1995-1996 Medline Abstracts for AD(H)D

Medline ADD, ADHD search - top 100 articles 1995 and 1996 <bracketed italics = my notes>

Treatment of hyperactivity and attention deficit with amphetamine. Experience with five adult prisoners Tidssker Nor Laegeforen 1996 Jun 30 (from Oslo)

According to the literature, 35-50% of children with ADHD will still suffer from symptoms when they reach adulthood. ADHD was diagnosed and stimulant medication was started in five adult men who had been imprisoned for serious crimes of violence. The response to treatment was good in all of them. After 4-6 years two had been successfully rehabilitated.

Relationships between free fatty acids and zinc, and attention deficit hyperactivity disorder: a research note J Child Psychol Psychiatry 1996 Feb Psychiatry Dept, Technical U - Trabzon Turkey

Free fatty acids (FFA’s) are lower by 2/3 in ADD patients compared to normal. Zinc lower by 43%. It’s possible that zinc deficiency plays a role in development or worsening of ADD.

Pemoline therapy in college students with ADHD: a retrospective study

Pemoline, a dopamine agonist, is effective in children with ADHD, but its efficacy in adults is unknown. ...The authors concluded that Pemoline is effective and safe in students (college at U of Wisconsin) with ADHD and has a lower abuse potential than methylphenidate (Ritalin) and dextroamphetamine (Dexedrene/Adderall). <Pemoline has a 46% higher risk of liver failure>

Hair lead levels related to children’s classroom attention-deficit behavior.

Arch Environ Health May-Jun 1996 (School Public Health - U Mass at Amherst)

The children’s (277 first grade pupils) hair lead concentrations ranged from less than 1 to 11.3 ppm (ucg/g). The striking dose-response relationship between levels of lead and negative teacher ratings remained significant after controlling for age, ethnicity, gender, and socioeconomic status. An even stronger relationship existed between physician-diagnosed attention-deficit hyperactivity disorder and hair lead in the same children. There was no apparent "safe" threshold for lead. Scalp hair should be considered a useful clinical and epidemiologic approach for the measurement of chronic low level lead exposure in children. <can environmental lead cause elevated serum lead levels? Can environmental pollutants trigger or worsen ADD?>

Psychiatric and developmental disorders in families of children with ADHD.

Arch Pediatr Adolsec Med 1996 Feb

By parent report, children with ADHD were significantly more likely than the control children to have a parent affected by alcoholism, drug abuse, depression, delinquency, learning disabilities and ADHD - similar patterns were evidenced in other close relatives.

Behavioral Side Effects of Gabapentin (Neurontin) in children Epilepsia 1996 Jan

7 children who received gabapentin as additional medication and subsequently developed behavioral side effects...tantrums, aggression directed towards others, hyperactivity, and defiance. ...reversible...managed by dose reduction or discontinuation of gabapentin. All children had baseline ADHD and developmental delays.

Auditory neurophysiological responses and discrimination deficits in children with learning problems Science 1996 Aug 16

Children with learning problems often cannot discriminate rapid acoustic (sound) changes that occur in speech. ... These results indicate that some children’s discrimination deficits originate in the auditory pathway before conscious perception and have implications for differential diagnosis and targeted therapeutic strategies for children with learning disabilities and attention disorders.

School Problems in Tourette’s Syndrome Arch Neurolo 1996 Jun

Tics represented the primary reason for referral (to U of Rochester Med Center Dept of Neurology). But did not emerge as a significant predictor of academic problems. Rather, school-related difficulties appeared to be strongly associated with comorbid attention-deficit hyperactivity disorder.

Quantitative brain MRI in ADHD Archives Gen Psychiatry Jul 1996 (NIMH - Castellanos)

CONCLUSION: This first comprehensive morphometric analysis is consistent with hypothesized dysfunction of right-sided prefrontal-striatal systems in ADHD.

Conduct disorder, substance use disorders and coexisting conduct and substance use disorders in adolescent inpatients. Am J Psychiatry 1996 Jul (Yale Psychiatric Institute)

...conduct disorder patients without a coexisting substance use disorder are more likely to have attention deficit hyperactivity disorder.

