Dr. Russell Barkley

So that's really the difference.

Clinicians use disorder, governments use disabilities, and the two of them blend together.

Well, we used to think it explained everything, and now we know that things are a lot more complicated.

But back in the day when I came in in the 70s and 80s, the guessing was that ADHD had to be due to dopamine deficiency because the drugs we've discovered to manage it all produced increases in dopamine availability internationally.

the brain and they did it through various mechanisms they don't all do it the same but at the end of the day the net result is that there's more dopamine in the brain to do the job that it's not doing in people with ADHD and it turned out that while that is true we also began to discover that norepinephrine which is related to dopamine

also is implicated in the disorder.

Hence, you have Eli Lilly coming out with Stratera, which is a norepinephrine drug that increases norepinephrine in the brain.

Then you have the new Calbrie that came out just this past April, and that's a new drug.

That's a norepinephrine drug.

But then we also began to realize, no, wait a second, there's other things going on in the brain here.

we're discovering that these alpha-2 ports, as they're called, in the frontal lobe, which are little, I'll call them sphincters.

A sphincter says what?

But portholes on neurons in the frontal lobe that open and close to determine how much noise is in the nerve cell, that these alpha-2 ports...

which are responsive to alpha two drugs also are beneficial for ADHD because they fine tune the nerve signals in the executive brain.

So we can get at ADHD now through at least three and probably more neurotransmitters.

Dopamine being one, and that's what the stimulants are doing.

Norepinephrine being the other, and that's what the non-stimulants are doing.

And then managing the alpha-2 ports and the noise in the frontal lobe, and that's what the antihypertensive drugs are doing, clonidine and guanfacine.

So we've got six different medications out there, and we've got many, many new delivery systems for those medications.

But those are the three classes of medicines that we're using.