Dr. Steven Scholzmann summarize the balancing act as follows:

"We can't dismiss the dangers of these drugs—but we must also respect the dangers of the illnesses themselves. Kids with untreated ADHD lag behind kids on medication—both at school and in their emotional and physical development. They also have high rates of substance abuse. And untreated mood and anxiety disorders are major risk factors for suicide, the third leading cause of death in young people."

Newsweek article: Psychiatric Drugs: The New Pharmacopoeia

The Orlando Sentinal has a good report on the state of brain imaging for ADHD today.

The paper notes that "imaging technology has allowed scientists to see that brain structure and brain activity in children with attention deficit/hyperactivity disorder are markedly different than in nonafflicted children."

(Photo above - normal brain on left, ADHD brain on right) These images created by scanning the brains of ADHD-positive children support theories that the ADHD has a physiological basis in the brain -- "which contradicts skeptics who view the disorder as nothing more than initials that stand for an unruly, undisciplined brat."

"People don't believe in things until they see a picture," says Michael Stevens, researcher at the Olin Neuropsychiatry Research Center at Hartford Hospital's Institute of Living.

One NIMH imaging study found that children with ADHD have 3 percent to 4 percent smaller in several brain areas.

Another study found a significantly lower amount of white matter -- the cells that form the connections between neurons -- in the brains of ADHD patients who never had been medicated.

Children with ADHD who had received stimulants had volumes of white matter similar to that of healthy kids.

The major differences in brain structure found thus far have been in areas that govern behaviors affected by ADHD, such as movement, impulse control and planning.

See full story: Scientists focus on image of ADHD

Shire Pharmaceuticals Group plc (LSE: SHP, NASDAQ: SHPGY, TSX: SHQ) today announced positive preliminary results from clinical trials of its methylphenidate transdermal system* (MTS) which is being developed in conjunction with Noven Pharmaceuticals Inc. for children with attention deficit and hyperactivity disorder (ADHD).

These trial results will be included as part of an amendment to the New Drug Application for the product currently pending at the FDA. Both Shire and Noven believe that the studies will address the issues raised by the FDA's review in April 2003. The FDA has previously confirmed that the amendment will be reviewed within six months after submission.

The two studies, a phase 2 study involving 79 patients over a seven week period and a phase 3 study involving 268 patients over a seven week period, examined MTS in children between the ages of 6 and 12 previously diagnosed with ADHD. In these studies, use of MTS was well tolerated and the objectives of both studies were achieved.

Attention Deficit Hyperactivity Disorder (ADHD) is not just a condition of childhood but can continue into adult life, causing people real problems in their everyday lives.

Dr Bramham assessed 218 adults, aged between 16 and 50 years, who had been diagnosed with ADHD. She tested their ability to focus attention and to concentrate, as well as their ability to control impulsive responses. She also asked them to complete questionnaires about symptoms of anxiety and depression.

The tests revealed no differences between age groups with regard to attention abilities, but there was an improvement in response inhibition with age. The questionnaires showed that older ADHD individuals reported higher levels of both anxiety and depression, suggesting that the longer a person has experienced the disorder, the more distress it can cause.

Dr Bramham says: "These findings confirm that ADHD does not necessarily disappear by the time a child reaches their 18th birthday. Some adults can continue to experience significant cognitive and emotional problems associated with the disorder. Treatment can substantially improve their functioning but still many services do not recognise that ADHD may persist beyond childhood."

Roughly two-thirds of these parents (66%) and teenagers (61%) report their teen/they currently receive treatment for ADHD. Both groups credit their treatment -- in the form of medication, counseling and/or behavior therapy, and school services -- with contributing to better grades in school, higher self-esteem, improved social relationships and enhanced participation in extracurricular activities.

"ADHD amplifies the issues that all teens grapple with, such as heavy
demands at school, more complicated social situations, and a growing desire for independence," said Michael Faenza, MSSW, President and CEO, National Mental Health Association (NMHA), the country's oldest and largest nonprofit organization addressing all aspects of mental health and illness. "Therefore,it is critical that they receive the support and treatment needed to succeed during these critical years."

