Response 1

Need to defend stance for the use of Alpha Adrenergic Agonist drug class and the use of specific medications like (intuniv {guanfacine} or kapvay {clonidine} instead of Methylphenidate by supporting or expand on original argument to refute colleague's claims. Work to share additional perspectives on the issue described by your colleague. Responses need to be supported by two (2) scholarly peer-reviewed resources located outside of your course Learning Resources. The following is what the essay defends against: The PROs of Methylphenidate for ADHD: A Case Study for Malcolm Mechanism of Action and Appropriateness for Malcolm Methylphenidate is a central nervous system stimulant commonly used to treat Attention-Deficit/Hyperactivity Disorder (ADHD). It works primarily by inhibiting the reuptake of dopamine and norepinephrine in the brain, thereby increasing their availability in the synaptic cleft. This mechanism helps improve attention, focus, and control over impulses, which are crucial for individuals with ADHD. For Malcolm, a 9-year-old with ADHD, combined presentation, methylphenidate can be particularly appropriate due to its efficacy in reducing symptoms such as hyperactivity, impulsivity, and inattention. Studies have shown that methylphenidate significantly improves academic performance and social interactions in children with ADHD (Aral et al., 2022). Advantages and Disadvantages of Methylphenidate Advantages: 1. Variety of Formulations: Methylphenidate is available in several formulations, including immediate-release (IR), sustained-release (SR), and extended-release (ER) versions. This variety allows for flexibility in dosing and duration of effect, making it easier to tailor treatment to Malcolm's specific needs (Shirafkan et al., 2020). 2. Quick Onset of Action: Immediate-release methylphenidate begins working within 30-60 minutes, which can be beneficial for managing symptoms during school hours (Bozkurt & Balta, 2023). 3. Proven Efficacy: Methylphenidate has been extensively studied and is one of the most effective treatments for ADHD, providing symptom relief for the majority of children with the disorder (Ji-Woo et al., 2021). Disadvantages: 1. Potential for Abuse: As a stimulant, methylphenidate has a potential for abuse and dependence, although this risk is generally lower in children treated for ADHD (Shirafkan et al., 2020). 2. Side Effects: Common side effects include appetite suppression, insomnia, and potential cardiovascular effects. These side effects require careful monitoring and management (Shirafkan et al., 2020). Advantages of Alternative Medications Non-Stimulant Medications: Non-stimulant medications, such as atomoxetine and guanfacine, can be effective for ADHD and may have a lower risk of abuse. They also offer a different side effect profile, which might be preferable for some patients. 1. Atomoxetine: This medication is a selective norepinephrine reuptake inhibitor. It has a lower potential for abuse and can be beneficial for patients with coexisting anxiety (Park et al., 2022). 2. Guanfacine: This alpha-2 adrenergic agonist can help with both ADHD symptoms and aggression, which might be beneficial for Malcolm's issues with hitting other children (Park et al., 2022). Possible Side Effects and Considerations Methylphenidate: Side effects to be aware of include: • Appetite Suppression: Monitoring Malcolm’s growth and nutritional intake is crucial. • Insomnia: Adjusting the timing of doses can help mitigate this. • Cardiovascular Effects: Baseline and periodic monitoring of heart rate and blood pressure are recommended (Bozkurt & Balta, 2023). Legal, Ethical, and Social Implications Legal Consideration: Ensuring that the prescription and use of methylphenidate comply with regulations regarding controlled substances. Proper documentation and monitoring are essential to prevent misuse (Shirafkan et al., 2020). Ethical Consideration: Informed consent and assent must be obtained from both Malcolm and his parents. They should be fully informed about the benefits, risks, and alternatives to methylphenidate to make an educated decision (Ji-Woo et al., 2021). Social Consideration: Addressing potential stigma associated with ADHD and stimulant medications is important. Providing education to Malcolm's school and peers about ADHD and its treatment can foster a supportive environment (Shirafkan et al., 2020). Conclusion Methylphenidate is a well-supported treatment option for Malcolm, offering significant benefits in managing his ADHD symptoms. However, it is crucial to monitor for side effects and consider the legal, ethical, and social implications of its use. By tailoring the treatment plan to Malcolm's specific needs and ensuring comprehensive education and support, optimal outcomes can be achieved. References Aral, A., Onat, M., & Aydemir, H. (2022). Functional outcomes of extended-release methylphenidate and atomoxetine in children: retrospective chart analysis. The Egyptian Journal of Neurology, Psychiatry, and Neurosurgery, 58(1) https://doi(dot)org/10.1186/s41983-022-00532-3Links to an external site. Bozkurt, A., & Balta, S. (2023). The effect of methylphenidate on pain perception thresholds in children with attention deficit hyperactivity disorder. Child and Adolescent Psychiatry and Mental Health, 17, 1-9. https://doi(dot)org/10.1186/s13034-023-00667-yLinks to an external site. Ji-Woo, S., Soltis-Vaughan, B., Mahato, K., & Hwang, S. (2021). Practical and Ethical Issues in Pediatric Psychopharmacology: Introductory Considerations: Psychiatric Annals, 51(10), 450-458. https://doi(dot)org/10.3928/00485713-20210913-01Links to an external site. Park, J., Dong, Y. L., Kim, C., Yo, H. L., Su-Jin, Y., Sangha, L., Seong-Ju, K., Lee, J., Park, R. W., & Shin, Y. (2022). Long-term methylphenidate use for children and adolescents with attention deficit hyperactivity disorder and risk for depression, conduct disorder, and psychotic disorder: a nationwide longitudinal cohort study in South Korea. Child and Adolescent Psychiatry and Mental Health, 16, 1-9. https://doi(dot)org/10.1186/s13034-022-00515-5Links to an external site. Shirafkan, H., Mahmoudi-Gharaei, J., Fotouhi, A., Seyyed, A. M., Yaseri, M., & Hoseini, M. (2020). Individualizing the dosage of Methylphenidate in children with attention deficit hyperactivity disorder. BMC Medical Research Methodology, 20, 1-8. https://doi(dot)org/10.1186/s12874-020-00934-yLinks to an external site.