title: Metabolic, toxicological, and safety considerations for drugs used to treat ADHD.
abstract: BACKGROUND
  Pharmacotherapy is frequently used to treat symptoms of attention-deficit/hyperactivity disorder (ADHD), the most common neurobehavioral disorder of childhood. The typically prescribed agents for ADHD have varying durations of effect and degrees of efficacy. The broad range of pharmacological treatments available allows for both single and combination therapies for achieving optimal therapeutic effects. Metabolic, toxicological, and safety information are critical for an informed evaluation of the risk/benefit considerations in prescribing practices.
  
  
  METHODS
  This article focuses on the medications with current FDA approval for use in the treatment of ADHD in pediatric and adult populations. This review covers the stimulants (amphetamine and methylphenidate) and non-stimulants (atomoxetine, clonidine extended release, and guanfacine extended release) used to treat ADHD and presents an overview of their respective metabolic, toxicological, and safety features. A literature search and review of the relevant medications were carried out using the PubMed database up to November 2011.
  
  
  CONCLUSIONS
  New trends in study design based on drug profiles include the use of adjuvant therapies and the inclusion of patients with comorbidities. The recent expansion of inclusion/exclusion criteria in pediatric clinical trials of ADHD allows for a more rigorous analysis of associated benefits and risks with the use of adjuvant therapy.
authors.affiliation: University of California, Child Development Center, Irvine, Department of Pediatrics, Irvine, CA 92612, USA.
authors.forename: Sophie
authors.initials: S
authors.lastname: Duong
authors.forename: Kara
authors.initials: K
authors.lastname: Chung
authors.forename: Sharon B
authors.initials: SB
authors.lastname: Wigal
mesh_terms: D000662:Amphetamines / Q000009:adverse effects / Q000493:pharmacokinetics; D000069445:Atomoxetine Hydrochloride; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000493:pharmacokinetics; D002986:Clinical Trials as Topic; D003000:Clonidine / Q000009:adverse effects / Q000493:pharmacokinetics; D015897:Comorbidity; D004338:Drug Combinations; D064420:Drug-Related Side Effects and Adverse Reactions; D016316:Guanfacine / Q000009:adverse effects / Q000493:pharmacokinetics; D006801:Humans; D008774:Methylphenidate / Q000009:adverse effects / Q000493:pharmacokinetics; D011437:Propylamines / Q000009:adverse effects / Q000493:pharmacokinetics
chemical_list: D000662:Amphetamines; D000697:Central Nervous System Stimulants; D004338:Drug Combinations; D011437:Propylamines; D008774:Methylphenidate; D016316:Guanfacine; D000069445:Atomoxetine Hydrochloride; D003000:Clonidine