ADHD Treatment Approaches: Update on Medication Management Webinar
Speaker: Tanya Froehlich, MD, MS
CE Credits: 2.0
Learning Level: Intermediate
OPA Member: $40 | Non-Member: $60
This program from Dr. Tanya Froelich provides an overview of the FDA-approved classes of ADHD medications, including stimulants, atomoxetine and the alpha-adrenergic agonists. For each medication class, the mechanism of action, effect size (regarding ADHD symptom reduction), response rate, side effects, and adverse events will be reviewed. Hot topics, including long-term effects of ADHD medication use on academic performance, linear growth, brain development and later substance abuse risk, will also be covered. Full description and objectives are listed below.
This program will provide an overview of the FDA-approved classes of ADHD medications, including stimulants, atomoxetine, and the alpha-adrenergic agonists. For each medication class, the mechanism of action, effect size (regarding ADHD symptom reduction), response rate, side effects, and adverse events will be reviewed. Hot topics, including long-term effects of ADHD medication use on academic performance, linear growth, brain development, and later substance abuse risk , will also be covered.
This workshop is designed to help you:
1) Identify the 3 classes of medications approved for the treatment of ADHD by the Food and Drug Administration.
2) State the mechanism of action for each of the 3 FDA-approved ADHD medication classes, and how these classes differ in their mechanism of action.
3) State the effect size (regarding ADHD symptom reduction) and response rate for the 3 FDA-approved ADHD medication classes, and identify which class has the largest effect size and highest response rate.
4) Identify the common side effects and well as more serious adverse events that may occur with the 3 FDA-approved ADHD medication classes.
5) Recognize research findings on long terms effects of ADHD medication use on academic performance.
6) Recognize research findings on long terms effects of ADHD medication use on linear growth and brain volumes.
7) Recognize research findings on long terms effects of ADHD medication use on later substance abuse risk.
Dr. Tanya Froehlich is an Assistant Professor of Pediatrics at Cincinnati Children’s Hospital Medical Center, where her work focuses on learning and behavioral issues in school age children in general and on ADHD in particular. Dr. Froehlich strives for a multi-dimensional understanding of ADHD, and her research has approached the disorder from the vantage points of epidemiology, etiology, and treatment. During fellowship, Dr. Froehlich published the first paper to determine the national prevalence of ADHD in U.S. children based on DSM-IV criteria, and showed that poor children were most likely to meet criteria for ADHD, yet were least likely to receive consistent ADHD pharmacotherapy. Interested in understanding why certain children (including the socioeconomically disadvantaged) may be more vulnerable to ADHD than others, Dr. Froehlich also studies the contribution of environmental exposures to ADHD. Central to this work is her measurement of exposure by biomarkers, rather than family or self-report, whenever possible to increase study precision and to contribute to our understanding of ADHD as a biologically-based disorder rather than a subjective (and therefore dubious) collection of symptoms. In a follow-up to her study on the U.S. national prevalence of ADHD, Dr. Froehlich showed that a large part of the association between poverty and ADHD was explained by the effects of childhood lead and in utero tobacco exposure. In an additional study, she found that boys and those with certain dopamine-related genetic variants were particularly susceptible to the adverse effects of lead exposure on ADHD-related executive functioning. Passionate about understanding how additional environmental exposures may contribute to ADHD because she believes this knowledge is integral to preventing the disorder, Dr. Froehlich is currently co-investigator on a National Institute of Environmental Health Sciences R01 grant which aims to determine the effects of pyrethroid pesticide exposure on ADHD symptoms and executive functioning.
Dr. Froehlich’s research has also been shaped by her clinical experiences. Frustrated by our current “trial and error” approach to ADHD pharmacotherapy and the roller coaster ride families often experience in their search for the best medication, Dr. Froehlich is the recipient of a National Institute of Mental Health K23 Award aimed at identifying genetic and phenotypic predictors of ADHD medication response. She has authored reviews on ADHD pharmacogenetics, as well as a recent paper showing that individuals with the dopamine receptor D4 and dopamine transporter genotypes believed to confer lower susceptibility to ADHD had greater improvement in their hyperactive-impulsive symptoms with methylphenidate treatment than those with the “high risk” genetic variants. Dr. Froehlich also coauthored a study on a novel genotyping assay for carboxylesterase 1 (CES1), the enzyme which metabolizes methylphenidate, and is currently undertaking a study on the effects of CES1 genetic variants on methylphenidate response. In the future, Dr. Froehlich hopes that her work will contribute to the development of a treatment algorithm that would allow more expeditious identification of the most effective and well-tolerated ADHD medication for each child.
Originally from northwestern Pennsylvania, Dr. Tanya Froehlich’s medical training took her to Yale University for medical school and the Children’s Hospital of Philadelphia for a residency in pediatrics. She then returned to her middle America roots for fellowship at Cincinnati Children’s Hospital Medical Center, where she completed a DB Peds fellowship, a National Research Service Award fellowship, and a Masters in Epidemiology at the University of Cincinnati.