"Research shows that as many as 80 percent of children with ADHD exhibit persistent symptoms during adolescence, and 60 percent go on to display symptoms during adulthood," said David Goodman, M.D., Assistant Professor of Psychiatry and Behavioral Sciences, Johns Hopkins University. "Left untreated, many teenagers with ADHD experience academic impairment, driving- related incidents, and are at higher risk of substance abuse, encounters with law-enforcement, and consequent negative impact within the family."

After receiving help, parents and teens experienced tremendous progress in their lives. Nearly six in ten (56%) teens saw their grades get better. A majority of both groups (81% parents, 73% teenagers) reported some to a great deal of improvement in their ability to feel good/feel happy. In addition, the ability to make and keep friendships dramatically improved; most parents and teens reported some to a great deal of improvement in making new friends
(70% parents, 61% teenagers) and getting along with friends (77% parents, 67% teenagers).
Additional survey findings include:

* Teens with ADHD and parents share similar views about the disorder. Both groups view it as a medical condition and behavioral problem (59% parents, 43% teenagers) and do not attribute ADHD to poor parenting or a lack of discipline.

* More than one in three teens (37%) are embarrassed about having ADHD. Teens who are embarrassed are more likely to report being teased (68%) or treated differently by others (76%) than teens with ADHD who are not embarrassed by their diagnosis.

* Among teenagers receiving treatment, therapy with prescription
medications is nearly universal (97% parents, 95% teenagers). Nearly
nine in 10 parents with a teen receiving treatment believe that
prescription medication is the most effective treatment for ADHD.

For additional survey findings and more information about ADHD, visit
http://www.NMHA.org.

ABOUT ADHD
Attention Deficit Hyperactivity Disorder is a real, common and treatable medical condition characterized by a variable attention span and/or hyperactivity-impulsivity. According to a report by the Centers for Disease Control and Prevention, approximately 7.5% of school-age children in the U.S. have ADHD.

ABOUT THE SURVEY
The survey was conducted online within the United States by Harris
Interactive from July - August 2004, for the NMHA through a grant from McNeil Consumer & Specialty Pharmaceuticals. The survey evaluated the responses of a nationwide sample of 268 parents of teenagers, ages 14 to 18, who have been diagnosed with ADHD and 265 teenagers, ages 14 to 18, who have been diagnosed with ADHD. Parents and teenagers were recruited independently and were not matched pairs (i.e., parents and teenagers from the same family).

ADHD Teen & Parent Findings

Families with teenagers diagnosed with Attention Deficit Hyperactivity
Disorder (ADHD) strongly believe that treatment of the condition can lead to marked improvements in school and at home, according to a new nationwide survey. Researchers interviewed 265 teenagers and 268 parents of teenagers (ages 14 to 18) diagnosed with ADHD about their attitudes, beliefs and experiences with the disorder. Following are some of the key findings from the survey.

Impact on Academic Success
* Parents (86%) and teenagers (77%) agree that it is much or somewhat
more difficult for teens with ADHD to do their best in school compared
to other teens without ADHD.

* About half (52%) of parents surveyed believe that their ADHD teenager will attend college, while 61% of teens report that they plan to attend college.

* Teenagers with ADHD are three times more likely than parents to report that ADHD affects them only at school and not at other times.

Effect on Relationships & Social Issues

* More than one in three teenagers (37%) are embarrassed about having the disorder. Teens who are embarrassed about having the disorder are more likely to report being teased (68%) or treated differently by others (76%) than teens with ADHD who are not embarrassed by their diagnosis.

* Parents are more likely than teenagers to say that the condition
affects teen's relationships with siblings, teachers, and friends "a
great deal."

Types of Treatment
* Approximately two-thirds of parents and teenagers report their
teenager/they currently receive treatment for ADHD, including
medication, counseling and behavioral therapy (66% and 61%,
respectively).
* Nearly nine in 10 parents with a teen receiving treatment (88%) believe
that prescription medication is the most effective treatment for ADHD.

Impact of Treatment

* Prior to receiving treatment for ADHD, parents and teens report that it was very difficult to stay focused on activities, make new friends, get along with friends, and participate in school activities. After starting treatment, both groups report "some" to "a great deal" of improvement in these areas.

