Abstract Attention Deficit Hyperactivity Disorder Research Articles

An (un)happy marriage: child psychotherapy with children who are medicated for ADHD

ABSTRACT Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common psychiatric diagnoses given in childhood. The recommended treatment is medication in combination with behavioural intervention, and psychoanalytic treatments are rarely recommended or sought. However, in recent decades, there has been an increase in psychoanalytic interest in ADHD, conceptualising it as a complex, biopsychosocial phenomenon requiring a multimodal approach, and suggesting that psychoanalytic psychotherapy can be helpfully and effectively combined with medication in treatment. This study aimed to empirically investigate this practice, by interviewing psychoanalytic child psychotherapists about their experiences of treating children medicated for ADHD. Semi-structured interviews were carried out with six child psychotherapists. The data were analysed qualitatively, using thematic analysis and discourse analysis. Participants presented psychotherapy and medication as theoretically compatible and complementary, but expressed uncertainty about and resistance to the use of medication alongside psychotherapy in practice. Interviewees adopted positions of compliance, avoidance and resistance to the practice of combining medication and psychotherapy, understood as negotiations of the powerful medical discourse of ADHD. While the literature emphasises the potential for psychopharmacological and psychoanalytic approaches to be mutually enriching, this study highlights the challenges of adopting a multi-perspective approach in this contested field.

Intervensi Inklusif Sukan Terhadap Murid Gangguan Kecelaruan Tumpuan dan Hiperaktif (ADHD)

Attention deficit/hyperactivity disorder (ADHD) is a form of disruption to the brain often experienced by growing children. ADHD children are often labelled as naughty by some. There are several forms of treatment that can be taken against this disorder such as the use of medication. However, the use of medicine will side effect such as loss appetite, disrupting sleep time and anxiety. This study was conducted by observing and recording anecdotes as a means of collecting data. The subject was an ADHD student who had undergone academic inclusiveness and also a special need athlete. The purpose of the study was to explore the effects of sports inclusive intervention on the negative, physical behaviour and social of the student. The findings of the study show that sports inclusion interventions can reduce the negative behaviour of ADHD students and can be an alternative to medication treatment. The effect of this intervention is more harmonious with no side effects and impact for a long time. Sports activities also have goals such as the Individual Teaching Plan concept. In Malaysia, sports intervention is quite new in the Integrated Special Education Program. The impact of this study is expected to open the mind of all parties to make sure that sport activities for special needs students is conducted for the purpose of treatment. The cooperation of all parties including parents is important in this alternative treatment.

The Effect of Attention Deficit/Hyperactivity Disorder on Physical Health Outcomes: A 2-Sample Mendelian Randomization Study

Attention-deficit/hyperactivity disorder (ADHD) is associated with a broad range of physical health problems. Using different research designs to test whether ADHD has a causal role in these associations is important because comorbid health problems increase the serious social and economic impacts of ADHD. We used 2-sample Mendelian randomization (MR) to infer causal relationships between ADHD and previously implicated physical health conditions. Different MR methods were used to test the robustness and plausibility of our findings. Consistent findings underwent bidirectional and multivariable MR. We found evidence of ADHD having a causal effect on childhood obesity (odds ratio = 1.29, 95% confidence interval: 1.02, 1.63) and coronary artery disease (odds ratio = 1.11, 95% confidence interval: 1.03, 1.19) with consistent results across MR approaches. There was additional MR evidence for a bidirectional relationship between ADHD and childhood obesity. The relationship with coronary artery disease attenuated when controlling for childhood obesity. There was little evidence for inferring a causal effect on other cardiometabolic, autoimmune, allergic, and neurological diseases. Our findings strengthen the argument for effective treatment of children with ADHD, and suggest that clinicians who manage ADHD need to be aware of the risk of childhood obesity to reduce future risks of coronary artery disease.

Childhood attention-deficit hyperactivity disorder: Family therapy from an attachment based perspective

Abstract Attention-Deficit Hyperactivity Disorder (ADHD), a common presenting problem in the mental health profession, occurs in about five percent of children and has a high heritability factor. It is, therefore, common for clients with ADHD to have another family member also diagnosed with ADHD and/or display typical ADHD behaviors. ADHD is often correlated with emotion regulation difficulties and problematic family functioning. One way to address emotion regulation problems and problematic family functioning is through attachment-based interventions. Among research supported therapeutic interventions for children with ADHD, few, if any, treatment practices include overtly addressing attachment in treatment. Treating child ADHD through attachment in family therapy may be beneficial in reducing common behavioral problems that accompany ADHD (i.e., hyperactivity, inattentiveness, impulsivity, etc.). We suggest a Family Therapy Attachment Based (FTAB) therapeutic module (this module has yet to be empirically supported) to implement alongside common evidence-based treatment for treating child ADHD.

