PRACTICE PEARLS

Practice Pearls for ADHD

 

Do you know how to optimize your management of ADHD? These practice pearls can help!

Medication can help patients get the most out of behavioral therapy. When basic deficits in behavioral and emotional inhibition and working memory have been improved with medication, behavioral techniques can be implemented more easily to teach enduring coping strategies.1

 

Improve efficacy with titration. The best dose of medication for a given child is the one that leads to optimal effects with minimal side effects.2

 

Involve adolescents in their own treatment. Adolescents may be more receptive to medication when you take the time to explain ADHD, how medication works, that there are different medication options, and listen to their concerns.3

 

Make a contract with adolescents who refuse medication. Adolescents who don’t want medication shouldn’t be pressured. However, a contract with the patient to improve specific target symptoms, eg, improving grades and changing specific behavior, over the next few months can be made. If the target behaviors fail to improve, then medication should be discussed again.3

 

References: 1. Whittemore D, Hill P. ADHD in the post-MTA era: real pearls from warring oysters. BHSI Newsletter. 2005;1:1-2. Available at: http://www.bhsimn.com/newsletters/v1n1p1.html. Accessed July 17, 2007. 2. American Academy of Pediatrics, Committee on Quality Improvement and Subcommittee on Attention-Deficit/Hyperactivity Disorder. Clinical practice guideline: treatment of the school-aged child with attention-deficit/hyperactivity disorder. Pediatrics. 2001;108:1033-1044. 3. Robin AL. Attention-deficit/hyperactivity disorder in adolescents: common pediatric concerns. Ped Clin North Am. 1999;46:1027-1038.

CONCERTA® is indicated for the treatment of attention deficit hyperactivity disorder (ADHD).

IMPORTANT SAFETY INFORMATION

CONCERTA® should not be taken by patients with: allergies to methylphenidate or other ingredients in CONCERTA®; significant anxiety, tension, or agitation; glaucoma; Tourette's syndrome, tics, or family history of Tourette's syndrome; current or recent use of monoamine oxidase inhibitors (MAOIs). Children under 6 years of age should not take CONCERTA.®

Abuse of methylphenidate may lead to dependence. CONCERTA® should not be used in patients with known structural cardiac abnormalities, cardiomyopathy, serious heart rhythm abnormalities, coronary artery disease, other serious cardiac problems, or patients with pre-existing severe gastrointestinal narrowing. Use with caution in patients with hypertension and other cardiovascular conditions, psychosis, bipolar disorder, and history of seizures/EEG abnormalities. Stimulants may cause new psychotic or manic symptoms; discontinuation of treatment may be appropriate. Aggressive behavior or hostility should be monitored in patients beginning ADHD treatment. Methylphenidate may produce difficulties with visual accommodation and blurring of vision. Hematologic monitoring is advised during prolonged therapy. Growth should be monitored during treatment with stimulants, and patients who are not growing or gaining height or weight as expected may need to have their treatment interrupted.

The most common adverse reaction (>5%) reported in children and adolescents was abdominal pain upper. The most common adverse reactions (>10%) reported in adults were dry mouth, nausea, decreased appetite, headache, and insomnia.

Please see full U.S. Prescribing Information

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Last Modified Date: Jun 15 2010 at 16:01:18 EDT