Stimulant Medication Treatments for Childhood ADHD
Safety Alerts for Mediations
The Food and Drug Administration has responded to recent concerns regarding sudden deaths, heart attacks, and other cardiovascular events. It is, however, always been recommended by the FDA that any individual with a known heart problem not take these medications. They recommend that parents keep giving their children these medication in treatment for attention deficit hyperactivity disorder and to be continually monitored for any blood pressure or heart rate changes.
On November 1, 2011 the FDA completed its research study in children that were suffering from ADHD and released they found no association of adverse affects of using these medications. A full list of medications are available in the table below that are included in these recommendations.
FDA Stimlant Medication Deemed Safe
List of Stimulant Medication Recommended
Focalin, Focalin XR
Dexedrine, Dexedrine Spansules, Dextroamphetamine ER, Dextrostat
Concerta, Daytrana, Metadate CD, Metadate ER, Methylin, Methylin ER, Ritalin, Ritalin-LA, Ritalin-SR
Adderall, Adderall XR
Have you ever been prescribed a drug that you and/or your doctor knew you didn't need?
- ADHD & Stimulants
Scientific Review of Mental Health Practice Journal Overuse of Prescription Stimulants for Children reported in new Duke Study
Summary of Stimulant Medication and Individual Descriptions
SUMMARY OF MEDICATION: TO AIDE THE CONFUSED PARENT
Here are some facts to help you differentiate the variety of medications and answer some basic questions about the medication that is dispensed for ADHD in children and adults. First the FDA requires that medication be given a different name for the form its in. That is whether its a capsule, if its liquid, in pill form etc. This also pertains to if it is an instant release or a delayed release medication.
Ritalin, for example, is methylphenidate. Let's say you got a prescription for Ritalin LR in the for the morning dose before your child goes to school and at noon he has to have the nurse dispense Ritalin. Do you know the difference? (For Adderall it is XR and Adderall.) You pick up the script and the pharmacist is giving you the 'talk' of the basic things you need to know since its a new prescription and the first bottle is Ritalin. He would pour out and show you (some do others assume you now already and won't) the pill that your child will take. It is a small blue pill that once swallowed will immediately release into your child's bloodstream. Typically, it will last about four hours. Than when he shows you the next bottle you might be expecting a similar version of the pill but you will see, instead, a capsule that is extended release and will last longer. These are good for people like myself, that happen to metabolize our medication faster and thus need a higher dosage at times or extended release
RITALIN AND ADDERALL
There are two main classifications for stimulant medications that are formulated to stimulate specific cells in your child's brain so that it can produce the neurotransmitters that they are difficient in.
Since the 1960s the generic names that have been used are: methylphenidate and dextro-amphetamine
Adderall is a modification of the drug dextro-amphetamine.
No matter what the actual form of the pill is the medication is the same.
These two also come in liquid form. Daytrana is the one that is released through apatch that is placed on the skin.
Any medication with a precursor of dextro, will be more effective in the handling of symptoms than the ones that are levo. So Adderall is one of the most effective on the market according to some research done in the 1960s. It is also more affectve than the Ritalin.
Below I detail a table that will give the name of the medication, the typical dosage, and the amount of time that it is actively working in your system.
Breakdown of ADHD Medicatons
Daners and Side Effects of Adderall
Breakdown of Stimulant Medication
Studies Done "Prove" That Drugs Aren't Working
There was research conducted measuring the effectiveness of stimulant medication in children with ADHD and the findings published online in the Journal of American Academy of Child and Adolescent Psychiatry.
According to another online source, researchers have been arguing for the ten years prior to 2009 this very thing and referred to the MTA Study (Multi-modal Treatment Study of Children with ADHD). The MTA has been the biggest study done as of the day this was reported on the possible benefits of stimulant medication on behavioral interventions. The study was a longitudinal one which means they followed the same children for a long time, in this case 485 kids in 8 years and found that they children didn't do any better than the ones that were not on any medication. Some of the kids even stopped taking the stimulants.
A positive finding was that even though there are some questions about the effectiveness of the medication they found that the kids that did the best were the ones that took the medication and also had other behavioral interventions in place. They did better than the group just taking the medications and also the group that took no medications but had other intervention measures in place.
Many other organizations and researchers studied he MTA findings and after looking at all the data came to the conclusion that taking these medications was stunting the child's growth.