Effectiveness of a Manual Therapy Program as Adjuvant Treatment for School-Age Children With Attention-Deficit/Hyperactivity Disorder: A Randomized Pilot Study

Attention-deficit/hyperactivity disorder (ADHD) is a neurobiological disorder. Common symptoms are inattention, hyperactivity, impulsivity, and executive functions deficit, often with comorbidities. Main treatment involves pharmacological and non-pharmacological therapies (cognitive-behavioral therapy, psycho-pedagogical programs). Emerging non-pharmacological treatments include manual therapies (MTs) in mental health. Several MT techniques have shown effectiveness in ADHD. The objectives of this study are as follows: (a) to assess short-term effects and persistence of an MT program on neuropsychological (hyperactivity index through the Conners’ Global Index [CGI]) and neurophysiological (time–frequency domain parameters of heart rate variability [HRV]) variables in ADHD children, and (b) to test the feasibility of the design. This study was approved by the Parc Tauli Corporation Clinical Research Ethics Board (#2017311). Pilot, controlled, multidisciplinary study of eight children with ADHD randomly assigned to control group (CG; n = 4) and intervention group (IG; n = 4). Both followed multimodal treatment, and IG also received an MT program per week for 4 weeks. A physiotherapist and a psychologist analyzed short-term effects (1-week post-program) and persistence (36 weeks). Eight children (boys, 62.5%; girls, 37.5%) with an average age of 10.375 ± 0.74 years were included. Baseline HRV parameters showed basal sympathetic predominance. The MT program increased the parasympathetic activity, which was significantly maintained at 1 to 36 weeks; there were no changes in CG. One-week post-program IG showed significant CGI reduction (–7 points, p = .016*), CG without changes ( p = .41), with significant differences CG – IG ( p = .0097*), and very large effect size ( d = 2.235); 36 weeks post-program showed no effects (IG, p = .293; CG, p = .247), without differences CG – IG ( p = .369). The MT program reduced the hyperactivity index with a 1-week persistence and increased the parasympathetic activity with a 36-week persistence. More investigations are needed to generalize the outcomes. Additional research is planned to further explore the possibilities of MT in psychiatric disorders with autonomic imbalances.

The child behind Attention-Deficit/Hyperactivity Disorder: an illustrated account

Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental condition if identified early can ensure less morbidity and better prognosis. It is important to help the child behind the problem and not to look at child as the problem. A holistic approach involving parents as active agents of change will serve the best interests of the child. Therefore, psychoeducation of family members is essential as it helps to improve parental understanding of the condition and reduce punitive responses toward the child. Parents also need to be empowered with behavioural management techniques to manage the problem behaviours stemming from the underlying condition. In this article, we present an illustrated model using a fictional character for psychoeducation of families about ADHD and give an overview of major psychosocial interventions with a focus on environmental modification.

Reduced organizational skills in adults with ADHD are due to deficits in persistence, not in strategies.

BackgroundAttention Deficit Hyperactivity Disorder (ADHD) is commonly associated with poor organizational skills, as per the definition of ADHD. However, the contribution of each of the following factors (and their interactions) to the aforementioned poor organization, while comparing individuals with and without ADHD, has not been analyzed in-depth: Work Organization; Communication Clarity; Punctuality; Goal-oriented behaviour; Assiduity; Workspace Organization; Strategies; and Attentiveness. The purpose is to examine the self-reported levels of organizational skills in adults with and without ADHD.MethodsSeven hundred seventy-four (n = 303 with a diagnosis of ADHD) adults from the community were recruited online. Participants completed a measure of organizational skills and a screening measure of ADHD.ResultsParticipants with a diagnosis of ADHD displayed lower scores than individuals without a diagnosis of ADHD on all organizational skills with the exception of using strategies to remain organized and learn new information. Higher levels of education were associated with higher levels of organizational skills. While there was no difference between males and females with ADHD, females without ADHD scored higher than males without ADHD.ConclusionThis study supports that individuals with ADHD can efficiently develop strategies, but may have difficulties using those strategies in a continuous manner. Suggestions to increase organizational skills in adults with ADHD are presented.

