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Old 03-08-2012, 02:30 PM   #1
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Huge improvement in how to titrate ADHD meds

Another big, real big improvement in the New ADHD Guidelines.

Recommendation: Primary care clinicians should titrate doses of medication for ADHD to achieve maximum benefit with minimum adverse effects.

Benefits: The optimal dose of medication is required to reduce core symptoms to or as close to the levels of children without ADHD.

Harms/risks/costs: Higher levels of medication increase the chances of adverse effects.

Benefits-harms assessment: The importance of adequately treating ADHD outweighs the risk of adverse effects.

They rated this recommendation "Strong"

The next is so wonderful. Past failure to recognize the problems caused by the suboptimal effects from a low dose has caused many of us a lot of needless grief.

Because stimulants might produce positive but suboptimal effects at a low dose in some children and youth, titration to maximum doses that control symptoms without adverse effects is recommended instead of titration strictly on a milligram-per-kilogram basis.

The next is more wonderful.

Because stimulant medication effects are seen immediately, trials of different doses of stimulants can be accomplished in a relatively short time period. Stimulant medications can be effectively titrated on a 3- to 7-day basis.

For good reason, doctors must monitor both ends. The higher the dose the more likely the adverse side effects. If insomnia results at a higher dose, the efficacy of that dose drops like a lead balloon from beneficial to detrimental.

I got one more big one coming in my next post. I tell you, these guys are getting so smart I'm just may award them an increase in competency rating from bozo to MD? Maybe. I'll be son-a-gun. I never thought I see this day.

So cool.

So good for us.

Bob

 
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