Useful websites for clinicians
Royal College of Psychiatrists
Royal College of Psychiatrists has just launched a detailed online knowledge base containing information on the pharmacological treatment of Attention Deficit Hyperactivity Disorder (ADHD). Areas covered include: Clinical picture, basic science, therapy, resources and self assessment quiz.
There is also a CPD module on Adult ADHD available upon subscription (http://www.psychiatrycpd.co.uk/learningmodules/adultadhd.aspx)
National Institute for Health and Clinical Excellence (www.nice.org.uk)
National Institute for Health and Clinical Excellence Review of technology Appraisal 13- methylphenidate, atomoxetine and dexamphetamine for attention deficit hyperactivity disorder (ADHD) in children and adolescents available via www.nice.org.uk/TA098.
A booklet entitled “Information for children and adolescents with attention deficit hyperactivity disorder, their families and the public” is available from www.nice.org.uk/TA098publicinfo
Scottish Intercollegiate Guidelines Network
Scottish Intercollegiate Guidelines Network, 9 Queen Street, Edinburgh EH2
1JQ,
Tel. 0131-225 7324 Email: d.service@rcpe.ac.uk. (www.sign.ac.uk/guidelines/)
Attention Deficit and Hyperkinetic Disorders in Children and Young People. Sign Publication No.52
This guidance published in Scotland in 2001 covers the management of ADHD in children and young people. The document can be downloaded complete or by individual chapters. There is also a separate section showing an example of a shared care protocol for the management of children and young people with ADHD.
Texas Department of State Health Services
The Children's
Medication Algorithm website (CMAP)
shows treatment algorithms for: Attention-deficit/ Hyperactivity Disorder;
Co-morbid ADHD and MDD; ADHD with tics; ADHD with intermittent explosive disorder
And tactics tables for the use of: Stimulants, tricylic antidepressants, bupropion,
alpha agonists and SSRI's.
The above should be read in conjunction with the published articles:
Pliszka SR, Greenhill LL, Crismon ML et al. (2000a & b).
Royal College of General Practitioners
The RCGP Education Network have a set of training materials for child health promotion and development. These include a teaching session on ADHD which can be accessed at (http://www.rcgp.org.uk/live/default.aspx?page=2597 )
The American Academy of Pediatrics
The AAP has published 2 clinical practice guidelines intended for use by primary
care clinicians working in primary care settings in the USA:
1/ Clinical practice guideline: diagnosis and evaluation of the child with
attention-deficit/hyperactivity disorder (2000)
(http://aappolicy.aappublications.org/cgi/reprint/pediatrics;105/5/1158.pdf)
2/ Clinical practice guideline: treatment of the school-aged child with attention-deficit/hyperactivity
disorder (2001). (http://www.aap.org/policy/s0120.html)
WHO Guide to Mental and Neurological Health in Primary Care
This book includes a chapter on Attention-deficit / hyperactivity disorder which can be down loaded. (http://mentalneurologicalprimarycare.org/content_show.asp?c=16&fid=1169&fc=011005)
San Diego ADHD
This site provides information handouts for clinicians to share with parents on common topics related to children with ADHD. Some handouts are available in Spanish.
BMJ learning
Via http://www.bmjlearning.com
Offers online CPD modules for clinicians. Under the General Practitioner
section is a module entitled Attention Deficit Hyperactivity Disorder:
Diagnosis and treatment
Archives of Disease in Childhood
Useful information for clinicians on assessment and treatment of ADHD (including titration procedures when starting a variety of medications) is contained in a paper entitled An auditable protocol for treating attention deficit/hyperactivity disorder. P. Hill and E.Taylor (2001). Archives of Disease in Childhood, 84, 404-409. This paper is available in full text form on line via http://adc.bmjjournals.com/ .This web address takes you to the home page. Enter Hill in the author box and ADHD in the keywords box and this will lead you to the article which can be downloaded in pdf format.
