ADHD Drugs - Yes or No?
84The 8-year-old, bright but struggling in school, begins a Ritalin "trial." Soon, though, the child psychiatrist switches the child to Dexedrine sustained release because the capsule can be opened, and the drug sprinkled on a spoonful of apple sauce or pudding. Like many children with ADHD, the boy has difficulty with his "gag" reflex. He won't learn how to "swallow" a pill until he's 15.
His mother gives him one "dose" before he goes to school. At school, a second dose at 1 p.m. should help him focus for the rest of the afternoon, plus have a less frustrating time with homework when he gets home.
He does seem less easily distracted. But his mom notes something else. He's lost his "sparkle."
ADHD drugs. Good or bad?
Some ADHD drugs have been in the news following a handful of "sudden deaths" from cardiac arrest. Last year, the FDA (www.fda.gov) ordered manufacturers of stimulant ADHD drugs to include "black box" warnings regarding potential side effects and risk of death. One such drug that now must carry the warning is Ritalin.
While many believe Ritalin is "overprescribed" - statistics would indicate otherwise. Of the three to five percent of children government experts say have ADHD, only one to two percent take Ritalin. The number of children who have ADHD may even be as high as nine percent, if a study of four U.S. communities is reflective of the total population, which would make the percentage of those taking Ritalin even lower.
Two years ago, the FDA's Pediatric Advisory Committee pointed out two possible dangers regarding Ritalin and another ADHD drug, Concerta. The committee said the drugs might cause psychiatric disturbance and cardiovascular events like stroke and heart attack. After looking into the deaths of 25 people taking "stimulant" ADHD meds like Ritalin, 19 of whom were children, eight months later, the FDA's advisory panel voted for the black box warning - the strongest such warning a prescription drug can carry. Other ADHD drugs required to carry the stronger warning are Adderall, Adderall XR, Methylin and Metadate, and their generic equivalents.
Although it was determined that some with ADHD who died while taking Ritalin or Concerta had pre-existing heart problems or hypertension; the FDA admits that potential risks associated with ADHD drugs have not been adequately studied. The FDA now links a newer, non-stimulant ADHD drug, Strattera (atomoxetine), to suicidal thinking.
Conversely, research shows that, statistically, ADHD drugs are 15 times less dangerous than over the counter anti-inflammatory drugs like Advil, Aspirin and Aleve, and an FDA review found fewer than one case of death or serious injury per 1-million filled ADHD prescriptions. Also, 52 percent of those with ADHD who receive no treatment abuse alcohol or drugs, but a Harvard Medical School study found that medication for ADHD lowered the risk of substance abuse in males by 85 percent. Sixty eight percent of children diagnosed with ADHD will still struggle with the disorder as adults, according to the National Institutes of Mental Health (http://www.nimh.nih.gov/).
The statistics and study are cited by Dr. Rick Sponaugle, medical director and founder of Florida Detox (http://www.floridadetox.com/, 888-775-2770). Dr. Sponaugle is board certfied in addiction medicine and anesthesiology. Important, he says, is to put the recorded deaths in the broader context of how many adults and children take ADHD drugs to help them focus and control restlessness and fidgeting: 2.5-million children and teens; 1-million adults, according to NIMH. The 25 who died spanned a five year time frame (1999-2003), during which another 54 suffered serious cardiac events while taking psychostimulant medications.
In 2005, a small Texas study raised an alarm concerning the use of stimulant drugs to treat ADHD and possible DNA damage. Such chromosomal abnormalities can cause cancer. Teams of FDA researchers are attempting to replicate the study on a larger scale. Investigating the smaller study, the FDA learned that all the children studied showed suspect DNA changes within a very short time. The FDA concluded the findings of the study could not be ignored.
This year, the FDA approved a new stimulant ADHD drug, Vyvanse, that it says is less likely to produce the sensation of other amphetamine-type drugs like Ritalin, and thus have less likelihood of being "abused." However, it carries the same warnings as the older psychostimulants - such as sudden death from heart related problems. Parents are warned to tell the child's doctor about any family history of heart problems or symptoms such as shortness of breath, fainting or chest pain that develop once medication is begun. Psychiatric issues, such as unwarranted suspicion or seeing, hearing or believing things that aren't real, should also be reported. Vyvanse is a once-a-day medication.
