lithium-chloride and Attention-Deficit-Disorder-with-Hyperactivity

The authors examined the efficacy of methylphenidate (MPH) and lithium to treat attention-deficit/ hyperactivity disorder (ADHD) in adults, using a randomized, double-blind, crossover design. Patients received 8 weeks of MPH treatment (up to 40 mg/day) and 8 weeks of lithium treatment (up to 1,200 mg/day), by random assignment. Independent evaluators blind to group assignment assessed response every 2 weeks and at the end of each phase. The primary outcome measure was the Conners' Adult ADHD Rating Scale sum score for the clusters of hyperactivity, impulsivity, and learning problems. Secondary outcome measures were scores of irritability, overt aggression, antisocial behavior, anxiety, and depression, and scores on tests of verbal learning and sustained attention. In this preliminary study, lithium and MPH produced similar improvements on the primary outcome measure and on measures of irritability, aggressive outbursts, antisocial behavior, anxiety, and depression.

Topics: Adolescent; Adult; Attention Deficit Disorder with Hyperactivity; Confidence Intervals; Cross-Over Studies; Double-Blind Method; Female; Humans; Lithium Chloride; Male; Methylphenidate; Middle Aged; Neuropsychological Tests; Treatment Outcome

Attention deficit/hyperactivity disorder (ADHD) is encountered among patients with epilepsy at a significantly higher rate than in the general population. Mechanisms of epilepsy-ADHD comorbidity remain largely unknown. We investigated whether a model of chronic epilepsy in rats produces signs of ADHD, and thus, whether it can be used for studying mechanisms of this comorbidity. Epilepsy was induced in male Wistar rats via pilocarpine status epilepticus. Half of the animals exhibited chronic ADHD-like abnormalities, particularly increased impulsivity and diminished attention in the lateralized reaction-time task. These impairments correlated with the suppressed noradrenergic transmission in locus coeruleus outputs. The other half of animals exhibited depressive behavior in the forced swimming test congruently with the diminished serotonergic transmission in raphe nucleus outputs. Attention deficit/hyperactivity disorder and depressive behavior appeared mutually exclusive. Therefore, the pilocarpine model of epilepsy affords a system for reproducing and studying mechanisms of comorbidity between epilepsy and both ADHD and/or depression.

Topics: Animals; Attention Deficit Disorder with Hyperactivity; Behavioral Symptoms; Brain; Chronic Disease; Compulsive Behavior; Convulsants; Disease Models, Animal; Epilepsy; Functional Laterality; Immobility Response, Tonic; Lithium Chloride; Male; Photic Stimulation; Pilocarpine; Rats; Rats, Wistar; Reaction Time; Swimming

Topics: Adrenergic alpha-Agonists; Antimanic Agents; Antipsychotic Agents; Aripiprazole; Asthma; Attention Deficit Disorder with Hyperactivity; Cardiovascular Diseases; Chest Pain; Child; Dyskinesia, Drug-Induced; Family; Female; Guanfacine; Humans; Lithium Chloride; Male; Mood Disorders; Neuropsychological Tests; Obesity; Paroxetine; Piperazines; Polypharmacy; Pregnancy; Prenatal Exposure Delayed Effects; Psychomotor Agitation; Quinolones; Selective Serotonin Reuptake Inhibitors; Smoking; Social Environment

We report on three cases of acutely manic prepubertal children diagnosed with bipolar disorder who were treated with olanzapine in addition to their existing mood stabilizer regimens. All three had marked improvement of their manic symptoms within 3-5 days of beginning olanzapine therapy as measured by clinician-rated instruments. Adverse effects included sedation and weight gain. These results suggest that olanzapine may have an antimanic or mood stabilizing effect in acutely manic children with bipolar disorder.

Topics: Antimanic Agents; Antipsychotic Agents; Attention Deficit Disorder with Hyperactivity; Benzodiazepines; Bipolar Disorder; Child; Drug Therapy, Combination; Humans; Lithium Chloride; Male; Olanzapine; Pirenzepine; Sleep Stages; Valproic Acid; Weight Gain