Multi-modal management approaches to ADHD- Useful web based information for clinicians to download for parents/carers
- (http://www.sandiegoadhd.org/Families/index.htm)
- (http://www.youngminds.org.uk/adhd/YoungMinds_adhd_leaflet.pdf)
- (http://rcpsych.ac.uk/info/mhgu/newmhgu5.htm)
- (http://www.mentalhealth.org.uk/html/content/all_about_adhd.pdf)
- (http://www.mentalhealth.org.uk/page.cfm?pagecode=PBBFAD)
- (http://www.chadd.org)
- (http://apps.cignabehavioral.com/web/basicsite/consumer/
educationAndResourceCenter/adhd.jsp) - (http://www.austinchildguidance.org ) click on parents, then click on articles
- (http://www.dshs.state.tx.us/) By entering 'ADHD' into the search box at the top of the home page, this will lead the viewer to a number of information sheets on aspects related to ADHD which can be printed out.
Useful web based sources of information on pharmacological treatment of children with ADHD
- Royal College of Psychiatrists ( http://www.rcpsych.ac.uk/traindev/cpd/adhd/therapy.htm) The Royal College of Psychiatrists has just launched a detailed online knowledge base containing information on the pharmacological treatment of Attention Deficit Hyperactivity Disorder (ADHD). The Therapy section contains information on pharmacological treatments (graded), available guidelines, algorithms and protocols, and drug therapy with methylphenidate.
- Attention Deficit and Hyperkinetic Disorders in Children and Young People. Sign Publication No.52 ( http://www.sign.ac.uk/guidelines/fulltext/52/index.html)
- The Children's Medication Algorithm website (CMAP) has tactics tables for the use of: stimulants, tricylic antidepressants, bupropion, alpha agonists and SSRI's. ( http://www.dshs.state.tx.us/mhprograms/adhdpage.shtm)
- Clinical Evidence. This is a BMJ publication. In the child health section is a section on ADHD (Ramchandani et al, 2002). Treatments for ADHD including methylphenidate, dexamphetamine, clonidine, psychological and behavioural treatments are evaluated and categorized according to the evidence on their benefits and harms. The information can be accessed via http://www.clinicalevidence.com/ceweb/conditions/chd/0312/0312.jsp.
- National Institute for Clinical Excellence (www.nice.org.uk) By entering ADHD into the search facility on the home page the viewer can access information relating to National Institute of Clinical Excellence "Guidance on the use of Methylphenidate (Ritalin, Equasym) for Attention Deficit/Hyperactivity Disorder (ADHD) in Children (October 2000).
Further up to date information about stimulant medications and other pharmacological treatments for ADHD can be found in the British National Formulary which is updated every 6 months. Clinicians can register to access the contents of the current BNF on line (www.BNF.org).
Psychostimulant side effects and suggested management options
(taken from SIGN guidelines (2001) - Section 5 pharmacological therapy (http://www.sign.ac.uk/guidelines/fulltext/52/index.html)
Further up to date information about stimulant medications and other pharmacological treatments for ADHD can be found in the British National Formulary which is updated every 6 months. Clinicians can register to access the contents of the current BNF on line (www.BNF.org).
First line pharmacological options in the treatment of ADHD
(http://www.clinicalevidence.com/ceweb/conditions/chd/0312/0312.jsp). (Ramchandani et al, 2002).
Useful web based sources of information on starting medications for children with ADHD
- The Texas Children's Medication Algorithm Project is useful alternative source of information relating to the use of stimulants for ADHD (http://www.dshs.state.tx.us/mhprograms/stimtbl.pdf). This site also contains information relating to the use of TCA's for ADHD (http://www.dshs.state.tx.us/mhprograms/tritbl.pdf) as well as treatment algorithms for: Attention-deficit/ Hyperactivity Disorder; Co-morbid ADHD and MDD; ADHD with tics; ADHD with intermittent explosive disorder (http://www.dshs.state.tx.us/mhprograms/adhdpage.shtm)
- The Medicines and Healthcare products Regulatory Agency has two printable information sheets: one for clinicians and one for parents and patients on the risk of hepatic disorders with Stattera (Atomoxetine) (http://www.mhra.gov.uk/)
Useful web-based sources of information on pharmacological treatment of ADHD and co-morbid disorders
- The Children's Medication Algorithm website (CMAP) (http://www.dshs.state.tx.us/mhprograms/adhdpage.shtm) shows treatment algorithms for: Attention-deficit/ Hyperactivity Disorder; Co-morbid ADHD and Major Depressive Disorder (MDD); ADHD with tics; ADHD with intermittent explosive disorder