* Nearly three in four parents and teenagers say that before beginning treatment, it was somewhat to very difficult for teenagers to feel happy/feel good about himself/herself. After beginning treatment, the majority of parents and teens report some to a great deal of improvement in their ability to feel good/feel happy (81% parents, 73% teenagers).

* Nearly six in ten (56%) teens note that their grades have improved since beginning treatment.

The ADHD Teen & Parent survey was conducted for the National Mental Health Association (NMHA) by Harris Interactive and supported through a grant from McNeil Consumer & Specialty Pharmaceuticals. Parents and teenagers were recruited independently and were not matched pairs (i.e., parents and teenagers from the same family).

According the study from England, "the genetic and environmental mediation of continuity and change in parent-reported attention deficit-hyperactivity disorder (ADHD) symptoms were investigated in a cohort of over 6000 twin pairs at 2, 3 and 4 years of age."

"what is stable for ADHD symptoms is largely genetic. Contrast effects acting in the same direction at different ages contributed to the observed continuity: longitudinal correlations were greater for dizygotic than monozygotic twins," scientists indicated.

Price and colleagues published the results of their research in Behavior Genetics (Continuity and change in preschool ADHD symptoms: Longitudinal genetic analysis with contrast effects. Behav Genet, 2005;35(2):121-132).

Memory and cognition-focused biopharmaceutical firm Saegis Pharmaceuticals has initiated a phase II clinical study of its lead product candidate, SGS742, in adult ADHD patients

The phase II trial is a placebo-controlled, double-blind crossover study, where patients will be randomized to receive either placebo or active drug, and then crossed over to the alternate agent. The trial will measure improvement in standard ADHD scales, and is expected to be completed in Q3 2005.

"In preclinical and clinical studies, SGS742 has consistently shown positive benefits on the ability to improve attention, learning and memory," said Dr Rodney Pearlman, president and CEO of Saegis. "We are excited to be conducting an efficacy study among the adult ADHD population where safe, non-stimulatory medicines are needed."

Source: Saegis Marketing Release/Press Release

While the UK Department of Health advises that women can safely drink one or two units of alcohol per week, a team of psychiatrists in London highlight several studies which cast doubt on the guidance.

The authors looked at reports into foetal alcohol syndrome, a condition developed by some babies exposed to alcohol in the womb, resulting in stunted growth, facial abnormalities and neurocognitive deficits (brain disorders). An overarching foetal alcohol spectrum disorder - traceable to the pregnant mother's alcohol consumption say the authors - has also been identified.

Both the syndrome and disorder cause a wide range of behavioural disorders, they argue, including hyperactivity, problems with mental organisation, and difficulties in understanding the consequences of one's behaviour. Symptoms may also overlap with conditions such as autism and attention deficit hyperactivity disorder (ADHD).

Expectant mothers should be advised not to drink alcohol, as this may pose health risks to the foetus, argues an editorial in this week's British Medical Journal.

While the UK Department of Health advises that women can safely drink one or two units of alcohol per week, a team of psychiatrists in London highlight several studies which cast doubt on the guidance.

The authors looked at reports into foetal alcohol syndrome, a condition developed by some babies exposed to alcohol in the womb, resulting in stunted growth, facial abnormalities and neurocognitive deficits (brain disorders). An overarching foetal alcohol spectrum disorder - traceable to the pregnant mother's alcohol consumption say the authors - has also been identified.

Both the syndrome and disorder cause a wide range of behavioural disorders, they argue, including hyperactivity, problems with mental organisation, and difficulties in understanding the consequences of one's behaviour. Symptoms may also overlap with conditions such as autism and attention deficit hyperactivity disorder (ADHD).

Previously the syndrome was thought to be caused by mothers drinking heavily in pregnancy. But the authors argue that recent studies suggest that far less exposure to alcohol in the womb may put babies at risk – as little as one drink per week in one study. Individual differences in alcohol metabolism may protect most women when drinking small quantities, add the team, but it is currently impossible to predict who is at risk and who is not.

More research is needed to find out just how much alcohol may be damaging to a foetus, argue the authors. In the interim, the only safe message for expectant mothers is to abstain from alcohol, they conclude.

