Attention Deficit Hyperactivity Disorder

ADD / ADHD

What is Attention deficit disorder?

Attention deficit disorder (ADD) is characterized by inattentiveness, easy distractibility, impul-siveness, and difficulty completing tasks; excessive activity may or may not be seen. The person can appear to others as forgetful or careless. It begins in childhood and persists into adulthood for fifteen to fifty percent of children. The symptoms may be more subtle in an adult, and may not be easily diagnosed, particularly if hyperactivity is not seen. Those with attention deficit disorder develop more self-restraint and attention span in adulthood. By adulthood it is usually seen in its incomplete form (the modifier, "in partial remission," is added).

How is Attention deficit disorder diagnosed?

  • History involves any combination of failure to pay attention to details, difficulty maintaining attention to a task (especially an uninteresting one), not seeming to listen when spoken to, not following through on instructions given, difficulty organizing tasks, avoidance of tasks that require sustained mental attention, losing things, easily distracted by surrounding stimuli, or being forgetful in daily life. There could also be symptoms of hyperactivity and being impulsive, such as difficulty sitting still or being quiet, talking excessively, difficulty waiting, or feelings of restlessness. These symptoms result in a significant limitation of social, occupational, and academic functioning.
  • Physical exam is not helpful in this diagnosis.
  • Tests are not sufficient for diagnosis, but may demonstrate a cognitive impairment such as inattention, disorganization, short-term memory, or "executive functions" (the ability to make themselves do something they dislike or are not interested in).

Attention deficit disorder signs and symptoms

  • Squirms in seat; fidgets with hands or feet.
  • Unable to stay seated when required to do so.
  • Easily distracted.
  • Blurts out answers before a question is finished.
  • Difficulty waiting turn in games and lines.
  • Difficulty following instructions.
  • Unable to sustain attention in work or play activities.
  • Shifts from one uncompleted project to another.
  • Difficulty playing quietly.
  • Talks excessively.
  • Interrupts or intrudes on others.
  • Doesn't appear to listen.
  • Loses items necessary for tasks.
  • Often engages in dangerous activities without considering consequences.

How is Attention deficit disorder treated?

Drug treatment is usually helpful using stimulants, anticonvulsants, or antidepressants. Group or individual psychotherapy is also employed, and support groups are available. Biofeedback using brain waves (EEG biofeedback) remains a somewhat controversial treatment.

ADD Medications

Information Brand Generic Label Rating
Sertraline Zoloft Sertraline Off-Label
Neurontin uses Neurontin Gabapentin Off-Label
Strattera without prescription Strattera Atomoxetine On-Label
Generic Bupropion Zyban Bupropion Off-Label
Effexor Effexor Venlafaxine Off-Label
Generic Paroxetine 20mg Paxil Paroxetine Off-Label

Luvox (Fluvoxamine), Prozac (Fluoxetine), Tofranil (Imipramine), Aricept (Donepezil)

What might complicate it?

Tourette's syndrome or tics can accompany ADD. Anxiety disorders or depression can result from a lifetime of feeling impaired. Alcohol abuse, cocaine abuse, or amphetamine abuse can occur (perhaps as an attempt to self-medicate for the condition). A higher rate of accidents and injuries can result from inattentiveness or impulsiveness. An antisocial personality disorder may emerge, and various troubles with the law may happen. ADD can result in social isolation and difficult personal relationships. The person may end up undereducated due to the disorder; learning disabilities could affect reading, writing, memory, or math. There may also be difficulty with learning strategies or problem solving. The person may also become under-employed, due to frequently getting fired.

Predicted outcome

Drug treatment will usually improve the individual's functioning.

Alternatives

Other similar conditions are caffeine intoxication or side effects from bronchodilators or anticonvulsants, bipolar disorder, depression, generalized anxiety disorder, living in a chaotic environment, schizophrenia, or personality disorders (such as antisocial, borderline, or histrionic).

Appropriate specialists

Psychiatrist or psychologist.

Last updated 20 December 2011


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