Treatment of hyperkinetic syndrome include:
B i.e. Methyl phenyclateThe drug of choice for attention deficit - hyperactivity disorder is methylphenidate.CNS - Stimulant medication- Remain the drugs of choice in the pharmacological treatment;d/t significant efficacy, and excellent safety records.- Sustained release preparations are preferred d/t single doseand no rebound irritability.- FDA approves use of dextroamphetamine in children 3 years old and older and methyl phenidate in children 6 years old and olderQ. These are two most commonly used treatments for children.- Drug of 1,, choice methylphenidate is a sho acting medication generally used to be effective during school hours. It's most common side effects are headaches, stomachaches, nausea and insomnia. In some rebound effect (brief period of hyper activity), exacerbation of tic disorder and growth suppression can occur, but children tend to make up the growth when are given drug holidays in the summer or on weekends.- d- enantiomer - dexmethylphenydate (Focalin) is recently introduced to maximize target effects & minimize adverse effects in individuals who obtain paial response from methyl - phenydate.Dextroamphetamine & dextroamphetamine + amphetamine salt combinations are usually the second drugs of choice when methylphenydate is not effective.- Modafinil (provigil), a CNS stimulant, originally developed to reduce day time sleepiness in patients with narcolepsy, has also been tried.Non stimulant medicationAtomoxetine is a presynaptic norepinephrine uptake inhibitor approved by FDA in treatment of ADHD for children age 6 years and above. It is effective for inattention & impulsivity in children and adults. It improves mood and anxiety.Modafinil (provigil) is a ble treatment of ADHD in adolescents.Although stimulants remain the drug of choiceQ, a body of evidence now suppos the use of non stimulants, including atomoxetine and modafinil (Kaplan 1213)Bupropion has been used as both an antidepressant & in the treatment of ADHD- Venlafaxine used especially for children & adolescents with combinations of ADHD and depression or anxiety features.- a adrenergic agonists eg clonidine & guanfacine. Clonidine may be helpful when patients also have tic disorders.Other classes of medications, tricyclic drugs and premoline previously used to treat ADHD are no longer recommended because of potential adverse effects on liver function (premoline), potential cardiac arrhythmia effects (TCA) and sudden death (with desipramine)Very rarely antipsychotics are used to treat refractory hyperactivity in children & adolescents who are severely impaired and do not respond to other treatments.Quetiapine (like risperidone, olanzapine, clozapine, & Ziprasidone) is a serotonin domamine - antagonist (SDA; which is also known as second generation - atypical antipsychotic drugs). All SDAs have a higher ratio of serotonin type 2 (5-HT2) to D2 dopamine receptor blockades and a low D2 receptor blocking effect when compared with typical, conventional dopamine receptor antagonists (DRA). So there is a reduced risk of extrapyramidal side effects. These drugs have proved efficacy as treatments for Schizophrenia & acute maniaQ. Quetiapine is also used in bipolar depression, insomnia, on aggression in children with autism, childhood or adolescent antisocial behaviour (with episodes of explosive behaviour, aggression and violent out bursts), conduct disorders, and for schizophrenia and mania in children & adolescent.
Imipramine
Methyl phenidate
Haloperidol
Clozapine