ADHD – DIAGNOSTIC AND FDA ISSUES Stephen M. Soltys, MD Professor of Psychiatry Southern Illinois University

PRINCIPALS OF TREATMENT Core symptoms of ADHD are distractability, hyperactivity and impulsivity These are the only symptoms that respond to ADHD meds Treatment failure can result from diagnosing ADHD when it is not there or not recognizing other disorders along with ADHD

DIFFERENTIAL DIAGNOSIS DEPRESSION CONDUCT DISORDER OPPOISIOTNAL- DEFIANT DISORDER LEARNING DISABILITIES BIPOLAR DISORDER (OVER DIAGNOSED) ANXIETY DISORDER TOURETTE’S

INFORMATION Patient interview Parent information School or daycare Past tesing Standardized scales (CBCL, Conners, Vanderbilt)

TESTING In the absence of clear indications of medical, neurological or environmental issues in the history, tests such as MRI, CAT Scan, EEG, thyroid levels, lead levels are not indicated APA cites lack of validity of tests involving radioactive nucleotides in the diagnosis and treatment of ADHD and thus significant safety issues with radiation exposure Psychological testing not indicated in absence of low IQ or learning disabilities

FDA APPROVAL FDA approval is focused on regulating the indications for which a company can market its drug Is not based on a constant monitoring of scientific literature Companies will only go for FDA approval if they feel the financial return will be significant

FDA APPROVAL As a result the scientific literature may have numerous citations about how a drug may be safely used yet not have FDA approval for advertizing The FDA does not intend “approval” to mean that medications cannot be used for other indications supported by the medical science literature, only that companies cannot advertize for these uses