Meantime, Yale School of Medicine researchers in the April 20 issue of Cell report the first evidence of a molecular mechanism that significantly alters higher brain "circuitry" in the ADHD brain.
The area of the brain associated with "executive" functions, such as stop and think (impulsivity), is the prefrontal cortex. Yale researchers found that neurons in the prefrontal cortex have ion "channels" that specialize in receiving information. If the brain's prefrontal neurons "short circuit" when, for example, the ADHD person is under stress - the neuron networks disconnect. This impairs working memory, and makes the ADHD brain easily distracted.
The researchers describe ADHD as highly "heritable" (having a strong genetic link), and think those who have it may have genetic changes in molecules that weaken the production of the brain chemical norepinephrine. Norepinephrine helps "reconnect" the information network in the prefrontal cortex.
A drug, guanfacine, from Shire Pharmaceuticals Group has been shown to enhance information receptors in the higher brain in much the same way norepinephrine does. Yale has a license agreement with Shire to develop guanfacine as a treatment for those afflicted with ADHD.
Have questions about a specific ADHD drug? Call the FDA toll free at 1-(800) INFO-FDA (463-6332).
ADHD Medications
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Drugs should only be a last resort. Behavior managment works in most cases without having to poison our kids.
ADHD drugs good or bad? Research continues to find that the brain of people with ADHD is just different from non-ADHD brains. In time, it may be proved that ADHD is a normal condition for many people. Like being left handed and trying to use right handed tools, being ADHD and trying to fit into a system designed for others is difficult.
Often medication is an effective tool to help them fit into the current system. As with all tools, each person needs to determine which is the best tool to meet their goals and needs. Generally more than one tool is needed to achieve the goals. Taking the drugs is a personal decision and should be based on how well it helps to achieve the goals.
Maybe the question is not: drugs good or bad. The question may be: fitting into the current system: good or bad
I used to think the same way that behavior management would work instead of medications. That is completely untrue for so many children. I adopted a 5 year old boy with clearly known ADHD. I refused to let Dr.'s put him on medication because I thought I could fix it with giving him a routine and a loving home. I was so wrong and all I did was hurt this child for another year unitl he was started on medication. What a world of difference. He can now focus at school and be able to do his work. He is still a behavior problem but his mind is not racing at 100 mph anymore and he can calm himself down now. I am so thankful for the medications out there to help so many children with this disorder.
Hi,
My son, 8, recently been diagnosed with ADHD, my husband is totally against medication usage in a young child for one of the reasons that you gave about fitting into the system. I am a nurse, I am on the fence about it. I am so used to finding every possible treatment to cure and now that it's come to my son, I have a hard time not doing the same. However, I also see what you and my husband are saying. Along with putting medication into a young child, what is that teaching him, whenever you have an ailment there's a pill? Does this mean he's not aloud to be different in today society and taking the pill only encourages him to be the same as everyone else? How about the little boy we are so used to and now how will a different chemical make him a different personality all together? How as parents, do we make a responsible, just, moral, decision either way concerning our child???
Tearful,
Becky
Hi,
My son, 8, recently been diagnosed with ADHD, my husband is totally against medication usage in a young child for one of the reasons that you gave about fitting into the system. I am a nurse, I am on the fence about it. I am so used to finding every possible treatment to cure and now that it's come to my son, I have a hard time not doing the same. However, I also see what you and my husband are saying. Along with putting medication into a young child, what is that teaching him, whenever you have an ailment there's a pill? Does this mean he's not aloud to be different in today society and taking the pill only encourages him to be the same as everyone else? How about the little boy we are so used to and now how will a different chemical make him a different personality all together? How as parents, do we make a responsible, just, moral, decision either way concerning our child???
Tearful,
Becky
Becky, it's a tough call. When my son was taking Dexedrine sustained release he lost his sparkle. But he was able to focus and get his school work done. Which meant he didn't engage in behaviors that resulted in him constantly listening to angry adults saying, "Why can't you sit still? Why don't you pay attention? What's WRONG with you," while his classmates snickered.
Children with ADHD truly suffer. Many blame the ADHD child and his or her parents, accusing them of using ADHD as an "excuse." If they could exchange brains for a day, perhaps they would be more kind.
