MedNet Portal

The following reflects new findings and outcomes in medical research as presented at major medical meetings and published peer-reviewed medical journals. In this section members can view reports from important congresses as well as summaries of some recently published journal articles. Please let us know if you have a particular area of interest you would like to see covered.

MEDICAL FRONTIERS - 163rd Annual Meeting of the American Psychiatric Association

Treatment of ADHD Across the Lifespan: Effective Therapies in Children Demonstrate Benefits in Adolescents and Adults

New Orleans, Louisiana / May 22-26, 2010

New Orleans - Efforts to better characterize the dimensions of attention-deficit/ hyperactivity disorder (ADHD) are also generating a more rational approach to symptom control. Once considered to be a developmental issue, potentially exacerbated by environmental triggers, ADHD is now well established as the product of a biochemical, typically genetically-induced, alteration in neurotransmitter signalling that is often a sustained and lifelong condition. In childhood, effective treatment is (...) Read more...

MEDICAL FRONTIERS - 29th Annual Conference of the Canadian Academy of Child and Adolescent Psychiatry

Managing ADHD: From Proper Diagnosis to Improved Treatment Effect

Toronto, Ontario / November 12-14, 2009

Toronto - Attention deficit/hyperactivity disorder (ADHD) is the major mental health problem affecting children today with symptoms frequently persisting into adulthood. In Canada, it is estimated that approximately 800,000 adults and 360,000 children have ADHD. North American guidelines recommend a long-acting stimulant as first-line therapy. However, maintaining treatment effect throughout the day is still problematic. Previously successfully applied to medications, the prodrug delivery (...) Read more...

MEDICAL FRONTIERS - 162nd Annual Meeting of the American Psychiatric Association

Optimizing Treatment Duration for ADHD Patients

San Francisco, California / May 16-21, 2009

San Francisco - Pharmacotherapy with psychostimulants for attention-deficit/hyperactivity disorder (ADHD) is well established as a safe and efficacious approach. However, it presents specific challenges in terms of the duration of action of the chosen medication. On one hand, the agent should ideally remain active for a sufficient time for the patient to derive therapeutic benefit for the full daily cycle of activities. This is important for children, who may need to complete homework (...) Read more...

55th Annual Meeting of the American Academy of Child & Adolescent Psychiatry

Addressing Unmet Needs of Children with ADHD

Chicago, Illinois / October 28-November 2, 2008

Chicago - Psychostimulants such as methylphenidate and amphetamines have been used effectively for decades as first-line treatments for attention-deficit/hyperactivity disorder (ADHD). Though efficacious and well tolerated, these medications are restricted by their inadequate duration of action, inconsistent delivery and potential for abuse. The first long-acting prodrug stimulant for treating ADHD in children aged 6 to 12 years in the US, lisdexamfetamine dimesylate (LDX) may help address (...) Read more...

Expert Opinion on Pharmacotherapy June 2008, Vol. 9, No. 9, Pages 1565-1574

Lisdexamfetamine dimesylate: the first long-acting prodrug stimulant treatment for attention deficit/hyperactivity disorder

Stephen V Faraone PhD Director, Medical Genetics Research, Professor of Psychiatry and Professor of Neuroscience and Physiology Director, SUNY Upstate Medical University, Child and Adolescent Psychiatry Research, 750 East Adams Street, Syracuse, NY 13210, USA +1 315 464 3113; +1 315 849 1839; faraones@upstate.edu

Background: Lisdexamfetamine dimesylate is the first long-acting prodrug stimulant and is indicated for the treatment of attention deficit/hyperactivity disorder. Lisdexamfetamine dimesylate is a therapeutically inactive molecule. Methods: Following oral ingestion, it is converted to L-lysine and active d-amphetamine, which is responsible for the therapeutic effect. Lisdexamfetamine dimesylate was developed with the goal of providing a long duration of effect with the potential for less (...) Read more...

Neuropsychiatric Disease and Treatment Issue: ON-LINE EARLY; Pages:0-0

Once-daily treatment of ADHD with guanfacine: patient implications

Brandon C Strange

The standard of care for treating ADHD is to use a psychostimulant as the first line agent. Recent medical literature reports that approximately 70%–90% of patients with ADHD received some benefit from a stimulant medication. Even though psychostimulants have a high rate of efficacy, an estimated 30%–50% of children and adults may discontinue psychostimulants secondary to adverse effects or inadequate response. Guanfacine has been used for a number of years as an off label alternative to (...) Read more...

Based on an article in Pediatrics 2006;118:e704-10.

Improving Driving Performance in Patients with ADHD

February 2008

INTRODUCTION
There is a clear link between attention-deficit hyperactivity disorder (ADHD) and poor driving, including increased rates of accidents and traffic violations. Ideally, a patient with ADHD who has or wants to obtain a driving permit should be screened with a questionnaire or undergo practical assessment to predict poor performance. Stimulant medications, which unquestionably improve inattention, distractibility and impulsivity, can also successfully influence a patient’s ability (...) Read more...