Figures from the Health Insurance Commission have revealed the drug dexamphetamine was prescribed to patients aged under 20 at four times the rate of other states last year.

Figures from the Health Insurance Commission have revealed the drug dexamphetamine was prescribed to patients aged under 20 at four times the rate of other states last year.

A total of 42,000 prescriptions were written.

A Health Department review into the drug's use has been conducted.

Respected psychiatrist Dr Aaron Groves heads the panel formed to implement the review's recommendations.

President of the AMA's Western Australian branch, Paul Skerritt, says there could be a number of explanations for the figures.

"The last round of figures suggested that there were a small number of doctors who prescribed a very large number of the amphetamines," Dr Skerritt said.

"It's a possibility that there are some doctors who attract a lot of referrals in that direction or it is possible that some doctors are over-prescribing.

"It would be nice for Dr Groves to winkle out that question but I don't think it's an automatically answered one."

Dr Skerritt says he is not concerned about the figures as they can be interpreted in a number of ways.

"Some of the experts would maintain that the figures for the incidence of the diagnosis are still less than that," he said.

This work, released at the annual American College of Neuropsychopharmacology (ACNP) conference in Puerto Rico, is among the first to examine the effects of early Ritalin exposure in rats on behavior and brain function during the later periods of life.
"Attention-deficit hyperactivity disorder can be a serious medical problem for children and their parents," says lead researcher William Carlezon, Ph.D., director of McLean Hospital's Behavioral Genetics Laboratory and associate professor of psychiatry at Harvard Medical School.

"While Ritalin is an effective medication that improves the quality of life for many children with ADHD, accurately diagnosing and identifying the correct treatment regimen for the disorder is essential, especially when considering health effects that can last through adulthood."

This work, released at the annual American College of Neuropsychopharmacology (ACNP) conference in Puerto Rico, is among the first to examine the effects of early Ritalin exposure in rats on behavior and brain function during the later periods of life.

"Attention-deficit hyperactivity disorder can be a serious medical problem for children and their parents," says lead researcher William Carlezon, Ph.D., director of McLean Hospital's Behavioral Genetics Laboratory and associate professor of psychiatry at Harvard Medical School. "While Ritalin is an effective medication that improves the quality of life for many children with ADHD, accurately diagnosing and identifying the correct treatment regimen for the disorder is essential, especially when considering health effects that can last through adulthood."

Ritalin is a generic medication prescribed for children with attention-deficit hyperactivity disorder (ADHD), a condition that consists of a persistent pattern of abnormally high level of activity, impulsivity, and/or inattention. Usually diagnosed in children of preschool or elementary school age, ADHD has been estimated to affect 3 to 12 percent of children and is twice as common among boys. Children with ADHD are also likely to have other disorders, such as a learning disability, oppositional defiant disorder, conduct disorder, depression, or anxiety.

Because most children show some of these behaviors of inattention and hyperactivity at times, the diagnosis of ADHD is a complex process that should involve specialists. It is critical to determine whether a child's behavior is simply immature or exuberant, related to another issue such as a vision problem or learning disability, or is characteristic of a disorder such as ADHD.

In the work funded by the NIH, Dr. Carlezon and his chief collaborator, Dr. Susan Andersen, examined the effects of exposing rats to Ritalin during early development on behaviors later in life. They exposed normal rats to twice-daily doses of Ritalin during a period that is equivalent to approximately 4-12 years of age in humans. Examining the behavior during adulthood, Carlezon and Andersen conducted several types of tests that all showed that the animals had a reduced ability to experience pleasure and reward, particularly when it was measured by sensitivity to cocaine. In addition, they found that the animals exposed to Ritalin during pre-adolescence were more prone to express despair-like behaviors in stressful situations (such as swim tests) as adults. Overall, the animals showed more evidence of dysfunctional brain reward systems and depressive-like behaviors in adulthood.

These findings are critical because they suggest that Ritalin can have long-term consequences on normal-functioning brains. The study is particularly relevant when considering the difficulty in correctly diagnosing children with ADHD. In 1999, approximately 90 percent of children diagnosed with the disorder were taking Ritalin, with children beginning drug therapy at younger ages today, even during preschool in some instances. There is increasing evidence to suggest that correct diagnosis of ADHD is of the highest importance – children who are misidentified as having ADHD and subsequently placed on prescription drug therapy could face possible impaired brain performance as adults.

