(Updated at Mar 23 / 2023)
Why is leaving ADHD untreated can be dangerous and how to choose the right drug?
Attention deficit hyperactivity disorder (ADHD) is a controversial syndrome. Many people still deny its existence and blame parents for poor home education. Nevertheless, the healthcare authorities all around the world recognize the condition and provide guidelines for the therapy. Besides, the official medical point of view is that if ADHD is untreated it can lead to serious social, professional, and health consequences. It is proven that teenagers with untreated ADHD cannot succeed academically, are ostracized by their peers, and are in a risk group of becoming drug addicts, alcoholics, and criminals.
You shouldn’t be scared to get the wrong diagnosis for you or your kid as there are clear guidelines and criteria on which the diagnosis is based.
How is the diagnosis established?
According to the Diagnostic and Statistical Manual of mental disorders (DSM), the condition can be diagnosed in kids aged 12 years or older. Listed-below symptoms must be present in different situations and circumstances. The condition is established in the presence of at least six symptoms. For teenagers 17 or more, five symptoms are enough.
These behavioral features must be observed for at least half of a year. Patients should be behind the level of development of most adolescents of their age. Symptoms must appear before the age of 12 and cannot be explained by other mental disorders.
The symptoms of ADHD are:
- Frequently cannot focus on detail, makes multiple mistakes in school assignments, etc.
- Finds it difficult to focus while implementing tasks or in games (for instance, is not attentive during classes, discussions, and or long reading).
- It seems that a kid doesn’t listen when he or she are talked to, for instance, it seems that their thoughts are elsewhere even if there is no evident distraction.
- Frequently doesn’t follow the instructions, doesn’t finish homework, chores or routine tasks (for instance, starts implementing a task but is easily distracted).
- Frequently has difficulty organizing independent tasks and other activities (for instance, difficulty in managing tasks with an established sequence, trouble having materials and things in order; erratic, unorganized work, bad time management, failure to meet deadlines).
- Frequently avoids undertaking tasks that require long-term preservation of mental stress (for example, school or homework, for adolescents and adults -making reports, filling out forms, analyzing long documents).
- Frequently loses important things, for instance, school materials, keys, tools, phone, wallet, etc.
- Is easily distracted by the external stimuli (for adolescnets and adults, it may include abstract thoughts).
- Often shows forgetfulness in everyday situations (for example, fulfilling duties, completing assignments, for teens and adults - callbacks, paying bills, making appointments).
Hyperactivity and Impulsivity
- Restless movements in the hands and feet.
- Frequently leave their sit in a class during a lecture or in other situations when they should stay in place. - Frequently aimlessly moves: runs, tries to climb objects when it is unacceptable (for teens and adults it can be limited by anxiety).
- Usually cannot play quietly.
- Frequently is at a constant movement, finds it uncomfortable to be at a restaurant, on meetings, and so on. - Can be excessively talkative. - Frequently starts answering a question without hearing it till the end.
- Often is impatient, for instance, cannot wait in a line.
- Frequently interrupts or engages in someone else’s talks, take someone else’s toys without asking, and so on.
If you find five or six symptoms in your kid's behavior and have proof that he or she has problems at school and with their peers, it is strongly advised to find a doctor specializing in ADHD therapy in kids. You can get an appointment first going to your pediatrician.
How is ADHD treated?
There are two main methods of disorder therapy – behavioral therapy and medications use. Preferably, two of these methods are combined. A child psychologist can help you find a way to get your kid to listen to you, give advice on how to help them with their school work, how to instruct your kids teachers about the diagnosed condition so that they would be more patient, and so on. And medicines help with attention and bettering of other cognitive functions such as memory, speed of thinking, and so on.
ADHD is an actual problem for many adults too. Many people who have not been diagnosed with ADHD in their early years do not know that this could be an underlying cause for their inability to focus, difficulties in learning, organizing working space around, and even for failed personal relationships.
