Drug of choice for treating Attention Deficit Hyperactivity Disorder (ADHD) in a 6-year-old boy whose father has a history of substance abuse:
Ans: (b) AtomoxetineRef: Stahl's Essential Psychopharmacology, 4th editionTreatment for ADHDA. Pharmacotherapy: (Note: Drugs reserved till 6 years of age)Three types of drugs used currently:Stimulants (Amphetamines, Methylphenidate)They are first-line drugsThey act by several mechanisms which ultimately end up in enhancing monoamine actionsMost importantly catecholamine (epinephrine, norepinephrine) and dopamine are enhancedComplications: Seizures, Psychosis, DependenceHence contraindicated if a person is having/had/family history of these conditions AtomoxetineIt is a Norepinephrine reuptake inhibitor (NRI)It has no side effect profile like amphetamines.Hence, useful when in conditions where stimulants are contraindicated.Contraindicated in hypertension, arrhythmias, pheochromocytomaIt is useful in adults also.ClonidineIt improves attention by increasing noradrenergic tone in locus coeruleus and prefrontal cortex (binding to postsynaptic a2A adrenergic receptors)It controls hyperactivity by suppressing sympathetic outflow.B. Psychotherapya. Behavior therapy (Positive reinforcement)b. Neurofeedback
Methylphenidate
Atomoxetine
Clonidine
Dexamphetamine
Drugs & Other Biological Methods of Treatment