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Attention deficit hyperactivity disorder (ADHD) is a neurological condition which is estimated to affect approximately 5% of children and approximately 2-4% of adults in the UK. The first behaviours are often found in early childhood, most children start to become recognised as having ADHD between the ages of 5 and 9 years. Boys are more often affected than girls. Boys more commonly display symptoms of hyperactivity, girls more commonly display symptoms of inattention. The condition continues throughout the school years and it is thought that 60 % of children will carry some symptoms through to adulthood.

 

The exact cause of ADHD is not known, but it is thought that ADHD may be due to a hereditary or genetic cause, or from damage to the developing baby’s brain during pregnancy or the child's brain at or shortly after birth. There is evidence to suggest that parts of the brain that control impulsive behaviour and the ability to concentrate respond more slowly in children with ADHD than they do in children without ADHD. As a result, a child with ADHD is not able to process information in the same way as other children, so they fidget, they can not concentrate and they quickly become bored.

Children suffering from ADHD will display some, if not all of the following symptoms:

 

• Inattention - Many sights, sounds, memories and other stimulations compete for a child's attention at the same time. This makes the child easily distracted, with a tendency to flit from one thing to another, forgetting instructions. They will often look distant, dreamy or spaced out.
• Impulsiveness - The child may speak or act without thinking at times inappropriately and may have a short fuse, leading to temper tantrums.
• Over-activity - The child can be restless and fidgety, constantly tapping their feet or fiddling with their fingers.
• Insatiability - Never satisfied the child appears to go on and on about a certain subject, it can seem as though they are interrogating and generally trying to intrude or take over conversation. This can cause enormous tension.
• Social clumsiness - The child never seems to quite 'fit' in with their peers and can act silly in a group. They can be overpowering and bossy, wanting to be the centre of attention, whatever the cost.
• Poor co-ordination - The child may be clumsy and appear awkward in their movements. They have difficulty doing two actions at the same time and will probably produce untidy written work.
• Disorganisation - Blind to mess and oblivious to organisation the child can have problems structuring school work and find homework and projects difficult to start.
• Variability - The child can have severe mood swings and be very volatile. They have good and bad days with no explanation.
• Specific learning disabilities - Although most children appear to have a high I.Q. most will have learning difficulties due to their poor attention span. Many however do appear to have a combination of ADHD and a more specific learning difficulty, for example, dyslexia or a language problem.

In adults symptoms include at least twelve of the following:

• A sense of underachievement, of not meeting one's goals (regardless of how much one has already accomplished).
• Difficulty in getting organised.
• Chronic procrastination or trouble getting started.
• Many projects going simultaneously; trouble with follow through.
• A tendency to say what comes to mind without necessarily considering the timing or appropriateness of the remark.
• A frequent search for high stimulation.
• An intolerance of boredom.
• Easily distracted, trouble focusing attention, tendency to tune out or drift away in the middle of a conversation or a page. Often coupled with an ability to hyperfocus at times.
• Often creative, intuitive, highly intelligent.
• Trouble in going through established channels, following "proper" procedure.
• Impatient; low tolerance of frustration
• Impulsive, either verbally or in action, as in impulsive of spending money, changing plans, enacting new schemes or career plans, and the like; hot-tempered.
• A tendency to worry needlessly, endlessly; a tendency to scan the horizon looking for something to worry about, alternating with in-attention to or disregard for actual dangers.
• A sense of insecurity.
• Mood swings, mood lability, especially when disengaged from a person or a project.
• Physical or cognitive restlessness.
• A tendency toward addictive behaviour.
• Chronic problems with self-esteem.
• Inaccurate self-observation.
• Family history of ADHD or manic-depressive illness or depression or substance abuse or other disorders of impulse control or mood.
• Childhood history of ADHD.

Medicines

A child with ADHD faces many challenges. It is a chronic condition that continues into adulthood in approximately 60% of children who are affected and, if left untreated, it is likely to interfere with their social and working lives.

Treatment is aimed at helping the child learn, control behaviour and increase his or her self-esteem. A combination of methods is usually recommended to help the child learn, to increase his or her ability to deal with the emotional cruelty of other children and to increase self-confidence. Special behavioural programmes tailored to suit the child's needs can be effective in helping the child learn.

There is no medical cure for ADHD. However there are some medicines that may help with the symptoms. The most commonly used drug is methylphenidate. This drug is known as a central nervous system (CNS) stimulant. While this may appear strange giving a stimulant to a person who is already hyperactive, it appears that methylphenidate probably stimulates those parts of the brain that control compulsive behaviour and concentration that are otherwise slow to respond. Dexamfetamine is another CNS stimulant that may be tried if there is no response to methylphenidate. If neither medicine works, the doctor may prescribe atomoxetine. Unlike the other two, atomoxetine is not a stimulant. Instead it improves the way messages are relayed in the brain, helping concentration and controlling compulsive behaviour.

There are no medicines that a pharmacist is able to recommend without a prescription for the treatment of ADHD. However, if you are buying other medicines to treat another illness, it is important that you tell your pharmacist if you or your child has ADHD and let him or her know which medicine has been prescribed. Also say whether you or your child is taking any other medicines or food supplements that have been prescribed or bought over the counter from pharmacies and health food stores. The medicines used to treat ADHD should not be used if you have certain other illnesses such as heart problems and glaucoma, and they may interact with other prescription and OTC medicines and supplements.

If you or your child is feeling down, tell your pharmacist. A small number of people who take atomoxetine have thoughts about suicide. Your pharmacist will refer you to your doctor.

 

It is important to seek treatment if you think you or your child has ADHD. There is no simple test to confirm that it is ADHD but your doctor will arrange for you or your child to see a specialist. The specialist, usually a psychiatrist or paediatrician, can make an accurate diagnosis after a detailed assessment. The assessment will involve a series of interviews and reports from other people such as teachers.

The specialist or your doctor is likely to recommend using medicines as well as behavioural programmes.