Non-stimulant Approaches to ADHD

There are situations that come up in a primary care setting when a pediatric patient presents with symptoms that are concerning for Attention Deficit Hyperactivity Disorder (ADHD) but where there are concerns about prescribing a stimulant medication. These are some of the situations when this can occur: The patient’s presentation meets the symptom checklist for […]

Choosing a Medication Treatment for ADHD

Once a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) has been made, a decision has to be made about treatment. Most children do well with a combination approach of medication and behavioral therapy. The most likely medication to start with is a stimulant medication. And then the provider has to make a decision from many, […]

Link Between Lead Toxicity and ADHD

When a child first presents with symptoms of Attention Deficit Hyperactivity Disorder (ADHD), it is important to assess if there is an underlying medical cause for the symptoms. Lead is a neurotoxin that has been well studied to affect children’s cognition and behavior, and the behavioral profile seen with lead toxicity can mimic ADHD. Children […]

ADHD And Co-Morbid Tic Disorder

A call recently came into the SmartCare PC2 line that highlights an important clinical situation. Case Presentation: 10 yo boy with history of motor tic disorder (eye blinking, shoulder shrugging) who was then diagnosed with ADHD combined type. He was started on Concerta and titrated to 36 mg qAM, which has been helpful for his […]

Treating ADHD in Young Children

The diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) is becoming increasingly prevalent, in part because of better assessments, but also in part because of misdiagnosis and jumping too early to diagnose. The effect is that the diagnosis of ADHD is being given at younger and younger ages. This leads to the question of the best […]

Anxiety in Children and Adolescents

Up to one in three children and adolescents experience clinically significant anxiety, and it is often under-recognized and under-treated. It is particularly important for primary care providers to be aware of the symptoms of anxiety in pediatric patients, because patients typically present first in this setting. Often the presenting complaint is a physical symptom, rather […]

Understanding Disruptive Mood – Dysregulation Disorder

Disruptive Mood Dysregulation Disorder (DMDD) is a new diagnosis in DSM V. It was added as a diagnosis to fill a gap in important diagnostic categorization when thinking about childhood psychiatric concerns. While there is overlap in symptoms among DMDD and Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD) and Bipolar Disorder, there are […]

The Link Between PTSD and ADHD

It has been shown that the risk for Post-Traumatic Stress Disorder (PTSD) is higher in individuals with Attention Deficit Hyperactivity Disorder (ADHD) compared to those without ADHD and the risk for ADHD is higher in individuals with PTSD than those without PTSD. The strongest correlation is for the risk of PTSD in individuals with ADHD […]

How to Assess for ADHD in Adults

  Attention-deficit/hyperactivity disorder (ADHD) affects about 1/3 of adults who had ADHD in childhood. It can be difficult to diagnose because of the overlap in symptoms of adult ADHD with depression, anxiety and substance abuse, and reliance solely on the patient’s self report of symptoms. Studies of self-referral suggest that only 1/3-1/2 of adults who […]