Treatment of ADHD


first-line treatment is drugs in children aged 6 and above. In children below 6 years, the first line of treatment is behavioral therapy.

Among drugs, first, try stimulants (amphetamine/ methylphenidate).

Second-line options are atomoxetine and clonidine. 

what is the mechanism of action of atomoxetine

norepinephrine reuptake inhibitor

How to titrate the dose of the stimulant?

we should titrate it every week until max dose is reached or the patient experiences intolerable side effects.

How long to wait to see whether the stimulant will be effective?

its effect is seen within 1 week. if the patient does not feel improvement within 1 week, change to alternate medications.

what are the features of stimulant toxicity?

diaphoresis, mydriasis, tachycardia, hypertension, dilated pupil, anxiety, agitation, psychosis, decreased appetite

cannabis intoxication also causes tachycardia, and hypertension; then how to differentiate it from stimulant toxicity?

in cannabis intoxication, there is increased appetite, tachypnea, conjunctival injection

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