[Pharmacotherapy of attention-deficit/hyperactivity disorder (ADHD) and comorbid disorders].
Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most commonly diagnosed disorders in child and adolescent psychiatry. Patients with ADHD show increased risk for comorbid psychiatric disorders such as mood disorders, anxiety disorders, tic disorders and disruptive behavior disorders. Using criteria and methods of evidence-based medicine, in this paper possible algorithms for ADHD and comorbid disorders are presented. In conclusion, these algorithms aim to support health care professionals and can serve as guideline in decision making in pharmacotherapy. Stimulants are first-line medication treatment of ADHD without comorbid disorder. In co-existing aggression, major depressive disorder and tic disorder treatment with stimulants should be initialized at first. Only in case of unchanged persistence of comorbid symptoms specific pharmacological therapy should be combined. In comorbid anxiety disorders atomoxetine can be used as first-line treatment.
Wiesegger
Georg
G
Universitätsklinik für Psychiatrie und Pyschotherapie, Klinische Abteilung für Biologische Psychiatrie, Medizinische Universität Wein. Georg.Wiesegger@meduniwien.ac.at
Kienbacher
Christian
C
Pellegrini
Elisabeth
E
Scheidinger
Hans
H
Vesely
Christine
C
Bangerl
Waltraud
W
Friedrich
Max
M
D018759:Adrenergic Uptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D000069445:Atomoxetine Hydrochloride; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000627:therapeutic use*; D015897:Comorbidity; D000075202:Contraindications; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D006801:Humans; D019964:Mood Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D009661:Nortriptyline / Q000009:adverse effects / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D011437:Propylamines / Q000009:adverse effects / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D013981:Tic Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology
D018759:Adrenergic Uptake Inhibitors; D014150:Antipsychotic Agents; D000697:Central Nervous System Stimulants; D011437:Propylamines; D000069445:Atomoxetine Hydrochloride; D009661:Nortriptyline