Why non-stimulant therapy should be used more than st
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Why Non-Stimulant Therapy Should Be Used More Than Stimulant Therapy
Treatment of ADHD with stimulant drugs is associated with a number of side effects like abdominal discomfort, generalized lassitude, increased heart rate and blood pressure. Stimulant drugs may also lead to the development of tics, and there may be hypersensitivity reactions to such drugs that may lead to hepatic damage (Barkley 165). Long term effects of stimulants on growth in children are still under investigation. Another factor to consider in the use of this class of drugs is that since they have abuse potential they are under the rules and regulations of drug enforcement agencies and their procurement is a difficult and tedious task.
All the above-mentioned factors along with decreased response to stimulants in some ADHD patients necessitated research into other class of drugs that could be helpful in ADHD.
Various drugs are being used to treat ADHD. The first non-stimulant drug that was approved for use in ADHD was atomoxetine sold under the brand name of Strattera (Gadde et al. 1142). This drug belongs to the class of norepinephrine reuptake inhibitor and can be used in both adults and children. The main points that favor use of atomoxetine over stimulants includes decreased abuse potential and longer action. The drug can act for 24 hours, and there is no sudden wearing off of action as associated with stimulant drugs. It scores over stimulants as it does not produce any tics, by virtue of its antidepressant action it can be used quite effectively in patients who are experiencing anxiety or depressive symptoms. However, side effects like decreased appetite, nausea and mild increase in heart rate and blood pressure are associated with it.
The second major non-stimulant drug for ADHD is guanfacine that has the brand name of Intuniv. The exact mechanism of guanfacine in ADHD is being studied, but it seems to act on certain areas in the brain that lead to improvement in memory, attention and reduces distractibility. It is being used for children in the age group 6 to 17. Minor side effects like stomach ache, sleepiness, and headache have been reported with use of this drug.
Kapvay or clonidine is also successfully being used for the treatment of ADHD in 6-17 year-old children. This drug is an alpha two agonist that shows improvement in ADHD symptoms. Tricyclic antidepressants and non-tricyclic antidepressants are also being explored as viable alternatives to stimulants in ADHD. They usually act as either dopamine or norepinephrine or serotonin reuptake inhibitors and are not as addictive as stimulants (Pliszka 258).
The prime advantage that non-stimulant drugs offer is their reduced abuse potential and decreased chances of addiction. These drugs can also help in refractory cases that are not showing improvement with stimulant therapy. Symptoms related to anxiety and depression can also be ameliorated by the use of such drugs. The side effect profile of non-stimulants is less ominous and concerns about long-term effects less worrying as compared to stimulants. They have sustained action that is maintained through the day (Wilens et al. 1490).
However, it must be remembered that there is no magic pill for a condition as complex as ADHD. Drugs can help only to a certain extent, and the role of behavioral therapy and family support is of extreme importance. A healthy lifestyle with the correct choice of medicines can help a person with ADHD to lead a normal life.
Barkley RA. A review of stimulant drug research with hyperactive children. J Child Psychol Psychiatry.1977. Print.
Gadde, KM; Yonish, GM; Wagner, HR; Foust, MS; Allison, DB. Atomoxetine for weight reduction in obese women: a preliminary randomised controlled trial. International Journal of Obesity. 2006. Print.
Pliszka SR. Non-stimulant treatment for attention-deficit hyperactivity disorder. CNS Spectr.2003. Print.
Wilens TE, Biederman J, Abrantes AM, Spencer TJ. A naturalistic assessment of protriptyline for attention-deficit hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 1996. Print
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