Good luck. It won't be easy. Your best bet is seeking out a private school setting that specializes in kids with ADHD. -- Carol
I think most of the approch towards people with ADHD and ADD is most people think there is a problem. I think the problem is with us we can't seem to truly comprehend the people that we think have ADHD or ADD I think they are just more advanced than we are. I beleave if we truly understood we would seen that they just think at a high rate of speed and the way we put the thoughts together in a human body becomes frustrating because everthing is just to slow.
Http://www.adhdconcerns.com
My son was diagnosed with ADHD in 2002 and put on various meds until one was deemed working appropriately. The last medication was Straterra. I took him off meds after 2 years when I noticed he was more like a zombie than my child and cried all the time. Oh yeah and 2 weeks after I took him off it was stated that Straterra causes thoughts of suicide. He seemed so depressed. I did my research, as should you. He has been off meds since 2004 and has good grades and copes just fine. His diet needed to change, his way of coping with ADHD, he needed to understand what ADHD is and how it affects him, and not use it as a crutch. We just have to be very consistent with him and do alot of follow-up. We do have to stay on him, but it's well worth it knowing what the possilbe consequences can be due to medicating. Please do your research before you even decide to put him on meds. I'm glad my husband and I did.
hi
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I was looking at ways to help children with medical issues and what i worked on parents started to use with ADHD kids.
It is only an educational extra tool. UK moms like it a lot. As alsways we need money for research.
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I recently learned of a homeopathic remedy for AD(H)D called "Attend." No side effects, no prescription necessary, Google it and you can order on line. One dad I know said it has turned his son's life around. I have no personal experience with it, but the information on the manufacturer's home page (www.vaxa.com) appears well researched and accurate. -- Carol
I have to respond to Thin Man's comment. I do not find it to be abusive at all and thank God that I chose to go with my own instincts. My 9 year old is now able to complete school and home work without a problem, makes lasting friendships and does clean up after himself (with reminders). It was not an easy process, though through regular communication with the school, diet and behavior modification, my son has made trememdous progress without any medication. Your child might, too.
My point being that it is not abusive to hold off on medicating while determining whether your child can learn to focus and control his impulses, Becky. As Margaret states, her child still has behavior problems on medication.
I am not certain that my son will ever be as calm as my older child. He is still quite a chatter box and needs to stay busy at all times, though he certainly is not unmanagable (as long as he does not have red dye 40) and is learning to handle the emotional impulses, too. A reward system works well with that.
I have noticed that developing organizational skills is still a challenge, though I am not certain that this is ADHD or just characteristic of boys :)
I wish you the best in your decision.
My son is 10 1/2 years old and has been diagnosed with ADD. My problem is that he doesn't have problems at home with focusing. If the teacher gives him homework of 30 math problems, he does them with no complaining. Or any other homework. He is not hyper. The problem seems to be that in the classroom he always has to go up to the teacher and ask her with she said about the directions. I am so worried about putting his on medication.
The doctor also said he has been diagnosed with Working Memory problems. Will the ADD medication solve his working memory problems. Or should I just concentrate on the working memory problem - as I see on the internet that Working Memory deficiencies can be improved upon?
Help - I welcome any comments? Thanks
Does your son have "preferential seating"? Make sure he's sitting in the front row if he doesn't already. Also, as an accommodation, the teacher could check his assignment notebook to make sure he's writing down assignments completely and accurately. You could set up e-mail contact weekly to stay on top of long term assignments: materials, requirements and due dates. Also, ask for a copy of the teacher's syllabus at the beginning of each quarter/semester. An Occupational Therapist might be able to do "brain training" exercises with your son to help with the memory issues. -- Carol
First of all I would like to say, if you are on ADD/ADHD medicine, please reconsider. I myself have been put on it(and have been on many different kinds). It is the worst feeling to be on it. Yes, I am angry, at the joint deceitful ways of PHD psychologists, and pharmaceutical companies who are trying to take away my artistic streak, of creativity and leave me spiritless. How dare they prescribe it to young 3 year old children... still developing, and succeed by controlling the media and hiding the amounts of deaths and heart problems caused due to it. Quietly putting the money in their pockets. Yes it will help you concentrate. but at what a cost? loosing our true personality. please hear me now, for your own good, there are other ways to concentrate, don't drug your self up with the lies that funds corruption>> be free, and live true'ly
Have you tried something called 'Attend'? Anecdotally, a dad I know said it changed his ADHD son's life. He said it is a more 'holistic' med without the side effects. When my son was taking Dexedrine sustained release (he couldn't take Ritalin because of his accentuated gag reflex -- common, I was told, in ADHD children) I felt he lost his 'sparkle'. Now 25, even though ADHD impairs his life in several significant ways, he is very medication-resistant. I'm wondering whether anyone else has had good result with Attend. (When he was in 4th and 5th grade, the Dexedrine capsule could be opened up and sprinkled on a spoonful of pudding or applesauce. It did make an enormous difference in his ability to pay attention and stay focused long enough to get his homework done. But, these drugs are amphetamines. I suspect that at the very least, the Dexedrine retarded his growth.) Incidentally, my son was unable to swallow a pill until he was 15.
