What is ADHD? 

Attention deficit hyperactive disorder (ADHD) is a neurodevelopmental disorder that usually starts in childhood and may extend up to adolescence and is characterized by a lack of awareness of detail and hyperactiveness. (1) A child with ADHD may present signs and symptoms such as daydreaming, talking excessively, making silly mistakes, and sometimes being risky. There are two types of ADHD which are as follows:

1. Predominantly inattentive presentation.
2. Predominantly hyperactive-impulsive presentation.

Predominantly inattentive presentation- in this type of ADHD, a person cannot complete the daily routine tasks, forgets the given instructions, and easily gets distracted by distractors leaving behind whatever they are doing.

Predominantly hyperactive-impulsive presentation- in this type of ADHD, an individual tends to talk a lot, they do not sit, and in the case of children, they are always jumping and climbing and also talk at improper times.

Comorbid conditions with ADHD:

Among children with ADHD, the comorbid conditions usually present include mood, behavioral disorders, and anxiety. (2) Whereas among adults, the comorbid conditions include substance use disorder, anxiety, and moods. The prevalence of comorbidity is not gendered biased among ADHD individuals.

Neurofeedback techniques for ADHD:

Currently, many studies have given a piece of evidence that ADHD is a neurobiological disorder and involves several regions and neurotransmitters in the brain. Dopamine is related to being involved in ADHD, and neurologically, the prefrontal cortex shows its association with ADHD. Dopamine is present in high amounts in the prefrontal cortex and is involved in cognitive functions. In addition, it is found that some brain areas are less developed in individuals suffering from ADHD.

Electroencephalogram feedback or Neurotherapy is used to alter or modulate brain activity. In this system, EEG electrodes are placed on a person’s scalp and send electrophysiological signaling to developed software. The main aim is to control the physiological responses via training. The neurofeedback technique enhances the production of healthier brain waves and produces high frequency to help the patient with slow waves. This technique has largely been investigated for attention deficit hyperactive disorder (ADHD).

Pharmacological options for treating ADHD:

Pharmacological options include stimulants and non-stimulants and are approved for use in North America.

Stimulants:

Stimulants remain the first choice of drug to be used among ADHD individuals, as they are more productive than non-stimulants. (3) Methylphenidate, Dexmethylphenidate, Lisdexamfetamine dimesylate (LDX), and mixed amphetamine salts are used as stimulant drugs for ADHD. These are given through different delivery systems, such as sprinkles, tablets, sprays, and patches. They are also available as pro-drug, immediate-release, and extended-release formulations. (4) Side effects related to stimulants are very few; however, the potential for misuse and abuse of these drugs is there, presenting concerns about their use.

Non-stimulants:

Some non-stimulant options were found to be effective in treating individuals with ADHD. Modafinil and reboxetine are the two non-stimulant options that show promising results in treating ADHD. Clonidine and guanfacine are FDA-approved drugs to be given along with stimulants for treating individuals with ADHD. (5)

REFERENCES:

1. Centers for Disease Control and Prevention. (2021, September 23). What Is ADHD? Centers for Disease Control and Prevention; CDC. https://www.cdc.gov/ncbddd/adhd/facts.html
2. Angold, A., Costello, E. J., & Erkanli, A. (1999). Comorbidity. Journal of Child Psychology and Psychiatry, 40(1), 57–87. https://doi.org/10.1111/1469-7610.00424
3. Faraone, S. V., Biederman, J., Spencer, T. J., & Aleardi, M. (2006). Comparing the efficacy of medications for ADHD using meta-analysis. MedGenMed: Medscape General Medicine, 8(4), 4. https://pubmed.ncbi.nlm.nih.gov/17415287/
4. Chavez, B., Sopko, M. A., Ehret, M. J., Paulino, R. E., Goldberg, K. R., Angstadt, K., & Bogart, G. T. (2009). An update on central nervous system stimulant formulations in children and adolescents with attention-deficit/hyperactivity disorder. The Annals of Pharmacotherapy, 43(6), 1084–1095. https://doi.org/10.1345/aph.1L523
5. Antshel, K. M., Hargrave, T. M., Simonescu, M., Kaul, P., Hendricks, K., & Faraone, S. V. (2011). Advances in understanding and treating ADHD. BMC Medicine, 9(1). https://doi.org/10.1186/1741-7015-9-72