ATTENTION-DEFICIT HYPERACTIVITY DISORDER - CLINICAL-FEATURES AND TREATMENT OPTIONS

Attention deficit hyperactivity disorder (ADHD) is a heterogeneous dis order of unknown aetiology. It usually affects school-aged children wi th an estimated prevalence of 3 to 6%. ADHD is characterised by a core of symptoms that include short attention span, easy distractibility a nd social impulsivity. Stimulants continue to be the most efficacious and least toxic agents used to treat the disorder in the majority of c hildren, and are the drugs of choice in children in whom cardiovascula r status is questioned. Tricyclic antidepressants are also effective a nd are especially beneficial in individuals who are resistant to stimu lants or in whom ADHD is accompanied by comorbid depression, anxiety, enuresis, tic disorders, substance abuse or sleep disturbance. Other a ntidepressants such as clorgiline (clorgyline), nortriptyline, fluoxet ine and monoamine oxidase inhibitors have also been shown to reduce AD HD symptomatology. These agents may provide therapeutic options in the future. Adverse effects associated with stimulants include decreased appetite, insomnia, gastrointestinal upset, headache and potential gro wth suppression. Tricyclic antidepressants may cause drowsiness, antic holinergic effects and cardiovascular changes. Tolerance does not deve lopment with stimulants but may occur with tricyclic antidepressants.