I have been on four of the 8 ADHD medications. I deserve a prize when I get off the eighth one. I hate how it feels, and I'm beginning to wonder if my parents are desperate to fix me. From the time I was four, I've been going to countless psychiatrists and therapies, and classes. I've been trying out different medications, and on top of that, I'm being nagged about my grades and how I like to be alone. They think its that I don't know these skills, but I do. I'm not shy or socially awkward in any way, I'm just introverted. My parents call it being a teenager, and everything I do wrong is somehow going to be "redeemed" with ADHD medications. I HATE my ADHD. HATE IT HATE IT HATE IT.
Hi, Ally. Are you truly introverted -- or do you avoid social interaction because you were ostracized by other kids when you were younger? I say that because I've struggled with ADHD all my life, but when I was a kid, it didn't have a label. Maybe you're ADD, not ADHD. I was hyper, loud, interruptive and mouthy -- because I lacked the ability to sit still, read social cues, and consider consequences.
If none of the ADHD meds they've tried with you have worked -- maybe what's going on biochemically in your brain isn't ADD. Sounds like your parents saw something that worried them, though, if they sought help for you as early as age 4. My mom often said, "We should have taken you to a child psychologist when you were 3."
Being a teenager who other kids see as 'odd' is no picnic. Just know that everyone has something, and if you make an effort to focus on the other person, making them feel comfortable by asking them about things you think they'll like to talk about (such as themselves), you can be popular, even if you do have ADHD (or are shy).
Don't give up, and if you haven't tried Attend, see whether that might make a difference. Anecdotally, I've been told it's 'non-invasive' (few to no side effects).
Your parents mean well, Ally. At your age it's hard to consider how painful it is to love a child, think they're in emotional pain, but feel helpless to help them.
Try to accept the things you can't change, and work overtime to see things from the other person's point of view.
i feel sorry for anyone including parents who give our children these class 2 narcotic for any reason under the sun,i know the bible says if anyone hurts one of my little ones it would be beast to put a millstone around their neck and jump in the ocean. so if people dont stand up and be the voice for gods little babies,well its not going to be good....
The brain is an physical organ. Science is working overtime to understand why some parts of it don't always function as God intended. Not enough is known, for example, about environmental exposures in the womb. If a child's brain chemistry, or genes, are damaged, and medicine can improve the child's quality of life, denying that child a medicine that straightens out his or her brain is like denying insulin to a severely diabetic child.
I have been on this drug for who knows how long....currntly age 15 and took it starting in 2nd or third grade I believe. I am now on concerta which is basically the same thing(aderall, I once tried, I believe my mom told me recently that while on it I threatened to do something like jump out the window. Vyvance sharply increased my heart rate, I had to wear a heart monitor for 24 hours because of that) I currently cannot cope without it, I was once off it for a few days and ended up unable to stay awake for more than a few hours at a time...quite scary...I currently also take anti anxiety medication. The thing is, before i started taking medication i was uncontrollable, when I started my medicine I went from failure to straight As in school, face the facts, it is best to give your kids the meds, otherwise it hurts them and those around them
Thin Man 4 years ago
Withholding treatment from an accurately diagnosed ADHD kid borders on child abuse. If only I had been diagnosed at age 6 instead of age 43 (13 years ago). God knows what I could have achieved!