Methylphenidate treatment of adult ADHD patients improves the degree of ADHD severity under routine conditions

Attention-deficit hyperactivity disorder (ADHD) is associated with substantial personal and social impairments. Besides psychosocial interventions, current guidelines recommend a therapy with methylphenidate (MPH). This prospective, non-interventional study aims to investigate the efficacy and tolerability of MPH treatment of adult ADHD patients in a real-world setting. 468 adult patients with newly diagnosed ADHD were observed for 12–14 weeks. Primary efficacy endpoint was the clinical global impression (CGI) by the physician. Secondary endpoints comprise patient evaluation (Wender–Reimherr self-report, WR-SR), safety, tolerability, and dosage of MPH. With a mean daily dose of 35.8 (±17.0) mg MPH, the population of patients being severely/most extremely ill or markedly ill decreased by 64% and 61%, respectively. According to physicians’ assessment (CGI), 74.5% of patients were identified as treatment responders. The total score of patient-based assessment (WR-SR) improved by 23.5% (50.1 ± 40.3 points) with the most profound improvement in attention deficit (−30.0%), disorganization (−26.6%), and hyperactivity / unrest (−23.3%). Self-evaluation revealed a responder rate of 35.4%. In summary, MPH treatment improves the degree of ADHD severity under routine conditions. In addition, activities of daily living were facilitated when taking MPH. The rather poor responder rates determined by patient assessment as well as the comparatively low applied mean daily dose of 35.8 mg (median 40 mg) indicate sub-optimal dosing under routine conditions, not exploiting the full beneficial therapeutic potential of MPH.

Objective Evaluation of Therapeutic Effects of ADHD Medication Using a Smart Watch: A Pilot Study

Attention-deficit hyperactivity disorder (ADHD) is the most common neurobehavioral disorder in schoolchildren. Several methods are used to evaluate ADHD therapeutic effects, including the Swanson, Nolan, and Pelham (SNAP) questionnaire, the Vanderbilt ADHD Diagnostic Rating Scale, and the visual analog scale. However, these scales are subjective. In this study, we employed an objective method to evaluate the aforementioned therapeutic effects. Ten patients (nine boys and one girl) with ADHD were enrolled. An accelerometer was embedded in a smart watch to record the movements of patients with ADHD. The variance values of the accelerometer before and after one month of medication (methylphenidate) use were compared. The results demonstrated that the variance values along the y- and z-axes of the accelerometers significantly decreased after one month of methylphenidate use. Before and after one month of methylphenidate use, the variance values were 4.4227 ± 2.1723 and 2.3214 ± 0.6475 (p = 0.0119) on the y-axis, and 4.0933 ± 1.5720 and 2.4091 ± 0.8141 (p = 0.0140) on the z-axis, respectively. In addition, the correlation was moderate-to-strong between the SNAP hyperactivity subscale and variance along the y-axis. Thus, a smart watch with an accelerometer inside is potentially an objective and useful method for evaluating the therapeutic effects of ADHD medications.

The Duration of Breastfeeding and Attention-Deficit Hyperactivity Disorder in School-Aged Children

ABSTRACT Attention-deficit hyperactivity disorder (ADHD) is one of the most common childhood-onset neurodevelopmental disorders. In some recent studies breastfeeding had positive effects on physical health and mental development of children and these studies have recommended further studies in this issue. This study evaluated the relationship between duration of breastfeeding and ADHD. This case-control study was carried out in 2017 on 404 children aged 7–12 (196 children with ADHD and 208 children without ADHD). The questionnaire included items on the risk factors such as the child’s sex, age, delivery method, birth weight, birth rank, gestational age, age of mother, duration of breastfeeding, history of neonatal hospitalization, history of drug use in neonatal period, history of drug use in pregnancy, history of hypothyroidism and hyperthyroidism in pregnancy, history of neonatal icter, history of neonatal blood exchange. Data were analyzed using t-test, chi-square and logistic regression. The mean of breastfeeding duration in children with ADHD was 17.05 ± 7.52 months compared with 18.59 ± 6.74 months in control group (p = .03). A stepwise logistic regression that included the variables was found to be significant in univariate analysis, demonstrating a significant association between ADHD and breastfeeding duration (p = .01), male gender (OR = 2.8), mother hypothyroidism(OR = 4.5) and history of drug use in neonatal period (OR = 1.9). Long-term duration of breastfeeding (more than 12 months) could be a protective factor in ADHD. However, further studies are required.

