Psychiatric Drugs and Medications Q 21
Joseph is a child diagnosed with attention deficit disorder. Which of the following drugs is commonly used for his condition?
A. methylphenidate (Ritalin)
B. diethylpropion (Nobesine)
C. phendimetrazine (Adipost)
D. caffeine
Correct Answer: A. methylphenidate (Ritalin)
Methylphenidate (Ritalin) is the drug of choice for attention deficit disorder. Stimulants are further broken into amphetamines and methylphenidates. Both types of stimulants block the reuptake of dopamine at the presynaptic membranes and postsynaptic membranes. Amphetamines also directly release dopamine. Stimulants are the mainstay of treatment for ADHD. They are effective in about 70% of patients. There is a number needed to treat 2. There are multiple formulations of each subtype of stimulants including immediate-release and extended-release, long-acting, or sustained release. Side effects of stimulants include changes in blood pressure, decreasing appetite and sleep, and risk of dependency. B and C are commonly used for exogenous obesity.
Option B: Anti Obesity medications can be used for BMI greater than or equal to 30 or BMI greater than or equal to 27 with comorbidities. Medications can be combined with diet, exercise, and behavior interventions. FDA-approved antiobesity medications include phentermine, orlistat, lorcaserin, liraglutide, diethylpropion, phentermine/topiramate, naltrexone/bupropion, phendimetrazine. All the agents are used for long-term weight management.
Option C: Phentermine on its own has been used for short-term treatment of obesity in combination with exercise and caloric restriction. Phentermine is a sympathomimetic amine anorectic. It has a similar mechanism of action as amphetamine in that it is an agonist at TAAR1 receptor site stimulating the release of norepinephrine and epinephrine. It is a stimulant.
Option D: Caffeine is a mild CNS stimulant that is not used for attention deficit disorder. Caffeine is a naturally occurring, central nervous system (CNS) stimulant of the methylxanthine class and is the most widely taken psychoactive stimulant globally. Caffeine’s primary mechanism of action is on the adenosine receptors in the brain. As it is both fat and water-soluble, it readily crosses the blood-brain barrier, resulting in antagonism to all four adenosine receptor subtypes (A1, A2a, A2b, A3). Specifically, the antagonism of the A2a receptor is responsible for the wakefulness effects of caffeine.