Attention Deficit Hyperactivity Disorder

Symptoms

Attention deficit hyperactivity disorder (ADHD, ADHD) is a developmental disorder of the central nervous system. Leading symptoms include:

  • Inattention, decreased ability to concentrate.
  • Hyperactivity, motor restlessness, restlessness.
  • Impulsive (thoughtless) behavior
  • Emotional problems

Although ADHD begins in childhood, it also affects adolescents and adults and is more common in boys than girls. It presents itself, also depending on age and gender, very heterogeneous and in a varying degree of severity. Mostly, ADHD is diagnosed from the age of about 6 years and after entering school, because skills such as attention, concentration and discipline are of particular importance there. ADHD may also go undetected or not be diagnosed until adulthood. It is estimated that over 5% of children are affected, which is a high figure. ADHD is stressful and affects various areas of life (school, family, work, leisure). People with ADHD are at increased risk for accidents, substance abuse, emotional conflict, breaking the law, psychiatric illness, and suicide.

Causes

ADHD begins in childhood and, on the one hand, is caused by genetic factors, meaning that heredity plays an important role. On the other hand, environmental factors are also involved to a lesser extent, especially before during and after birth. Risk factors include:

  • Smoking and alcohol consumption during pregnancy.
  • Environmental toxins
  • Very low birth weight
  • Premature birth
  • Early childhood love deprivation (deprivation)
  • Poor mother-child relationship
  • Brain damage

The pathogenesis is not fully understood. The development is considered multifactorial. It is a functional and structural developmental disorder of the brain.

Diagnosis

Diagnosis is made in specialist treatment primarily using standardized questionnaires, checklists, with neuropsychological tests, and with structured discussions. This is done both with the patients themselves and with important contacts. Physical examinations and laboratory tests are used to rule out other causes.

Nonpharmacologic treatment

Currently, no curative therapy exists. For symptomatic treatment, nonpharmacologic measures are combined with pharmacologic measures. ADHD should be approached individually and multimodally.

  • Psychoeducation, counseling and guidance (coaching), emotional support.
  • Behavioral therapy
  • Psychotherapy
  • Group therapy

Drug treatment

For drug treatment, stimulants from the group of amphetamines are used, on the one hand. This seems paradoxical because they actually have stimulating and activating effects. However, their effectiveness is well documented. Their effects are based on interaction with neurotransmitter systems in the brain. The best-known ADHD drug is methylphenidate (Ritalin, generic). Amphetamines can potentially cause numerous adverse effects and are also abused as intoxicants by patients without ADHD. They are subject to narcotics legislation and are highly regulated by authorities. Detailed information can be found under the active substances: Amphetamines (Stimulants):

Other agents are available that do not belong to the group of stimulants. They also exert their effects by affecting neurotransmission: Selective Norepinephrine Reuptake Inhibitors (SNRIs):

Selective norepinephrine and dopamine reuptake inhibitors (SNDRI):

  • Dasotraline (registration phase).
  • Bupropion (no regulatory approval).

Alpha2 receptor agonists:

  • Clonidine (Kapvay)
  • Guanfacine (Intuniv)