"Ritalin can be highly effective in the treatment of ADHD, but our work highlights the importance of getting a proper diagnosis", states Carlezon. "Although individuals such as teachers and coaches can assist in identifying children with the disorder, an experienced health care professional is best-trained to make the final assessment and recommend avenues of treatment."

ACNP, founded in 1961, is a professional organization of more than 700 leading scientists, including four Nobel Laureates. The mission of ACNP is to further research and education in neuropsychopharmacology and related fields in the following ways: promoting the interaction of a broad range of scientific disciplines of brain and behavior in order to advance the understanding of prevention and treatment of disease of the nervous system including psychiatric, neurological, behavioral and addictive disorders; encouraging scientists to enter research careers in fields related to these disorders and their treatment; and ensuring the dissemination of relevant scientific advances.

The drug methylphenidate (brand name Ritalin) increased activity in brains of children with attention-deficit/hyperactivity disorder (ADHD) as well as those with a reading disorder, researchers at Yale report in the American Journal of Psychiatry.

"During a test of divided attention, Ritalin increased activation in the basal ganglia, a structure of the brain involved in cognition and behavior," said first author Keith Shafritz, former graduate student in the interdepartmental Neuroscience Program at Yale and now a research associate at Duke University Medical Center. "We saw this activation in children with ADHD and those with reading disorder."

The study used functional magnetic resonance imaging (fMRI) to analyze the effect of the drug on brain function. Researchers found that adolescents with ADHD or reading disorder who were on placebo (not medicated) had less activation of the basal ganglia than a group of healthy participants. When the same participants received Ritalin, the drug normalized the activation, which relates to the amount of blood flow to a specific brain region in response to a cognitive task.

ADHD is characterized by inattention, but previous neuroimaging studies have examined the brain dysfunction associated with impulsivity. "This is one of few studies that used a test for attention rather than a cognitive test for impulsivity," said Shafritz. "It is also the first study, using fMRI to find that the attention circuitry in the brain is directly affected by ADHD."

The 27 study participants, ages 14 to 18 with either ADHD or reading disorder, were randomly assigned to receive Ritalin first or placebo first and didn't know to which group they were assigned. While in the MRI, the participants were given auditory or visual performance tasks to decide whether they saw or heard a real English word or a nonsense word. Their results were compared to a group of 14 healthy adolescents who were not given Ritalin.

Although Ritalin did not affect performance, it altered the areas of the brain that were active during the simple performance of tasks. These results suggest that both ADHD and reading disorder are associated with dysfunction in the brain's attentional circuitry and that methylphenidate normalizes activation within this neural system.

Other authors on the study included Karen E. Marchione, John C. Gore, Sally E. Shaywitz, and Bennett A. Shaywitz.

###

Citation: American Journal of Psychiatry, Vol. 161 November 2004.

The bolded warning indicates that the medication should be discontinued in patients who developed jaundice (yellowing of the skin or whites of the eyes) or laboratory evidence of liver injury.

Strattera has been on the market since 2002 and has been used in more than 2 million patients. In clinical trials of 6000 patients, no signal for liver problems (hepatotoxicity) had emerged.

FDA has asked the manufacturer to add a bolded warning about severe liver injury to the labeling. Eli Lilly has agreed to alert health care professionals about the new information in a Dear Health Professional letter. The company will also update the patient package insert with information about the signs and symptoms of liver problems, which include:

* Pruritus (Itchy skin)

* Jaundice

* Dark urine

* Upper right-sided abdominal tenderness

* Or unexplained “flu-like” symptoms

Health care professionals are encouraged to report any unexpected adverse events associated with Strattera directly to Eli Lilly, Indianapolis, Ind., at 1800-LillyRx or to the FDA MedWatch program at 1800-FDA-1088. The MedWatch form is available online at http://www.fda.gov/medwatch/safety/3500.pdf for download by mail (or fax, 1800-FDA-0178) to MedWatch, HFD-410, FDA, 5600 Fishers Lane, Rockville, Md. 20857.

