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Overview of treatments for ADHD: pharmacological, complementary and alternative medicine and the associated safety problems
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Resumo(s)
O ponto-chave desta tese é explicar em que consiste esta Perturbação de Hiperatividade e Défice de Atenção (PHDA), a população mais afetada por ela, como pode ser diagnosticada e tratada, explicando a farmacodinâmica das terapias convencionais no cérebro das pessoas com PHDA e os problemas de saúde associados a estas terapias.
A PHDA é uma perturbação neurológica que afeta vários aspetos da vida de uma pessoa. Caracteriza-se por desatenção, hiperatividade e impulsividade. Pensa-se que a PHDA é causada por fatores genéticos, ambientais e neurobiológicos.
Observou-se que o número de receptores dopaminérgicos está envolvido no desenvolvimento da perturbação e que estes estão reduzidos no córtex frontal das pessoas com PHDA. Outros receptores que também parecem estar envolvidos são os receptores noradrenérgicos, uma vez que os efeitos favoráveis dos medicamentos utilizados para tratar a PHDA estão também relacionados com a atividade do recetor alfa-1 adrenérgico.
O diagnóstico é efectuado clinicamente com base em questionários, entrevistas clínicas e, por vezes, testes neuropsiquiátricos. As entrevistas e os questionários são efetuados com o doente, mas também com pessoas que estão presentes na vida do doente, como professores, pais, irmãos.
Um diagnóstico correto do doente e uma avaliação criteriosa são fundamentais para poder delinear um plano de tratamento correto. Antes de decidir sobre o tratamento, é necessário efetuar uma avaliação geral do estado de saúde do paciente.
Existem diferentes métodos para tratar esta doença, consoante as necessidades e os sintomas da pessoa. As abordagens de tratamento incluem a intervenção farmacológica, combinada, ou não, com a intervenção não farmacológica ou apenas não farmacológica. Os tratamentos farmacológicos podem incluir quatro grupos de fármacos: os fármacos estimulantes, este grupo é o que tem mais efeitos adversos; os fármacos não estimulantes; os antipsicóticos e os antidepressivos.
Os tratamentos não farmacológicos podem ser divididos em dois grupos: as terapias psicológicas e as terapias complementares e alternativas.
É importante conhecer os diferentes tipos de PHDA e os diferentes tipos de tratamento que existem, a fim de proporcionar o tratamento mais adequado a cada doente e dar-lhes os melhores resultados possíveis e menos efeitos adversos associados à medicação.
The key point of this thesis is to explain what this Attention Deficit Hyperactivity Disorder (ADHD) consists of, the population most affected by it, how it can be diagnosed and treated, explaining the pharmacodynamics of conventional therapies in the brains of people with ADHD and the health problems associated with these therapies. ADHD, is a neurological disorder, which affects several aspects of a person's life. It is characterized by inattention, hyperactivity, and impulsivity. ADHD is thought to be caused by genetic, environmental and neurobiological factors. It was observed that the number of dopaminergic receptors is involved in the development of the disorder, and they are reduced in the frontal cortex of people with ADHD. Other receptors that also appear to be involved are the noradrenergic receptors, since . The diagnosis is made clinically based on questionnaires, clinical interviews and sometimes neuropsychiatric tests. Interviews and questionnaires are carried out with the patient, but also with people who are present in the patient's life, such as teachers, parents, siblings. A correct diagnosis of the patient and a thorough assessment is crucial to being able to outline a correct treatment plan. Before deciding on treatment, it's necessary to carry out a general assessment of the patient's health. There are different methods to treat this disorder, depending on the needs and symptoms of the person. The treatments approaches include pharmacological intervention, combined, or not, to non-pharmacological or just non-pharmacological intervention. The pharmacological treatments can include four groups of drugs: stimulant drugs, this group has the most adverse effects; the non-stimulant drugs; the antipsychotics and the antidepressants. The non-pharmacological treatments can be divided into two groups: psychological therapies and complementary and alternative therapies. It's important to know the different types of ADHD and the different types of treatment that exist in order to provide the most appropriate treatment for each patient and give them the best possible results and fewer adverse effects associated with medication.
The key point of this thesis is to explain what this Attention Deficit Hyperactivity Disorder (ADHD) consists of, the population most affected by it, how it can be diagnosed and treated, explaining the pharmacodynamics of conventional therapies in the brains of people with ADHD and the health problems associated with these therapies. ADHD, is a neurological disorder, which affects several aspects of a person's life. It is characterized by inattention, hyperactivity, and impulsivity. ADHD is thought to be caused by genetic, environmental and neurobiological factors. It was observed that the number of dopaminergic receptors is involved in the development of the disorder, and they are reduced in the frontal cortex of people with ADHD. Other receptors that also appear to be involved are the noradrenergic receptors, since . The diagnosis is made clinically based on questionnaires, clinical interviews and sometimes neuropsychiatric tests. Interviews and questionnaires are carried out with the patient, but also with people who are present in the patient's life, such as teachers, parents, siblings. A correct diagnosis of the patient and a thorough assessment is crucial to being able to outline a correct treatment plan. Before deciding on treatment, it's necessary to carry out a general assessment of the patient's health. There are different methods to treat this disorder, depending on the needs and symptoms of the person. The treatments approaches include pharmacological intervention, combined, or not, to non-pharmacological or just non-pharmacological intervention. The pharmacological treatments can include four groups of drugs: stimulant drugs, this group has the most adverse effects; the non-stimulant drugs; the antipsychotics and the antidepressants. The non-pharmacological treatments can be divided into two groups: psychological therapies and complementary and alternative therapies. It's important to know the different types of ADHD and the different types of treatment that exist in order to provide the most appropriate treatment for each patient and give them the best possible results and fewer adverse effects associated with medication.
Descrição
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, 2024, Universidade de Lisboa, Faculdade de Farmácia
Palavras-chave
ADHD Symptoms Epidemiology Pharmacological intervention Side effects Mestrado Integrado - 2024