In addition to medication, there are also non-pharmacological treatments. However, non-stimulants such as atomoxetine, clonidine and guanfacine have also been found to be efficacious in treating ADHD. Pharmacological approaches to treatment are the most common, and typically consist of stimulant medication, such as methylphenidate, dexmethylphenidate, mixed amphetamine salts and lisdexamfetamine dimesylate (LDX). There are both pharmacological and non-pharmacological treatments for ADHD for both children and adults. In the following section, current treatment options for both adults and children with ADHD will be discussed. Over the past 3 years, however, more attention has been paid to prescribing patterns, matching medication with patient characteristics, and factors that promote treatment adherence in pediatric and young adult populations. Psychopharmacological agents affecting catecholaminergic and α-2-adrenergic transmission continue to figure prominently in ADHD treatment. Within the past 3 years (2008 onwards), theories about the etiology of ADHD and therapies for it have evolved concurrently. Research on ADH) has been published at an exponential rate during the past 30 years. ADHD in adults is not always comorbid with other concurrent psychiatric conditions, and some data suggest that 'uncomplicated' ADHD exists in about 20 to 25% of adults with ADHD. Comorbidity rates in adult ADHD do not differ as a function of gender. Likewise, adult ADHD is also associated with diagnoses of comorbid mood, anxiety and substance-use disorder. Pediatric ADHD commonly co-occurs with multiple psychiatric disorders including mood, anxiety and disruptive behavioral disorders. Research has indicated that some of these brain regions are slightly smaller or have decreased activation in people with ADHD. The prefrontal cortex has many reciprocal connections with other brain regions, including the striatum (caudate nucleus, putamen), cerebellum and parietal cortex. The prefrontal cortex has a high requirement for dopamine, and plays a role in cognitive functions such as executive functions. Neurologically, the prefrontal cortex seems to be relevant to understanding ADHD. Biologically, the neurotransmitter dopamine has received considerable attention as being relevant to understanding ADHD. Many regions of the brain and several neurotransmitters have been implicated in ADHD. Ĭurrent advances in cognitive neuroscience, neuroimaging, and behavioral and molecular genetics have provided evidence that ADHD is a complex neurobiological disorder. Although diagnosed as a categorical disorder, ADHD may actually represent the extreme end of a normal continuum for the traits of attention, inhibition and the regulation of motor activity. Differences across ethnic groups within North America are sometimes found, but seem to be more a function of social class than ethnicity. The disorder is found in all countries surveyed, with rates similar to, if not higher than, those found in North America. Prevalence clearly varies, with risk factors including age, male gender, chronic health problems, family dysfunction, low socioeconomic status, presence of a developmental impairment and urban living. The ADHD prevalence was once estimated to be 3 to 5% of school-age children, but more recent studies place the figure closer to 7 to 8% of school-age children and 4 to 5% of adults.
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