Epidemiology

Etiology

Options include stimulant and nonstimulant therapy. Stimulant therapy is usually first-line treatment for children ≥ 6 years of age and adults.

Options: methylphenidate or amphetamine analogues (e.g., lisdexamfetamine, dextroamphetamine)
Mechanism of action: indirect and central sympathomimetic activity → increased release and blocked reuptake of norepinephrine and dopamine (minor effect on serotonin) → increased concentration of norepinephrine and dopamine in the synaptic cleft → increased mental performance (e.g., improved concentration, cognition, short-term memory) and fine motor skills
Adverse effects
- Sympathomimetic effects
  - Anxiety, agitation, restlessness, bruxism, tics
  - Difficulty falling asleep (insomnia)
  - Reduced appetite, nausea, vomiting, weight loss
  - Increased arterial blood pressure, tachycardia

SSRI
- Options: atomoxetine or viloxazine
Alpha-2 adrenergic agonists
- Options: guanfacine extended-release or clonidine extended-release