 Best Practices in Adult ADHD: Special Considerations PsychCast™ (63 Minutes)
Faculty: Lenard A. Adler, MD, Thomas J. Spencer, MD, Mark A. Stein, PhD, and Jeffrey H. Newcorn, MD
This CME Expert Review PsychCast™ is jointly sponsored by the Mount Sinai School of Medicine and MBL Communications.
Release Date: November 2008
Termination Date: November 30, 2010
Estimated time to complete this activity: 1 hour
Medium: The content is delivered by PsychCast™ with a PDF or web-based Posttest
Acknowledgment of Commercial Support: Funding for this activity has been provided by an educational grant from Shire Pharmaceuticals Inc.
CME Course Director: This activity has been peer-reviewed and approved by James C.-Y. Chou, MD, associate professor of psychiatry at the Mount Sinai School of Medicine. Review Date: October 2, 2008
Faculty Affiliation
Dr. Adler is associate professor of psychiatry and child and adolescent psychiatry, and director of the Adult ADHD Program, both at the New York University Langone School of Medicine.
Dr. Spencer is associate professor of psychiatry at Harvard Medical School and associate director of the Clinical and Research Program in Pediatric Psychopharmacology at Massachusetts General Hospital in Boston.
Dr. Stein is professor in the Department of Psychiatry a the University of Illinois in Chicago and director of the Adult ADHD Clinic.
Dr. Newcorn is associate professor in the Department of Psychiatry at the Mount Sinai School of Medicine in New York City.
Faculty Disclosure Policy Statement
It is the policy of the Mount Sinai School of Medicine to ensure objectivity, balance, independence, transparency, and scientific rigor in all CME-sponsored educational activities. All faculty participating in the planning or implementation of a sponsored activity are expected to disclose to the audience any relevant financial relationships and to assist in resolving any conflict of interest that may arise from the relationship. Presenters must also make a meaningful disclosure to the audience of their discussions of unlabeled or unapproved drugs or devices. This information will be available as part of the course material.
Faculty Disclosure
Dr. Adler is a consultant to and on the advisory boards of Abbott, Cephalon, Cortex, Eli Lilly, Novartis, Ortho-McNeil, Janssen, Johnson and Johnson, Merck, New River, Organon, Pfizer, sanofi-aventis, and Shire; is on the speaker’s bureaus of Eli Lilly and Shire; and receives grant/research support from Abbott, Bristol-Myers Squibb, Cephalon, Cortex, Eli Lilly, Janssen, Johnson and Johnson, Merck, National Institute of Drug Abuse, New River, Novartis, Ortho-McNeil, Pfizer, and Shire. Dr. Adler mentions the following experimental/off-label medications for adult ADHD: bupropion and modafinil.
Dr. Newcorn is a consultant to Abbott, Biobehavioral Diagnostics, Eli Lilly, Lupin, Novartis, Ortho-McNeil, Psychogenics, sanofi-aventis, and Shire; and receives research support from Eli Lilly and Ortho-McNeil. Dr. Newcorn mentions the following experimental/off-label medications for adult ADHD: bupropion, clonidine, guanfacine, modafinil, tricyclic antidepressants, and velafaxine.
Dr. Spencer is a speaker for Eli Lilly, GlaxoSmithKline, Janssen, Novartis, Ortho-McNeil, and Shire; is on the advisory boards of Cephalon, Eli Lilly, GlaxoSmithKline, Janssen, Novartis, Ortho-McNeil, Pfizer, and Shire; and receives research support from Cephalon, Eli Lilly, GlaxoSmithKline, Janssen, National Institute of Mental Health, Novartis, Ortho-McNeil, Pfizer, and Shire.
Dr. Stein is a consultant/advisor to Abbott, Novartis, and Pfizer; is a speaker for Novartis and Ortho-McNeil; and receives research support from Eli Lilly, National Institute of Mental Health, Organon, Ortho-McNeil, and Pfizer.
Dr. Hollander reports no affiliation with or financial interest in any organization that may pose a conflict of interest.
Learning Objectives
- Discuss the potential cardiovascular risks of ADHD treatments and appropriate screening methods to identify at-risk patients.
