Stahl's Illustrated Attention Deficit Hyperactivity Disorder by Stephen M. Stahl & Laurence Mignon

Author:Stephen M. Stahl & Laurence Mignon
Language: eng
Format: mobi, azw3
ISBN: 9780521133159
Publisher: Cambridge University Press
Published: 2009-08-23T21:00:00+00:00

FIGURE 4.12. Unlike what has been suggested by some mainstream media, stimulants do not have a paradoxical effect in ADHD patients. As has been shown previously, patients with ADHD often exhibit lowered, not heightened, activity in the prefrontal cortex, thus adequate treatment needs to increase this activity. Similarly to any other pharmacological compound however, stimulants do have different effects at low versus high doses, and these have been observed both in preclinical and clinical studies. At low doses, stimulants are hypothesized to enhance prefrontal cortical activity by facilitating DA and NE stimulation of postsynaptic D1 and alpha2A receptors, respectively. Higher doses of stimulants may lead to impaired prefrontal cortical functioning, by inducing excessive release of DA and NE and thus leading to the over-stimulation of additional receptors including D1, alpha1, and/or beta1 receptors. As shown in Figure 1.21, NE and DA levels need to be tuned adequately, not over- or under-stimulated, as both extremes can be detrimental and lead to decreased prefrontal cortical signal output.

“Slow-Dose” Stimulants Amplify

Tonic NE and DA Signals

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