Posts in category ADD & ADHD

The Same Medications for Different Psychiatric Disorders. Why?

How Do Drugs From 1 Psychiatric Disorder Treat Symptoms of Another

How is it that Lamotrigine, an antiepileptic, can help depression, a seemingly different disorder altogether? And why can Prozac, an antidepressant, help reduce anxiety? Or an antipsychotic for schizophrenia help depression? In other words, how is it that drugs for one type of major psychiatric disorder treat the symptoms of another type?

The root causes of psychiatric illnesses such as bipolar disorder, major depression, schizophrenia, autism and ADHD are far from understood. Even so for more than 125 years, clinicians have based diagnosis on groups of symptoms observed in patients. Many psychiatrists have thought for a long time now that the current categories don’t really make sense, and that new categories should be based not on symptoms but on the underlying biology.

Moving in that direction more than 300 scientists at 80 research centers in 20 countries scientists have now found that the five psychiatric disorders mentioned above share a common genetic basis. The overlap of these disorders was highest between schizophrenia and bipolar; moderate for bipolar and depression and for ADHD and depression; and low between schizophrenia and autism.

These findings still leave much of the inherited genetic contribution to the disorders unexplained. And none of this accounts for the non-inherited genetic factors that go into determining what a person is like. However, they demonstrate  that science is now moving toward understanding the molecular basis of psychiatric illness, which could provide insight into the biological pathways that may predispose someone to health or disease. All this could ultimately lead to new treatments.

Genetic inheritance does not mean our fate is carved in stone, i.e. that because we are wired in a particular way genetically our fate is sealed. This is because it has become increasingly clear over the last 10 years or so that environmental factors determine which of our genes are “turned on” and which are “turned off”. In the scientific literature this is often spoken of as which genes are “expressed” and which are not. Whether your genes are turned on or turned off matters just as much as much as which genes you have.

Childhood ADHD or Just Lack of Sleep?

ADHD and Sleep Deprivation Treatment Los Angeles CAPotential Misdiagnosis of ADHD

The symptoms of sleep deprivation in children resemble those of Attention Deficit Hyperactivity Disorder (ADHD). These include being wired, moody and uncooperative, unable to pay attention or sit still, and to have poor social skills.

The truth is that many children are given a diagnosis of ADHD when in fact the real problem may lie in a sleep disorder such as sleep apnea. This misdiagnosis may account for a significant 22% increase from 2003-2007 in the number of children adjudged to have ADHD.

The latest study to propose a link between inadequate sleep and ADHD symptoms appeared last month in the journal Pediatrics.  Researchers followed 11,000 British children for six years, starting when they were 6 months old.  The findings were eye-opening: children whose sleep was affected by breathing problems were 40 percent to 100 percent more likely to develop behavioral problems resembling A.D.H.D. than normal breathers.

Karen Bonuck, the study’s lead author and a professor of family and social medicine at Albert Einstein College of Medicine in New York says, “Lack of sleep is an insult to a child’s developing body and mind that can have a huge impact.”

Other studies now under way indicate that removal of a child’s adenoids (tonsils) improves behavioral issues and resulted in less likelihood of an ADHD diagnosis.  But perhaps most significant is the finding that most children already found to have ADHD before tonsillectomy surgery subsequently behaved so much better that they no longer fit the ADHD profile.

Dr. Ronald Chervin, a neurologist and director of University of Michigan Sleep Disorders Center in Ann Arbor feels that behavioral problems linked to nighttime breathing difficulties are more attributable to  inadequate sleep than oxygen deprivation.  Other sleep experts point out that children who lose as little as half an hour of needed sleep per night can exhibit behaviors typical of ADHD.  To compound this misdiagnosis, drugs like Ritalin prescribed to treat ADHD in children may only exacerbate the problem because they can cause insomnia.

Sleep deprivation is difficult to spot in children.  Of the 10,000 members of the American Academy of Sleep Medicine, only 500 have specialty training in pediatric sleep issues.  Professor Bonuck says, “It’s incredible that we don’t screen for sleep problems the way we screen for vision and hearing problems.”