From the Guidelines
Withholding Azstarys and administering multiple intramuscular injections of antipsychotics is not an appropriate treatment approach for ADHD. The use of antipsychotics such as Latuda, Zyprexa, Haldol, and Thorazine is not a standard treatment for ADHD, and may even exacerbate the patient's condition, particularly if they have a history of psychosis or other contraindications 1.
- The American Academy of Child and Adolescent Psychiatry practice parameters suggest that stimulants, such as Azstarys, are a first-line treatment for ADHD, and that antipsychotics should not be used as a primary treatment for the disorder 1.
- The package inserts for stimulants, including Azstarys, do not mention psychosis as a contraindication, but the AACAP practice parameters suggest that psychosis is a contraindication for stimulant use 1.
- The use of multiple intramuscular injections of antipsychotics, particularly in a patient with a primary diagnosis of ADHD, is not a recommended treatment approach and may increase the risk of adverse effects such as severe hypertension, cerebrovascular accident, and worsening of psychosis 1.
- Stimulants, such as Azstarys, are generally considered safe and effective for the treatment of ADHD, and should not be withheld in favor of antipsychotics, unless there are specific contraindications or concerns, such as a history of psychosis or other conditions that may be exacerbated by stimulant use 1.
From the Research
Administration of Antipsychotics
- The administration of multiple intramuscular injections of antipsychotics, including Latuda (lurasidone), Zyprexa (olanzapine), Haldol (haloperidol), and Thorazine (chlorpromazine), is not a recommended treatment for Attention Deficit Hyperactivity Disorder (ADHD) 2, 3.
- Studies have shown that intramuscular injections can be associated with injuries and other complications, and that the choice of injection site, needle size, and technique are important factors to consider 2, 3.
- The use of antipsychotics for ADHD is not supported by evidence, and may potentially exacerbate the patient's condition 4, 5.
Medication Adherence
- Medication adherence is a critical factor in the success of treatment, and non-adherence can be costly for the health service 6.
- Factors that affect an individual's compliance with a medication regimen include intentional or non-intentional non-adherence, and many factors can influence an individual's decision to take their medication as prescribed 6.
- The interaction with a health professional is important for understanding the reason for non-adherence and for promoting adherence 6.
Treatment of ADHD
- Azstarys (serdexmethylphenidate and dexmethylphenidate) is a prescribed medication for the treatment of ADHD, and withholding it in favor of antipsychotics is not a recommended treatment approach 4, 5.
- The treatment of ADHD should be guided by evidence-based practices, and the use of antipsychotics should be reserved for patients with a diagnosis of a condition that is supported by evidence for the use of these medications 4, 5.