ABSTRACT
Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in childhood. Children and adolescents with ADHD are at increased risk for behavioral issues, academic issues, substance abuse issues, and legal problems. Approximately 50% of cases of childhood ADHD will persist into adulthood where it can impact employment, organizational skills, and frustration tolerance. Use of amphetamine and methylphenidate stimulant medications have shown to have the best outcomes, and are considered first line treatments. It is important to monitor stimulant use closely in individuals with substance abuse concerns, however, studies in adolescents with both substance abuse histories and ADHD tend to support their use and benefits. It is important to identify other co-morbid conditions that a patient with ADHD may be struggling with and treat those accordingly. Providers should re-evaluate the symptoms and clinical presentation of patients that show minimal or no improvement with treatment to ensure a proper diagnosis has been made.
Subject(s)
Attention Deficit Disorder with Hyperactivity , Methylphenidate , Humans , Adolescent , Child , Attention Deficit Disorder with Hyperactivity/diagnosis , Attention Deficit Disorder with Hyperactivity/drug therapy , Amphetamine , Methylphenidate/therapeutic use , Employment , AttentionABSTRACT
The rationale for CIM treatments in youth psychoses is to optimize treatment by targeting symptoms not resolved by antipsychotics, such as negative symptoms (major drivers of disability). Adjunctive omega-3 fatty acids (ω-3 FA) or N-acetyl cystine (NAC usage for > 24-week) can potentially reduce negative symptoms and improve function. ω-3 FA or exercise may prevent progression to psychosis in youth (in prodromal stage). Weekly 90-minute moderate to vigorous physical activity or aerobic exercise can reduce positive and negative symptoms. Awaiting better research, CIM agents are also recommended because they are devoid of any serious side-effects.
Subject(s)
Antipsychotic Agents , Fatty Acids, Omega-3 , Integrative Medicine , Psychotic Disorders , Adolescent , Humans , Psychotic Disorders/drug therapy , Psychotic Disorders/prevention & control , Antipsychotic Agents/therapeutic use , Fatty Acids, Omega-3/therapeutic useABSTRACT
Attention-deficit/hyperactivity disorder (ADHD) is a commonly encountered diagnosis in the child and adolescent populations, and stimulant medications are often prescribed for their treatment. There are numerous available options in this category, including immediate and extended release formulations. There have been many case reports in the literature involving purposeful overdose on immediate release stimulants, but a relative paucity involving extended release forms. Additionally, they often involve Caucasian and Asian populations. We treated a Native American adolescent who took an overdose of extended-release methylphenidate with the intention of suicide. He developed transient orofacial dyskinesia and upper extremity choreoathetosis as a result which did not abate during his time in the emergency department. Once transferred to our care, he was given a one-time benzodiazepine dose with some benefit. This case report describes objective sequelae of a long-acting methylphenidate overdose as well as treatment for the benefit of treating clinicians with similar patient populations and situations.
Subject(s)
Attention Deficit Disorder with Hyperactivity , Central Nervous System Stimulants , Dyskinesias , Methylphenidate , Adolescent , Attention Deficit Disorder with Hyperactivity/drug therapy , Central Nervous System Stimulants/adverse effects , Child , Dyskinesias/drug therapy , Humans , Male , Methylphenidate/adverse effects , Upper ExtremityABSTRACT
In the state of South Dakota, there are 39 accredited substance abuse providers who service over 11,000 individuals each year. Knowledge of which substance abuse providers are accredited is important for families looking to find financially affordable substance abuse treatment/care for their loved ones. In order to begin the process of entry into a substance abuse treatment program, an adolescent must first complete a needs assessment with one of the accredited providers. The needs assessment will help to identify the severity of the substance use disorder as well as identify the appropriate level of treatment/care for the individual.
ABSTRACT
With the recent legalization of recreational marijuana in Colorado, Washington, Alaska, the District of Columbia and legislation pending for both medical and recreational marijuana in several other states, it is important for the facts regarding its potential for serious mental health consequences to be known. Little has been said about the psychiatric risks of this substance, particularly in youth. Several studies have shown increased rates of depression, anxiety and schizophrenia among those who use marijuana on a regular basis. In addition, permanent loss of IQ and structural changes in the brain have been demonstrated with habitual use. Legalization of marijuana for recreational use can influence an adolescent's perception of this substance as "safe." In states that have legalized marijuana for medical purposes, there is the very real problem of "diversion." As many as 34 percent of 12th-graders who use marijuana in states with legalized marijuana had obtained it from a person who had received it through a prescription.
