What is Attention Deficit Disorder

Attention Deficit Disorder, commonly referred to as ADD or ADHD is a neurologically based disorder of inattention, impulsive behavior and hyperactivity. The two terms, ADHD (attention deficit hyperactive disorder) and ADD (attention deficit disorder) are used interchangeably.

History of ADD and ADHD

ADD/ADD was first described in 1845 by Henrich Hoffman. He was both a doctor and a writer of poetry. In a search of stories to read to his 3 year old son, he decided to write his own story books, one of which was “The Story of Fidgety Phillip.” This main character was a boy who exhibited all the symptoms of ADHD. However, it was not until 1902 that a thorough observation of children with ADHD was done and ADHD became recognized as a neurological disorder that needed medical treatment.

ADD and ADHD Causes and Research

To date, there is no single cause that has been attributed to the onset of ADHD/ADD, but science has come a long way in proving that the disorder stems from biological factors. Many causes have been suggested including minor head trauma, refined sugar, food additives and family environment. All these however, have come under scientific investigation over the years and have all been left unsubstantiated.

MRIs (magnetic resonance images) have been used to investigate the anatomical and physiological basis of the disease. MRIs are 3D maps of the brain. In a recent study, it was found that patients with ADHD/ADD have reduced bilateral (on both sides) brain size in parts of the frontal and temporal cortices. These are parts of the brain that have all been found to have an input in attention and impulse control.

Other research has investigated the biochemical basis of the disease. One study researched the inability of the brain to produce sufficient dopamine, as a cause for ADD/ADHD and found that patients with the disease produced lower levels of dopamine than healthy controls. Other evidence showed that ADD/ADHD patients did not metabolize glucose at the same level as those without the disease. These discoveries have become the basis of some of the medications available to those with ADD/ADHD.

ADD and ADHD Treatment

There are several options when it comes to the treatment of ADD/ ADHD including behavioral modifications and medications. There are two subsections of ADD/ ADHD medications available, stimulants and non-stimulants.

Methylphenidate, Amphetamines, and Dextroamphetamines are the main stimulants. These medications work by stimulating the part of the brain that controls attention and impulsivity and allow the patients to have greater self control. Cylert is another stimulant that was used in the 1980s, but was found to cause liver damage, and was ultimately discontinued by 2005.

Nonstimulants can be taken by themselves or together with stimulants. The most commonly prescribed nonstimulants are Selective Norepinephrine Reuptake Inhibitors. Norephinephrine is both a neurotransmitter (carries nerve impulses) and hormone (travels in the blood). It affects the parts of the brain where attention is controlled. When a nerve cell releases a neurotransmitter, the neurotransmitter either reaches the target location or the next nerve in the pathway. The neurotransmitter then diffuses across, the synaptic cleft. Any neurotransmitter not taken in by either of the intended cells is either re-uptaken by the nerve or rapidly degraded by enzymes. The longer a neurotrasmitter can linger in the synaptic cleft or the more that can be taken in by the target location, the longer the effect will last. Norepinephrine Reuptake Inhibitors work by stopping the reuptake of norepinephrine from the synaptic cleft. Norephinephrine therefore lingers for a longer time in the synaptic cleft and is able to have a longer lasting effect.

ADD/ADHD is a neurological disorder. Many researchers now agree that there are many factors (rather than a single cause) that contribute to the onset of the disease. Much research is underway and making many advances to enhance the treatment methods already available.