After reading these articles, you should be able to…

Recently three new psychostimulant formulations have been approved (Daytrana, the Ritalin patch, and Focalin XR), and one older medication received a new indication (Adderall XR is now indicated for adult ADHD).

On April 6, 2006, the FDA announced the approval of Daytrana, a transdermal patch version of Ritalin (methylphenidate). While you wouldn’t know it by the gushy promotional copy on Daytrana’s website (www.daytrana.com), the Ritalin patch just barely squeaked through the FDA approval process.

Rarely has a 7-year old with a rash caused the stock price of a major corporation to gyrate so dramatically.

Mr. H., now 49, was first diagnosed with ADHD at the age of 40, when he was evaluated at the suggestion of an old friend, a psychologist who had known him in grade school.

Dr. Diller, as a behavioral pediatrician you certainly prescribe stimulants and other psychiatric medications to children, but at the same time you have spent much of your career speaking and writing about some the potential negative consequences of the excessive use of stimulants. You’ve also studied the history of stimulant use, and have thought about how this can inform our decisions now.

After reading these articles, you should be able to…

We’ve all noticed the trend: children are increasingly being diagnosed with bipolar disorder. This issue is controversial, because psychiatrists are already accused of overmedicating children.

The STEP-BD study, an NIMH-funded study of bipolar disorder, has enrolled its last patient, and we have already begun to see the first results filtering through to the psychiatric journals.

The latest foray into the controversial issue of antidepressant-induced switching appeared in the February issue of The American Journal of Psychiatry (2006;163:232-239). The last time TCPR took up this topic (June 2005), we reviewed a meta-analysis of antidepressant use in bipolar disorder. That paper concluded that SSRIs cause the same rate of manic switching as placebo (Am J Psychiatry 2004;161:1537-1547). The authors of the newly published research would beg to differ.