Talk:Attention deficit hyperactivity disorder management

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Tone??[edit]

This article is frankly terrible. I feel like the whole article reads like someone is trying to convince me not to take ADHD medicines, warning of the CRAZY dangers of stimulants in the treatment of ADHD. I'm sure some of the statements are true, but others are un-backed and rather alarming bits of mis-information.

The largest case of which is the repeated statement of "there is no research showing long term effectiveness of psychostimulants". This is blatantly false. I found two articles today (read 26 and 27) demonstrating that usage of psychostimulants of many different types was marked by increases through neural plasticity of dendritic spinal density and connectivity in key regions of the brain (such as the PFC and nucleus accumbens, two regions with abnormally low development in people with ADHD).

Also, I find the section on antipsychotic medications particularly alarming, due to the fact the same article referred to global decreases in dendritic density in the prefrontal cortex after useage of these SPECIFIC drugs. Uses this by name. And granted, the review is fairly new (2012) but some of the studies it references date all the way back to 1988.

This article seems to be written more as a witch-hunt against medication as a cure for ADHD, and while some of these concerns are well-founded, the sad truth is many of these statements are not founded in the hard scientific literature.

((see references 26 and 27 in the main body text))

Nott All Who Wander 16:18, 26 June 2014 (UTC)

ADHD Types and Treatments[edit]

I would like to know if the different medications are prescribed based on the three different types of ADHD. These types are: Primarily Inattentive, Primarily Hyperactive/Impulsive, and Combined Type. I am diagnosed with Primarily Inattentive [commonly referred to as ADD] and have been prescribed Concerta, then Adderall XR, and now Daytrana; none of these have produced any effect whatsoever. If anyone has any information on a) if different types of meds are prescribed for the different types of ADHD and b) information on treatment of ADHD/preferrably treatment of Primarily Inattentive/ADD type. And c) any explanation as to why the medication does not work? I have an idea that I am willing to go into depth about if you ask. I have read about people claiming the medications are simply placebos in the sense that the meth/amphetamines do not affect concentration. Is there truth to these statements? MattTheMan 01:39, 19 April 2007 (UTC)

Answered on talk page Sifaka talk 20:57, 19 April 2007 (UTC)

Extended release drugs[edit]

I think that maybe the descriptions of the different kinds of extended release drugs should be in a table off to the right next to all the FDA medications, but I don't know how to do this or which templete to use so please help!!! ThanksEdward Bower 05:11, 15 April 2007 (UTC)

Manual of style[edit]

This page needs a lot of work per WP:MOS, and the title should be adjusted to Treatment of attention-deficit hyperactivity disorder, Management of attention-deficit hyperactivity disorder or Attention-deficit hyperactivity disorder treatment. Unless there is disagreement, I'd like to put the article {{inuse}} and do extensive cleanup of the formatting and other problems with WP:MSH and other WP:MOS issues (I already made the fixes per WP:FN, but there's more to do). Wikilinking also needs attention, per WP:MOS and WP:CONTEXT; common terms should not be linked, while the first occurrence of important terms should be. SandyGeorgia (Talk) 13:19, 15 April 2007 (UTC)

Since DavidRuben started on the cleanup, I went ahead and did it. Wikilinking still needs attention, and references need cleanup. All sources should identify a publisher, author and date when available, and websources should indicate a last access date. See WP:CITE/ES. SandyGeorgia (Talk) 13:40, 15 April 2007 (UTC)
I agree with the article name changingEdward Bower 15:39, 15 April 2007 (UTC)
I just picked a name, not really knowing what to call it. I picked Attention-deficit hyperactivity disorder treatments because it was shorter than Treatments for Attention-deficit hyperactivity disorder or such. Change away. I am not particularly familiar with naming conventions for these kinds of articles. Just for refs I like the first and third one you suggested, User:SandyGeorgia. I see if I can do any cleanup. I just kind of forked it and left it without doing anything because I didn't have the time to flesh it out much. Sifaka talk 22:58, 17 April 2007 (UTC)

Sources used[edit]

I have just removed two dismally wrong and outdated pieces of information relating to Tourette syndrome, tics and tic disorders, so I am concerned about the sources used in this article. One of the incorrect pieces of info was from Arnold, which is used extensively in this article, and doesn't appear to be up to date. See Treatment of Tourette syndrome. I'm continuing on the ref cleanup; PMIDs need to be added. SandyGeorgia (Talk) 14:47, 15 April 2007 (UTC)