Primary-care approach to the diagnosis and management of ADHD

Mayo Clin Proc May 1996

"Physicians are often reluctant to treat children with ADHD, possibly because of the lack of a practical approach to the assessment. The medical model, with some modifications, is well suited for this purpose. Comprehensive treatment, including both medication and nonmedical intervention, should be coordinated by the primary-care provider. Primary-care physicians, who have detailed information about children and their families, are in an ideal position to treat patients with ADHD.

Venlafaxine in adults with ADHD - an open clinical trial. J clin Psychiatry 1996

CONCLUSION: Venlafaxine may be a promising agent for the treatment of ADHD in adults. Controlled clinical trials are needed.

An open trial of Pemoline in drug-dependent delinquents with ADHD

J Am Acad Child Adolesc Psychiatry 1996 Aug

CONCLUSIONS: Preliminary data indicate that Pemoline may be a useful treatment for ADHD in substance-dependent delinquents; the authors propose a controlled trial.

Quantitative EEG differences in a nonclinical sample of children with ADHD and undifferentiated ADD J Am Acad Child Adolesc Psychiatry 1996 Aug

CONCLUSION: Quantitative EEG techniques may prove useful in differentiating specific subtypes of ADHD.

Biological correlates of learning and attention: what is relevant to learning disability and ADHD? J Dev Behav Pediat 1996 Apr (Hopkins)

Findings from cognitive (thinking) neuroscience offer explanations of the neuroanatomical and neurophysiological underpinnings of learning problems and the frequent comorbidity of learning disabilities and ADHD.

ADHD in adults Postgrad Med 1996 Sep (UC SD med school)

ADHD may affect up to 3% of the adult population. Inattention and distractibility, impulsivity, and hyperactivity are the classic symptom triad of ADHD, but adults often lack the full symptom complex, especially hyperactivity. Mood-associated symptoms (eg, low frustration tolerance, irritability) are often present. Since the diagnosis is a clinical one, a comprehensive interview is the most important diagnostic procedure. Rating scales, collateral reports, and neuropsychological testing can be useful and should be part of any rigorous assessment for the disorder. When a definitive diagnosis is not possible, a trial of pharmacologic therapy may be appropriate.

Hyperactivity: is candy causal?

Crit Rev Food Sci Nutr 1996 Jan (W VA School of Med)

"Twelve double blind, placebo-controlled studies of sugar challenges failed to provide any evidence that sugar ingestion leads to untoward behavior in children with ADHD or in normal children. Likewise, none of the studies testing candy or chocolate found any negative effect of these foods on behavior.

6 week, double blind, placebo-controlled study of desipramine for adult ADHD

Am J Psychiatry 1996 Sep (Mass General)

...desipramine at a target daily dose of 200mg in 41 adult patients...68% of desipramine treated subjects and no subjects in the placebo group were considered positive responders. Response to desipramine was independent of dose, level of impairment, gender, or lifetime psychiatric comorbidity with anxiety or depressive disorders. CONCLUSIONS: These results, similar to findings in children and adolescents with ADHD, indicate that desipramine is effective in the treatment of ADHD in adults.

Is maternal smoking during pregnancy a risk factor for ADHD in children?

Am J Psychiatry 1996 Sep (Mass General)

CONCLUSIONS: These findings suggest that maternal smoking during pregnancy is a risk factor for ADHD.

Pharmacotherapy of ADHD: a review

J Clin Psychopharmacol 1995 Aug (Mass General)

Open studies on the nonserotonergic antidepressants (tricyclics, bupropion, and MAO inhibitors) also show a moderate anti-ADHD effect. The literature appears to support the use of robust doses of both stimulants and antidepressants for ADHD in adults.

Abnormal auditory P300 topography in ADD predicts poor response to pemoline.

Clin Electroencephalogr 1995 Oct

We conclude that P300 topography classifies ADD into group 1 with normal P300 topography and good response to pemoline, and group 2 with small right fronto-central auditory P300 amplitudes and poor response to pemoline.

The treatment of ADHD in Tourette’s syndrome: a double blind placebo controlled study with clonidine and desipramine. Pediatrics Jan 1995 (Hopkins)

...desipramine may be a useful alternative for the treatment of sx of ADHD in children with TS.

