ebook_ADHD2019

The World Federation of ADHD Guide 91 Broad targets for treatment in ADHD include: yy Core ADHD symptoms both at home and at school yy Oppositional and disruptive behaviour in the home yy Oppositional and disruptive behaviour in at school yy Academic problems yy Parent–child relationship and communication problems yy Peer relationships yy Other associated symptoms (e.g. anxiety, mood instability, depression, mo- tor coordination problems, specific learning disorders, speech and language problems, etc.) Whilst medications are most effective at treating the core symptoms, they can also impact positively on other problems. When choosing targets for intervention it is important to start to think about how outcomes will be assessed and to take baseline measures so that any changes can be accurately identified. Psychoeducation forms the cornerstone of all treatment approaches to ADHD and, when medication is to be part of a treatment programme it is essential that the psychoeducation includes giving accurate advice about the medications, their potential effects, positive and negative, the likelihood of response, expected time- Figure 5.2 Plasma levels of methylphentidate and amphetamin over time with different preparations and their immediate release and extended release proportions. RITALIN LA MPH (ng/mL) 5 10 Hours MPH IR BID MPH (ng/mL) 5 10 Hours % IR 100% % ER CONCERTA XL MPH (ng/mL) 5 10 Hours % IR 22% % ER 78% 50% 50% VYVANSE Lisdexamfetamine (ng/mL) Not available Not available 5 10 Hours