1. Neurotransmitters re- dopamine and norepinephrine
lated to ADHD
2. ADHD Across the Symptoms change with age.
Lifespan Not only a childhood diagnosis
Hyperactivity decreases markedly with age
Primary Symptoms: inattention, restlessness, cog-
nitive & emotional impulsivity, executive functioning
deficits, and self-regulation
Adults struggling with executive functioning difficul-
ties and disorganization may experience occupation-
al stress or anxiety.
3.
4. Neuroanatomy of Specific ADHD symptoms may arise from abnormal-
ADHD ities within circuits in the prefrontal cortex (PFC),
which affect executive function.
5. Neural Networks of symptoms often become noticeable - 6-7 old
ADHD Due to abnormalities in the prefrontal cortex circuits
or errors in the synaptic pruning process.
Modulated by the corticostriatal-thalamocortical
(CSTC) loop, the same loop that is associated with
anxiety. ADHD is an alternative diagnosis to consider
when clients present with anxiety symptoms.
6. Neural Signaling of Norepinephrine (NE) and dopamine (DA) are asso-
ADHD ciated with inefficient information processing in the
prefrontal circuits. ADHD medications commonly tar-
get both dopamine and norepinephrine. Stimulants,
including stimulant medications, caffeine, and nico-
tine enhance DA release and arousal.
7. Why does atomoxe- It increases dopamine levels in the prefrontal cortex
tine lack abuse poten- but not in the nucleus accumbens.
tial?
8. Which of the fol- Pulsatile stimulation amplifies undesirable phasic DA
lowing accurately ex- and NE firing, which can lead to euphoria and abuse.
1/9
, NR 546 Week 7
plains the effects
of different stimulant
formulations on neu-
ronal firing?
9. Chris is a 44-year-old Alcohol abuse
client presenting
with comorbid al-
cohol abuse, gener-
alized anxiety, and
ADHD. Which disor-
der should be treated
first?
10. Stimulants stimulate the release of NE and DA or boost the firing
of associated neurons may help improve information
processing.
effective for 70-80% of clients with ADHD
first choice of medications for children
schedule II controlled substances
no refills permitted
11. Nonstimulants work by selective inhibition of presynaptic norepi-
nephrine reuptake in the prefrontal cortex and en-
hancement of norepinephrine neurotransmission.
help lower distractibility and improve attention, work-
ing memory, and impulsivity.
low risk of abuse or diversion
often prescribed for adults with ADHD
12. Methylphenidate Low risk of adverse effects
Available formulations:
Ritalin- available in immediate release (IR) and ex-
tended release (XR)
available in beads that may be sprinkled on food for
children who cannot swallow pills
Concerta- biphasic - combined immediate and de-
layed release in one medication
Daytrana - patch applied in the morning and removed
after 9 hours
2/9
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