[The results of the pharmacological treatment of attention deficit hyperactivity disorder: evaluation with neuropsychological methods].

OBJECTIVE: To investigate the dynamics of behavioral indicators, attention and memory in children with attention deficit hyperactivity disorder (ADHD) treated with noofen (capsules 250 mg). MATERIAL AND METHOD: In an open study, 50 patients were randomized to 2 equal groups: patients of group 1 were treated with noofen (15-20 mg/kg (500-700 mg) per day perorally in 2-3 doses); the control group received low doses of multivitamins. Duration of treatment was one month. RESULTS: The results of neuropsychological testing revealed the improvement of cognitive functions, including the indicators of self-control, sustained, directed and divided attention, acoustic-verbal memory, to the end of treatment. CONCLUSION: The initial positive changes may be the basis for obtaining better clinical results during long-term treatment.

[Attention-deficit hyperactivity disorder: determination of the optimal medical treatment duration].

Thirty-two patients with attention-deficit hyperactivity disorder (ADHD), 23 boys and 9 girls, aged 6-12 years, were examined in two months intervals during the long-term treatment (up to 6-8 months) with pantogam (homopantothenic acid) in daily dosages of 500-1000 mg. The treatment results were evaluated by the ADHD Rating Scale-DSM-IV and The Weiss Functional Impairment Rating Scale - Parent Report (WFIRS-P). While the core symptoms of ADHD were according ADHD-DSM-IV diminished after 2 months, the improvement of WFIRS-P parameters required the longer duration of medical treatment. Only after 4 months of treatment, the improvement was achieved in selfesteem and social activities, and after 6 months in learning and behavior at school as well as in the level of life skills along with the decrease of risky activities. Thus, getting over psychosocial adaptation problems needs the longer treatment duration than the decrease of ADHD core symptoms.

[Attention deficit - hyperactivity disorder and enuresis in children and adolescents].

Frequency of comorbid disorders and neuropsychological state, executive functions (EF), were studied in two groups of patients aged from 5 to 14 years: 53 patients with attention-deficit hyperactivity disorder (ADHD) in the association with enuresis and 71 patients with ADHD without enuresis. The most cases of enuresis (50 out of 53 patients) were represented by primary nocturnal enuresis. The significant increase of total number of ADHD cases with comorbidity for oppositional-defiant disorder, anxiety disorder, tics or encopresis (77.7%) was found in the first group compared to the second one (60.6%). The presence of enuresis in ADHD was associated with the significant increase of frequency of anxiety disorders (54.7% versus 39.4%). Moreover, in the group of patients with ADHD and enuresis, the frequency of oppositional-defiant disorder and encopresis was higher in the age of 5-9 years while the frequency of obsessive-compulsive disorder and tics increased in the period of 10-14 years as compared to patients without enuresis. The assessment of executive functions with the Wisconsin Card Sorting Test did not reveal any differences between patients of two groups.

[Atomoxetine and piracetam in the treatment of attention deficit hyperactivity disorder in children].

Therapeutic effect of atomoxetine and piracetam has been assessed in the open controlled study included 42 patients with attention deficit hyperactivity disorder (ADHD), aged from 6 to 13 years. Group 1 (16 patients) received atomoxetine (strattera) in daily dosage 0,8-1,2 mg/kg as a monotherapy for 6 weeks. Patients of group 2 (14 children) received piracetam as a monotherapy in daily dosage 50-70 mg/kg for 6 weeks. No pharmacological therapy was conducted in group 3 (a control one) which included 12 patients with ADHD. The high effectiveness of both atomoxetine and piracetam has been shown. However, comparing to piracetam, the therapeutic effect of atomoxetine was reached earlier (two weeks after the beginning of therapy) and was more pronounced for all components of syndromes.

[Disorders comorbid to attention deficit hyperactivity syndrome in children].

Attention deficit hyperactivity disorder (ADHD) is a common behavioral disorder found in children. Comorbid disorders, including oppositional/aggressive behaviors and emotional disorders, may be present in the majority of children diagnosed with ADHD thus complicating an optimal choice of pharmacotherapy. We evaluated the comorbid disorders in an out-patient sample of 76 children with ADHD (59 boys and 17 girls) aged 5-11 years using the Russian version of Kiddie-Shedule for Affective Disorders and Schizophrenia - Present and Lifetime Version. In all cases, a diagnosis met ICD-10 diagnostic criteria. Only 23 (30,3%) subjects had pure ADHD and 53 (69,7%) suffered from at least one comorbid disorder, i.e. oppositional defiant disorder (43,4%), anxiety disorder (39,5%), tics (9,2%), nocturnal enuresis (17,1%) and encopresis (5,3%). The recently published data of double-blind placebo controlled studies are reviewed indicating that in children and adolescents with ADHD and comorbid disorders atomoxetine is superior to placebo in treating ADHD and alleviating the symptoms of comorbid disorders.

[The use of instenon in children with minimal brain dysfunction]. / Primenenie instenona pri lechenii minimal'noi mozgovoi disfunktsii u detei.

Minimal brain dysfunction (MBD) represents the most common type of neuropsychic disorders in childhood. Resulting in focal damages, underdevelopment and dysfunction of one or another cortical regions of brain hemispheres, MBD manifested in children as movement and speech disorders, dysgraphy, dyslexia, dyscalculia and attention deficit hyperactivity disorder. In the open controlled study, an efficacy of the complex nootropic medication "Instenon" was evaluated in the treatment of 59 MBD patients, aged 4-12 years. Control group included 27 children with MBD assigned to low polyvitamin (Sana Sol) doses. The treatment duration was 1 month. Before and after treatment, children with MBD underwent complex examination, which included parent's interviewing using structured questionnaire, general examination, with detailed analysis of complaints, neurological status investigation and psychological study. In the children taken instenon, distinct positive effect has been achieved in 71% of the cases, in control group--in 15%. Positive effect emerged in improvement of behavior characteristics, better school marks, movement, attention and memory indices, functions of psychic activity, organization, programming and control. When strictly keeping a scheme prescribed (gradual dose increase, drug taking in morning and day time), a risk for unfavorable side effects is minimal.