A retrospective study of the combined effects of stimulant and low dose anticonvulsant medication on cognition and function in adults with ADHD

Mr Gabriel Roux (). A retrospective study of the combined effects of stimulant and low dose anticonvulsant medication on cognition and function in adults with ADHD Professional Doctorate, School of Psychology, The University of Queensland.

       
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Author Mr Gabriel Roux
Thesis Title A retrospective study of the combined effects of stimulant and low dose anticonvulsant medication on cognition and function in adults with ADHD
School, Centre or Institute School of Psychology
Institution The University of Queensland
Thesis type Professional Doctorate
Supervisor Dr Ken McFarland
Dr Maggie Bailey
Total pages 124
Total colour pages 3
Total black and white pages 121
Abstract/Summary Attention-deficit hyperactivity disorder (ADHD) is a developmental disorder of childhood that is increasingly diagnosed in adults. Optimal pharmacological treatment for the disorder has not yet been established. Stimulant medication has remained the mainstay of treatment, but recent research suggests that anticonvulsant medication may also be useful in the treatment of ADHD symptoms in adults. The present retrospective study examined the effectiveness of a combined regime of stimulant and low dose anticonvulsant medication for the treatment of ADHD symptoms in an outpatient population of 28 adults. Measures used to assess improvements in symptoms included the Conners’ Adults ADHD Rating Scale(CAARS), the Developmental Eye Movement (DEM) test, and a visual analogue scale (VAS) used to measure the participants self-reported improvements in overall functioning. It was hypothesised that the addition of anticonvulsant medication would lead to improvements in self and observer rated symptoms on the CAARS scale, beyond those observed when stimulant medication was administered alone. Another hypothesis stated that participants would rate themselves as having improved in overall functioning since commencing anticonvulsant medication, and that the degree of improvement would be similar to that experienced when they first commenced stimulant treatment. Finally, there was an expectation that participants’ performance on the DEM test would improve following the introduction of anticonvulsant medication, providing evidence for enhanced cognitive functioning. Results showed that participants rated their symptoms as significantly less severe following the introduction of anticonvulsant medication to their treatment regime. However, the participant’s relatives or significant others did not note a significant change in ADHD symptoms when anticonvulsant medication was used in conjunction with stimulant medication. As expected, participants rated themselves as having improved in overall functioning following the introduction of anticonvulsant medication to their stimulant treatment regime and the level of improvement was comparable to that experienced after they were first treated with stimulant medication. Following the introduction of anticonvulsant medication, the time it took participants to complete the horizontal subtest of the DEM test significantly improved. No significant results were found for the vertical and ratio scores on the DEM test. These findings provide evidence that low dose anticonvulsant medication may be safely used in conjunction with stimulant medication to improve ADHD symptoms in adults. There is also evidence to suggest that the addition of anticonvulsant medication leads to an improvement in perception of overall functioning. Low dose anticonvulsant treatment may improve some cognitive functions,specifically oculomotor eye movements in adults diagnosed with ADHD. The results of this investigation provide preliminary support for the use of anticonvulsant medication in conjunction with stimulant medication for the treatment of ADHD symptoms. However, several methodological limitations restrict the generalisability of the results, and placebo-controlled randomised trials are needed to further investigate the use to anticonvulsant medication in this population.
Keyword Retrospective study
Stimulant Medication
Anticonvulsant Medication
Cognition
Adults
ADHD
Additional Notes 43, 44, 58 = Colour pages 42, 43, 44, 51, 53, 55, 57, 58, 63 = To be printed landscape

 
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Created: Tue, 31 Mar 2009, 15:21:02 EST by Mr Gabriel Roux