I found another error sourced to Arnold; depression is not a personality disorder. There are too many errors, so I'm adding a disputed tag until they are sorted out. I'm also concerned that I don't see any of the names of the most recognized researchers in ADHD. Where are Wilens, Biederman, Spencer et al among the sources ?? SandyGeorgia (Talk) 15:34, 15 April 2007 (UTC)
Thanks for fixing all my mistakes and misinformation. If you want to make one of those list things about fixing this articles, you seem to be a very good editor so you'd probably know how to make a nice list about that.Edward Bower 15:39, 15 April 2007 (UTC)
If you're going to take out any sources that you aren't sure what I meant by the statements and know that it's not flat out wrong (this would not include the error about Tourrette Syndrome and Depression), it'd be helpful if you could list them somewhere on this talk page after you take them out, so I could try to explain their importance. ThanksEdward Bower 15:42, 15 April 2007 (UTC)
I will do that when the content is salvageable, but those examples weren't. They were just completely, irreparably, wrong. New information from new sources needs to be added. SandyGeorgia (Talk) 16:08, 15 April 2007 (UTC)
Ya sorry that they were wrong, I didn't know they were but I now that it's been said I trust that those were wrongEdward Bower 16:13, 15 April 2007 (UTC)

I've added in an updated section on treating ADHD in the presence of tic disorders, but it doesn't work with the current article structure (in fact, I think the current article structure should be changed). Treating ADHD in the presence of tic disorders now has mixed info regarding approved and off-label medications, and it really doesn't make sense to split the information. Not sure how to solve this, but it suggests that the article structure should be changed in order to comprehensively cover the topic. Since children are treated off-label for so many spectrum disorders, the organization of this article may reflect POV problems surrounding the whole issue. SandyGeorgia (Talk) 16:45, 15 April 2007 (UTC)

On second thought, since the article structure makes little sense and the TS info didn't fit into either, I moved it to its own section at the bottom. Since a very high percentage of clinically-referred patients with ADHD also have tic disorders, it might as well have its own section. And by the way, so should bipolar. SandyGeorgia (Talk) 16:51, 15 April 2007 (UTC)
Good idea about having it's own section on the buttom, I think that maybe the format should be "Endorsed by the APA", then "Comorbid Disorders" and in the comorbid disorders it should first say somethign about how, as you said spectrum disorders are treated usually treated off-label.. (and more information too), and in the "Comorbid Disorder" section there should be subsections for Tic Disorders, BiPolar(maybe anxiety). And then after that it should talk about the "treatment not endorsed by the APA"(orwhatever the correct type of title ya'll decided on). Edward Bower 16:56, 15 April 2007 (UTC)
So I moved it because I don't know how often you're checking the talk page and I didn't want us to be working on two different versions of the same article, but if you feel that it should be below, then maybe it should. And also I obviously did this very quickly so the main part of comorbid disorder section had very little time dedicated to making it (like 1 minute), so any help there would be appreciated alsoEdward Bower 17:03, 15 April 2007 (UTC)
I've done about all I can do for now; this should give you some good directions for continued work on the article and indications of the work still needed. SandyGeorgia (Talk) 17:23, 15 April 2007 (UTC)

Not comprehensive, and not balanced[edit]

The article doesn't use the most reliable up to date sources, isn't comprehensive, doesn't cover the topic thoroughly, and gives undue weight to unproven treatments, without presenting balance regarding the unproven treatments. It needs extensive work to correct these deficiencies. SandyGeorgia (Talk) 15:14, 15 April 2007 (UTC)

Which unproven treatments?Edward Bower 15:39, 15 April 2007 (UTC)
A lot of the content in the "Not endorsed" section is unbalanced and doesn't present NPOV info; that is, info that disputes some of those treatments. SandyGeorgia (Talk) 16:10, 15 April 2007 (UTC)
I didn't author anything in the not endorsed section so I can't defend any of thatEdward Bower 16:13, 15 April 2007 (UTC)
I think I authored that section when I originally forked it and honestly I don't know much about the disputes. I just separated the treatments into on label and off label. I didn't mean to show any kind of bias for or against them, I was just trying to categorize the information that was in the section. I suppose I can add a sentence to the top of the off label section that since these are not approved by the FDA, any supposed benefits in treating ADHD have not been rigorously proven. Sifaka talk 23:03, 17 April 2007 (UTC)

Formatting[edit]

Reference formatting done and PMIDs added. Some references are to non-MEDLINE-indexed journals, and need to be checked. The prose needs work, and I'll have to leave an accuracy check to a more knowledgeable editor. Fvasconcellos (t·c) 16:23, 15 April 2007 (UTC)

Maybe we could list the non-MEDLINE-indexed journals here, and systematically check them, investigating each individually to see if they should be stay or be removed.Edward Bower 17:13, 15 April 2007 (UTC)
I've checked and apparently there are only three:
Only articles published after 2002 on J Atten Disord are available on PubMed, but I don't think that's a problem, as JAD is peer-reviewed and this article may be accessed through the DOI. Fvasconcellos (t·c) 17:22, 15 April 2007 (UTC)

paragraph on benefits of dextrothreomethylphenidate, dextroamphetamine[edit]

This section had a copy edit on it and its title line was benefits. I think this section is not particularily relevant to the article because it isn't strictly related to ADHD. A better home for most of this would probably be in the various articles on the drugs being described. A better section might be how these specific benefits improve ADHD symptoms which seems to be rather lacking in this article. I am removing it because it kind of stuck out. Discuss here or on my talk page. Sifaka talk 00:03, 18 April 2007 (UTC)

When people are given a drug containing dextrothreomethylphenidate, they find math problems “more interesting, exciting, and motivating”.[1]