- Distinguish between abuse, misuse, and diversion of medications, and discuss how these problems pertain to patients with ADHD.
- Review the conditions that tend to simulate ADHD and methods of ruling out these conditions at the early stages of diagnosis.
Target Audience: This activity is designed to meet the educational needs of primary care physicians and psychiatrists.
Accreditation Statement: This activity has been planned and implemented in accordance with the Essentials and Standards of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the Mount Sinai School of Medicine and MBL Communications, Inc. The Mount Sinai School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.
Credit Designation: The Mount Sinai School of Medicine designates this educational activity for a maximum of 1 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Disclaimer: These are the opinions of the authors not of the sponsors or supporters. For more information, contact MBL Communications at cme@mblcommunications.com.
Minimum Hardware/Software Requirements
Macintosh: PowerPC processor, Mac OS 8.6, 9.0.4, 9.1, or Mac OS X, 64MB of RAM, 24MB of available hard-disk space, and Safari 1.x or 2.x.
Windows PC: Intel Pentium processor, Microsoft Windows 95 OSR 2.0, Windows 98 and 98 SE, Windows Millennium Edition, Windows NT 4.0 with Service Pack 5, Windows 2000, or Windows XP, 64MB of RAM, 24MB of available hard-disk space, and Internet Explorer 6.x and newer or Firefox 1.x and newer.
This CME Activity and Posttest information file is a PDF (Portable Document Format) document. To view this file, you will need Adobe Acrobat Reader, which is available free at www.adobe.com. Follow the instructions on that page to download and install the software.
Best Practices in Adult ADHD: Special Considerations PsychCast™ (63 Minutes)
Faculty: Lenard A. Adler, MD, Thomas J. Spencer, MD, Mark A. Stein, PhD, and Jeffrey H. Newcorn, MD
Abstract
The treatment of adult attention-deficit/hyperactivity disorder (ADHD) is not without potential complications. Concerns exist regarding the cardiovascular safety of ADHD medications. The vulnerability of ADHD patients to cardiovascular problems may be unclear during diagnosis, and can require close attention by the physician before and during treatment. ADHD may be obscured by the presence of mimics, conditions responsible for symptoms or impairments that look like, and may be confused for, ADHD. Mimics can divert attention away from the real underlying disorder and can compel a physician to prescribe unnecessary treatment. There is also concern about the potential for diversion and misuse of ADHD medications. To avoid these possible complications, clinicians must screen patients for preexisting cardiovascular events and family history of cardiac dysfunction. The American Heart Association has recently published guidelines for cardiovascular monitoring for children and adolescents who are receiving psychostimulant therapy. To rule out the possibility of medical or psychiatric mimics, diagnosis must be thoughtful and thorough. Neuropsychiatric testing may help identify certain mimic conditions. Though it appears that rates of stimulant abuse are not higher among treated ADHD patients compared to the general population, physicians must be vigilant about the possibility of misuse among their patients.
In the final segment of a 3-part Expert Roundtable PsychCast™ series on Best Practices in Adult ADHD, Lenard A. Adler, MD, offers an introduction to the special considerations in treating adult ADHD; Jeffrey H. Newcorn, MD, reviews issues in safety and cardiovascular risk for ADHD patients; Thomas J. Spencer, MD, reviews data on the diversion and misuse of stimulant medications; and Mark A. Stein, PhD, discusses conditions that mimic or present co-morbid with ADHD as well as neuropsychological testing.
To receive credit for this activity: Listen to the PsychCast™, reflect on the material presented, and complete the online CME Posttest/Evaluation here or to submit the CME Posttest/Evaluation by mail or fax, download a PDF here. To obtain credit, you should score 70% or better. The estimated time to complete the PsychCast™ and the posttest and evaluation is 1 hour. Successful completion of the posttest and evaluation will allow you to claim credit and print a certificate.
Early submission of this posttest is encouraged: please submit by October 1, 2010 to be eligible for credit. If you have any questions, please e-mail cme@mblcommunications.com.
Read the extended CME supplement related to this PsychCast™ activity here
Supported by Shire Pharmaceuticals Inc. |
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