Journal of Child Psychology and Psychiatry Volume 49 Issue 1 Page 70-78, January 2008

Predictive validity of DSM-IV and ICD-10 criteria for ADHD and hyperkinetic disorder

Soyoung I. Lee11Department of Psychiatry at Soonchunhyang Bucheon Hospital, College of Medicine, Soonchunhyang University, Korea, Russell J. Schachar22Department of Psychiatry and Research Institute, Hospital for Sick Children, University of Toronto, Canada, Shirley X. Chen22Department of Psychiatry and Research Institute, Hospital for Sick Children, University of Toronto, Canada, Tisha J. Ornstein22Department of Psychiatry and Research Institute, Hospital for Sick Children, University of Toronto, Canada, Alice Charach22Department of Psychiatry and Research Institute, Hospital for Sick Children, University of Toronto, Canada, Cathy Barr2,32Department of Psychiatry and Research Institute, Hospital for Sick Children, University of Toronto, Canada3Toronto Western Research Institute, University of Toronto, Canada, and Abel Ickowicz22Department of Psychiatry and Research Institute, Hospital for Sick Children, University of Toronto, Canada 1Department of Psychiatry at Soonchunhyang Bucheon Hospital, College of Medicine, Soonchunhyang University, Korea; Department of Psychiatry and Research Institute, Hospital for Sick Children, University of Toronto, Canada;

Background: The goal of this study was to compare the predictive validity of the two main diagnostic schemata for childhood hyperactivity – attention-deficit hyperactivity disorder (ADHD; Diagnostic and Statistical Manual– IV) and hyperkinetic disorder (HKD; International Classification of Diseases– 10th Edition). Methods: Diagnostic criteria for ADHD and HKD were used to classify 419 children ages 6 to 16 years referred to a clinic for behavioral problems into one of four groups: HKD, ADHD (...) Read more...

Journal of Child Psychology and Psychiatry Volume 49 Issue 1 Page 59-69, January 2008

Quantifying ADHD classroom inattentiveness, its moderators, and variability: a meta-analytic review

Michael J. Kofler, Mark D. Rapport and R. Matt Alderson Department of Psychology, University of Central Florida, USA

Background: Most classroom observation studies have documented significant deficiencies in the classroom attention of children with attention-deficit/hyperactivity disorder (ADHD) compared to their typically developing peers. The magnitude of these differences, however, varies considerably and may be influenced by contextual, sampling, diagnostic, and observational differences. Methods: Meta-analysis of 23 between-group classroom observation studies using weighted regression, publication (...) Read more...

Pediatric Neurology Volume 38, Issue 1, January 2008, Pages 20-26

Effects of Iron Supplementation on Attention Deficit Hyperactivity Disorder in Children

Eric Konofal MD, PhD , †, , , Michel Lecendreux MD , †, Juliette Deron PhD, Mps , Martine Marchand MD‡, Samuele Cortese MD , Mohammed Zaïm MD§, Marie Christine Mouren MD and Isabelle Arnulf MD, PhD†

Iron deficiency has been suggested as a possible contributing cause of attention deficit hyperactivity disorder (ADHD) in children. This present study examined the effects of iron supplementation on ADHD in children. Twenty- three nonanemic children (aged 5-8 years) with serum ferritin levels 30 ng/mL who met DSM-IV criteria for ADHD were randomized (3:1 ratio) to either oral iron (ferrous sulfate, 80 mg/day, n = 18) or placebo (n = 5) for 12 weeks. There was a progressive significant (...) Read more...

Journal of the American Academy of Child & Adolescent Psychiatry. 46(11):1437-1444, November 2007.

Executive Function in Adolescents With ADHD.

MARTEL, MICHELLE M.A.; NIKOLAS, MOLLY M.A.; NIGG, JOEL T. Ph.D.

Objective: The aim of this study was to clarify executive function weakness in attention-deficit/hyperactivity disorder (ADHD) during adolescence and determine the specificity of executive function weakness to ADHD symptom domains. Method: A total of 182 adolescents (105 boys), ages 13 to 17 years, completed a multistage diagnostic assessment; 85 were diagnosed with ADHD: 43 primarily Inattentive type (ADHD-PI) and 42 Combined type (ADHD-C). Participants completed the Stop, Trail Making, (...) Read more...

