ADHD

New research reported at the annual meeting of the American Psychiatric Association in Toronto in May shows that Shire Pharmaceutical Group's methylphenidate transdermal system (Daytrana) appears a safe and well-tolerated alternative to OROS methylphenidate, and is equally efficacious.

The second of a four-part series on nutritional interventionsexamines evidence of a salicylate-elimination diet for ADHD.

A new study on potential interactions between genetic and environmental factors in ADHD suggests that current limits on lead exposure are too high. Lead exposure below the current limits allowed by Environmental Protection Agency regulations produced measurable impairment of executive functions, especially in boys, who have a specific variation in the DRD4 dopamine receptor gene.

A 9-year-old girl presents with multiple hyperpigmented lesions, some of which have been present since birth (Figure 1). The lesions have increased in size and number. There is no history of seizures. Her 40-year-old mother has multiple skin nodules (Figure 2).

ASSESSMENT

The longest and most complex study of methylphenidate (Ritalin) in preschool children shows that it can be safe and effective for some children in that age group who have attention deficit hyperactive disorder (ADHD), according to the study's lead author.

The US Food and Drug Administration (FDA) recently approved Adderall XR (an extended-release formulation of mixed salts of amphetamine) as a once-daily treatment for attention deficit hyperactivity disorder in adolescents 13 to 17 years old. That action bridges an "indication gap" between earlier approval of the product for patients 6 to 12 years old and for older (18 years) adolescents and adults.

Q Parents of a 4 1/2-year-old boy in my practice are concerned because he takes too many risks. They report that he always seems to be doing something dangerous, which often results in injury.

At pediatricians' disposal today are numerous formulations of approved medications for ADHD--traditional psychostimulants and newer agents. We also have developed an appreciation of the value of a multipronged approach to this chronic disorder.

Step-by-step evaluation of an adolescent girl who may have ADHD highlights the strengths and limitations of the AAP diagnostic guidelines and offers insight into how to augment them.

Diagnosing and treating a child?s ADHD is often not enough. Most patients have coexisting developmental or psychiatric disorders that must be addressed.

Pediatric Puzzler: Weakness (thyrotoxic periodic paralysis)

The prognosis for teenagers with ADHD is better than ever, thanks to more effective therapies and greater understanding of how the disorder manifests itself in adolescence.

Attention deficit hyperactivity disorder doesn&t disappear in teens. But it does look different, and failure to recognize and treat it can have a devastating impact.

Parents of children with ADHD need assistance adapting to their child's condition, enhancing his or her achievement and self-esteem, and getting the special help the youngster needs and deserves. These books, videos, and Web sites point the way.