Bupropion, tricyclic antidepressants (TCAs), and alpha-agonists are often used in the treatment of ADHD even though they are not approved by the FDA for this purpose.Although there is at least one double blind, randomized controlled trial for bupropion, and TCAs, the evidence base for these medications is far weaker than for the FDA-approved agents.This strategy may require reducing the dose when a higher dose produces side effects or no further improvement.The best dose of medication for a given child is the one that leads to optimal effects with minimal side effects.Medications known as stimulants have long been employed in the treatment of Attention Deficit Hyperactivity Disorder.These medications improve a chemical imbalance in the brain which is causing the symptoms.Specific neurotransmitters (brain chemicals) are necessary to carry a nerve impulse (message) along a neuropathway (circuit).When a neurotransmitter is not fully available, a message may be stopped short of its intended destination.
Primary care physicians most likely will consider referral to a child and adolescent psychiatrist at this point.
[An article from the University of Maryland addresses selection of medication for ADHD treatment] A new medication came on the market that appears to be of value to children who do not have a favorable response to stimulants.
Intuniv, a once-daily formulation of guanfacine, was approved by the US Food and Drug Administration (FDA) on September 2, 2009 as the first selective alpha-2A agonist for the treatment of ADHD.
Although the mechanism of action is not known, guanfacine, the active ingredient in INTUNIV, is thought to selectively stimulate alpha-2A adrenoreceptors in the prefrontal cortex.
Stimulation of the postsynaptic alpha-2A receptors is thought to strengthen working memory, reduce susceptibility to distraction, improve attention regulation, improve behavioral inhibition, and enhance impulse control.
Attention Deficit Hyperactivity Disorder Medication Prescribing Practice Unlike most other medications, stimulant dosages usually are not weight dependent.