Debate on ADHD Medication for Malcolm and Jessica

Mechanism of Action

Amphetamines, such as Adderall, act by increasing the levels of dopamine and norepinephrine in the brain, enhancing focus and reducing impulsivity and hyperactivity (Mullen et al., 2020). This mechanism is particularly beneficial for Malcolm, whose hyperactive and impulsive behaviors are disrupting his education and social interactions. Amphetamines can offer rapid symptom relief and have flexible dosing options (American Academy of Pediatrics, 2019). Conversely, non-stimulants like atomoxetine work differently by inhibiting norepinephrine reuptake, leading to improved attention and reduced impulsivity without the addictive potential of stimulants (Barbuti et al., 2023).

Advantages and Disadvantages

Amphetamines have the advantage of rapid symptom relief and multiple dosing options, but their potential for abuse and side effects such as insomnia and increased heart rate raise concerns, particularly for young children like Malcolm. Non-stimulants could be advantageous for Jessica due to their longer duration of action and reduced risk of dependency, making them suitable for sustained attention in a work environment. However, non-stimulants may take several weeks to become effective and can cause side effects like fatigue and gastrointestinal disturbances (Martin & Le, 2023).

Considerations and Implications

Ethically, prescribing amphetamines includes the potential for misuse, especially in a school setting where medication diversion is possible. Legally, prescribers must ensure strict adherence to controlled substance regulations. Socially, there may be stigma associated with stimulant use. For non-stimulants, ethical concerns include ensuring patient adherence given the delayed onset of action. Legally, these are less stringently controlled, but the social impact of managing side effects like fatigue must be considered, as it can affect daily functioning (Lam et al., 2020).

Conclusion

Both medication classes have distinct advantages and limitations that must be carefully weighed based on the individual needs and contexts of Malcolm and Jessica. Amphetamines provide rapid relief but come with significant side effects and abuse potential, while non-stimulants offer a safer profile but require patience for effectiveness.

References

Barbuti, M., Maiello, M., Spera, V., Pallucchini, A., Brancati, G. E., Maremmani, A. G. I., Perugi, G., & Maremmani, I. (2023). Challenges of treating ADHD with comorbid substance use disorder: Considerations for the clinician. Journal of Clinical Medicine, 12(9), 3096. https://doi.org/10.3390/jcm12093096

Lam, C., Figueroa, W., Yomogida, K., & Bavarian, N. (2020). Prescription stimulant diversion on a college campus: Intrapersonal, interpersonal, and environmental correlates. Journal of Drug Issues, 50(3), 329–340. https://doi.org/10.1177/0022042620917103

Martin, D., & Le, J. K. (2023, July 31). Amphetamine. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK556103/

Mullen, J. M., Richards, J. R., & Crawford, A. T. (2020). Amphetamine related psychiatric disorders. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK482368/

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We’ll write everything from scratch

In Week 5, you were assigned by the Faculty to argue either the pro (for) or con (against) a particular medication. You were also provided information for a patient case study scenario. Week 5 was your opportunity to conduct research for this debate.

Debate on ADHD Medication for Malcolm and Jessica

This week, you will present and defend your assigned stance (pro or con) and specific medication for your patient case study scenario with your peers. Within the debate, you will also share your perspective on why the alternative medication class would not be appropriate for the patient case scenario.

Support your answers with evidence-based, peer-reviewed scholarly literature.

Note: APA style format with citations and references will apply.

As a reminder, these were the assigned medications:

Pro Con
Amphetamine

Amphetamine

Methylphenidate

Alpha Adrenergic Agonist

Non-Stimulant