Attention Deficit Hyperactivity Disorder in Children and Adults

Attention deficit hyperactivity disorder (ADHD) is a chronic condition that affects millions of children and often continues into adulthood. It is characterized by problems paying attention, excessive activity, or difficulty controlling behavior, which is not appropriate for a person's age. When comorbid with Tourette syndrome (TS), pre-natal maternal smoking strongly correlates with ADHD. High rates of comorbidity between ADHD and smoking have been described, but the etiology of this relationship is largely unknown. In addition to common genetic denominators, the relationship between smoking and ADHD can be explained by the impact of nicotine on neurotransmitter systems. The dopaminergic neurotransmission system is altered in ADHD patients, so that they exhibit lower levels of dopamine due to the elevated number of dopamine transporters. Clinical trials with nicotine patches conducted so far reported positive results such as improved cognitive performance and overall reduction of ADHD symptoms with some adverse effects (nausea, stomach ache, itching, and dizziness). Nicotine nasal spray and transdermal patches are proposed for ADHD patients to aid in quitting smoking. In this chapter the impact of smoking and nicotine on ADHD is described.