الفهرس 
REVIEW OF LITERATUREOnly 14 pages are availabe for public view
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Abstract
Attention deficit hyperactivity disorder (ADHD) is now one of the most common children’s mental health conditions. It involves symptoms of inattention or impulsivity and hyperactivity that lead to behavioral impairments. Approximately (50) percent of children diagnosed with ADHD continue to show clinically significant symptoms and impairment as adult. ADHD is not a single pathophysiological entity and appears to have a complex etiology. Multiple genetic and environmental factors act together to create a spectrum of neurobiological liability.
Treatment of ADHD includes pharmacological and psychosocial intervention. Treatment interventions are determined by the age of the child and level of severity of the condition.
Caffeine is found in coffee, tea, and chocolate and it’s one of the world’s favorite drugs. The right amount of caffeine can help to focus, but too much might make the person jittery, anxious, or irritable.
Caffeine, or more properly, 1,3,7-trimethylxanthine and quickly absorbed once consumed and it immediately gets to work stimulating neurotransmitter release.
Caffeine is considered a stimulant. It stimulates the body’s central nervous system and boosts the brain’s production of a neurochemical known as dopamine, which controls the ability to focus and maintain concentration. This stimulation can cause a person to feel energized and not to feel the effects of fatigue as strongly.
The aim of the present study was to assess the correlation between the combining effect of caffeine and stimulant drugs and effect of stimulant drugs alone, the present study involved (50) child aged (6-11) years diagnosed as ADHD according to DSM-V and on regular stimulant drug attended Child Psychiatry Clinic in Zagazig University Hospital during the period between January 2016 till June 2017; received caffeine regularly and their parents were agreeing to follow caffeine regimen (Test group), another group consisted of (100) child same age diagnosed as ADHD according to DSM-V and on regular stimulant drug only (control group).
Both two groups passed through pre assessment by:
- Full medical history taking focusing on symptoms and signs and stressing on nutritional history.
- Thorough clinical examination assessment.
- Confirming diagnosis of ADHD according to DSM-V criteria and they all were already on regular same stimulating drug.
Both groups were assessed by IQ (Intelligence Quotient assessment by Stanford Binet fifth edition and Conners’ for parent and teacher rating scale, and Elbehairy scales before and after application of caffeine regimen on the Test group as follow:
The children of the test group were encouraged to take (1.8 gm) of classic black Nescafe with (180cc) milk twice daily at (7 am and 4 pm) every day for continuous six months (sweetening of caffeine was standardized to all children). Children were advised to drink plenty of water during the day at least four glasses of water per day to overcome the diuretic effect of caffeine.
- Monitoring the amount of caffeine which were given per week by (follow up chart) given to mother weekly noting everyday as received caffeine or not and excluding children who weren’t on regular caffeine intake schedule and dropping two days of caffeine.
- Given written instruction about diet and restricted food containing caffeine and restricted sugar intake, food additives and junk foods.
Results of this study showed that There is no significance difference regarding age, Gestational age, post-natal resuscitation, need for Babysitter, going to day care, past history of head trauma development of speech, long period of watching TV and presence of preceding events except post-natal incubation showed significance difference according to males in test and control groups. Also, there is no significance difference regarding gestational age, post-natal incubation, need for babysitter, going to Day care, past history of head trauma, development of speech, long period of watching TV and presence of preceding events and post-natal incubation according to females.
There is no significance difference regarding Status of parents, Family history of ADHD, and Consanguinity or prenatal maternal diseases. Except socioeconomic level according to males of both groups. And same for females except Prenatal maternal diseases. And according to IQ There is no significance difference regarding (males and females) both groups before intervention regard IQ. But it showed significance difference post-intervention in both groups regarding males and no significance difference post intervention in both groups regarding females, in this study parents and teacher scores, standard ranks and percentile ranks were compared in both groups according males and females before intervention and there were not statistically significant and became statistically significant after intervention, paired T test for comparison between before and after treatment for males and females according previous parameters in intervention group and it showed significance difference and no significance difference in control group.
CONCLUSION
Caffeine is a biphasic weapon affecting ADHD children if it is used in precise dose in regular times, will offer more potent and synergetic combining effect with stimulant drugs in school age (6-11) years provided that other nutritional caffeine sources should be restricted and monitored to avoid its side effects.
RECOMMENDATIONS
• Caffeine use for ADHD should always be prescribed with a physician by précised dose and restrictive way.
• Caffeine treatment is effective adjuvant therapy for ADHD (6-11) years.
• Further researches of use of different doses of caffeine as a trial to withdraw the dose of stimulant drugs on a larger sample of ADHD patients are recommended.
• Further researches better to be done on other age groups to detect efficacy of the combining effect of caffeine and stimulant drugs.
• Further researches better to be done on other routes of administration of caffeine rather than oral form.