ADHD Briefcase - Edition 10 - 2023

Introduction

The borderland of Tourette’s and ADHD

Phenomenology and epidemiology

The prevalence of ADHD is between 5 and 16%, with 30 to 40% of individuals still having moderate to marked symptoms in adulthood.  The male: female ratio is 2-3:1. In clinical settings, 20% of individuals with ADHD has comorbid tic disorders, while the co-occurrence in community settings are 2.3%. The onset of symptoms usually precedes the onset of tics with 2-3 years.3 The prevalence of TS is 0.3 to 3.4%, with 25% of individuals having moderate to severe tics during adulthood. The male: female ration is 4:1. In clinical settings, 60-80% of individuals have comorbid ADHD, while in community settings, the co-occurrence is 15%. Motor tics usually have an onset between 5 and 7 years, while vocal tics start 3 to 4 years later. The intensity and frequency of tics typically diminishes during the later teenage years. One third of patients will achieve significant remission, although complete, lifelong remission is rare. One third will have mild, persistent, but “non- impairing” tics. 

The power trio for managing ADHD: The ketogenic diet, gut microbiome, and omega-3

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that affects a high proportion of children worldwide, including South Africa. It is characterised by symptoms such as inattention, hyperactivity, and impulsivity, which can significantly impact a child’s academic performance and overall well-being. While medication and behavioural therapies are commonly used to manage ADHD, emerging research suggests that dietary interventions, such as the ketogenic diet, optimising the gut microbiome, and increasing omega-3 intake, may play a crucial role in addressing ADHD symptoms. In this article, we will explore the scientific evidence supporting the use of these three strategies and their potential as actionable points in managing ADHD.

Treating long COVID with stimulants

COVID-19 caused a worldwide pandemic which resulted in 120 million cases with 2.6 million deaths to date. When symptoms exist beyond 12 weeks post-COVID-19 syndrome (long COVID) is diagnosed.2 The development of this disorder is unrelated to the severity of the acute illness. Long COVID may present with fatigue, shortness of breath, myalgia, headache, decreased sense of taste or smell, post exertional malaise, cognitive impairment, depression, apathy, anxiety, and possible post-traumatic stress symptoms.