Title : Psychostimulants for children: Are we over or under dosing?
Abstract:
An estimated 3% to 10% of school children meet the DSM-V criteria for ADHD (Attention-Deficit/Hyperactivity Disorder), however, to be over-diagnosed, the rate of children inappropriately diagnosed with ADHD (false positives) would have to be larger than the number of children with ADHD who are under-identified and not diagnosed (false negatives). Accordingly, a number of investigators take the position that under-treatment with psychostimulants, especially in children and adolescence, will result in continued ADHD symptomatology including future Substance Use Disorder (SUD). However, other researchers and clinicians believe otherwise and espouse laudable arguments for caution and prolonged methylphenidate or other psychostimulant treatment. While there is ongoing controversy of the role of genetics and epigenetics linked to ADHD, it seems clear that a number of dopaminergic genes and their risk polymorphisms act as DNA antecedents impacted by epigenetic induced methylation. Our hypothesis and literature review suggest that one possible solution is to embrace non addictive interventions to induce global dopamine homeostasis.
Audience Take Away Notes:
The audience will learn about the genetic antecedents of Attention Deficit Hyperactivity Disorder and the importance of genetic prescreening for prevention of Reward Deficiency Syndrome which is the hypodopaminergic state which is the real phenotype of mental health disorder endotypes like Substance Use Disorder. The new psychiatric genomic science helps to identify medications which are right for the individual brain. In all cases for children especially nutraceutical interventions are preferred over pharmaceutical interventions. A diet devoid of sugar and caffeine is the most prudent. Addressing the genetically induced dopamine deficiency state of RDS in early children will hopefully prevent future manifestation of Substance Use Disorders.
