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Low dopamine function in attention deficit/hyperactivity disorder: should genotyping signify early diagnosis in children? - PubMed

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Low dopamine function in attention deficit/hyperactivity disorder: should genotyping signify early diagnosis in children?

Mark S Gold et al. Postgrad Med. 2014 Jan.

Abstract

Attention deficit/hyperactivity disorder (ADHD) is present in 8% to 12% of children, and 4% of adults worldwide. Children with ADHD can have learning impairments, poor selfesteem, social dysfunction, and an increased risk of substance abuse, including cigarette smoking. Overall, the rate of treatment with medication for patients with ADHD has been increasing since 2008, with ≥ 2 million children now being treated with stimulants. The rise of adolescent prescription ADHD medication abuse has occurred along with a concomitant increase of stimulant medication availability. Of adults presenting with a substance use disorder (SUD), 20% to 30% have concurrent ADHD, and 20% to 40% of adults with ADHD have a history of SUD. Following a brief review of the etiology of ADHD, its diagnosis and treatment, we focus on the benefits of early and appropriate testing for a predisposition to ADHD. We suggest that by genotyping patients for a number of known, associated dopaminergic polymorphisms, especially at an early age, misdiagnoses and/or over-diagnosis can be reduced. Ethical and legal issues of early genotyping are considered. As many as 30% of individuals with ADHD are estimated to either have secondary side-effects or are not responsive to stimulant medication. We also consider the benefits of non-stimulant medication and alternative treatment modalities, which include diet, herbal medications, iron supplementation, and neurofeedback. With the goals of improving treatment of patients with ADHD and SUD prevention, we encourage further work in both genetic diagnosis and novel treatment approaches.

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Conflict of interest statement

Conflict of Interest Statement

Mark S. Gold, MD, discloses no conflicts of interest. Kenneth Blum, PhD, discloses that he is the owner of and employed by Synaptamine Inc; and owns 100% of stock and all patents issued and pending. He also owns 80% of the stock for Igene LLC; 50% of Impact Genomics, LLC; 10% of Victory Nutrition, LLC; and 25% of Kenber LLC. Marlene Oscar-Berman, PhD, discloses no conflicts of interest. Eric R. Braverman, MD, is the owner of Total Health Nutrients, Inc.

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References

    1. Greenhill LL, Posner K, Vaughan BS, Kratochvil CJ. Attention deficit hyperactivity disorder in preschool children. Child Adolesc Psychiatr Clin N Am. 2008;17(2):347–366. ix. - PubMed
    1. Setlik J, Bond GR, Ho M. Adolescent prescription ADHD medication abuse is rising along with prescriptions for these medications. Pediatrics. 2009;124(3):875–880. - PubMed
    1. Archer T, Oscar-Berman M, Blum K. Epigenetics in Developmental Disorder: ADHD and Endophenotypes. J Genet Syndr Gene Ther. 2011;2(104):ii. - PMC - PubMed
    1. Goldman LS, Genel M, Bezman RJ, Slanetz PJ. Diagnosis and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Council on Scientific Affairs, American Medical Association. JAMA. 1998;279(14):1100–1107. - PubMed
    1. Huang YS, Tsai MH, Guilleminault C. Pharmacological treatment of ADHD and the short and long term effects on sleep. Curr Pharm Des. 2011;17:1450–1458. - PubMed

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