Many parents have long sought to find a treatment for ADHD that is not a stimulant. In the past, there were not many alternative treatments for ADD. There has been considerable controversy over the years over the use of stimulant therapy for ADHD. Parents have had concerns regarding putting their children on amphetamine like drugs and many physicians do not feel comfortable prescribing stimulants to children. Recently two medicine for ADD that are not stimulants have been become available.
In the Unites States, stimulants have the additional disadvantage of being controlled substances which cannot be phoned into pharmacies. Physicians must physically write prescriptions for stimulant therapy and patients must physically travel to their physician's office to pick up these prescriptions. AN ADD medication which was not a stimulant would not require these inconveniences
In November of 2009, the pharmaceutical company, Shire, released the first long acting alpha2 receptor specifically marketed to treat ADHD. The name they gave this medicine is Intuniv (Guanfacine, long acting).
Intuniv is an ADHD drug that is not a stimulant.
Alpha2 receptor medications have been used in addition to the stimulants for a while. Tenex is the medicine most commonly used. Tenex (Guanfacine) is a blood pressure medicine that was coincidentally found to help patients with ADHD. Tenex can be sedating and doctors have used it to help with the 'crash' experienced by some patients when stimulant medicines wear off.
The science of these ADHD medications is relatively new but some researchers believe that it is the alpha2 receptor drugs, and not the stimulants, that better target the symptoms of inattention, impulsivity, and working memory deficits. They believe that while the stimulants work they do not address the underlying problem at the Prefrontal Cortex.
The medicines act on the Prefrontal Cortex (PFC), the area of the brain that controls attention, impulsivity, hyperactivity, and working memory. Studies done on Monkeys showed that blockage of the alpha2 receptors in the monkey's PFC recreated the symptoms of ADHD, resulting in impaired working memory, increased impulsivity, and locomotor hyperactivity.
Alpha-2A adrenergic receptors also improve brain communication. These receptors are stimulated by guanfacine which strengthens the connectivity of PFC networks and improves working memory and reduces distractibility.
Unlike the stimulants, Guanfacine provides these benefits to the PFC even in the event of stress. Stress has been shown to temporarily disconnect networks which can make the symptoms of ADHD much worse. Perhaps the most exiting findings with regards to this class of medicine are the fact that it also helped patients who were primarily inattentive.
Statterra, the other medicine for ADHD that is not a stimulant works on the norepinephrine neurotransmitter pathways and work very well in some individuals with ADHD. These two medicine have finally provided an alternative treatment for Add and ADHD that is not a stimulant. Who knows?? Guanfacine may turn out to be the future 'gold standard' of treatment for the symptoms of ADHD. Time will tell...
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