For an adult individual, it is crucial to understand ADHD and learn how to organize their life so that the harm is minimal. For instance, you can work with your therapist on the tips on how to cope with your impulsiveness episodes, how to avoid distractions, plan your eating, what exercises (meditation and/or working out) can help you calm your hyperactivity, and so on. If for some reason you cannot get professional help, you can still find plenty of useful information on the Internet on how to manage ADHD with or without medications.
What drugs are used for ADHD?
Before choosing the therapy, it is important to understand that there are different types of ADHD that require different approaches:
- With predominant inattentiveness and inability to focus;
- With predominant hyperactivity and impulsivity;
- The mixed form.
The medicines used for the condition both for kids and adults are mostly stimulants of the central nervous system such as methylphenidate (Ritalin), amphetamine (Adderall), dexamphetamine (Dexedrine).
The mechanism of these medicines is well studied - they temporarily suppress normal spontaneous behavioral reactions. However, in the incorrect dosage or a predominance of attention-deficit over hyperactivity, the medications can suppress the development of self-discipline and actually cause social adaptation problems.
In predominant impulsivity and aggressiveness, antidepressants such as Atomoxetine, Bupropion, and Desipramine can be used.
It is crucial to identify the type of ADHD both for kids and adult patients to choose the right therapy. For instance, for predominant attention deficit, there is no need for antidepressants or even Ritalin use as they can inhibit normal social interactions and can a person become even more excluded from society. For these people, it is better to use the drugs that can improve cognitive functions, i.e. focus, memory, speed of thinking, such as Armodafinil (Nuvigil or its generic form Artvigil). This drug doesn’t inhibit reaction time so it wouldn’t be advised to be used alone for patients with pronounced impulsivity and even aggressiveness for which antidepressants would be recommended. Although, it could be combined with drugs able to inhibit the reaction.
Here you can find the comparison of different drugs for ADHD cased on their key features
This antinarcoleptic medication doesn’t suppress or promote agitation. It promotes wakefulness and cognitive functions (i.e. memory, speed of thinking, time of reaction, focus, etc.) It is not the first choice for kids or people of any age with the predominant impulsiveness and aggressiveness. It can be recommended to be used for people with predominant attention deficit and inability to focus on tasks.
The major benefits of Armodafinil are:
- Minimum contraindications (severe heart disease, cirrhosis of the liver, pregnancy, intolerance of the drug);
- Minimum and rare side effects (dose-dependent headache, insomnia, and nausea).
The medication is a first choice for children with ADHD as it helps with cognitive functions and ability to focus. However, it can cause hyperactivity as a side effect so if it is used in kids with predominant hyperactivity, additional sedative (calming) drugs are advised to be used.
The major advantages of Ritalin are:
- It had been used for over 45 years for ADHD in kids;
- It can cause side effects in kids but they are usually minor and dose-dependent (in dose lowering they can go away).
It is one of the options for ADHD treatment. It can be used alone or with stimulants. The drug is effective for ADHD in some patients but the effects are believed to be less pronounced than with the use of stimulants.
Advantages of Atomoxetine:
- It has low dependence development potential.
- It can be used in children aged 6 years or older.
- Can be stopped used without any withdrawal or rebound symptoms.
- Can be used with other stimulants to lower their dosage.
Disadvantages of Armodafinil in ADHD treatment:
- Insufficient tests in children;
- Can be bought only at an online drugstore for ADHD.
Disadvantages of Ritalin ADHD treatment:
- Is contraindicated in multiple conditions;
- Can cause a wide range of side effects;
- Can cause drug dependence;
- Can cause inhibition of growth in children in long-term use or high-doses use;
- Can enhance hyperactivity.
- Can cause rebound effect after therapy discontinuation.
Disadvantages of Atomoxetine ADHD treatment:
Is contraindicated in multiple conditions;
- Less pronounced effect than in the use of stimulants;
- Can cause a wide range of adverse effects.
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