The fact that there are so many studies and researchers that come up with conflicting evidence it poses the question as to what are we to do when we are trying to make a choice for our child? How accurate are the findings? Was the experiment measuring what it should have been measuring? Did they find cause and effect or was it a correlation they found? The author of the website that gave this information questioned some of the same things and had interviewed, William Pelham, a pioneer in the study of behavioral treatments for ADHD and one of many researchers who participated in the MTA study and is now a professor of psychology.
Pelham has criticized the MTA findings. According to Pelham what the study isn't telling us is that the results at one year were drastically different that at the follow ups. They had continued to tell people that the drug was useful when it really wasn't. He explains that there are short term differences and improvements but its not going to make a change in the long term. There aren't studies that have done experiments to examine the long term benefits and the effects of the medication because they are so much harder to do as it takes years and years.
The main thing to know here is that studies are going to conflict from time to time, its not an easy answer. Findings have to be interpreted and encoded. Best thing to do if I was the parent of a child that I had some huge concerns about, would be to go straight to the source...the published journal. Read it and analyze their conclusions and use it to formulate your own conclusion.
I researched the research studies that have been published and there is overwhelming evidence that there is short term benefits but that long term is less than desirable. I decided to see what main stream media websites, the ones that are most likely ( I believe) are going to be the ones that are seen by parents that want information to make an intelligent and informed decision. The main reason, to see if they conflict or aren't reporting the factual evidence the journals detail.
Mood Disorders Associated with Stimulant/Cocaine Abuse
Mainstream Media Reports Effectiveness of Stimulants in ADHD
According to Web MD, stimulant medication is detailed as an effective method of treating the symptoms of ADHD. Stimulants control the child's attention span, create the ability of the child to control their impulsive behaviors, and calm them down from being hyperactive. It gives you the advice that you can either use it alone or in combination with behavior therapy. The cited statistics are that symptoms improve within 70-80% of children with ADHD and as long as medication is taken the symptoms will continue to improve. The only problems not proving to be long term improvements are school performance and social adjustments.
The best piece of information yet ( and I am being completely sarcastic and tell you why in a minute if you haven't figure it out yet ) is that stimulants are not habit forming when taken in the dosages prescribed for ADHD, leaving also no evidence to link use of the medication to and later illegal drug use. The cover the rear when they say, BUT there is always a risk of becoming addicted especially if you have had problems in the past with addiction to drugs. Hmmm...
The rest of the information about what drugs are used to treat ADHD and side effects etc. was all accurate and will be addressed later. I want to point out, that while I am not a psychiatrist with a PhD, even though I have not specifically been a part of one of those studies and although I don't have every piece of documentation at my disposal to fact check; I can confidently say that they twisted the information and facts to someone's benefit. They are trying to look neutral and not start controversial discussions and people challenging them by reporting any information that contradicts what the public, the pharmeceutical companies, the governmental agencies tied to them, the doctors and anyone else that would look like an idiot for not doing the research and not doing the right study or releasing the wrong information. Whatever the reason, I am disappointed in Web MD because out of all of them I figured I could bet money they would be more accurate.
First and foremost the use of stimulant medication is recommended strongly to be used along with the behavioral treatments and therapy provided, as well as getting a child on an IEP at school. Using them alone has been stated as not as effective and is only a short term relief. School performance is not noticeably different when they go off from when they are on it. The medication when prescribed, is done so in order to control the behavior that is causing problems and so its easier to teach the child techniques to handle their ADHD once they choose to get off the medication.
It further mentions that the medication given in the doses needed to treat ADHD, is not addictive. That is the biggest load of B.S. I have ever heard. First, it is an amphetamine drug. It is virtually legalized speed. One 10mg XR could make someone addicted if they used it enough and if they took it a specific way. Any medication like that you can't stop taking overnight as you will experience withdrawal. When its that you are going to have to deal with and its in the information they give you at the pharmacy, than you should know its addictive and habit forming. When you take it every day for years? How could it not? The thing is that I know from first hand experience and you add in the fact I read the journals and the articles and the studies and the local media, before writing and my view hasn't changed because the data backs me up. I am on Adderall XR for Adult ADD and on 30mg XR in the morning and 20mg XR at noon. I have been taking it on and off for around five years. I can tell after one week of being on the drug that I have a physical dependency to it. I also know that it increases other behaviors like irritability in women and girls and they add another medication to aide in that. So its replacing undesirable actions and behaviors with what? Less desirable but not intolerable ones?
