Bibliography
A Quick Reference to Our Sources
Contraindications to stimulant use – Cardiac:
Personal history of:
Cardiac disease
Arrhythmia
Palpitations, syncope, hypertension, exercise intolerance not attributed to other reasons (signs of hypertrophic cardiomyopathy)
Family history of:
Sudden death in children or young adults
Hypertrophic cardiomyopathy
Long QT syndrome
Class vs. Stage
Stimulant Class refers to either the Methylphenidate Class or Amphetamine Class. On our website, we also refer to them as Stage 1 (Methylphenidate Class) or Stage 2 (Amphetamine Class). This is because we are creating a flowchart based on the ADHD Texas Medication Algorithm you can easily follow depending on where your patient is at.
Sleep Hygiene
Routines and settings surrounding sleep. Having a good “sleep hygiene” means you are optimizing your bedtime routine and sleep space to enable the best quality and quantity of sleep possible.
Adverse Effect vs Side Effect
We use these terms interchangeably
Class Effect
An adverse effect that is usually present across all medications within a certain class (or Stage).
Comorbidity
An illness or disease that is commonly associated with another illness or disease (i.e. ADHD and Anxiety).
SSRI or SNRI
Selective Serotonin Reuptake Inhibitor or Selective Norepinephrine Reuptake Inhibitor- a common class of medications used to treat Anxiety, Depression, and other mental health disorders.
Treatment Goal
The point at which we consider the medication effective, and we do not need to continue adjusting (as long as side effects are tolerable). This can be measured a few ways:
— The patient has met most of their personal goals determined prior to starting treatment.
— Scores on symptom monitoring forms, such as the Vanderbilt (treatment goal is considered when scores are < 6/9 on questions #1-9 and #10-18)
Remission
When patient has reached their personal goals, as well as score on symptom monitoring forms are very low.
Titration
On our website, this refers to the dose increase of a medication by a recommended amount every 1-2 weeks until the treatment goal is reached.
Short Acting vs Long Acting Medications
Short acting medications refer to those with only an immediate release. Long Acting medications refers to any medication with a delayed release component. This can include medications labeled LA, XR, ER, CD, etc. Since every patient has a slightly different metabolism, we consider each long acting in the same category. There are some medications advertised and created with the intent to last 8-14 hours. We recommend you titrate the medication as you would normally, and monitor for duration, adding a corresponding short acting if needed.
Generic Names
There is an official naming convention for ADHD medications, however, Electronic Medical Records may represent them differently. In order to standardize this for our website, we have come up with our own naming convention.
Administration
How a medication is given, i.e. chewable, orally disintegrating, etc.
Content and Distribution
Ratio between short acting and long acting contained in a medication.
Peak
The time it takes from taking the medication until the peak concentration. There may be 1-3 peaks depending on the medication.
Duration of Action
The time it takes from the time it is effective until the medication effect wears off.
Maximum Dose
There is a maximum dose determined by the FDA. However there are times you may be able to go above that maximum dose, based on clinical experience and published literature.
Dose Table
List of available strengths and the total doses that can be given based on the available strengths.