Read a selection of your colleagues’ posts. Focus specifically on those colleagues’ arguing the opposite of your claim.

Respond to at least two of your colleagues on 2 different days that were assigned the opposite of your claim. Support or expand on your argument to refute their claims. Work to share additional perspectives on the issue described by your colleague.

Note: Your response needs to be supported by two (2) scholarly peer-reviewed resources located outside of your course Learning Resources

Colleague post 1

NURS 6630 Week 6 Discussion: Cons of Non-Stimulants

Non-stimulant medications are sometimes prescribed for ADHD when stimulant medications are not suitable or effective for an individual (Mechler et al., 2022). While they can be beneficial for many people, there are potential drawbacks or cons associated with using non-stimulant ADHD medications like atomoxetine (Strattera) or guanfacine (Intuniv) for people like Malcolm (Mechler et al., 2022). Here are some considerations:

Non-stimulant medications typically take longer to start working than stimulant medications (Mechler et al., 2022). It may take several weeks of consistent use before the full effects are felt, which means Malcolm might not experience immediate symptom relief.
Non-stimulant medications may be less effective than stimulants for managing certain symptoms of ADHD, such as impulsivity and hyperactivity (Radonjić et al., 2023). Malcolm’s symptoms, including impulsivity and hyperactivity, may not respond as strongly to non-stimulant medications.
While stimulant medications are associated with side effects such as appetite suppression, insomnia, or an increased heart rate, non-stimulant medications can also have side effects (Radonjić et al., 2023). Common side effects of non-stimulant ADHD medications may include fatigue, drowsiness, an upset stomach, or headaches (Radonjić et al., 2023). These side effects may impact Malcolm’s daily functioning and quality of life.
In some cases, non-stimulant medications can have more serious side effects, although these are rare (Cutler et al., 2020). For example, atomoxetine (Strattera) has been associated with an increased risk of suicidal thoughts or behaviors, particularly in children and adolescents (Cutler et al., 2020). Monitoring for mood changes and suicidal ideation is important when using this medication (Cutler et al., 2020).
Non-stimulant medications may be more expensive than stimulant medications, and insurance coverage for these medications can vary (Mechler et al., 2022). Cost may be a barrier to access for some individuals and families (Mechler et al., 2022).
There is less research evidence available on the long-term efficacy and safety of non-stimulant medications compared to stimulant medications for ADHD (Mechler et al., 2022). This may contribute to uncertainty about their use, particularly for certain populations and age groups (Mechler et al., 2022).

Colleague post 2

MAIN POST

For this week’s discussion post, my assigned medication class for the treatment of ADHD is non-stimulants taking a PRO stance. The most common non-stimulant medication used to treat ADHD in children ages six and older is atomoxetine (Strattera). Atomoxetine is a norepinephrine reuptake inhibitor and increases the “concentrations of norepinephrine and dopamine in the prefrontal cortex” (Brown et al., 2018, Non-stimulant medications section). Additionally, it also blocks the norepinephrine transmitter and prevents serotonin reuptake. Side effects of atomoxetine include headache, insomnia, nausea, vomiting, and abdominal pain (Fedder et al., 2023).

According to Preston & Johnson (2024), non-stimulants can work in combination with stimulants to help boost the effects of the stimulant, or they can be used in “monotherapy” (p58). When used in combo (for example, atomoxetine and methylphenidate), both can be given in the morning; while the stimulant will be active until midday, the non-stimulant will continue to be effective throughout the rest of the day until evening. If used in monotherapy, it is less effective than a stimulant. However, it has fewer side effects than a stimulant, especially in patients who have Tourette’s, tics, and anxiety, where stimulants may worsen their symptoms.

The disadvantages of amphetamine include worsening symptoms in patients with tics, anxiety, and Tourette’s. It is habit-forming as it is a Schedule II drug and may lead the patient to develop a tolerance (Stahl, 2020). Additionally, the disadvantages of alpha-adrenergic agonists such as clonidine are that a patient needs to take twice or sometimes three times a day, depending on the age, and the patient may forget to take the medication. It also may cause withdrawal symptoms if stopped abruptly, as well as it may cause rebound hypertension (Stahl, 2020). Lastly, the disadvantages of methylphenidate, like amphetamine as both stimulants, may worsen symptoms in patients with tic, Tourette’s, or anxiety disorders. Methylphenidate may cause stunted growth in children who use it long-term (Verghese & Abdijadid, 2022). This medication should be avoided in patients who have underlying cardiac issues as it may worsen arrhythmia. Additionally, methylphenidate should be avoided or at least keep patients monitored for “activation of known or unknown bipolar disorder” (Stahl, 2020, p. 479).

A legal consideration for non-stimulant drug usage in ADHD management is that ADHD lowers the patient’s self-esteem as they lack self-determined behavior and are not able to engage in activities fully. It is essential to report any signs of child abuse and bullying that a child or adolescent may be going through either at home or school. Ethically, when treating patients with ADHD, it is essential to respect autonomy and remain advocates for the patient. If the patient is underage, seek consent from the parent or caregiver while keeping the child’s wishes in mind when creating a treatment plan. For many parents and caregivers, pharmacotherapy for ADHD in children and adolescents is still considered controversial. Lastly, a social implication is that patient education and medication literacy are critical in treating and managing ADHD in children and adolescents. Many parents may make the mistake of giving medication during the school week and taking the patient off the medication on the weekends, thinking this is helping their child remain “who they are” with their “quirks” when all they are doing is disrupting the chemical balancing in the child’s brain.

Nb
There are two post
I need a page of response for each post
Each post must have a separate reference page in apa
References must be less than 5 years, meaning no reference accepted after 2019
Follow instruction
No references accepted from weekly resources

Weekly resources
Goldin, D. S. (2023). Fast facts for psychopharmacology for nurse practitioners. Springer Publishing.
Chapter 9, “Stimulants/Neurodevelopmental Disorders” (pp. 178–208)
Chapter 10, “Antidementia” (pp. 208–227)
American Academy of Pediatrics. (2019, October). Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents Links to an external site.. Pediatrics, 144(4), Article e20192528. https://doi.org/10.1542/peds.2019-2528
Drugs.com Links to an external site.. (2023). https://www.drugs.com/
Note: Please use the following resource to check the most up-to-date box warnings, FDA approvals and indications, recommendations for follow-up evaluations, changes, etc.
CHADD’s National Resource Center on ADHD. (2023). ADHD medications approved by the U.S. Food and Drug Administration: Stimulant medications. https://d393uh8gb46l22.cloudfront.net/wp-content/uploads/2020/02/ADHD-Medications-Approved-by-FDA-2.23.pdf
Note: Utilize this medication table resource to familiarize yourself with the medications aligned with the topics presented this week.