Attention Deficit Disorder (ADD)

Attention Deficit Disorder, also referred to as Attention Deficit Hyperactivity Disorder, or Hyperkinetic Disorder, has been the subject of controversial discussion for many years. In general, it refers to what is described as a neurological, developmental disorder that affects roughly 5% of the world’s population.

ADD is most commonly diagnosed in children and is characterized by a number of behaviors including, inattention, hyperactivity, impulsiveness, forgetfulness, and being easily distracted. Critics question both the means of diagnosing ADD and its treatment, but while symptoms are in no way comparable to those of chronic mental disorders, ADD does appear to impair mental and behavioral functioning. It is now described as a persistent and chronic condition for which no medical cure has yet been effected.

What causes ADD?

Roughly 60% of children who have been diagnosed with ADD, continue suffering with the condition as adults. In fact, some studies indicate that there is a genetic predisposition to having ADD, which is not evident in adopted children. Studies of twins show that ADD is inherited and that genetics accounts for roughly 75% of the total number of people affected by it. However, it is also thought that 20% of ADD cases are precipitated by some form of minor brain injury caused by toxins, or some kind of pre or post natal, physical trauma.

Some studies have found an association between ADD and smoking during pregnancy, therefore, avoidance of smoking may help prevent the risk of developing it. Other research studies suggest that ADD is caused by a combination of genes that affect dopamine transporters. A study involving the Mount Sinai School of Medicine in New York proposed that ADD is affected by the brain’s ability to produce dopamine itself. The study involved injecting 20 individuals with ADD and 25 control subjects with a radiotracer that attaches itself to dopamine transporters. The study concluded that the transporter levels did not point to ADHD, in fact, ADD participants showed lower levels of dopamine across the board.

Stress has also been touted as a trigger for developing ADD. This is especially noticeable in cases where family relationships are unhappy, which may cause children to be disruptive. Children diagnosed with ADD often display signs of being under stress.

Lastly, the premise that certain foods and food additives may have an impact on a child’s behavior is gaining more credence. It is believed that artificial colors and flavors present in many processed foods can make a child bad-tempered and uncontrollable. It is best to cut out, or at the very least, cut down on foods with little or no nutritional value, including sugary snacks and anything with caffeine.

Despite there being no cure as such, there are a number of effective treatments for ADD. It is treated most effectively with medication, although psychotherapy, dietary management, herbal treatments, meditation, and supplementation with Omega 3 fatty acids, zinc and magnesium are also considered beneficial in terms of managing symptoms. To date, over 200 controlled studies have demonstrated the positive effects of stimulant medication. Treatment usually involves a combination of medications, behavioral and lifestyle modifications, and counseling.

One of the most common stimulant drugs used to treat ADD is Ritalin. It acts on the central nervous system, and is thought to “top up” the particular brain chemicals that aid communication between cells. Side effects can occur, especially at the beginning of treatment and may manifest themselves as weight loss, insomnia and loss of appetite. A very recent study conducted in the US has cited evidence that drugs such as Ritalin have a limited use as they do not appear to work better than therapy after three years of treatment. Findings also suggested that long term use of these types of drugs may impair children’s growth. These results appear to contradict those of the 1999 American study that claimed that 12 months of medication worked better than behavioral therapy for ADD patients.

A British program on ADD featured a 14 year old who had been taking ADD medication for 10 years. A video diary of his explosive and aggressive behavior (including self harm, assault and night terrors) may also be seen as evidence of the inefficiency of these medications after a certain period of time.

Nootropic drugs, also referred to as “smart drugs”, are considered anti-aging brain drugs, and also useful in managing ADD. These drugs enhance memory, recall, alertness and attention.

Vinpocetine is an alkaloid of the Periwinkle plant, vinca minor. It has been in use for nearly 30 years and is shown to have few, if any, side effects. It works to enhance the cerebral metabolic rate, as well as being a selective cerebral vasodilator (increasing blood flow to areas of the brain that need it). Vinpocetine enhances oxygen and glucose uptake by brain neurons, and increases cerebral, energy production, even under hypoxic (low oxygen) conditions.

Piracetam is another, nontoxic nootropic drug that can be used to treat ADD as it has been found to improve memory, alertness and intellectual performance in a number of human research studies. Similarly, Deprenyl, also called selegiline, has many positive effects. It is a potent neuro-protector and inhibits MAO-B, a neuro-enzyme that breaks down the neurotransmitter dopamine.

As this article suggests, there are a number of alternatives other than Ritalin worth considering, if you or your child have been diagnosed with ADD. Although it can be extremely difficult to manage the condition, particularly in large, busy families, evidence indicates that lifestyle and dietary changes may help to reduce its effects. Equally, the nootropic drugs may be of benefit by improving the ability of the child or adult to focus, and stay alert and attentive.

28/11/07 GI