33. ADHD and Anxiety Meds with Dr. Jeffrey Strawn: alpha agonists, norepinephrine reuptake inhibitors

Send us Fan MailIt's time for some Advanced Q+A with Dr. Jeffrey Strawn about medication treatment for ADHD +/- Anxiety!?Q:? When do you use alpha agonists (like Clonidine, Guanfacine)??A:  as adjunctive treatment for kids who are having trouble tolerating stimulants,  and/or who have residual impulsivity when they're being treated with stimulants.  Q: How can you prescribe alpha-agonists to kids who cannot swallow pills?A: We've talked about the possibility of using compounding pharmacies to help create liquid formulations of certain short acting alpha agonists for kids who have trouble swallowing pills. Q: When/ would you *start* treatment for ADHD with an alpha-agonist?A: Almost Never.  Start with stimulant medication when you're considering medication treatment for ADHD, regardless of how old the child is.   So for preschool aged children with ADHD for whom you're considering medication treatment, start with stimulant medication as opposed to non-stimulant medication.  Side note: Atomoxetine or Straterra is not as effective as first-line treatments for ADHD, nor is it as effective as our first-line treatments for anxiety. And finally we covered the amazing resource of Case Studies: Stahl's Essential Psychopharmacology: Volume 4: Children and Adolescents by Jeffrey R. Strawn and Stephen M. Stahl | Nov 9, 2023 available on Amazon and through Cambridge University PressCheck out our website PsychEd4Peds.com for more resources!Follow us on Instagram @psyched4pedsCheck out our NEW CME Audio-based, on-demand CME Course online at:Pediatric Mental Health CME Toolkit - Cracking the ADHD Code: Essentials for Pediatric Clinicians. https://ce.nemours.org/content/podcast-series-cracking-adhd-code-essential-skills-pediatric-clinicians#group-tabs-node-course-default1