Depression in mothers of children with ADHD

Fam Med 1995 Mar

CONCLUSIONS: The incidence of major and minor depression in primary care outpatients is 4-6% and 5-14%, respectively. However, the present study reveals an incidence of 17.9% for major depression and 20.5% for minor depression in mothers of children with ADHD, suggesting that routine screening for maternal depression needs to be considered when children are diagnosed with ADHD in primary care settings.

Bupropion vs methylphenidate in the Rx of ADHD

J Am Acad Child Adolesc Psychiatry 1995 May

Methylphenidate .4-1.3mg/kg/day (mean .7mg/kg per day). Bupropion 1.4-5.7 mg/kg/day (mean 3.3mg/kg/day). Conclusions: in this double-blind, crossover trial, bupriopion and methylphenidate were both effective and did not differ in their overall efficacy as treatments for ADHD. <note: this is a relatively low dose of methylphenidate - Ritalin - and most patients I’ve treated perceive that Ritalin is far more effective>

Test of four hypotheses for the comorbidity of ADHD and conduct disorder

J Am Acad Child Adolesc Psychiatry 1995 May

Conclusions: These results support the distinctiveness of ADHD and conduct disorder and the hypothesis that the comorbid condition of ADHD and conduct disorder is a hybrid of pure ADHD and pure conduct disorder.

Psychiatric comorbidity among referred juveniles with major depression: fact or artifact?

J Am Acad Child Adolesc Psychiatry 1995 May (Mass General Hospital)

...our work suggests that major depression and other conditions may represent different disorders.

Utilization of maternal perinatal risk indicators in the differential diagnosis of ADHD and ADD children. Int J Neurosci 1995 Mar

...the greater the number of medical conditions prior aor during their pregnancy the more likely a child was diagnosed with ADD. In addition, if the mother experienced moderate emotional stress or smoked cigarettes during pregnancy the child was more likely to be diagnosed with an attention deficit disorder.

ADD during adolescence: a review: J Adolesc Health 1995 Mar (Brandeis University)

With or without hyperactivity, ADD does not disappear at puberty...As a condition associated with decreased metabolism in the premotor and prefrontal superior cerebral cortex, ADD in adolescents responds well to (pharmacological) treatment. Without effective treatment, ADD often results in increased risk of trauma, substance abuse and conduct and affective disorders during adolescence, and marital disharmony, family dysfunction, divorce, and incarceration in adulthood. Properly treated with medication and counseling, adolescents with ADD succeed as well as their peers.

Effective Treatment for ADHD Curr Opin Pediatr 1995 Apr

ADHD appears to respond best to a combination of stimulant medication, parent training in coping with behavior of affected children, and social skill training for the affected children themselves. A review of recent research failed to reach consistent correlations between resistance to thyroid hormone and ADHD.

Effects of methylphenidate on reward strength in boys with ADHD

J Am Acad Child Adoles Psychiatry 1995 Jul

Results: The "breaking point" above which the hyperactive child was unwilling to continue with the task was significantly higher during drug than placebo trials.

Do high doses of stimulants impair flexible thinking in ADHD?

Conclusions: Under the acute dosage conditions used in the study, methylphenidate doses up to .9mg/kg had an increasingly positive effect on measures of mental flexibility and other cognitive processes. Rather than eliciting perseveration, methylphenidate appeared to improve persistence.

Mania-like Sx suggestive of childhood onset bipolar disorder in clinically referred children.

Conclusions: Mania may be relatively common among psychiatrically referred children. The clinical picture of childhood-onset mania is very severe and frequently comorbid with ADHD and other psychiatric disorders. Because of the high comorbidity with ADHD, more work is needed to clarify whether these children have ADHD, bipolar disorder, or both.

Injury risk factors in children with ADHD Health Psychol 1995 Jul

Cognitive factors, including lower expectations of personal risk in hazardous situations and less ability to generate prevention strategies and safety rules, may contribute to increased injury liability in boys with ADHD.

An investigation of adult outcomes of hyperactive children in Shanghai Chin Med J (Engl) 1996 Nov;109(11):877-80 Compared to normals, after 15 year follow up 70% continued to show typical symptoms, completed less formal schooling, were less often employed in higher-level professions.