Week 9 Discussion


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Attention Deficit/Hyperactivity Disorder (ADHD)

  • Provide an overview of the case, differential diagnosis, target symptoms, appropriate laboratory or diagnostic test, and treatment plan. Include rationales for each section of the treatment plan.
  • Describe the difference in ADHD clinical presentation between children and adults. Compare the advantages of stimulants, norepinephrine dopamine reuptake inhibitors, or alpha-adrenergic agents in the treatment of ADHD,
  • Will share case study upon acceptance

One Paragraph response to the following discussion response:

Overview of the Case: Eddie, a 9-year-old boy, exhibits restlessness, impulsivity, attention issues, and social challenges. These symptoms have persisted since early childhood and significantly affect his academic and social life.

Differential Diagnosis: According to the DSM-5 some differential diagnoses include ;

  • Attention-Deficit/Hyperactivity Disorder (ADHD): Based on Eddie’s presentation, ADHD, especially the hyperactive-impulsive subtype, seems most likely. Symptoms such as impulsivity, inattentiveness, restlessness, and social difficulties are typical.
  • Oppositional Defiant Disorder (ODD): Characterized by defiant and hostile behavior towards authority figures. Eddie’s challenges at school could potentially overlap with this, though his impulsivity is more consistent with ADHD.
  • Anxiety Disorders: Sometimes, symptoms like restlessness can be due to anxiety, but Eddie doesn’t exhibit other classic symptoms like excessive worry.
  • Bipolar Disorder: Early onset can have symptoms like reduced need for sleep and hyperactivity, but Eddie doesn’t show mood episodes typical of bipolar.
  • Target Symptoms:
  • Hyperactivity
  • Impulsivity
  • Short attention span
  • Social interaction challenges

Treatment Plan with Rationales

  • Behavioral Therapy: Especially Parent Management Training, to equip parents with behavior management strategies. Rationale: Non-pharmacological interventions form the cornerstone of ADHD treatment, especially in younger children.
  • Stimulant Medications: e.g., Methylphenidate or Amphetamines. Rationale: According to Feldman et al ( 2018 ) these are considered first-line treatments for ADHD, and have proven to reduce core symptoms in many individuals.
  • Educational Interventions: Classroom accommodations or resource room support. Rationale: Tailored support can address Eddie’s unique needs, helping him academically.
  • Social Skills Training: To help Eddie interact positively with peers. Rationale: Social challenges can lead to isolation; this intervention fosters better relationships. Tailor non-pharmacological intervention to the child’s age and needs, and make sure it’s acceptable and feasible for the patient, family, and teachers.(Feldman et al., 2018).

Difference in ADHD Clinical Presentation: Symptoms of ADHD occur in childhood, and most children with ADHD will continue to have symptoms and impairment through adolescence and into adulthood (Wolraich et al., 2019).

  • Children: Symptoms are often more overt, with pronounced hyperactivity, impulsivity, and attentional challenges. Social difficulties and academic disruptions are common (APA,2013).
  • Adults: Hyperactivity may decrease but internal restlessness persists. Challenges shift to time management, organization, self-control, and maintaining relationships or jobs. Adults may have coexisting conditions like depression or anxiety (APA, 2013).

Comparison of ADHD Medications: It’s important to note that all medications and pharmacological interventions come with their own set of advantages and disadvantages. According to Stahl’s Essential Pharmacology (2021), certain ADHD medications have both benefits and drawbacks that should be taken into consideration.

  • Stimulants (e.g., Methylphenidate, Amphetamines):
  • Advantages: First-line treatment, rapid onset of action, high efficacy.
  • Disadvantages: Potential for misuse, side effects like appetite suppression, and sleep disturbances.
  • Norepinephrine Dopamine Reuptake Inhibitors (e.g., Atomoxetine):
  • Advantages: Non-stimulant, no potential for misuse, useful for coexisting anxiety or if stimulants are contraindicated.
  • Disadvantages: Slower onset of action, potential side effects like stomach upset.
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