Introduction
Attention deficit hyperactivity disorder (ADHD) is a mental health condition mainly affecting children and adolescents. It occurs due to an impaired neurotransmitter system that affects a person’s proper functioning, especially behavior. The symptoms are pervasive and increase or decrease depending on the prevailing environmental expectations and demands. ADHD disorder is incurable, but it can be managed using behavioral therapy, stimulants, and non-stimulant treatment options.
First-Line Treatment Options for ADHD
Treatment of ADHD needs to be prescribed depending on the individual case as defined by the symptoms, needs, severity, age, and subtype of condition. A qualified healthcare professional has to conduct a thorough evaluation to determine the most suitable treatment plan. Behavioral therapy is one of the standard first-line treatment options for children aged 4-5 years with ADHD (Brown et al., 2018). It involves training the affected child in positive reinforcement, social, and time-management skills. The training enables the child to manage their behavior, which enhances academic performance and social functioning.
Furthermore, the affected person can be treated through different kinds of medication, either stimulant or non-stimulant. Commonly used stimulants include amphetamines and methylphenidate, while non-stimulant medications include atomoxetine and guanfacine (Brown et al., 2018). Non-stimulant medications are an alternative first-line treatment option for children and adults who do not respond well to stimulant medications or have a history of substance abuse. The medications act by increasing the level of dopamine and norepinephrine in the brain, which helps to improve attention and reduce impulsivity and hyperactivity. Finally, medication can be combined with behavioral therapy, especially in patients with extreme impairment in multiple domains. The combination can result in better results than single-line treatment.
Symptoms to be Treated First
The specific symptoms that should be targeted first will vary with the personal case and the unique manifestation of ADHD. However, some symptoms are common and disruptive, requiring immediate attention. First, affected individuals suffer from attention problems and cannot adequately focus on tasks or follow instructions. In particular, the individual will have poor academic or work performance. The second symptom is impulsivity which causes a person to act on impulse. This leads to an impulsive manner where a person is prone to interrupting others, misbehaving, or engaging in dangerous behaviors (Tarrant et al., 2018). The other common symptom is hyperactivity, where the affected person becomes fidgety, restless, and cannot sit still. Participating in structured tasks or quiet activities becomes so hard for a person.
Pharmacological Considerations for Individuals with Co-morbid ADHD and Tic Disorder
Establishing the correct pharmacological interventions for people with co-morbid ADHD and tic disorder can be challenging. Some first-line medications for ADHD, such as stimulants, may worsen the tic disorder. Therefore, non-stimulant medications provide a better treatment option for such people. In particular, atomoxetine is an FDA-approved non-stimulant drug that does not exacerbate the tic disorder. The medication works by shutting off the reuptake of norepinephrine in the brain, which boosts its availability and helps to improve impulse control and attention. It is also beneficial when a person with ADHD suffers from anxiety, co-morbid depression, and mood disorder. In addition, guanfacine, an alpha-2 agonist, helps reduce ADHD signs and improve tics (Childress, 2021). The drug improves prefrontal cortex activity, which enhances attention and impulse control. Cognitive-behavioral therapy (CBT) and habit reversal training (HRT) are also helpful in people with co-morbid ADHD and tic disorder (Childress, 2021). CBT helps a person recognize and manage the emotional and behavioral stimuli that may exacerbate tics. HRT helps people identify and counter tic-related conducts with more adaptive behaviors.
Conclusion
ADHD mainly affects children and adolescents, and the first-line treatment options vary for each person. Standard treatment options include using stimulants, non-stimulants, and behavioral therapy. Treatment for ADHD should be tailored to the individual and their specific symptoms. The common symptoms include attention disorder, hyperactivity, and impulsive behavior. People with co-morbid ADHD and tic disorder should consider using non-stimulants and behavioral therapy.
References
Brown, K. A., Samuel, S., & Patel, D. R. (2018). Pharmacologic management of attention deficit hyperactivity disorder in children and adolescents: a review for practitioners. Translational Pediatrics, 7(1), 36–47. Web.
‌Childress, A. C. (2021). Novel Formulations of ADHD Medications: Stimulant Selection and Management. FOCUS, 19(1), 31–38. Web.
‌Tarrant, N., Roy, M., Deb, S., Odedra, S., Retzer, A., & Roy, A. (2018). The effectiveness of methylphenidate in the management of attention deficit hyperactivity disorder (ADHD) in people with intellectual disabilities: A systematic review. Research in Developmental Disabilities, 83, 217–232. Web.