Psychopharmacology of Pediatric Attention-Deficit/Hyperactivity Disorder

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevetopmental disorder identified in 4% to 8% of children, adolescents, and adults. Features of ADHD found in childhood and adolescence persist into adulthood in as many as 70% of pediatric patients with this diagnosis. Various behavioral therapies are helpful for ADHD. This discussion focuses on medications that research has shown to be beneficial for treating the core features of this condition. Drugs that are approved by the US Food and Drug Administration for ADHD are psychostimulants (methylphenidate and amphetamine products), long-acting alpha-2 agonists (clonidine, guanfacine), and a selective norepinephrine reuptake inhibitor (atomoxetine). Clinicians prescribing these drugs should monitor their patients for both beneficial and adverse effects. Although it is often difficult to find a specific medication that is superior to others for all people with ADHD, research does show that methylphenidate is typically superior to amphetamines. Thus, careful clinician scrutiny is needed to find the optimal formulation for those taking these medications.