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Re: Attention Deficit Disorder

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In a message dated 97-11-26 00:15:09 EST, you write:

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 > A 3 year 8 month old child was referred by the educational psychologist
 > who thought he was suffering from 'hyperactivity' and required drug
 > therapy. Objectively child fulfilled criteria for diagnosis of ADDH. He
 > had been adopted at age 2 years 6 months from an orphanage in Eastern
 > Europe. Has shown tremendous progress since adoption. Developmental age
 > around three years.
 >
 > Is drug treatment indicated and what would be the drug of choice?
 > Thank you.
 >
 > Tancred Agius MD MRCP(UK) >>

The choice of stimulant medication is probably the standard ones: Ritalin,
Dexedrine or Adderall. Unlikely Cylert due to the need to monitor blood
levels periodically and the rare hepatotoxicity. Beyond medication is the
need to insure the absence of a lead burden and no anemia, which also could
have behavioral effects. Parent education and support with respect to
behavior modification principals is a given. Good luck.
                             Marc Tanenbaum, MD