ADHD symptom profiles, intermittent explosive disorder, adverse childhood experiences, and internalizing/externalizing problems in young offenders

Attention-deficit/hyperactivity disorder (ADHD) and co-existing psychiatric/psychological impairments as well as adverse childhood experiences (ACEs) are common among young offenders. Research on their associations is of major importance for early intervention and crime prevention. Intermittent explosive disorder (IED) warrants specific consideration in this regard. To gain sophisticated insights into the occurrence and associations of ADHD, IED, ACEs, and further psychiatric/psychological impairments in young (male and female) offenders, we used latent profile analysis (LPA) to empirically derive subtypes among 156 young offenders who were at an early stage of crime development based on their self-reported ADHD symptoms, and combined those with the presence of IED. We found four distinct ADHD subtypes that differed rather quantitatively than qualitatively (very low, low, moderate, and severe symptomatology). Additional IED, ACEs, and further internalizing and externalizing problems were found most frequently in the severe ADHD subtype. Furthermore, females were over-represented in the severe ADHD subtype. Finally, ACEs predicted high ADHD symptomatology with co-existing IED, but not without IED. Because ACEs were positively associated with the occurrence of ADHD/IED and ADHD is one important risk factor for on-going criminal behaviors, our findings highlight the need for early identification of ACEs and ADHD/IED in young offenders to identify those adolescents who are at increased risk for long-lasting criminal careers. Furthermore, they contribute to the debate about how to best conceptualize ADHD regarding further emotional and behavioral disturbances.

A Place for Psychological Testing in the Assessment of Adult ADHD

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms of inattention, impulsivity, and hyperactivity that interfere with social, occupational, or academic functioning. Clinical communities differ regarding whether or not formal psychological or neuropsychological assessment is necessary for diagnosing ADHD. A comprehensive assessment model that emphasizes differential clinical diagnosis is recommended. This model provides practice guidelines that ensure accurate diagnosis when faced with potential complicating factors, such as symptom overlap, substance abuse, and symptom feigning.

Gripped by the chaos: a psychoanalytically-informed qualitative exploration of adolescent ADHD

Attention deficit hyperactivity disorder (ADHD) in adolescence has largely been overlooked in the literature in terms of the experience of those so diagnosed. In clinical practice there is an understanding that this population experiences profoundly painful interpersonal difficulties, but at an empirical level the experience of the adolescent is poorly understood. In this psychoanalytically-informed qualitative study, five adolescents, aged 16–17, with a diagnosis of ADHD took part in three interviews. The material was analysed in keeping with the psychoanalytically-informed method. Three inter-related themes emerged: ‘not being able to “let out” difficult emotion,’ which reflected participants’ struggle with overwhelming and unmanageable affect; ‘(un)soothing experience with self and other,’ which described the relationship between care-seeking and care-giving behaviours in the lives of these youths; and ‘being in and out of control,’ which relates to the complex relationship that participants have with self-control as well as the control of others. In the lives of these adolescents, the search for containment in interpersonal relationships is explored, as well as a discussion of a substitute for soothing in the absence of a ‘good enough’ object in early interactions.

Translation of the Adult Attention-Deficit/Hyperactivity Disorder Self-Report Scale into an African Language: An Exploratory Study.

Attention-Deficit/Hyperactivity Disorder (ADHD) is commonly perceived as a cultural construct due to its disproportionate global representation, however limited data is available from Africa. Standardisation of screening tools in epidemiological studies is essential for global prevalence comparison, but tools such as the Adult ADHD Self-Report Scale (ASRS) have not been translated into African languages. To assess the translation process followed in attempting to adapt the ASRS into an indigenous African language widely spoken within South Africa for cross-cultural research. Xhosa was selected as an appropriate target language for translation. An exploratory approach was used to assess linguistic considerations for adaptation of the ASRS. Blind translation was applied by two independent bilingual translators. A translational studies expert translated the ASRS into Xhosa. The translated document was back-translated into English by a bilingual pharmacist. Side-by-side comparison of the original and back-translated English versions revealed 13 content queries. Each query was discussed with the back translator, revealing common themes which complicated the effective Xhosa ASRS translation. Appropriate contextualisation of questions and removal or explanation of idiomatic terms were identified as key requirements to improve properties for Xhosa translation. Suitability of the original instrument for Xhosa translation was problematic and further investigation into appropriate cross-cultural translation techniques is needed to improve ASRS translation properties and assess its Xhosa translation. Development of a suitable Xhosa version of the ASRS is considered to be an important step towards broadening the scope of ADHD research in South Africa.

