Role of executive function in
ADHD.
Swanson JM.
Department of Pediatrics
University of California, Irvine, CA
J Clin Psychiatry. 2003 Dec; 64 Suppl 14: 35-9
Abstract
Attention-deficit/hyperactivity disorder
(ADHD) is a neuropsychiatric disorder characterized by inattention,
hyperactivity, and impulsivity. ADHD is commonly treated with behavioral therapy
and noradrenergic and dopaminergic pharmacotherapy with psychostimulants such as
methylphenidate and dextroamphetamine. Stimulants primarily have dopaminergic
and noradrenergic mechanisms of action, with blockade at the dopamine
transporter reducing reuptake, resulting in an increase in these
neurotransmitters at the synapse. Theoretically, inattention, hyperactivity, and
impulsivity in ADHD may be due to underlying executive functioning, alerting,
and orienting deficits, and the nonstimulant modafinil could be beneficial in
managing symptoms of ADHD by improving these components of attention that
accompany wakefulness. Although modafinil exhibits a small degree of
dopaminergic action by blocking the dopamine transporter, the major effect of
modafinil may be attributable to neuronal activity
in the hypothalamus, particularly pertaining to the recently discovered peptides
hypocretin 1 and 2 (also known as orexin A and B). However, further
placebo-controlled and flexible-dose studies are needed to determine the
efficacy of modafinil in treating the symptoms of ADHD in children and adults.
1. Modafinil for
sustaining the alertness of helicopter pilots
2. Modafinil augmentation
of antidepressant treatment
3. Modafinil the
unique properties of a new stimulant
4. Modafinil children
with attention-deficit/hyperactivity disorder
5. Modafinil dosage
and safety
6. Modafinil successful
treatment of hypersomnia & narcolepsy
7. Modafinil narcolepsy:
symptoms and management
8. Modafinil
amplification of cortical serotonin release
9. Modafinil
treatment of alcoholic organic brain syndrome
10. Modafinil
effect on melatonin, cortisol, and growth hormone
11. Modafinil
in obstructive sleep apnea-hypopnea syndrome
12. Modafinil
vs dextroamphetamine in treatment of adult ADHD
13. Modafinil
efficacy in narcolepsy
14. Modafinil
switching from narcolepsy drugs to modafinil
15. Modafinil
dopaminergic transmission mediates CNS stimulants