The specific benefits of eating dextroamphetamine convey a knack for alleviating certain symptoms of ADHD. Dextroamphetamine makes people declare that they are in a friendlier than average mood;[2] such a quality helps a diagnosed child who feels isolated from schoolmates. Dextroamphetamine improves self-control for people who have a hard time naturally controlling themselves;[3] this quality helps diagnosed children be less impulsive. Dextroamphetamine aids a person learning and memory of words, and perhaps makes the brain stronger.[4] When a person given dextroamphetamine is tested, their brain is extremely active in the brain parts required for the test and radically less active in other parts[2] this focusing quality can help diagnosed children do better in class. Short practice sessions with dextroamphetamine have a greater affect on learning than sessions without dextroamphetamine.[4] Persons taking dextroamphetamine score higher on hard thinking tests.[2] Dextroamphetamine raises decision-making scores, improves choices, and changes beliefs about rewards; at the same time, dextroamphetamine barely—if at all—affects guesses of time.[3] Those who feel lower amounts of joy from dextroamphetamine have greater impulsivity improvements compared to those who feel extreme happiness;[3] this fact upholds the notion that children who are prescribed stimulants do not feel the ecstasy experienced by people who abuse stimulants.[5]

Cleaning up, Staterra, and medical advice[edit]

I have been doing some cleaning up in the article. There are a few concerns/ to do list things I have.

  • First is that we are missing a paragraph on the non-stimulant medications like Staterra. That would be and incredibly valuable paragraph to have because it is not listed and such medications are wisely used.
  • Someone explain what the osmosis method is under the controlled drug release section.
  • Some info in this article sounds like medical advice. I cut down on that as much as I could but I don't know what to say.
  • I also replaced as many brand names with substance names when possible except in drug comparisons. I think this prevents an advertising like feel to it.
  • I deleted some stuff about high IQ patients benefiting from some kinds of drugs versus low IQ patients. It sounded kind of POV.
  • I think we need some more references coming from different sources, confirming some of these claims. I am not an expert, but I think this article needs attention from one.
  • I changed the medical paragraph name and moved it to the bottom after co morbid disorders have been discussed so it makes sense. I also changed the title.

If anyone has concerns, would like to work on anything I suggested go for it. Sifaka talk 00:35, 18 April 2007 (UTC)

Medication selection based on patient psychiatry[edit]

I removed this paragraph as well because it seemed to be a rather listy lists of random data paragraph. All the information in this could be moved to sections where the individual drugs, types of medications versus one another, and comorbid disorders (some not yet created or discussed) are/will be. I am putting it here where the bits and pieces can be added to their appropriate places as the article improves. This is the last of the major changes I will be making for a while, so it may take me a while (like a couple hours or a day) to get back to my talk page and this article. Put concerns there anyway. Sifaka talk 01:01, 18 April 2007 (UTC)


Trends between children’s psychiatric symptoms and reactions to specific medicines are noticed when a large volume of literature is closely analyzed. Some findings he indicate some medicines tend to be more effective for certain patients based on their ADHD type and other comorbid disorders.[6] Patients with comorbid tic disorders tolerate methylphenidates better than dextroamphetamine.[7] For patients with comorbid anxiety disorders Strattera is often chosen over other stimulant medications. .[8] Strattera needs to be tested against the specific stimulants. ADHD patients who also have depression may benefit from dextroamphetamine based medications which were popular antidepressants in the 1950s. The use of dextroamphetamine is encouraged over methylphenidate for patients with comorbid oppositional defiant disorder or conduct disorder.[6] Methylphenidate medications are effective for treating children with ADHD and Mental Retardation and borderline intelligence quotient scores .[9] Children with far lower than average intelligence scores seem to have a better response to methylphenidates than to Dexedrine.[6]

Children with ADHD and comorbid learning disorders seem to respond better to methylphenidates compared to dextroamphetamine.[6] .[10] However, Ritalin may be helpful. Strattera’s manufactures have suggested that patients with comorbid substance abuse disorders should use Strattera because it is considered to be a nonstimulant. Despite this suggestion, Strattera has never been clinically studied against stimulants. In fact, stimulants have actually helped patients with substance abuse disorders.[11] As it turns out, children with ADHD who take medicine are less likely to abuse substances later in life compared to the children who were never medicated for their ADHD.[11]

Improvement Drive. Stuff to work on.[edit]

Specific stuff that could use some improvement (some from above) Sifaka talk 01:07, 18 April 2007 (UTC)

  • First is that we are missing a paragraph on the non-stimulant medications like Staterra. That would be and incredibly valuable paragraph to have because it is not listed and such medications are wisely used.
  • Someone explain what the osmosis method is under the controlled drug release section.
  • Tone: make sure chemical rather than drug names are used when appropriate which will cut down on advertising feel
  • Work on psychotherapy section.
  • Filling in missing info (some invisible comments are located around the article)in order to balance article a bit more.
  • Vast expansion of comorbid disorder section, including bipolar disorder
  • Integration of data from the above paragraphs that I removed into the article where appropriate.

