Attention Deficit Hyperactivity Disorder (ADHD) affects 3-5%of school-aged children. Male to female ratio is 4 to 1. It is characterized by persistent and developmentally inappropriate level of inattention and/or hyperactivity-impulsivity. The cause is not identified in most cases. The pathology is unknown. Usually the risk of ADHD in first-degree relative is approximately is 25%. About 30-40% of children with ADHD have at least one first-degree relative with ADHD.

ADHD usually is associated with:
 
 School failure (33% kept back a grade before reaching high school)
 Poor peer relationships
 Sleep disorder (over 50%)
 Poor fine motor skills
 Increased risk of accidental injury
 Additional psychiatric diseases (over 40%)
 Learning disabilities (30%)

DIAGNOSIS

HISTORY
ADHD can be diagnosed by typical history such as persistent and developmentally inappropriate levels of inattention and /or hyperactivity-impulsivity.

Physicians usually will try to exclude the following problems, which may mimic the symptoms of ADHD, before they can determine correct diagnosis:

Medical
     Seizures (absence)
 Hypothyroidism/Hyperthyroidism
 Hearing and visual Impairments
 Medication side effects
 Neurodegenerative disorders
 
Developmental
 Mental retardation
 Autism
 
Educational
 Unrecognized learning disabilities

Psychiatric
 Depression
 Mania
 Anxiety disorders
 Oppositional defiant disorder
 Conduct disorder
 Obsessive-compulsive disorder
 
Family
 Disorganized/chaotic family environment

PHYSICAL EXAMINITATION
 May have “soft” neurologic signs such as overflow movements, chorieform movements, finger gnosis and etc.
 Remainder of physical and neurologic examination is usually normal.

TRADITIONAL TREATMENTS

Behavioral counseling and educational interventions are important components of treatment.

Medications
 Methylpheridate (Ritalin) is the most popular medication used to treat ADHD. About 80% of children with ADHD improve significantly.
 Dextroamphetamine (Dexedrine) has potency roughly twice that of methylphenidate, and a shorter duration of action.
 Pemoline (Cylert) primarily acts by increasing dopamine synthesis, rather than hastening release as the above-two compounds do. Hence, it takes longer to take effect.
 Other medications include clonidine and tricyclic antidepressants.

SIDE EFFECTS OF TRADITIONAL TREATMENTS
 

Methylpheridate (Ritalin):
 Appetite suppression
 Stomachaches
 Headaches
 Insomnia
 Dizziness
 Growth suppression
 Dysphoria
 Tics
 Tourette syndrome
 

Dextroamphetamine (Dexedrine)
 Palpitations
 Tachycardia
 Elevation of blood pressure
 Overstimulation
 Restlessness
 Headache
 Insomnia

Pemoline (Cylert)
 Hepatic dysfunction
 Seizures
 Tourette’s syndrome
 Insomnia
 Anorexia
 Weight loss
 

SIDE-EFFECTIVE FREE TREATMENTS
 Ginkgo Biloba: A double-blind study shows that ginkgo biloba may improve mental performance, behavior and mood. It can also enhance brain cell membrane fluidity. It is a strong antioxidant for nerve system.
 Vitamin B Complex: Vitamin B1, B12, B6 and folic acid can release energy to the brain, improve nerve system, rejuvenate brain function and stabilize mental status.
 Antioxidants including Vitamin A, C, E, Zinc and Selenium can repair cells of nerve system and brain damaged by free radicals.
 Green Barley contains 500 – 700 enzymes which can repair the nerve system and brain.
 Omega 3 Fatty Acid: Studies indicate that DHA is especially beneficial for patients with ADHD.

SUGGESTED DAILY REGIMENS based on 50kg patients
Ginkgo Biloba              240-360 mg
Omega 3 Fatty           Acid 6000 mg
Vitamin B Complex      6 tablets
Antioxidants               4 tablets (include Vitamin A, C, E, Selenium, Grape Seeds, Zinc, Green Tea )
Green Barley              4 tea spoons
Multi Vitamins             4 tablets or 2 scoops