Nichtpharmakologische Therapiemöglichkeiten der Aufmerksamkeitsdefizit‑/Hyperaktivitätsstörung im Erwachsenenalter: ein Update

Attention deficit hyperactivity disorder (ADHD) in adulthood is afrequent disorder with aprevalence of 2.5%, which can successfully be treated by pharmacotherapy in 50-70% of cases, depending on the response criteria. Therefore, besides medication nonpharmacological interventions are an important component of the treatment. The essential nonpharmacological interventions are presented and described with respect to the evidence for treatment. According to the S3 guidelines an extensive psychoeducation (PE) functions as the basis of the treatment. If there is still aneed for treatment after PE and the clarification of associated disorders, pharmacotherapy is applied. Further psychosocial interventions can then be used as accompaniment or supplement, e.g. when the effectiveness of medication treatment is insufficient. In particular, cognitive behavioral concepts and their variations (dialectic behavioral therapy, metacognitive training, reasoning and rehabilitation therapy) and coaching should be mentioned here, which show increasing evidence for treatment. Neurofeedback can be used if no other psychosocial treatment options are delayed or omitted due to the treatment. Mindfulness training and sport interventions seem to be meaningful as supplementation but similarly to the individualized cognitive training, further research studies are necessary to enable clear statements regarding treatment evidence in adulthood. Further controlled investigations regarding the effectiveness of nonpharmacological interventions on ADHD and associated symptoms and disorders are therefore desirable.

Temporal trends and geographical variability of the prevalence and incidence of attention deficit/hyperactivity disorder diagnoses among children in Catalonia, Spain

Attention deficit/hyperactivity disorder (ADHD) is one of the most common behavioral disorders in childhood. According to a recent systematic review, the worldwide estimate of ADHD prevalence is 7.2% in children. This study aims to assess the prevalence of ADHD diagnoses in 2017 and the incidence of ADHD diagnoses in 2009–2017 in children living in Catalonia, Spain, as well as their temporal and geographical variability, and stratifying by sex and age. We used administrative data for all children aged 4 to 17 years who were insured in the public Catalan Health System in 2009–2017. We identified all ADHD cases diagnosed in 2009–2017 (ICD-9 code 314). We estimated the prevalence of ADHD diagnoses in 2017 and the overall annual incidence of ADHD diagnoses in 2009–2017. We used Poisson regression models to assess temporal trends in the incidence. We estimated a prevalence of ADHD diagnoses of 4.06% (95%CI 4.03, 4.10) in 2017, being 5.81% (95%CI 5.75, 5.87) for boys and 2.20% (95%CI 2.16, 2.24) for girls, the highest prevalence being in 13-to-17-year-olds (7.28% (95%CI 7.20, 7.36)). We did not observe a statistically significant increase of the incidence of ADHD diagnoses during the study period. Geographical differences were found across the healthcare areas in both prevalence and annual incidence and constant during the study period. In conclusion, the prevalence of ADHD diagnoses observed in this study was 4.06%, which was lower than the estimates reported in previous systematic reviews, but in line with the prevalence estimates from other recent European studies. The prevalence was higher in boys than girls, with a sex ratio consistent with previous studies. We did not observe an increase in the temporal trend of incidence of ADHD diagnoses in recent years, but we found geographical differences.

Consumption of Synthetic Cannabinoids in Adult Attention-Deficit/Hyperactivity Disorder: a Pilot Study

