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Researchers also looked at how much patients were bothered by a combination of MS symptoms and AEs before, during, and after treatment. What they found was that the combined effect of symptoms and side effects was not substantially different between baseline and one week after treatment. This suggests that one week after treatment, the benefit gained from a decrease in MS symptoms was neutralized somewhat by the increased burden of adverse events related to treatment. Interestingly, the combined burden was the lowest on Day Two of IVMP treatment.

Accordingly, family physicians should consider several strategies to prevent misuse or diversion of stimulants prescribed for adults with ADHD. These include signing a controlled substances agreement; performing random urine drug screening to verify that the patient is taking the prescribed medication and to screen for nonprescribed or illicit drugs; and scheduling periodic follow-up visits to assess medication effectiveness and potential violation of the agreement. 41 Data Sources: A PubMed search was completed using the key term adult ADHD combined in separate searches with diagnosis, management, and treatment. The search included meta-analyses, randomized controlled trials, clinical trials, and reviews. Also searched were the Agency for Healthcare Research and Quality evidence-based practice database, the Cochrane Database of Systematic Reviews, the National Guideline Clearinghouse database, and Essential Evidence Plus. Search date: January 10, 2011.

Transdermal patches (adhesive patches placed on the skin) may also be used to deliver a steady dose through the skin and into the bloodstream. Testosterone-containing creams and gels that are applied daily to the skin are also available, but absorption is inefficient (roughly 10%, varying between individuals) and these treatments tend to be more expensive. Individuals who are especially physically active and/or bathe often may not be good candidates, since the medication can be washed off and may take up to six hours to be fully absorbed. There is also the risk that an intimate partner or child may come in contact with the application site and inadvertently dose himself or herself; children and women are highly sensitive to testosterone and can suffer unintended masculinization and health effects, even from small doses. Injection is the most common method used by individuals administering AAS for non-medical purposes. [45]

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