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The Informed Parent

New Medication For ADHD Disorder

by Peter W. Welty, M.D., F.A.A.P.
Published on Mar. 24, 2003

We have been alerting and informing the public for years about ADHD and ADD disorder. Our archives are filled with information--books and articles aplenty have been written. And now, most recently, we have a new medication that the readers of The Informed Parent need to be aware of.

ADHD, or Attention Deficit Hyperactivity Disorder, is a disorder of inattention, impulsivity and hyperactivity. A child with these symptoms must show significant dysfunction in several areas--in the home, school and community. Many of these children are treated with a combination of a behavioral modification program along with an ADHD medication. Thus far, these medications have included Ritalin, Adderall, Dexedrine, Concerta or others.

A new medication for the treatment of ADHD has recently been introduced. It is called Strattera (atomoxetine). Strattera works differently than other currently available medications for ADHD. It is a specific norepinephrine reuptake inhibitor--it improves concentration and focusing by increasing the amount of norepinephrine in certain areas of the brain, thereby causing a change in certain behaviors. By increasing the levels of norepinephrine in the brain, and indirectly, by increasing the amount of dopamine, Strattera improves the brain’s ability to change focus and attend to a new stimuli, to disengage from old stimuli, to analyze data, and to prepare for a response.

Children with ADHD frequently have a great deal of trouble with “rebound” in the afternoon and the evening. This is often a problem with twice-a-day dosing schedules on conventional ADHD medication. When one monitors the behaviors of children who are given Strattera with once-a-day dosing, there appears to be great improvements in these children’s ability to complete homework, sit through dinner, or play quietly. Children taking Strattera are found to be less distractible, do better with bedtime activities, and seem to have little trouble falling asleep. Additionally, children on conventional ADHD medications seem to have trouble with early morning activities, before their morning ADHD medication is given. Children in the studies who are taking Strattera on the once-a-day dosing regimen, however, show improvement in tasks such as getting out of bed, getting ready for school, and demonstrating less arguing or struggling.

Strattera appears to be well tolerated, when compared to conventional ADHD medications. The most prominent side effects include decreased appetite, heartburn, and dizziness. The incidence of insomnia is comparable to placebo. Strattera seems not to cause rebound or withdrawal effects. It is rapidly absorbed after taken orally, and its absorption is not affected by food. There seems to be a continuously positive effect with one-a-day dosing; some children do well with twice-a-day dosing. This looks to be a promising, exciting new medication in the ADHD treatment arsenal, for children and adults.

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