It does help me concentrate, but now I hyperfocus. It helps me be able to get a complete thought out, but now I just keep going. It controlled some impulses but it makes me more determined to do something too. They didn't tell you either that stimulant medication shouldn't be given to a child (say going through puberty) that is going through their aggression stage or is having anger problems etc. Why? Because as they can focus now and control their actions, they can focus on the anger as well and they become more explosive and more dangerous to others. Hmmm...why did they leave that out?
NEW YORK TIMES
The Times details an interview that is shocking but true, he is just the only one I have hard speak up about it. Dr. Michael Anderson in Georgia describes the kids he sees and the "made up" excuses that the kids need the medication and truthfully he does it so that the kids can do better in school. Kids that don't have ADHD, are knowingly being give a prescription for Adderall ( no wonder that is why they are strict as heck and make it impossible to pick it up a day or two early because you plan on leaving town, they look at you and insinuate you are selling the stuff ).
“I don’t have a whole lot of choice,” said Dr. Anderson, a pediatrician for many poor families in Cherokee County, north of Atlanta. “We’ve decided as a society that it’s too expensive to modify the kid’s environment. So we have to modify the kid.”
They are going on to tell you that not only is he outspoken about it but he is telling other physicians that are starting to seriously think about the same thing!
not to treat A.D.H.D., necessarily, but to boost their academic performance.
Dr. Rapport states it best that they are doing this more and more and that is "providing a medical straightjacket."
Now get this, even if the child is ADHD and comes in but gets As and Bs, the good doctor won't prescribe the medication. I know its possible to get those grades because growing up I did but its hard! to struggle through tests and readings and having to go over things ten times. Its frustrating and it pulls at your confidence. Makes you build up negative emotions for blowing up at a later date but because the kids work hard to accomplish a goal of good grades; despite their disorder, lets punish them because they are doing too well.
Now the next part is going to piss off all of you that are against Medicaid and think the funding needs to be cut and this I will give you to use for your argument. THESE KIDS THAT DON'T NEED THE DRUGS, ARE NOT ADHD, WILL NOT USE OTHER SERVICES....MEDICAID PAYS EVERY DAMN PENNY!!! Which I know because I am on it temporarily but I don't abuse it and I get what I need to get. I am not getting legalized speed for kids that don't need it; now that is creating a future meth ring when they are in high school.
So, you want to make your blood boil more? Mine is when I read this and I had knowledge of it already....you ready?
exposing children to unwarranted physical and psychological risks. Reported side effects of the drugs have included growth suppression, increased blood pressure and, in rare cases, psychotic episodes.
The Drug Enforcement Administration has these mediations classified at a Schedule 2 Controlled Substance.
The Academy of Pediatrics has a behavior rating scale for doctors to use when trying to see if a child has ADHD and 20% of doctors admit they don't use it, instead they follow Personal Instinct !!! WHAT!!! Does that mean I can be a doctor since he doesn't use his degree and he uses what I have...and instinct.
Dr. William Graf speaks some sense in response to this, as parents are also going along with it ( sorry but you do that and give a child a drug they don't need and you know they don't and on the street is called legalized speed? You should be answering to child services. ) and that there should be some protective authenticity issue...
“These children are still in the developmental phase, and we still don’t know how these drugs biologically affect the developing brain,” he said. “There’s an obligation for parents, doctors and teachers to respect the authenticity issue, and I’m not sure that’s always happening.”
I am getting to the point my blood pressure is about to skyrocket and my anger is really high because I have kids that have issues that I fight to keep off of drugs. A son that is going through puberty and got diagnosed with ADD learning how to manage the ADD without the medication. I have to take the stuff and even though it has some benefits there are many things that now that I know about because I take it? Would never give it to my kids. So, instead of just giveing you all the information regurgitated and with all of my commentary...here is the link to the article...please read it and feel free to come and comment on the hub and engage me in some intelligent banter. Forewarning though, I have never had a problem not getting passionatly invested in my discussions and I can't promise that this time. Let me know what you think.
© 2012 Abby K