Children with attention deficit hyperactivity disorder (ADHD) display anatomical brain abnormalities beyond chemical imbalance, according to research presented at the annual meeting of the Radiological Society of North America (RSNA). Stimulant medications prescribed to balance brain chemistry appear to normalize some of these brain irregularities, a second study reported.

"We found abnormality of the fiber pathways in the frontal cortex, basal ganglia, brain stem and cerebellum," said lead author of both studies, Manzar Ashtari, PhD., associate professor of radiology and psychiatry at North Shore-Long Island Jewish Health System in New Hyde Park, N.Y.

Children with attention deficit hyperactivity disorder (ADHD) display anatomical brain abnormalities beyond chemical imbalance, according to research presented at the annual meeting of the Radiological Society of North America (RSNA). Stimulant medications prescribed to balance brain chemistry appear to normalize some of these brain irregularities, a second study reported.

"We found abnormality of the fiber pathways in the frontal cortex, basal ganglia, brain stem and cerebellum," said lead author of both studies, Manzar Ashtari, PhD., associate professor of radiology and psychiatry at North Shore-Long Island Jewish Health System in New Hyde Park, N.Y.

"These areas are involved in the processes that regulate attention, impulsive behavior, motor activity, and inhibition-the key symptoms in ADHD children," Dr. Ashtari said. "They are also known to be part of a bigger circuit in the brain that establishes communication between the frontal lobe and cerebellum."

According to the National Institute of Mental Health (NIMH), ADHD affects 3 to 5 percent of children in the United States. Children with ADHD have difficulty controlling their behavior or focusing their attention.

Using diffusion tensor imaging (DTI) to compare 18 children with diagnosed ADHD with 15 control children to evaluate the brain's white-matter fiber development, Dr. Ashtari's team found differences in the brain fiber pathways that transmit and receive information among brain areas.

"Typically ADHD is described as a chemical imbalance, but our research has shown that there may also be subtle anatomical differences in areas of the brain that are important in this disorder," said co-principal investigator Sanjiv Kumra, M.D., a psychiatrist at the Zucker Hillside Hospital in Glen Oaks, N.Y.

In the second study, the researchers found that children who had received stimulant treatment for ADHD had fewer white matter abnormalities than children who did not receive medication.

Patients consisted of two groups, each comprised of 10 children with ADHD. The first group had not taken medication or had been minimally exposed to medications. The second group was exposed to stimulants for an average of 2.5 years. Each of these groups was compared with 10 age- and gender-matched controls. The medicated ADHD children exhibited a normalization effect in fiber pathways of several brain areas.

"The findings from this small, cross-sectional study indicate that the therapeutic effect of stimulants may involve a brain normalization process," Dr. Kumra said.

Most people diagnosed with ADHD in childhood continue to have problems in adolescence and adulthood. "Despite progress in the assessment, diagnosis and treatment of ADHD, this disorder and its treatment have remained controversial," said co-author of the stimulant study, Andrew Adesman, M.D. "This study is yet further proof that children with ADHD differ at a neurobiological level as compared to children without the disorder." Dr. Adesman is chief of developmental and behavioral pediatrics at Schneider Children's Hospital in New Hyde Park, N.Y.

Dr. Ashtari said further studies with larger patient groups must be conducted before offering parents advice for diagnosis or treatment.

Co-authors are Babak Ardekani, Ph.D., Shree Bhaskar, M.D., Tana Clarke, B.S., and Joseph Rhinewine, M.A. (DTI study only). The research was sponsored by an NIMH grant.

RSNA is an association of more than 37,000 radiologists, radiation oncologists and related scientists committed to promoting excellence in radiology through education and by fostering research, with the ultimate goal of improving patient care. The Society is based in Oak Brook, Ill.

Editor's Note: The original news release can be found here.

The scientists exposed newborn rats from 7 to 11 days old to either 20-second bursts of a gas containing low oxygen content or to bursts of compressed air. Once the rats matured into juveniles, the scientists studied their locomotive activity and brain dopamine levels. They found that juvenile rats exposed to brief reductions in oxygen during their neonatal period had a 50 percent reduction in release of dopamine and were hyperactive.