Osmosis[edit]

I believe I accurately explained how Concerta uses osmosis but I don't know where these ingredients fit into Concerta, if anyone does please add them into the osmosis section: butylated hydroxytoluene, phosphoric acid, poloxamer, sodium chloride, stearic acid, succinic acid, synthetic iron oxides, titanium dioxideEdward Bower 21:26, 21 April 2007 (UTC)

FDA[edit]

ADHD doesn't only affect Americans, I don't think the article should be so blatantly based around how the FDA classifies the drugs. Instead how about "recognized medications" or something more neutral... for instance methamphetamine isn't approved for use in Australia so methamphetamine is approved for use in some countries such as the US. cyclosarin 02:40, 18 May 2007 (UTC)


Strongly agree! Why is this article so American-centric in the way it's organized? --Sonjaaa 05:48, 5 October 2007 (UTC)

Article Tag[edit]

I've removed the article tag as I don't see it being necessary. If I am wrong, go ahead and comment and make the change back.JohnsonRon 17:06, 18 May 2007 (UTC)

neurofeedback and statins?[edit]

what about neurofeedback? i've heard that is pretty good for ADHD. also read somewhere that statins (cholestorol medicine) can even reverse certain learning conditions including ADHD. editors please look this up. it would be nice to have ALL possible treatments/cures listed on here so people can try everything and see what works for them. —The preceding unsigned comment was added by 24.190.38.106 (talkcontribs) 14:22, 9 June 2007 (UTC)

i've also heard that exercise is good, that should probably be listed too.

Well, listing all possible treatments/cures isn't really the role of Wikipedia. Additions here must be attributable to reliable sources (that is, they must have been published somewhere reliable before—we only report on findings). Fvasconcellos (t·c) 14:27, 9 June 2007 (UTC)

Transfer from ADHD (- Causes) page to ADHD treatment (- experimental treatments)[edit]

Hi, Scuro. I like the transfer you made. Sorry if I didn't do it myself. I included the subsection ADHD treatment-experimental treatments, and I hope it won't be a distortion of your original intent. I assure you that it is made in good faith.

Do you agree that there could be some kind of reference from the ADHD Causes section to the newly created ADHD treatment-experimental treatments subsection? This is how I'd phrase it:

BEFORE: Despite the lack of evidence that nutrition causes ADHD, studies have found metabolic differences in children with ADHD which may contribute to certain ADHD-like symptoms.

AFTER: Despite the lack of evidence that nutrition causes ADHD, studies have found metabolic differences in children with ADHD which may contribute to certain ADHD-like symptoms. + Experimental ADHD treatments are being conducted to characterize these differences.

And then we have the Treatment section, where there's a link to this page.

I guess that the remark on protein malnutrition should also be transferred here. Agreed?

As you can see, I tried to improve readability with little "bullets" (squares). Does it comply with the rules? There will be some rearrangements to do, as similar considerations on certain metabolic differences are scattered in the list. I'm going to do that.

In doing that, I'll try not to change any sentences, I'll just move things. It might be possible to remove some redundancies. I sure hope so!

Cheers, Pierre-Alain Gouanvic 21:43, 1 August 2007 (UTC)


Hi Pierre-Alain,

Sorry to rain on your parade, you went to some trouble to find this information and it looks to be good information with care taken in it's formation. It just didn't belong on the ADHD causes subsection. On the other hand, perhaps there is a small percentage of ADHD that has a nutritional cause. Science isn't there yet. Science is still even trying to sort out the different types of ADHD and if they are all related. There is a lot work to still be done in this field. If you want to add to the causes section of the ADHD article, I'd keep it short and sweet, clear, and directly related to causes. If a major review on the topic points that way...or say the New York TImes states something along that line...go with it. Otherwise be careful in using studies to advance a position. If there is a study that states some landmark conclusion point blank, quote it directly..and don't beat around the bush. Any addition should be short! With time as we learn more...this page will change.

I don't know if I like the title experimental treatments. As stated on other recent edits to the ADHD article, all ADHD does not have the same root cause. Anecdotally I hear that some kids respond well to supplemental treatments. Why should supplements be labelled experimental? For a small group of ADHDers supplements may be the best treatment option. In my opinion your information could even warrant it's own page. This is a treatment that is used, and has been used for a number of years. Researchers are taking a greater interest in this area, and there are findings of benefits.

Feel free to edit the treatment page as you wish. I just did a cut and paste job and in the back of my mind I thought that other editors would pick up the ball at some point. You don't have to be perfect on Wikipedia. If the edit is moving an article in the right direction that is a good thing. It's also good when you have a number of editors working on the same thing.