Attention-deficit/hyperactivity disorder (ADHD) is associated with an increased risk for substance abuse and addiction. Synthetic cannabinoids (SC) have gained rising importance as their consumption increased rapidly in the last few years. However, SC consumption in patients with adult ADHD has not been investigated yet. A prospective clinical pilot study was conducted, including 60 adults with ADHD, assessing the prevalence of SC consumption and its associations with psychiatric comorbidities and patient characteristics. A drug consumption survey was utilized to investigate the use of SC and other drugs. Current ADHD symptoms were evaluated via ADHD Self-Rating Scale (ADHD-SR) and retrospective childhood ADHD symptom severity via Wender Utah Rating Scale (WURS-k) questionnaire. A positive lifetime prevalence of SC consumption was found in 15.0% of the analyzed sample. SC consumption was significantly associated with current smoking, lifetime use of natural cannabis (NC), cocaine, amphetamines, and benzodiazepines. Lifetime NC consumption was indicated by 65.0% and found to antecede SC use in adult ADHD patients. Logistic regression analysis identified substance use disorder and male sex as predictive for SC consumption. Patients with history of SC use scored significantly higher in both WURS-k and ADHD-SR questionnaire compared with nonusers and suffered significantly more frequently from psychiatric comorbidities. Main side-effects of SC included gastrointestinal, cardiovascular, and neuropsychiatric symptoms. SC consumption in adults with ADHD is frequent and associated with stronger ADHD symptom severity. Given the underestimated dangerous effects and related comorbidities, SC use should be subject to scrutiny by clinicians treating ADHD patients. More studies are needed to further elucidate the impact of SC use in ADHD.

A Phenomenological Study of Undergraduates with Attention Deficit Hyperactivity Disorder and Academic Library Use for Research

Attention deficit hyperactivity disorder (ADHD) is a neurobiological disorder that is characterised by inattention, hyperactivity, and impulse control problems. Students with ADHD are entering higher education at an increased rate and although there is some research on this population in higher education, library specific literature on the topic is lacking. This research is an examination of how undergraduates with ADHD use the library to perform research for academic purposes. By employing observational task and phenomenological interview methods on three undergraduates with ADHD, we can begin to form a library user profile of students with attention disorders.

Survey on centres and procedures for the diagnosis and treatment of adult ADHD in public services in Italy.

Attention deficit/hyperactivity disorder (ADHD) often persists into adulthood. Although its persistence and relative high prevalence, ADHD in adults is often underdiagnosed and undertreated in Italy, leading to poor clinical and functional outcomes, and higher costs of illness. The aims of the study were to identify the Italian mental health services for ADHD in adults, describe the diagnostic and treatment procedures they follow, and compare this offer with the recommendations of the German and English guidelines. The centres, that adopt a clinical and assessment protocol for adult ADHD diagnosis (carried out by specifically trained personnel) and prescribe pharmacological treatment for adult ADHD, were selected from the list of accredited services provided by the Appendix B.2 of the ISTISAN 16/37 Reports of the ISS. An ad-hoc survey including open-ended and close-ended questions was sent to each selected centre in February 2020. The overall picture resulting from the data analysis was compared with the recommendations of the German and English guidelines. The present survey shows that only a few centres are specialised in the diagnosis and treatment of ADHD in adults in Italy. Furthermore, there are no national guidelines for adult ADHD in Italy. The collected data also suggest that there is no a unified practice shared by the Centres both for the patient's transition from child and adolescent to adult mental health services and for the diagnostic-therapeutic process. It is therefore crucial to create specific protocols and develop national guidelines to better identify and diagnose ADHD in adults and provide targeted and more efficient multimodal treatments.

Enhanced Nitric Oxide (NO) and Decreased ADMA Synthesis in Pediatric ADHD and Selective Potentiation of NO Synthesis by Methylphenidate.

Attention deficit hyperactivity disorder (ADHD) is a common pediatric psychiatric disorder, frequently treated with methylphenidate (MPH). Recently, MPH’s cardiovascular safety has been questioned by observational studies describing an increased cardiovascular risk in adults and blood pressure alterations in children. We considered members of the L-arginine (Arg)/nitric oxide (NO) pathway as possible early cardiovascular risk factors in pediatric ADHD children. They include the NO metabolites, nitrite and nitrate, the NO precursor Arg, and asymmetric dimethylarginine (ADMA), an endogenous NO synthase (NOS) inhibitor and a cardiovascular risk factor in adults. We conducted a prospective clinical trial with 42 ADHD children (aged 6–16 years) with (n = 19) and without (n = 23) MPH treatment. Age-matched children without ADHD (n = 43) served as controls. All plasma and urine metabolites were determined by gas chromatography-mass spectrometry. We observed higher plasma nitrite and lower plasma ADMA concentrations in the ADHD children. MPH-treated ADHD children had higher plasma nitrite concentrations than MPH-untreated ADHD children. As NOS activity is basally inhibited by ADMA, MPH treatment seems to have decreased the inhibitory potency of ADMA. Percentiles of systolic blood pressure were higher in MPH-treated ADHD children. The underlying mechanisms and their implications in the MPH therapy of pediatric ADHD with MPH remain to be elucidated in larger cohorts.