Tailor Made Treatment for ADHD

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Tailor made treatment for ADHD is in its infancy but the medical research community is moving faster than ever and our understanding of the complex neurotransmitter issues at work in ADHD is growing. This understanding is enabling us to better medically target individual brain differences when treating ADHD. The need for tailored treatment for ADHD stems from the puzzling fact that while one drug may work beautifully for one ADHD patient, it can be a treatment disaster for another. Some of these differences in treatment response may be related to subtype differences while others are related to individual differences.

There may be medical reasons, related to individual physiology, that explains why one Inattentive ADHD (ADHD-PI) patient will respond to coffee and another patient will have a bad reaction to coffee. Why a stimulant will work great for one kid with Hyperactive Impulsive ADHD (ADHD-HI) and horribly for another child with combined type ADHD (ADHD-C). Recent research, for instance, has allowed us to learn that some people have a genetic variant that causes them to metabolize caffeine very rapidly and abruptly while most of us metabolize caffeine slowly and continuously. Methylphenidate (Ritalin) and Amphetamine (Adderall) work in a unique way and research is pointing us towards an understanding of why some people with ADHD respond better to Ritalin and others respond better to Adderall.

Atomoxetine (Strattera) and Guanfacine (Intuniv) work on the ADHD brain in a different manner than the stimulant treatment for adhd test and some people benefit from these drugs while others have no effect from them or adverse effects from them. A new class of drug called a Histamine 3 (H3) receptor antagonist is in development and has shown promise in the treatment of ADHD. The H3 receptor antagonist work by enhancing the release of neurotransmitters. This new drug may help people that have had failed treatment responses to other drug therapies. The neurotransmitter receptors agonist and antagonist in our brains and bodies work differently in each of us and biological markers for this neurotransmitter activity are becoming more readily available. Physicians will soon have tools that will take some of the guesswork out of how you will respond to certain medical interventions.

These lab test and biological markers are, at the moment, prohibitively expensive and not readily available but the ready availability and affordability of this testing is not as far off as it was even a year ago. Genetic testing will also become more affordable and available which is important because genetics also plays a role in our response to treatment.

As researchers add medication to the ADHD arsenal, we will find that some patients will be uniquely helped by new medications like the H3 receptor antagonist and the Alpha-2 Adrenergic receptor agonist such as Intuniv while others will not be. We will see individual variations in the response to these medications and these variations may not always be related to the subtypes of ADHD. It is possible that Intuniv will help certain people with Inattentive ADHD (ADHD-PI) while others will have no effect from this medication.

We are not yet at the stage of medical testing where we can perform one lab test and know how well someone may respond to a medication. Researchers are progressing in their understanding of the complex brain processes involved in ADHD and there are now, as a result, more medications available to treat ADHD and more tests that can be performed that allow physician to understand who may benefit most from an ADHD medication.

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