About ADHD

In everyday speech we often use the term ADHD about this condition, even if, in the health service use diagnostic term disturbance of attention and activity, or Hyper Kinetic interference from diagnostic system ICD-10. The diagnosis (es) can be if a person has the concentration and attention difficulties and / or hyperactivity and impulsivity.

Defiance disorder, conduct disorder, anxiety disorders, OCD, sleep disorders and depressive disorders often occur together with AD / HD. In order to diagnose the symptoms must have been present for at least 6 months, they must have made ​​his debut before 7 years of age, and it must not be any other diagnosis or condition that better explains the difficulties. There may be many reasons for concentration problems, impulsiveness and hyperactivity in children, adolescents and adults, and it can therefore sometimes be difficult to make the correct diagnosis quickly.

In South Africa, used the term DAMP, Deficit in Attention, Motor Control and Perception, which include motor clumsiness. Children or adults who only have attention disorder and not hyperactivity, can be diagnosed with Attention Deficit Disorder (ADD).

Diagnosis usually occurs after the observations, the use of assessment tools and various tests. It is also under investigation common to interview or otherwise collect information from parents, teachers or other important people around the patient suspected to have ADHD.
It has also developed tests for head movements, OPTAX and eye movements, Pavlidis test that has been used to supplement the study of ADHD.

Genetic factors, ie the disturbance is passed, probably has a great significance for the development of ADHD. It has been shown that complications related to pregnancy and childbirth can increase the likelihood of developing ADHD. In some cases, ADHD can be associated with FAS (fetal alcohol syndrome) or preterm (premature birth).
Difficult social and / or psychological problems in or around the patient can significantly contribute to worsen the ADHD condition. Many of the patients also demonstrated different sleep disorders, and must be treated for these.
Follow-up studies show that untreated ADHD increases the risk for a variety of issues. It is a doubled risk of substance abuse. The incidence of severe behavioral disorders, depression, anxiety and other psychiatric disorders are also increased.

Few good studies have been conducted on the psychological or behavioral oriented treatments. Therefore, it is uncertain what effect they have compared with or in combination with drug treatments – with one exception: The combination of methylphenidate and behavior therapy appears to work better than behavioral therapy alone to reduce symptoms and change behavior in children with ADHD.

For some, the change in diet to be an important factor in the treatment of ADHD, and a good option if you have proven protein intolerance (hyperpeptiduri). Peptides (short chains of amino acids) is created when proteins decompose in the digestive system.Man is by protein intolerance is not able to break down the milk protein casein or wheat gluten protein product. The Norwegian physician Karl Ludvig Reichelt has been central to research on the effect of peptides in the body. Protein intolerance is also associated with other diagnoses than ADHD.
Some also report having good effect on the ADHD symptoms of using omega-3 fatty acids.

Development and strengthening of social skills can be an important factor in everyday life with ADHD. Many people with ADHD may have different or weak social skills that may make it difficult to get a foothold in the various social networks. A big reason the social problems is the lack of ability to concentrate.

Medicines to treat symptoms of ADHD are stimulants such as methylphenidate (Ritalin, Equasym / Equasym custodian and Concerta) and atomoxetine (Strattera). In some cases also used amphetamine sulphate (Dexamin). The traditional Ritalin tablets have a duration of three or four hours, and must therefore be taken several times daily. Depot preparation work so that the medication regularly pulled out of the capsule for several hours. Equasym depot has a duration of about 8 hours, and Concerta has duration about 12 hours.
Strattera has a behavior more similar to antidepressants of the SSRI type, and therefore longer-lasting effect.

In many cases, treatment with methylphenidate or atomoxetine provide good symptom relief also for the additional suffering, but sometimes it may be necessary also to use more specific drugs to alleviate these.

The clinical experience with metylphenidat spanning more than 80 years, and therefore well known to both efficacy and side effects of the drug. Atomoxetine is a relatively new agent, and both efficacy and side effect profile is more uncertain. It is known that in some drug can cause rare but serious leverskade. It is therefore very important to monitor liver function with blood tests the first time after starting the drug. Several studies and clinical practice suggest that methylphenidate improves symptom relief by strong motility, while atomoxetine may provide sufficient power if the concentration and / or processing of information is the main problem.

Clonidine may improve symptoms of ADHD, compared with placebo, but we’re not sure the difference is of importance for the patient. Treatment with Clonidine can cause low heart rate.
Medications that treat ADHD have long been a controversial topic. The research behind medicines are often funded by pharmaceutical companies have vested interest in getting medication for this disorder on the market. It has been shown that studies funded by pharmaceutical companies, which do not show beneficial effect of medication, many times will not be published . Therefore, there may be reason to look at the supposed beneficial effects of the drugs with some skepticism. A so-called significant effect means that the effect is measurable and can involve as few as 1-2 of 100 drug users have a beneficial effect of the medication. Then it is 98 -99 people who do not have power. Several meta-analysis done by the most common medications for ADHD, has often proved to have significantly higher power than mock medications. At the same time in recent years carried out studies showing that drug treatment of ADHD is ineffective for a long time.

Since ADHD over a few years is set as a diagnosis in more and more patients with possibly lighter degrees of the disease, the drug appears less effective and there is a greater risk of serious, are not acceptable side effects. These effects can be seen in relation to most conditions and its treatments.

It is estimated that 3-5% of children population in South Africa have ADHD. Both boys and girls may have the disorder, but up to now are more boys diagnosed than girls (about75% of those diagnosed are boys).

Diagnosis has historically primarily been associated with children and young people, as it turns out that the symptoms of many curbs or changes with age and maturity.

Many adults also achieves an improvement because they learn coping strategies. Yet there are many adults who have ADHD or who have confirmed diagnosis until adulthood. Many of these will benefit from drug therapy.

The main aims of treatment is to reduce the symptoms of ADHD, increasing the level of functioning in important areas of life and prevent the development of new problems secondary to ADHD.

As a rule, the treatment included a combination of several measures at once: Medical treatment, behavioral therapy (children), psychosocial , and adaptation to
school / work and at home.

A lengthy study in the United States (“MTA Study”) showed that drug treatment improves symptoms and school performance in children with ADHD. Behavior-oriented treatment alone had little effect, while treatment and behavioral therapy in combination gave the best effect.