Child and Adolescent Mental Health Volume 12 Issue 4 Page 160-163, November 2007

Attention Deficit Hyperactivity Disorder: New Ways of Working in Primary Care

Gill Salmon11Trehafod Child and Family Clinic, Waunarlwydd Road, Cockett, Swansea SA2 OGB, and Welsh Institute for Health and Social Care, University of Glamorgan, Pontypridd, Wales. E-mail: salmongn@doctors.uk & Amanda Kirby22The Dyscovery Centre, Alltyryn Campus, University of Wales, Newport, NP20 5DA, Wales1Trehafod Child and Family Clinic, Waunarlwydd Road, Cockett, Swansea SA2 OGB, and Welsh Institute for Health and Social Care, University of Glamorgan, Pontypridd, Wales. E-mail: salmongn@doctors.uk

Abstract Children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and prescribed pharmacotherapy require ongoing regular follow-up for many years. Recent literature outlining the role of primary care in the ongoing medication monitoring of children and young people with ADHD is reviewed. We propose that a General Practitioner with a Specialist Interest (GPwSI) model could be developed in relation to ADHD to ensure that shared care arrangements between CAMHS and primary care (...) Read more...

Journal of Paediatrics and Child Health Volume 43 Issue 10 Page 653-655, October 2007

Curing dyslexia and attention-deficit hyperactivity disorder by training motor co-ordination: Miracle or myth?

Dorothy VM Bishop Department of Experimental Psychology, University of Oxford, Oxford, UK

Abstract: Dore Achievement Centres are springing up world-wide with a mission to cure cerebellar developmental delay, thought to be the cause of dyslexia, attention-deficit hyperactivity disorder, dyspraxia and Asperger’s syndrome. Remarkable success is claimed for an exercise-based treatment that is designed to accelerate cerebellar development. Unfortunately, the published studies are seriously flawed. On measures where control data are available, there is no credible evidence of (...) Read more...

Journal of Child Psychology and Psychiatry Volume 48 Issue 8 Page 831-839, August 2007

ADHD and gender: are risks and sequela of ADHD the same for boys and girls?

José J. Bauermeister11Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico, Patrick E. Shrout22Department of Psychology, New York University, USA, Ligia Chávez11Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico, Maritza Rubio-Stipec11Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico, Rafael Ramírez11Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico, Lymaries Padilla33Carlos Albizu University, Puerto Rico, Adrianne Anderson11Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico, Pedro García11Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico, and Glorisa Canino11Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico

Background: Research comparing treatment-referred boys and girls with attention-deficit/hyperactivity disorder (ADHD) has yielded equivocal results. Contradictory findings may be associated with differential referral practices or unexplored interactions of gender with ADHD subtypes. Method: We examined possible gender differences in ADHD and its subtypes among children aged 4 to 17 in a representative community sample (N = 1896) in Puerto Rico. Caretakers provided information through the (...) Read more...

Based on the following article: Williams et al. American Journal on Addictions 2004;13:381-9

Attention-Deficit Hyperactivity Disorder: Assessing the Risks of Treatment Misuse and Abuse

INTRODUCTION
Relatively few patients take medication for attention-deficit hyperactivity disorder (ADHD) despite the confirmed efficacy of pharmacotherapy. Low rates of medication use and adherence may emanate from concerns that it may be misused or abused, either by the patient or through diversion of drugs to other individuals; or that it may lead to illicit substance abuse. Improper use of medications can be addressed with a proper diagnosis, identification of patients likely to misuse (...) Read more...

Biological Psychiatry Volume 61, Issue 12, 15 June 2007, Pages 1320-1328

Prenatal Smoking Exposure and Dopaminergic Genotypes Interact to Cause a Severe ADHD Subtype

Rosalind J. Neuman , a, , Elizabeth Lobosa, Wendy Reicha, Cynthia A. Hendersona, Ling-Wei Suna and Richard D. Todda

Background In utero exposure to smoking and alcohol are common risk factors that have been associated with attention-deficit/hyperactivity disorder (ADHD) in human beings and animal models. Furthermore, molecular studies have focused on the association between ADHD and DNA polymorphisms in dopamine pathway–related genes. We examined the joint effects of genetic and prenatal substance exposures on DSM-IV and population-defined subtypes of ADHD. Methods Logistic regression was used to (...) Read more...

Biological Psychiatry Volume 61, Issue 12, 15 June 2007, Pages 1370-1379

Impact of Emotional Salience on Episodic Memory in Attention-Deficit/Hyperactivity Disorder: A Functional Magnetic Resonance Imaging Study

Kerstin Krauela, , , Emrah Duzela, d, Hermann Hinrichsa, Stephanie Santelb, Thomas Rellumb and Lioba Bavingc, e aDepartment of Neurology II and Center for Advanced Imaging, University of Magdeburg, Magdeburg, GermanybDepartment of Child and Adolescent Psychiatry, University of Magdeburg, Magdeburg, Germany

Background Patients with attention-deficit/hyperactivity disorder (ADHD) show episodic memory deficits especially in complex memory tasks. We investigated the neural correlates of memory formation in ADHD and their modulation by stimulus salience. Methods We recorded event-related functional magnetic resonance imaging during an episodic memory paradigm with neutral and emotional pictures in 12 male ADHD subjects and 12 healthy adolescents. Results Emotional salience did significantly (...) Read more...