecting this decision

Ritalin is a brand name of methylphenidates, the mainly common prescribed stimulant medication for attention deficit hyperactivity disorder (ADHD). Ritalin is a stimulant categorized to the class of dopamine, norepinephrine reuptake inhibitor and releaser (DN-RIRe) (Stahl, 2014b). Ritalin is FDA approved for ADHD in both children and adults (Stahl, 2014b). It works by boosting dopamine and norepinephrine actions in particular brain regions which includes the dorsolateral prefrontal cortex and basal ganglia which may enhance wakefulness, hyperactivity concentration, attention and executive function (Stahl, 2014b). Ritalin has an established long-term efficacy as a first-line treatment for attention deficit hyperactivity disorder (ADHD) (Stahl, 2014b). In the class of stimulant drugs, Ritalin is the best known for the treatment of ADHD for more than 60 years (The Western journal of medicine, 2000). Stimulant medications such as Ritalin have been prescribed for decades for the treatment of ADHD and their recognition as cognition enhancers has recently risen among the healthy as well to boost mental performance (Fisher, 2008). Stimulant medications used to treat ADHD, like Ritalin, has been widely and lengthily studied and found to be safe. With over 6,000 patients treated in more than 200 clinical trials, methylphenidate is one of the best studied drugs in children and adolescents (Vitiello 2001).

According to research, Ritalin are more tolerated, acts quickly and have fewer side effects in most people than other medications (Haggerty, 2018). Psychostimulants, most commonly methylphenidates are mostly safe and well tolerated (Clancy et. al, 2011). Stimulants are the major treatment for ADHD and have been proven to be the most effective treatment with 80 percent response rate (Kolar et al., 2008). About 90 percent of cases, stimulant medication facilitates children to think before they act, improve their approach to schoolwork to get more focused and organized, get along better with others and break fewer rules; they often seem happier too (American Psychological Association, 2018). At the initial stage, the patient should not be placed on high amount of prescriptions of an oral dosage. The client is initiated at a less dosage, which reduces the chance of side effects. This will also give the provider the chance to keep assessing her response to it, and decide if the dosage should be increased, decreased or switched to another drug completely either because of side effects or for not having any therapeutic effect on the patient. Wellbutrin on the other hand was not selected due to numerous reasons. Wellbutrin has not been approved by the FDA for the treatment of ADHD. Wellbutrin including other antidepressants have been linked to suicidal ideation in children and adolescents and their Safety and efficacy have not been established (Stahl, 2014b). There is not enough scientific studies to back up Wellbutrin’s effectiveness and safety in treating ADHD (Low, 2018).

Intuniv belong to the nonstimulant medication types for ADHD. It’s an antihypertensive and centrally acting alpha 2A agonist (Stahl, 2014b). It has also not been approved by the FDA for the treatment of ADHD. The basic standard for treating ADHD is the use of a psychostimulant as the first line agent. Intuniv is a nonstimulant, and an option for ADHD patients who cannot take stimulants (Neuropsychiatric disease and treatment, 2008). Nonstimulants do not work as quickly as stimulants, but may be used when psychostimulant medications have been ineffective, unacceptable side effects have resulted, or the individual or child’s parents prefer a nonstimulant for other reasons. They do not appear to be as effective in improving symptoms of inattention (Low, 2018). Non-stimulants can be very effective for some kids with ADHD, but for most don’t have the same rate of success as stimulants, which work well in about 70 to 80 percent of cases (Rosen & Braaten, n.d.). Intuniv can cause an individual to be excessively sedated and sluggish throughout the day. There has also been reports of mania and aggressive behavior in ADHD patients taking Intuniv. Intuniv can cause changes in the blood pressure. It may lower the blood pressure about 30 to 60 minutes after first dose is taken and the highest reduction is seen after 2 to 4 hours of use (Stahl, 2014b). Attention Deficit/Hyperactivity Disorder (ADHD) paper

Attention Deficit/Hyperactivity Disorder (ADHD) paper