Traditionally, ADHD has been attributed to genetic causes, environmental toxins or maternal use of nicotine, alcohol or drugs. Also, researchers generally have believed that the newborn brain is somewhat resistant to subtle disturbances in blood oxygenation. This study demonstrates in rats, however, that while long-term decreases in the release of dopamine can occur following as few as five days of subtle, repetitive reductions in blood oxygen levels during a critical window of brain development, the hyperactivity and impaired learning that also occur are not noticeable until later, when juvenile animals are old enough to display these behaviors.

The Emory scientists found that juvenile rats exposed to repetitive drops in blood oxygen levels as newborns also had a 50 percent increase in the level of dopamine stored in the brain tissue of the striatum compared to control rats and a reduction in the release of dopamine, showing that instead of releasing dopamine, they were abnormally storing it.

"By linking reductions in blood oxygen during critical times of development to changes in dopamine function, we hope to shed light on the mechanisms of ADHD, which have been poorly understood to this point," said Dr. Keating. "Our results show that a relatively common occurrence in newborns could have long-lasting negative effects, and we believe our model has great potential for creating new insights and leading to new interventions and therapies."

"Our research also could help explain why amphetamines, such as Ritalin, and other non-amphetamines, such as Wellbutrin, that increase levels of brain dopamine are an effective treatment for children with ADHD," Dr. Decker said. "So far scientists haven't sorted out which neurotransmitters are responsible for this effect, but if that could be narrowed down to just dopamine, as suggested by our data, it would provide a basis for developing drugs without the potential addictive properties of existing therapies."

The Emory investigators are exploring different ways to measure altered behavioral outcomes in rats to further confirm the similarity of these behaviors to those identified in ADHD. They also are planning studies aimed at preserving the brain dopamine system in individuals at risk for repetitive reductions in blood oxygenation. These studies could include non-invasive, subtle dietary changes in the mother and the newborn.

-----------------------------------------------------------

This story has been adapted from a news release issued by Emory University Health Sciences Center.

Researchers from Iran carried out a controlled trial to assess the benefits of prescribing supplementary zinc alongside the more conventional methylphenidate treatment. They found that children taking additional zinc sulphate on a daily basis improved faster than those taking a placebo.

Researchers from Iran carried out a controlled trial to assess the benefits of prescribing supplementary zinc alongside the more conventional methylphenidate treatment. They found that children taking additional zinc sulphate on a daily basis improved faster than those taking a placebo.

"The efficacy of zinc sulphate to increase the rate of improvement in children, seems to support the role of zinc deficiency in the pathogenesis of ADHD," say the authors.

The study comprised 44 children who were diagnosed as suffering from ADHD at Roozbeh Psychiatric Hospital, Tehran. Prior to the trial none of these patients had taken any medication for their condition.

For the six weeks of the trial, half the children took zinc sulphate (55mg/day) in addition to the conventional treatment; the other half took a placebo. A child psychiatrist assessed the children's condition fortnightly.

The behaviour of both groups of children improved over the course of the trial, but the children taking the zinc supplements showed a more marked improvement in their condition after six weeks, compared with those taking the placebo.

Although the children taking zinc sulphate were three times more likely to report that they were suffering from nausea, the frequency of other side effects did not differ between the two study groups. However, almost all of the children taking supplementary zinc complained about the metallic taste of the tablets.

Zinc supplements may exert their positive effects by helping to regulate the function of the neurotransmitter dopamine. Dopamine signalling, which has been implicated in causing symptoms of ADHD, is believed to play an important role in the feelings of pleasure and reward.

The authors acknowledge that their study is only small. They suggest that further research in this area is needed to confirm the positive effects of zinc supplements on children with ADHD.

###

This press release is based on the following article:

Zinc sulphate as an adjunct to methylphenidate for the treatment of attention deficit hyperactivity disorder in children: A double blind and randomized trial [ISRCTN64132371] Shahin Akhondzadeh, Mohammad-Reza Mohammadi, Mojgan Khademi BMC Psychiatry 2004, 4:8

This article will be freely available according to BMC Psychiatry's Open Access policy at http://www.biomedcentral.com/1471-244X/4/8/