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Stimulation of the postsynaptic alpha-2A receptors is thought to strengthen working memory, reduce susceptibility to distraction, improve attention regulation, improve behavioral inhibition, and enhance impulse control. Since this class of medications has been used successfully to treat tic disorders including Tourettes, it may the drug of choice for ADHD children who also have a tic disorder.
Patients starting treatment for the first time or switching from another medication: -Initial Dose: 20 mg orally once a day Comments: -IR: The first dose should be given upon awakening; 1 to 2 additional doses should be given at intervals of 4 to 6 hours. -Where possible, drug administration should be interrupted occasionally to determine if continued therapy is required.
[See AAP Treatment Guidelines for further discussion of effectiveness]. It is important to note that all professional guidelines call for medication to be used AFTER behavioral treatment has been tried first and that when medication is used it should be COMBINED with behavioral treatment. According to a study conducted at State University of New York at Buffalo, “combining behavior modification therapy with medication is the most effective way to improve the behavior of many ADHD children. In fact, when the two are combined, the study showed, the amount of medication required to achieve the same results as use of medication alone can be reduced by two-thirds”.
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