Attention-deficit hyperactivity disorder:
the pharmacist's role
by
Levin GM
Albany College of Pharmacy,
Union University, NY, USA.
Am Pharm 1995 Nov; NS35(11):10-20
ABSTRACT
Included in the variety of options for treating ADHD are several classes of
pharmacologic agents with various side effects and monitoring parameters. The
pharmacist must understand the issues involved with the use of the agents in
each class. The pharmacist is often the most accessible health care professional
and can take advantage of this fact to counsel and support both patients and
family members. Table 5 offers counseling tips and additional information for
the pharmacist. Of the medications discussed here, the stimulants are recognized
as the most effective for treating ADHD, with the amphetamines and
methylphenidate providing equal benefit. In some instances, pemoline has also
been shown to be as effective as the other stimulants. Second-line agents are
the TCAs, of which imipramine is the most commonly prescribed. However, the
other TCAs are probably just as effective; some may have a less burdensome
profile of side effects and may result in better compliance. Next in line is
bupropion or clonidine, both of which show promise for ADHD treatment.
Nevertheless, these agents need to be tested in more rigorous trials. Agents of
last resort include the MAOIs, of which tranylcypromine has been the most
studied. The ideal agent for treating ADHD would have an immediate onset,
provide benefit throughout the day, have few or no side effects, lack the
potential for abuse, be effective for most patients, and be relatively
inexpensive. This ideal agent has yet to be discovered. Clinicians and
researchers are still looking for a medication to come as close to the ideal
therapy as possible. Therefore, it is not uncommon for a pharmacist to see a
patient with ADHD try several different medications. In addition, children in
whom ADHD is refractory to currently available options or who cannot tolerate
these options may also be given other psychotropic medications not mentioned in
this review.
ADHD
Adderall
Pemoline
Selegiline
Bupropion
ADHD and sport
Tranylcypromine
Methylphenidate
Methylphenidate SR
Adult attention-deficit disorder
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