Personally, I wouldn't remove the protein malnutrition because...from what I know..malnutrition may play a role in a very small percentage of people who have ADHD. Others may know more and if they do hopefully they will chime in.--scuro 23:29, 1 August 2007 (UTC)

Scuro,
No, no, I'm telling you: you did not rain on my parade, you're helping me. Low energy metabolism or low dopamine: those are causes. I think that it will be important, in the future, to have a section about gene-environment interactions. Low dopamine is a cause; the genetic causes may vary, it is probably polygenic, it might be strictly environmental, or a mix of both... As you say:"Science is still even trying to sort out the different types of ADHD and if they are all related. There is a lot work to still be done in this field."
You say: "In my opinion your information could even warrant it's own page." This is what I've been reflecting on recently. Something like "Biochemistry of ADHD", just like one has "Biochemistry of Alzheimer's disease"[1] in WP. But what an extraordinary task... Do you have an opinion on that?

Perhaps Gene-environment interactions in ADHD ?

I might have to take a break for a while. If I make edits, they will probably not be major.

Thanks for this great quality response made with kindness. This helps me to cope with the effects that recent events on another talk page had on me. I'm exhausted.

I'll read and reflect on your advice.

Pierre-Alain Gouanvic 00:28, 2 August 2007 (UTC)


I've created perhaps a dozen articles. Sometimes something simply needs a page and I'll create a basic page and create links from other pages to it hoping that someone else with either with more knowledge and energy will flush it out. Sometimes societies understanding of a topic is so poor that I have spent a great deal of time working on an original page or flushed out a small article. I see it as a public service. Here is an example http://en.wikipedia.org/wiki/Sluggish_cognitive_tempo These are things I simply have on the backburner until I have the time and drive to work on them. That is usually done on a weekend or during vacation.

Gene-enviroment interactions...sounds a little like Epigenetics - http://en.wikipedia.org/wiki/Epigenetics. I have seen some people on message boards take that concept to an extreme, almost to state the environment causes the change in genes in all ADHDers. Certainly that section could be flushed out on the article. It's not all genes or all environment. Personally, I think they will find that what they believe to be ADHD now may be 2 or more separate disorders. ADHD is such a huge umbrella term which encompasses behaviour at both extremes. Included in the spectrum of ADHD are kids who are so hyperactive they can't disengage from their environment. I've seen kids who literally can't stop and have drool coming from their mouths. At the other end we have kids who are shy, spaced out...kind of like someone has put them in sleep mode. There are other variants of ADHD which may be distinct.

Other editors can make working on Wiki very difficult. Stick to what you believe to be the supportable truth, completely disengage your emotions, and follow Wiki policy if necessary. Easier said then done. I simply make so much time for Wiki everyday. Sometimes it is wasted mainly on the behaviour of other editors. On the other hand I find that I am learning a lot here: new ideas, how to craft ideas, and group processes.--scuro 11:01, 2 August 2007 (UTC)

___ Gene-environment interactions looks good to me because it covers grey areas around solid findings like low dopamine and abnormal energy metabolism in certain brain regions. In order to prevent any accusations of "original research" I want to create articles which state openly the theoretical problem: we have to know in every detail what happens in there, that leads to (-) dopamine and hypometabolism in some regions. Some or many aspects are related to genes, but genotype-phenotype equivalence is rare, if not mythical.

I'm not talking about epigenetics necessarily (although this is a huge revolution coming, IMO -- did you read about epigenetic changes caused by stressful parenting? Revolutionary!). No, I'm talking about all the possible factors revolving around those solid facts. We have to understand how lead interacts with attention centers, the biochemistry of it. We have to understand how iron can be a problem and a solution (or none), in relationship with the Fenton reaction in the brain (iron-catalyzed lipid peroxidation) vs energy metabolism (cytochromes). We have to understand all this biochemistry to be really able to grasp the complex nature of this and most other diseases. We also have to understand how music, love, dreams, the chinese language, the color green, affect the brain in ADHD, etc, etc, etc.

Ok, this might look cryptic. But basically, what I found is that there are millions or researchers in the world and many will not get attention because they just contribute a little biochemical or neurophysiologic (or ...) piece to the whole, and we, in WP, try to accomodate this by choosing what's the most NY Times of all (C'mon, just pulling your leg ;-) ). But we're missing the point... Fundamentally, while researching about the human body, I found that there were vulnerable places were various kinds of causes could "conspire" to create a symptomatology. In Environmental Health studies, attention deficits and dopamine abnormalities are common... they are predictable. Endocrine disruption too... It's just commonplace, once things have been described properly, once dopamine is described properly and hormones are understood properly. And I agree, on the other hand, that we might have many different kinds of ADHD. For instance, look at Highly sensitive person (HSP), on which I worked a lot (but still not enough). You might find that many putative ADHDers are actually very disturbed HSPs. Or some kind schizos with god knows what difference?

None of the above: diagnoses are useful, but they're not at the same level of evidence as hard facts from biochemistry, neurochemistry, neurophysiology... at the other end of the spectrun, you have the educated guesses of psychiatry and sociology.

The reason why it is so difficult to keep this perspectivce in mind is that most of the money is put on diseases first, on the human body second. With so-called evidence-based medicine (EBM), this is getting worse and worse. And you know, many doctors are getting angry at EBM precisely because they have real living persons with all kinds of real complaints that do not quite fit in the nice definitions. ADHD with allergies? Often. ADHD with dyslexia? Sure. With obesity? Frequently. With drug problems, bad parenting, poor education, lack of exercise, etc.? Yes!! and it will take millenia to conduct all the randomized controlled trials necessary to assess the importance of those factors and to which extent they are caused and are causes of ADHD...

