ATTENTION DEFICIT HYPERACTIVITY DISORDER

Attention deficit hyperactivity disorder (ADHD) is a problem of not being able to focus, being overactive, not being able control behavior, or a combination of these. For these problems to be diagnosed as ADHD, they must be out of the normal range for a person's age and development.

Causes:

ADHD usually begins in childhood, but may continue into the adult years. It is the most commonly diagnosed behavioral disorder in children. ADHD is diagnosed much more often in boys than in girls.

It is not clear what causes ADHD. A combination of genes and environmental factors likely plays a role in the development of the condition. Imaging studies suggest that the brains of children with ADHD are different from those of children without ADHD.

Symptoms of ADHD fall into three groups:
-Not being able to focus (inattentiveness)
-Being extremely active (hyperactivity)
-Not being able to control behavior (impulsivity).

Some people with ADHD have mainly inattentive symptoms. Some have mainly hyperactive and impulsive symptoms. Others have a combination of different symptom types. Those with mostly inattentive symptoms are sometimes said to have attention deficit disorder (ADD). They tend to be less disruptive and are more likely not to be diagnosed with ADHD.

Inattentive Symptoms
-Fails to give close attention to details or makes careless mistakes in schoolwork
-Has difficulty keeping attention during tasks or play
-Does not seem to listen when spoken to directly
-Does not follow through on instructions and fails to finish schoolwork or chores and tasks
-Has problems organizing tasks and activities
-Avoids or dislikes tasks that require sustained mental effort (such as schoolwork)
-Often loses toys, assignments, pencils, books, or tools needed for tasks or activities
-Is easily distracted
-Is often forgetful in daily activities.

Hyperactivity Symptoms
-Fidgets with hands or feet or squirms in seat
-Leaves seat when remaining seated is expected
-Runs about or climbs in inappropriate situations
-Has problems playing or working quietly
-Is often "on the go," acts as if "driven by a motor"
-Talks excessively.

Impulsivity Symptoms
-Blurts out answers before questions have been completed
-Has difficulty awaiting turn
-Interrupts or intrudes on others (butts into conversations or games).

PHARMACOLOGY
CNS stimulants and drugs used for ADHD:

-Atomoxetine (Strattera).

-Dexamfetamine sulphate (Dexedrine).

-Methylphenidate hydrochloride (Ritalin, Concerta XL, Equasym XL, Medikinet XL).
-Modafinil (Provigil).

Source:
-http://www.nlm.nih.gov/medlineplus/ency/article/001551.htm
-BNF 57

ANTIDEPRESSANT DRUGS

DEPRESSION

Depression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for short periods.

Clinical depression is a mood disorder in which feelings of sadness, loss, anger, or frustration interfere with everyday life for a longer period of time.

Symptoms of depression include:
-Low or irritable mood most of the time
-A loss of pleasure in usual activities
-Trouble sleeping or sleeping too much
-A big change in appetite, often with weight gain or loss
-Tiredness and lack of energy
-Feelings of worthlessness, self-hate, and guilt
-Difficulty concentrating
-Slow or fast movements
-Lack of activity and avoiding usual activities
-Feeling hopeless or helpless
-Repeated thoughts of death or suicide.
Low self-esteem is common with depression. It is also common to have sudden bursts of anger and a lack of pleasure from activities that normally make you happy, including sex.

The main types of depression include:

-Major depression: to be diagnosed with major depression, you must have five or more of the symptoms listed above for at least 2 weeks. Major depression tends to continue for at least 6 months if not treated. (You are said to have minor depression if you have less than five depression symptoms for at least 2 weeks. Minor depression is similar to major depression except it only has two to four symptoms.)

-Atypical depression: occurs in about a third of patients with depression. Symptoms include overeating and oversleeping. You may feel like you are weighed down and get very upset by rejection.

-Dysthymia: a milder form of depression that can last for years, if not treated.

Other common forms of depression include:

Postpartum depression: many women feel down after having a baby, but true postpartum depression is more severe and includes the symptoms of major depression.

Premenstrual dysphoric disorder: symptoms of depression occur 1 week before your menstrual period and disappear after you menstruate.

Seasonal affective disorder (SAD): occurs most often during the fall-winter season and disappears during the spring-summer season. It is most likely due to a lack of sunlight.

Depression may also alternate with mania (known as manic depression or bipolar disorder).

PHARMACOLOGY

1. Tricyclic and related antidepressant drugs:

-Amitriptyline hydrochloride (Triptafen).

-Clomipramine Hydrochloride (Anafranil).

-Dosulepin Hydrochloride (Prothiaden).

-Doxepin (Sinepin).

-Imipramine Hydrochloride.

-Lofepramine.

-Nortriptyline (Allegron).

-Trimipramine (Surmontil).

Related antidepressant drugs: Mianserin Hydrochloride and Trazodone Hydrochloride (Molipaxin).

2. Monoamine-oxidase inhibitors (MAOIs):

-Phenelzine (Nardil).

-Isocarboxazid.

-Tranylcypromine.

-Reversible MAOIs: Moclobemide (Manerix).

3. Selective serotonin re-uptake inhibitors: 

-Citalopram (Cipramil).

-Escitalopram (Cipralex).

-Fluoxetine (Prozac).

-Fluvoxamine maleate (Faverin).

-Paroxetine (Seroxat).

-Sertraline (Lustral).

4. Other antidepressant drugs:

-Duloxetine (Cymbalta, Yentreve).

-Flupentixol (Fluanxol).

-Mirtazapine (Zispin SolTab).

-Reboxetine (Edronax).

-Tryptophan (Optimax).

-Venlafaxine (Efexor).

Sources:

-http://www.nlm.nih.gov/medlineplus/ency/article/003213.htm\

-BNF57