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Although the mechanism of action is not known, guanfacine, the active ingredient in INTUNIV, is thought to selectively stimulate alpha-2A adrenoreceptors in the prefrontal cortex.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.

Most authorities believe that stimulants are both over and under prescribed based diagnostic and patient compliance issues so that some children are receiving medication they do not need while others are not receiving this necessary treatment for their condition.

Medications that treat ADHD are not tranquilizers or sedatives. They actually improve functioning in various areas of the brain involved with attention, concentration and self-control.

Attention Deficit Hyperactivity Disorder Medication Prescribing Practice Unlike most other medications, stimulant dosages usually are not weight dependent.

Clinicians should begin with a low dose of medication and titrate upward because of the marked individual variability in the dose-response relationship.

Recent research shows that the number of prescriptions rose by 30% from 1991 to 1995 with 0.3% and 0.9% of the child population receiving prescriptions in the respective years.

However, with the prevalence of the disorder estimated to be at 5.0%, one could make a case for under prescribing.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”.The first dose that a child’s symptoms respond to may not be the best dose to improve function.Clinicians should continue to use higher doses to achieve better responses.When this happens, the function regulated by that circuit may not work as well as it should.

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