PHRM 311 Lecture Notes - Lecture 24: Dsm-5, Prefrontal Cortex, Adult Attention Deficit Hyperactivity Disorder

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12 May 2021
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Half-life: 5 h prolonged, higher cmax and auc in poor 2d6 metabolizers, or with. Titrate dosage up gradually (taken qd); continuous symptom coverage once working concurrent strong cyp 2d6 inhibitors. 2nd line treatment due to lower response rate compared to stimulants. May be useful for inattentive symptoms or with comorbid anxiety disorders. Can combine with stimulants after inadequate response to each agent alone. No known discontinuation syndrome; tapering off atomoxetine is not required but. Aggression possible in patients with psychiatric comorbidities. 2011 warning: heart rate/blood pressure some prescribers opt to do so. Response defined as 40% decrease in adhd-rs-iv score. Mph (56%) > atx (45%) > placebo (25%) at week 6. Response defined as 50% decrease in adhd-rs-iv score. Limited evidence supports efficacy of tcas (nortriptyline, desipramine) and bupropion (dnri) in children. -2a agonist central ne firing rates, connectivity in prefrontal cortex circuits. 2nd line treatment : helps both inattentive and hyperactive/impulsive symptoms, may help sleep & aggression/oppositional symptoms.

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