Affecting his life

Hyperactivity

Before 7 years old

inattentive

or more 2 situations

More than 6m

or more from one 6 category 1ST LINE: Ritalin (Action 4 hours)

5-10 mg starting 5-10 mg increasing weakly/Divided doses 2mg/kg/d - 100 mg maximum

(a) often fidgets with hands or feet or squirms in seat

(b) often leaves seat in classroom or in other situations in which remaining seatedb) often has difficulty sustaining attention in tasks or play activities is expected (c) often runs about or climbs excessively (c) often does not seem to listen when in situations in which it is inappropriate (inspoken to directly adolescents or adults, may be limited to (d) often does not follow through on subjective feelings of restlessness) instructions and fails to finish schoolwork, (d) often has difficulty playing or engagingchores, or duties in the workplace (not due to oppositional behavior or failure to in leisure activities quietly understand instructions) (e) is often "on the go" or often acts as if (e) often has difficulty organizing tasks "driven by a motor" and activities (f) often talks excessively f) often avoids, dislikes, or is reluctant to Impulsivity engage in tasks that require sustained mental effort (such as schoolwork or (g) often blurts out answers before home- work) questions have been completed (g) often Medical loses things necessary for tasks treatment (h) often has difficulty awaiting turn or activities (e.g., toys, school assignments, pencils, books, or tools) (i) often interrupts or intrudes on others (e.g., butts into conver-sations or games) (h) is often easily distracted by extraneous stimuli

a) often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities

2nd LINE: CONCERTA (Action 12 hours)

18 mg= 10 mg Ritalin 18 mg starting 54 mg maximum

3rd LINE: ATOMOXETINE (Action after 4 wks) Continue the stimulant for 4 wks on switching
<70 kg 0.5mg/kg/d then 1.2mg/kg/d Maximum 1.8mg/kg/d >70 kg Start with 40 mg Maximum 80 mg

During the interview Hyperactivity inattention May or may not be present

(i) isPsychological often forgetful in daily activities

Eating - Sleeping Tics Mood BP & Pulse Height & weight Can stop it during vacations

Follow up (side effect VS response)

investigation Conner's

Behavioral therapy & Parent training may be needed

Attention-Deficit/Hyperactivity Disorder Not Otherwise Specified This category is for disorders with prominent symptoms of inattention or hyperactivity- impulsivity that do not meet criteria for Attention Deficit/Hyperactivity Disorder.