Conclusion: a new page taking ADHD as a pretense to talk about biology. Biochemistry of ADHD. It's not hypocritical. It's knowledge about attention and hyperactivity and how it relates to ADHDers and others. You noticed my recent contribution about low dopamine? They found that non-psychiatric subjects also had evidence of low dopamine in proportion of their childhood learning problems. Beware hypochondriacs!!!

Thanks Pierre-Alain Gouanvic 12:43, 2 August 2007 (UTC)


Interesting reading although I don't have a science background to fully understand what you are talking about. Yes, Wikipedia and even science focuses on the most well known and "hot" topics. But from my personal experience I can tell you that the researchers that I know personally are dedicated and have no qualms in working in obscurity. Selfless people really,...knowledge for the sake of knowledge.

What I also do on Wikipedia is ask the opinion of other Wikipedian editors whom I respect. Perhaps you know someone like that. If not try passing your ideas by Nmg20, he always explains things in a highly balanced and knowledgeable way. He also has the science background. He is away until Oct. http://en.wikipedia.org/wiki/User:Nmg20--scuro 13:11, 2 August 2007 (UTC)

Yes, this is also the impression I had when meeting researchers. Thanks for the contact! Pierre-Alain Gouanvic 15:00, 2 August 2007 (UTC)


Quick point: is it "ADHD" or "AD/HD"? Ojcookies (talk) 00:19, 24 January 2008 (UTC)

Globalization tag[edit]

I have removed the generic globalization tag from this article. If you think the tag is deserved, please feel free to restore it -- but please also add a clear explanation right here on this talk page. Your actual concerns are much more likely to be adequately addressed if you identify them. WhatamIdoing (talk) 19:55, 4 March 2008 (UTC)

I think the globalization tag would be a good thing — Preceding unsigned comment added by 147.134.208.81 (talk) 19:29, 23 October 2013 (UTC)

Possible transfer from Attention-deficit hyperactivity disorder controversies[edit]

I believe info from ADHD controversy article should be moved to this article. Please have a look at that article and make suggestions. Attention-deficit hyperactivity disorder controversies here in talk. I believe the whole concerns about medication section could be moved to this article. It may require editing, edit on that page or make suggestions here in talk.

Thanks...--scuro (talk) 15:39, 3 May 2008 (UTC)

Sound like a good idea. Having a few good article is better then many not so good ones with duplication and contradictions.

Doc James (talk) 15:14, 19 September 2008 (UTC)

Image needs replacement[edit]

Hello all...

An image used in the article, specifically Image:Adderallrx.jpg, has a little bit of a licensing issue. The image was uploaded back when the rules around image uploading were less restrictive. It is presumed that the uploader was willing to license the picture under the GFDL license but was not clear in that regard. As such, the image, while not at risk of deletion, is likely not clearly licensed to allow for free use in any future use of this article. If anyone has an image that can replace this, or can go take one and upload it, it would be best.

You have your mission, take your camera and start clicking.--Jordan 1972 (talk) 01:00, 29 September 2008 (UTC)

Change name[edit]

Wondering if we should change the name of the article to ADHD management from treatment. Management implies a persistent disorder well treatment indicates an acute disorder. ie. you treat pneumonia you manage diabetes.

Doc James (talk) 14:13, 9 October 2008 (UTC)

JMH - you may want to wait for feedback before making such a considerable change. You have allowed what, all of one hour? --Vannin (talk) 15:53, 9 October 2008 (UTC)
It called being BOLD. It is easy to change it back if people disagree.--Doc James (talk) 16:07, 9 October 2008 (UTC)
I agree with the name change. There are few if any that claim that there is a bona-fide 'cure' for ADHD, other than waiting it out. Certainly stimulants are all about 'suppressing core symptoms' which does not constitute a 'cure'. Unomi (talk) 04:16, 29 March 2009 (UTC)

Current reference 31 use[edit]

Lie N (November 1998). "[Central stimulants in adults with AD/HD. Do they help?]" (in Norwegian). Tidsskr. Nor. Laegeforen. 118 (27): 4223–7. PMID 9857806.

The Medline translation of the abstract is

This article is a review of five controlled studies of the efficacy of methylphenidate in adults with attention deficit/hyperactivity disorder (AD/HD). All five had a placebo cross-over design. In one of the studies, patients noted from the side-effects whether they were taking methylphenidate or placebo, and it is, in fact, unlikely that any of the studies were blind. The diagnostic criteria used in two of the studies were not appropriate according to present knowledge, leaving three samples of subjects meeting the present criteria for AD/HD. In one study, the patient material was extremely selective: 74% of subjects belonged to social class 1 and 2, and only 35% of those who came for treatment were eligible. Only one study has an acceptable (though not perfect) design. In this study of patients in a psychiatric clinic, no difference was found between methylphenidate and placebo. In two studies, subjects who improved on methylphenidate were followed up. Of the total of 24 subjects in these two samples, only four continued with methylphenidate after 3-12 months; two of them suffered from narcolepsy and one was a substance abuser. Thus, the efficacy of methylphenidate on AD/HD in adults has not been demonstrated. Present research is more against than in favour of its existence.

