A Review of the Pathophysiology, Etiology, and Treatment of Attention-Deficit Hyperactivity Disorder (ADHD)

Sharma, Alok; Couture, Justin

doi:10.1177/1060028013510699

Cited by 516Attention Deficit Hyperactivity DisorderPharmaceutical studies and practicesDevelopmental and Educational Neuropsychology

A Review of the Pathophysiology, Etiology, and Treatment of Attention-Deficit Hyperactivity Disorder (ADHD)

Sharma, Alok, Couture, Justin·2014·Annals of Pharmacotherapy

DOI 10.1177/1060028013510699

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Abstract

Objective To review the pathophysiology, etiology, and treatment of attention-deficit hyperactivity disorder (ADHD). Data sources and data extraction A literature search was conducted in PubMed and EMBASE using the terms attention deficit hyperactive disorder, ADHD, pathophysiology, etiology, and neurobiology. Limits applied were the following: published in the past 10 years (January 2003 to August 2013), humans, review, meta-analysis, and English language. These yielded 63 articles in PubMed and 74 in EMBASE. After removing duplicate/irrelevant articles, 86 articles and their relevant reference citations were reviewed. Data synthesis ADHD is a neurological disorder that affects children, but symptoms may persist into adulthood. Individuals suffering from this disorder exhibit hyperactivity, inattention, impulsivity, and problems in social interaction and academic performance. Medications used to treat ADHD such as methylphenidate, amphetamine, and atomoxetine indicate a dopamine/norepinephrine deficit as the neurochemical basis of ADHD, but the etiology is more complex. Moreover, these agents have poor adverse effect profiles and a multitude of drug interactions. Because these drugs are also dispensed to adults who may have concomitant conditions or medications, a pharmacist needs to be aware of these adverse events and drug interactions. This review, therefore, focuses on the pathophysiology, etiology, and treatment of ADHD and details the adverse effects and drug interacti…

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DA interacts with five different receptors localized in postsynaptic neurons, which are dysregulated in several brain regions of patients with ADHD.
“DA interacts with five different receptors localized in postsynaptic neurons [75], which are dysregulated in several brain regions of patients with ADHD.”
From Molecular Characterisation of the Mechanism of Action of Stimulant Drugs Lisdexamfetamine and Methylphenidate on ADHD Neurobiology: A Review (2022) · cites this paper as [75]
Deficiencies in catecholamines such as NE and DA or dysregulation of such NTs are among the causing physiological alterations that have been reported to explain ADHD development.
“Deficiencies in catecholamines such as NE and DA [75, 79, 80] or dysregulation of such NTs, which are essential for normal brain function, including executive and attentional functions [33], are among the causing physiological alterations that have been reported to explain ADHD development.”
From Molecular Characterisation of the Mechanism of Action of Stimulant Drugs Lisdexamfetamine and Methylphenidate on ADHD Neurobiology: A Review (2022) · cites this paper as [75]
Treatments for ADHD, such as MPH and AMPH, increase the reservoir of NE and thereby attenuate the hyperactivity and impulsivity experienced in ADHD.
“Therefore, treatments for ADHD, such as MPH and AMPH, increase the reservoir of NE and thereby attenuate the hyperactivity and impulsivity experienced in ADHD [75].”
From Molecular Characterisation of the Mechanism of Action of Stimulant Drugs Lisdexamfetamine and Methylphenidate on ADHD Neurobiology: A Review (2022) · cites this paper as [75]
The prefrontal cortex (PFC), caudate and cerebellum are the main brain regions responsible for ADHD development.
“The prefrontal cortex (PFC), caudate and cerebellum are the main brain regions responsible for ADHD development [75].”
From Molecular Characterisation of the Mechanism of Action of Stimulant Drugs Lisdexamfetamine and Methylphenidate on ADHD Neurobiology: A Review (2022) · cites this paper as [75]
MPH and amphetamine-derived compounds (AMPH) act on DAT-1 by inhibiting its transporter function and thereby increasing the levels of extracellular DA.
“MPH and amphetamine-derived compounds (AMPH), the two most widely used drugs for ADHD, act on DAT-1 by inhibiting its transporter function and thereby increasing the levels of extracellular DA [75].”
From Molecular Characterisation of the Mechanism of Action of Stimulant Drugs Lisdexamfetamine and Methylphenidate on ADHD Neurobiology: A Review (2022) · cites this paper as [75]

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Authors: Sharma, A., & Couture, J.
Affiliations: Massachusetts College of Pharmacy and Health Sciences (US)
ORCID: Sharma, Alok
Venue: Annals of Pharmacotherapy
Publisher: SAGE Publications
Published: 2013-11-01
Volume: 48
Issue: 2
Pages: 209-225
ISSN: 0012-6578 (ISSN-L)
1060-0280
1542-6270
DOI: 10.1177/1060028013510699
OpenAlex: W2124613981
Cited by: 516
References: 30
Citations by year: 2026: 29 · 2025: 52 · 2024: 39 · 2023: 75 · 2022: 73 · 2021: 48 · 2020: 50 · 2019: 44 · 2018: 30 · 2017: 26 · 2016: 22 · 2015: 20 · 2014: 8
FWCI: 2.22
Type: journal article
Language: en
Open access: closed
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Annals of Pharmacotherapy (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmaceutical studies and practices
Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
Keywords: attention deficit hyperactivity disorder, ADHD pathophysiology, ADHD etiology, ADHD medication, methylphenidate, amphetamine, atomoxetine, adverse drug reactions, drug interactions, pharmacist dispensing, adult ADHD
MeSH terms: Atomoxetine Hydrochloride, Amphetamines, Attention Deficit Disorder with Hyperactivity, Drug Interactions, Humans, Methylphenidate, Propylamines

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A Review of the Pathophysiology, Etiology, and Treatment of Attention-Deficit Hyperactivity Disorder (ADHD)

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