Current issues around the pharmacotherapy of ADHD in children and adults

Background New drugs and new formulations enter the growing market for ADHD medication. The growing awareness of possible persistence of ADHD impairment beyond childhood and adolescence resulting in increased pharmacotherapy of ADHD in adults, is also a good reason for making an inventory of the what is generally known about pharmacotherapy in ADHD. Aim To discuss current issues in the possible pharmacotherapy treatment of ADHD in children, adolescents and adults with respect to the position of pharmacotherapy in ADHD treatment guidelines, the pharmacoepidemiological trends, and current concerns about the drugs used. Methods A search of the literature with an emphasis on the position of pharmacotherapy in ADHD treatment guidelines, the pharmacoepidemiological trends, and current concerns about the drugs used in pharmacotherapy. Results According to the guidelines, the treatment of ADHD in children consists of psychosocial interventions in combination with pharmacotherapy when needed. Stimulants are the first-choice drugs in the pharmacological treatment of ADHD in children despite a number of well known and frequently reported side effects like sleep disorders and loss of appetite. With regard to the treatment of adults, stimulant treatment was recommended as the first-choice pharmacotherapy in the single guideline available. Both in children and adults, there appears to be an additional though limited role for the nonadrenergic drug atomoxetine. The increase of ADHD medication use, in children, adolescents and in adults, can not only be interpreted as a sign of overdiagnosis of ADHD. Despite the frequent use of stimulants, there is still a lack of clarity on the effects of long-term use on growth and nutritional status of children. Cardiovascular effects of both stimulants and atomoxetine are rare but can be severe. The literature suggests that atomoxetine may be associated with suicidal ideation in children. Conclusion Although pharmacotherapy is increasing common in the treatment of ADHD in both children and adults, there are still a lot of questions about side effects and how best to counter them. This suggests an important role for close monitoring of children and adults treated with stimulants or atomoxetine

The Psychometric Properties of a New Measure of Sensory Behaviors in Autistic Children

Unusual reactions to sensory input became part of the diagnostic criteria for autism spectrum disorder in the DSM-5. Measures accurately assessing these symptoms are important for clinical decisions. This study examined the reliability and validity of the Sensory Behavior Questionnaire, a parent-report scale designed to assess frequency and impact of sensory behaviors in autistic children. The scale demonstrated excellent internal consistency and concurrent validity, and was a better predictor of autistic symptoms than the Short Sensory Profile within a group of 66 school-age autistic children. The scale also successfully discriminated between autistic and typical children of similar age and ability. The Sensory Behavior Questionnaire has potential as a measure of sensory behaviors in children on the autism spectrum.Medical Research Council; Research at the Centre for Research in Autism and Education; The Clothworkers’ Foundation and Pears Foundation

Tests of an Inversion Algorithm for Spectrally Resolved Limb Emission

Spectrally resolved infrared radiance profiles of the Earth's limb can be inverted to obtain vertical distributions of temperature and species concentration. The atmosphere below approximately 70 km, where LTE prevails and the undissociated CO2 distribution is known, can be probed using broadband limb measurements, as demonstrated by House and Ohring (1969), Gille et al (1975), Russell et al (1979), and others. The added dimension of spectral resolution offers the potential of obtaining umambiguous information in the non-LTE altitude regime. Zachor, Sharma, Nadile and Stair (1981), hereafter referred to as ZSNS, used a direct nonlinear technique to recover vertical profiles of excited nitric oxide concentration and kinetic temperature above 100 km altitude from spectral data obtained by the rocket-borne SPIRE CVF spectrometer (cf. Nadile et al (1977) and Stair et al (1981)).</jats:p

Signal Requirements for Remote IR Limb Sounding of Atomic Oxygen and Temperature in the Thermosphere

Atomic oxygen plays an important role in chemical and collisional processes in the earth's mesosphere and thermosphere. Current techniques, both in situ and remote, for measuring oxygen atom densities in this altitude regime have produced results with unexplained large disparities. We are investigating the feasibility of an approach wherein vertical profiles of translational temperature and oxygen atom density are recovered from measurements of the earth’s limb radiance profile near 147 micrometers and/or 63 micrometers wavelength, corresponding to the OI (3P0-3P1 and 3P1-3P2) transitions of the ground electronic state of atomic oxygen. The assumption that the 3P fine structure levels are in thermodynamic equilibrium (LTE) with the local translational temperature is crucial to the proposed technique, but seems a reasonable one based on the very long radiative lifetimes of the level transitions.</jats:p

A Feasible Technique for Remote Sensing of Thermospheric Temperature and O-Atom Density

Atomic oxygen and translational temperature play vital roles in the chemistry and heat balance of the earth's atmosphere above 80 km. However, existing techniques, both in situ and remote, for measuring vertical profiles of the temperature and O-atom density at these altitudes have severe limitations; see, eg., Zachor and Sharma (1989). Described in the present paper is a new remote sensing technique in which the data is a pair of limb radiance profiles corresponding to the spectrally unresolved 147 μm and 63 μm lines of atomic oxygen (the inter-multiplet transitions 3P0 → 3P1 and 3P1 → 3P2 of the ground electronic state). We outline a retrieval procedure that uses both the onion peeling and global-fit methods to recover temperature and O-atom density between 90 km and 300 km altitude. The global-fit technique (Carlotti, 1988), which provides solution values simultaneously for several altitudes, is used only near 200 km altitude, where a singular Jacobian causes the onion peeling method to diverge. The retrieval procedure was applied to noise-contaminated synthetic data in order to establish basic system requirements for a spaceborne sensor. It is concluded that the proposed remote sensing technique can be implemented with a small cryogenic sensor system based on (non-scanning) Fabry-Perot etalons and detectors having current state-of-the-art performance.</jats:p