How does "efficacy of methylphenidate on AD/HD in adults has not been demonstrated" become htom (talk) 19:33, 21 April 2009 (UTC)

The last sentence, "Present research is more against than in favour of its existence." I don't think that I took it out of context.--Literaturegeek | T@1k? 19:53, 21 April 2009 (UTC)

Oh sorry I got mixed up in my edits, thought you were referring to the statement of adult ADHD being controversial which I put in controversy article using that ref. I was skim reading again, bad habit. Anyway, I don't think that it is a gross misrepresentation of the citation. I have to reword text from abstract in my own words to avoid copy violations. Doc James has reworded that sentence anyway so I think that this is now resolved.--Literaturegeek | T@1k? 20:11, 21 April 2009 (UTC)

How about "Stimulants have been found in unblinded studies to be more often ineffective than effective in adults with ADHD.[31]" htom (talk) 20:18, 21 April 2009 (UTC)

No I don't agree because that would be inaccurate because they were placebo controlled trials so they were technically blinded trials. The unblinding due to side effects of drugs is a risk in almost all psychotropic drug clinical trials and even some non-psychotropic drug trials. They were just noting this limitation of placebo trials.--Literaturegeek | T@1k? 20:23, 21 April 2009 (UTC)

That problem would actually apply to all stimulant effects. Actually you could use the ref to say the unblinded but then would you agree that I can use that review article to dispute all positive effects of stimulant trials in the various ADHD and stimulant articles, might be due to unblinding?--Literaturegeek | T@1k? 20:27, 21 April 2009 (UTC)

There were other problems with the studies as well, not just the unblinding problem so saying the problems were just due to unblinding would be misrepresentation of the review article.--Literaturegeek | T@1k? 20:33, 21 April 2009 (UTC)

From family experience, it's not the side effects that cause the unblindness in AD/HD patients, it's the direct effect of the stimulants vs. the non-stimulant, and that is going to be a real problem in attempts at blinded studies (some patients can even accurately tell which stimulant, Ritalin or Adderall, they've been given!) In the study being discussed, it looks to me like two of the five are discarded, one there was no effect, and in two, only those who showed improvement (!) were followed up, of the four who continued after a year three cannot be considered to be typical, and why they discontinued is not known. So we appear to be basing the conclusion that there is no demonstrated effectiveness on one patient -- who was one who showed improvement. Claiming that this shows ineffectiveness seems bizarre. I can see the claim that it was not shown to be effective, it's up in the air, but it hardly seems to be showing ineffectiveness. htom (talk) 20:50, 21 April 2009 (UTC)

I reworded the text again. I think that this has been resolved now.--Literaturegeek | T@1k? 21:52, 21 April 2009 (UTC)

Except that those patients did show improvement -- but that's a squabble with them, not the article. Thank you for the change. htom (talk) 21:56, 21 April 2009 (UTC)

Section order swapping and relocation[edit]

Since this has the potential to be controversial I am discussing motivations here. I swapped the order of several main sections so that Medications are first, Psychotherapeutic approaches are second, and Experimental and alternative medicine treatments is third. My reasoning is that treatment with medications are by themselves considered the most effective according to the article references, followed by psychotherapeutic (behavioral) approaches, which are in turn followed by the experimental and alternative medical treatments (I renamed it to reflect the experimental section I squished into it) which mostly have not been evaluated much so their effectiveness is unknown, or haven't gained much traction in general practice, or have shown little overall effect. I also made biofeedback a subsection of experimental and alternative medical treatments because it seems to not have gained much traction in the main guideline literature, and according to the article the research behind it is still in the experimental stage. Neurofeedback is also listed under the category Alternative medical systems. Sifaka talk 00:19, 27 May 2009 (UTC)

I would like to note there is also a good argument for biofeedback to be placed under psychotherapeutic section. I am not to sure which to pick since it is both "experimental and alternative" as well as "psychotherapeutic." I have half a mind to move it again into psychotherapeutics (if moved remember to change it on the main ADHD page as well as this one, both in the treatments section and possibly in the intro), but I'm feeling lazy and I have decided that I'm going to see how other people react, especially on the main ADHD page which gets more eyes. Sifaka talk 01:20, 27 May 2009 (UTC)
Sorry Sifaka did not see this section before. A couple reasons for putting lifestyle interventions / pyschological measure first is: that is the way it is usually presented and one usually orders treatments not by effectiveness but by safety. Therefore if you look at articles on obesity, hypertension lifestyle measures are discussed first. In the case of obesity lifestyle measures and medications have been found to be of little benefit. The only thing that seems to work is surgery. Still however surgery is not mentioned first.
If you wish to mention meds first however I do not really mind. I am a proponent of having a consistent presentation of medical articles on wikipedia but this view does not seem to be supported by the community.--Doc James (talk · contribs · email) 13:30, 24 July 2009 (UTC)

