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Abstracts of the Invited Speakers<br />
Treatment approaches to psychiatric comorbidities of ADHD in adolescents<br />
Bengi Semerci<br />
Institute, Istanbul, Turkey<br />
E-mail: bengisemerci@bengisemerci.com, info@bengisemercienstitusu.com<br />
Adolescences with ADHD, who suffer from social problems, are under risk of depression, anxiety, destructive conduct disorder, and drug<br />
addiction. If there are co-morbid disorders associated with ADHD, it makes the treatment difficult and causes some other complications.<br />
The fundamental treatment principles of the psychiatric co-morbidities of ADHD are also effective for adolescence period. However,<br />
especially, we should be careful about the conditions that have high prevalence during adolescence period and the conditions which<br />
affect prognosis in a negative way. These situations need to be assessed in diagnosis and treatment plan.<br />
Anxiety Disorders: Some researches indicate that a stimulant treatment has small effects on anxiety disorder. The treatment of ADHD<br />
without anxiety disorder gets more successful results. However, according to recent research, treatment is also effective on anxiety<br />
disorder.<br />
In general, considering the effect of CBT on the anxiety disorder treatment, it is suggested that CBT beside medication treatment is<br />
effective on ADHD having co morbidity with anxiety disorder. If there is co morbidity, it is suggested that the priority needs to be given<br />
to ADHD and that if the anxiety symptoms continue, another medication treatment should be considered.<br />
Mood Disorders: Depression is an important problem in adolescence period. The important point in treatment is to identify that if ADHD<br />
causes to depressive findings or major depression.<br />
If ADHD cooccurs with major depression, both of them need to be treated. The treatment may be done either by stimulants or atomoxetine<br />
or only by SSRIs or tricyclic anti depressants. The last option is to use the two methods both.<br />
When there is co-morbid depression and ADHD, the efficacy of antidepressants is lower than when it is depression alone. In clinical<br />
observation, depression findings in adolescence period should be assessed attentively. If there is major depression, the treatment should<br />
be carried out together with ADHD. Selective serotonin reuptake inhibitors (SSRI) may be used with stimulants.<br />
Conduct Disorders: If ADHD is not treated, it may possibly turn to conduct disorder. In many studies, the use of stimulants for the<br />
treatment of co-morbid ADHD and conduct disorder is investigated. The results of these studies show that stimulants are effective when<br />
the morbidities are both separate or together.<br />
However, if there are co-morbid ADHD and conduct disorder, the effectiveness of stimulants on aggression is lower. If there are co-morbid<br />
ADHD and aggression and if the typical ADHD treatment does not work, it may be useful to add atypical antipsychotics to the treatment. If<br />
ADHD is co-morbid with conduct disorder, working with adolescents, using behavioural approaches, supporting families and to providing<br />
them education about the problem may be helpful.<br />
If ADHD co occurs with drug addiction, both disorders should be treated. Stimulants can be used in a controlled way. However, due<br />
to addiction, prescribing stimulants may be cause legal problems. Atomoxetine and bupropion could be other options. Eventhough,<br />
antidepressants are effective in ADHD, their effectiveness in addiction is limited.<br />
Key words: ADHD, adolescence, co-morbidity, treatment<br />
Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S96<br />
Treatment of neurological co-morbid disorders in children with ADHD<br />
Murat Yüce<br />
Department of Child and Adolescent Psychiatry, Ondokuz Mayıs University, Samsun, Turkey<br />
E-mail: muryuce@yahoo.com<br />
Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and<br />
impulsive behaviors. ADHD is one of the most common childhood psychiatric disorders.<br />
Children with ADHD also have many comorbid disorders and psychiatric symptoms. ADHD may be accompanied with neurological<br />
disorders such as epilepsy, headache, and cerebral palsy. Neurological co-morbid conditions can lead to reduction in the level of function,<br />
adherence to treatment difficulty, increasing the price of healthcare and medical complications. Therefore, diagnosis and treatment of<br />
these neurological co-morbid problems with ADHD are important.<br />
ADHD is seen more commonly in children with epilepsy according to the normal population. Approximately 20% of children diagnosed<br />
S96 Bulletin of Clinical Psychopharmacology, Vol: 21, Supplement: 2, 2011 - www.psikofarmakoloji.org