ADHD, highly heritable and one of the most common neurodevelopmental disorders that usually begins in childhood and in certain cases persists into adulthood, is characterized by patterns of inattention, hyperactivity, or impulsivity. Different kinds of medication exist for the treatments for ADHD, those involve stimulants and non-stimulants; however, the problem in hand is that depending on the country, different kinds of drugs are accepted or not. The medications used in the Czech Republic for the treatment of ADHD include antidepressants and stimulants such as Ritalin. Thus, it might be crucial to understand the function of each and how it can improve certain symptoms. 

Concerning clinical manifestations among adults with ADHD, the clinical symptoms tend to be slightly different than in childhood, for instance, it is more common for adults to display symptoms of emotional dysregulation, disorganization, attention problems, or other executive functions such as short-term memory. Moreover, ADHD tends to have comorbidity with other disorders, such as mood or anxiety disorders, sleep problems, personality disorders, or substance abuse (Mohr et al., 2013; Alderson et al., 2013). 

So far a non-stimulant meant to treat ADHD approved by the Czech Republic seems to be atomoxetine (Strattera), it seems to be beneficial for patients specifically with ADHD and comorbid with an anxiety disorder or patients at risk of developing substance abuse (Mohr et al., 2013). Atomoxetine is not a stimulant but rather a selective norepinephrine reuptake inhibitor that attempts to make more noradrenaline in your brain and it works by aiding in the improvement of focused attention and decrease impulsive behavior (Cleveland Clinic, n.d). 

On the other hand, methylphenidate (Ritalin) seems to also be approved by the Czech Republic for the treatment of ADHD but apparently only for children and not for adults. Interestingly, concerta which is also composed of methylphenidate but only has a different name is approved for the treatment of ADHD in adults whose ADHD has not improved from childhood to adulthood. Methylphenidate works by increasing dopamine (DA) levels in the brain; furthermore, this medication does not seem to be addictive, or at least in rare cases it could cause addiction, which is probably the reason for being accepted for the treatment of ADHD in adults (Gottlieb, 2001). Additionally, methylphenidate aids in narcolepsy which is a disorder where a person falls asleep during the day without expecting it. This drug can also aid in concentration difficulties, distraction issues, impulsive behavior, or decrease restlessness. 

To conclude, ADHD seems to be a difficult disorder to treat since there is limited medication accepted in different countries. However, it has been recommended by experts that individuals with ADHD might benefit from combining either Ritalin or atomoxetine with therapy, thus making a synergistic effect by combining both and improving more symptoms where if not combined one treatment might be able to improve whilst others might not aid in and vice versa. 

By Marta Padron Pena, Mental Health Intern

References 

Alderson, M. R., Kasper, L. J.,  Hudec, K. L., & Patros, C. H. G. (2013). Attention-Deficit/Hyperactivity Disorder (ADHD) and working memory in adults: A meta-analytic review. American Psychological Association, 27(3), 287-302. Doi: 10.1037/a0032371

Atomoxetine Capsules, Cleveland Clinic. (n.d.). https://my.clevelandclinic.org/health/drugs/20224-atomoxetine-capsules#:~:text=What%20is%20this%20medication%3F,group%20of%20medications%20called%20SNRIs. 

Gottlieb S. (2001). Methylphenidate works by increasing dopamine levels. BMJ (Clinical research ed.), 322(7281), p. 259. https://doi.org/10.1136/bmj.322.7281.259 

Methylphenidate (Oral Route). Mayo Clinic. (2023, April 1). Retrieved on May 15, from https://www.mayoclinic.org/drugs-supplements/methylphenidate-oral-route/description/drg-20068297 

Mohr, P., Anders, M., Přikryl, R., Masopust, J., Praško, J., & Höschl, C. (2013). Konsensus ČNPS o Diagnostice a Léčbě ADHD v Dospělosti. Psychiatrie, 17(4), 188-201. https://www.semanticscholar.org/paper/Konsensus-%C4%8CNPS-o-diagnostice-a-l%C3%A9%C4%8Db%C4%9B-ADHD-v-Mohr-Anders/247edb31571c75e8bb2eb798d694e5aca870a99d

 

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