Expert tag[edit]

The tag has been on the article well over one year. Most articles need improvement; I don't think this one needs it any more than most scientific articles. If there is no objection in a week or two, I think the tag needs to go. Cresix (talk) 01:43, 31 July 2010 (UTC)

The division in FDA verses non FDA[edit]

This is very US centric. Would be like dividing into Health Canada verses none Health Canada approved.--Doc James (talk · contribs · email) 01:11, 10 January 2011 (UTC)

Neurofeedback[edit]

I think that Neurofeedback should be actualized. One meta-analysis called Efficacy of Neurofeedback Treatment in ADHD: the Effects on Inattention, Impulsivity and Hyperactivity: a Meta-Analysis (from 2009 incl. 15 studies and 1194 people) draws the conclusion "Therefore, in line with the AAPB and ISNR guidelines for rating clinical efficacy, we conclude that neurofeedback treatment for ADHD can be considered “Efficacious and Specific” (Level 5) with a large ES for inattention and impulsivity and a medium ES for hyperactivity.". The full analysis is available here:PDF. Regards --Cyrus Grisham (talk) 14:36, 11 January 2012 (UTC)

Sleep[edit]

The article should have a section about improving sleep. Children who don't sleep long enough (link) or who snore (or have other breathing difficulties during sleep) (link) are more likely to be hyperactive - and getting more or better sleep improves the condition. --New Thought (talk) 09:38, 15 March 2012 (UTC)

I do so agree with you. Children with circadian rhythm sleep disorders (CRSD) are also sleep deprived. There have been cases where the ADHD diagnosis disappeared when the child was diagnosed with (and treated for) sleep apnea or CRSDs. --Hordaland (talk) 03:11, 17 March 2012 (UTC)

Mess[edit]

I've tagged this as it's a sprawling mess. Many of the problems are those present in another article and detailed by SandyGeorgia in her comment here. Please see the wikilinks in her comment especially WP:MEDRS.

There's reliance on out-of-date material as well as random selection of primary studies, laypress or other primary sources being used to source content throughout. For such a well-studied topic where high quality reliable sources exist these should be used to develop an article without undue weight or other problems. --92.6.211.228 (talk) 15:24, 23 April 2012 (UTC)

Removed all of these tags - WP:DRIVEBYTAGGING Seppi333 (talk) 02:05, 27 October 2013 (UTC)

Move tag[edit]

Could the tagger please give some details of what is wanted and why. If the tagger intends to make the changes soon then we don't need many details. If it is to be left to someone else then a lot more information would be required. Op47 (talk) 20:42, 27 July 2012 (UTC)

Cannabis[edit]

I was diagnosed with ADHD at IQ 138 in the 1980s, and forced against my will as a nine-year old child to take legally prescribed speed, in the form of Ritalin and later Amphetamines. The medicine has helped, in the right circumstances, but the side effects can be unpleasant, severe, and potentially deadly, with a high potential for life-threatening abuse. I have also had negative experiences with prescribed antidepressants, which are known to cause a host of unpleasant and sometimes life threatening side effects in some patients.

Last month I saw a lecture by Dr Allan Frankel (his website is http://www.greenbridgemed.com/) in Copenhagen, Denmark on the subject of medical cannabis, popularly known as the increasingly less illegal drug marijuana. Looking around the web in follow up, I can see that this is a major emerging direction in treating ADHD, but outside the scope of the corporate pharmaceutical industry and thus the mainstream treatment of ADHD in most places.

Yet cannabis is currently being prescribed for ADHD, and lauded both for its efficacy and its safety— in fact, according to the state of the art in the research, it is actually impossible to suffer a life-threatening overdose from cannabis alone. So it's high time for us to begin a new section on Cannabis as a treatment for ADHD in this article, so we can all benefit from details of treatments in the field and the the developing research as this new approach widens. Thank you for your time and attention. Kaecyy (talk) 12:08, 16 January 2014 (UTC)

Anyone who cares to read the text I drafted will probably find it very good linguistically, with excellent primary sources, so it should probably serve as the basis of a first draft, as we add in this section together.
But I am not at all adept at the minutia of Wikipedia and I have to get the hell out of Dodge at the moment, so— if someone with a constructive approach could improve the high-quality secondary source aspects of the text I just posted, to help make Wikipedia all that much better, it would be very much appreciated— on behalf of myself and others who suffer from this terrible affliction. Kaecyy (talk) 15:17, 16 January 2014 (UTC)
I just reduced the cannabis section to just the most basic details— this is a current and expanding treatment, and as an ADHD patient I think it is unethical not to at least mention it as a possibility in the article. Please improve it but not delete it if it is not up to par in your opinion— and help improve this section as the research advances. Thanks! Kaecyy (talk) 11:39, 11 February 2014 (UTC)
Health claims need to be sourced to sources compliant with WP:MEDRS. Please find high quality review articles or similar high quality sources before adding medical claims to the article. Yobol (talk) 17:42, 17 March 2014 (UTC)


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