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Theme 9 - Coggle Diagram

- - - - Psychoeducation
        
        Ensuring the patient and the family understand what ADHD is;
        
        Enhancing therapeutic compliance by involving the patient and the parents in the treatment plan and making sure they understand the advantages and risks of certain drugs;
        
        Identification of barriers to the treatment.
      - Behavioral therapy
        Identify problematic behavior - preceding factors/eliciting factors
        Detailed plan on how to tackle
        Less effective than pharmaceutical treatment
      - Neurofeedback
        Train patients to improve their self-control over brain activity patterns (EEG) while focussing
      - Computerised Cognitive Training (CCT)
        Enhancing accomplishments in neuropsychological functions ass. with ADHD (e.g. attention). However, has no effect on core symptoms.
        Gamified, engaging, cognitive exercises from their own computers or mobile devices anytime anywhere
        Targeted to improve overall cognition or specific domains (such as learning and memory, attention, speed, executive functioning), as well as daily living skills such as financial knowledge or driving performance.
        They can potentially be adjusted and adherence supervised remotely.
      - Diet
        Excluding artificial additives
        Poly-saturated fatty acid supplements
      - Pharmacotherapy
        Stimulants
        
        Methylphenidate (Ritalin; first choice)
        
        Dexmethilphenidate
        
        Dextroamphetamine
        
        Mixed amphetamine salts.
        
        Long-acting medications are more expensive.
        Side effects: insomnia, headache, agitation, irritability, nervousness, tremor, anorexia, nausea, weight loss
        Ritalin can be stopped in summer to prevent growth retardation. It can cause sudden cardiac death in individuals with structural heart defects.
        All stimulants have potential for abuse. Esp. in people with comorbid behavioral problems or disorders
        Non-stimulants
        Second line treatment (intolerance, contraindications, failure of 1st line treatment)
        
        Atomoxetine (SNRI; secondary increase in dopamine levels. Good option if there are comorbid anxiety disorders)
        
        Extended-release guanfacine or sustained release clonidine (alpha-2 agonists; used if there are comorbid tics or Gilles de la Tourette syndrome)