The Truth About Over Medicating ADHD Children
This is likely the most controversial topic when it comes to the ADD/ADHD subject. So what's the controversy over medicating children with ADD or ADHD?
Your child is sick, you give them medicine, they become healthy again. With ADD/ADHD medications, they only help the symptoms temporarily and they come packaged with long warning labels and a list of side effects. The majority are stimulants and we wonder what the long term effects are. Will they become addicted? Will they become reliant on a "pill" to function in the future?
Most importantly it effects the parent(s) of ADD/ADHD children, because you are the ones who make the ultimate decision. Should we or shouldn't we medicate? This decision should only be made after thorough investigation and weighing the options, pros and cons.
Medications Used, What Are They?
Children with ADD/ADHD are commonly treated with stimulants, such as:
• Methylphenidate (Ritalin, Metadate, Concerta, Daytrana)
• Amphetamine (Adderall)
• Dextroamphetamine (Dexedrine, Dextrostat)
• And the newest FDA approved in 2007 stimulant lisdexamfetamine dimesylate (Vyvanse) for children 6-12 years of age.
• A nonstimulant (antidepressant) medication atomoxetine (Strattera)
Stimulant medications can be short-acting or long-acting. Short-acting wear off quicker and additional medication may needed during the day. Long-acting, sustained, and extended release forms allow children to take the medication just once a day before school. Some of the medications wear off after an 8-12 hour period and therefore are used for school.
The parent and Doctor should make the decision together what, when and which medication is right for the child.
Sources: NIMH, Wikipedia.com, FDA
How Do They Work?
ADHD medications help many children and adults who are hyperactive and impulsive. They boost concentration and focus while reducing impulsive and hyperactive behaviors. Essentially, they help people focus, work, and learn. Stimulant medication also may improve physical coordination.
ADHD drugs given in low dose form boosts levels of two neurotransmitters (chemical messengers) in the brain, dopemine and norepinephrine. Much more research in this area is being done and how these effect the pre-frontal cortex part of the brain, which performs our executive functions and is dysfunctional in the ADD/ADHD brain.
- Executive functions relate to abilities to differentiate between conflicting thoughts, determine good and bad, better and best, same and different, future consequences of current activities, working toward a defined goal, prediction of outcomes, expectation based on actions, and social control.
In essence, these medications have the opposite effect on the ADD/ADHD brain than you would think, by boosting the neurotransmitters thus helping with focus and self control.
The most common side effects are:
- Decreased appetite
- Sleep problems
- Stomachaches and headaches
- Blurred vision
- Increased heart rate
- Increased sweating
Less common side effects: (consult with your physician if these occur)
- Sudden repetitive movements or sounds, called tics.
- Appearing 'flat' or without emotion.
In 2007, the FDA required that all makers of ADHD medications develop Patient Medication Guides. The guides must alert patients to possible heart and psychiatric problems related to ADHD medicine. The FDA required these Guides because a review of data found that ADHD patients with heart conditions had a slightly higher risk of strokes, heart attacks, and sudden death when taking the medications. The review also found a slightly higher risk (about 1 in 1,000) for medication-related psychiatric problems, such as hearing voices, having hallucinations, becoming suspicious for no reason, or becoming manic. This happened to patients who had no history of psychiatric problems.
The FDA recommends that any treatment plan for ADHD include an initial health and family history examination. This exam should look for existing heart and psychiatric problems.
Blood tests to check the effects of medication on the liver also should be done a minimum of once a year.
The non-stimulant ADHD medication called atomoxetine (Strattera) carries another warning. Studies show that children and teenagers with ADHD who take atomoxetine are more likely to have suicidal thoughts than children and teenagers with ADHD who do not take atomoxetine.
A medication that works for one child, may produce unwanted side effects in another child. Sometimes different medications or dosages must be tried before finding what works for your child.
What ADD/ADHD Medications Are Not.
ADD/ADHD medications are not a cure. Stop the medications and the symptoms return.
They are not a fix-all magic pill. Even while taking medication, children can still have symptoms of ADD/ADHD, though reduced.
Medications are not the only option. No one can force you to medicate your child/children. Not doctors, school officials, teachers, the decision is yours.
Even if you do opt for medication, there are numerous other things that need to be modified in your child's daily life; nutrition, behavioral modification, social skills development, etc.. But that's another Hub.
What do you think?
Are ADD/ADHD Meds over-prescribed?
My Two Cents
First, let me say that I am neither for or against using ADHD medications. It's an individual choice, your decision as to what works for your family. So, in essence, I'm neither an advocate nor a protester.
Secondly, let me add that we have four, yes four, children with ADHD. How can we have so many? Must be our parenting? According the a genetic study through USC it was explained to us like this if one parent has ADD/ADHD in the family, you are likely to have a 50% chance of having a child with ADD/ADHD. If both parents have the disorder in their families the likelihood increases to 70%. That's exactly what we have.
When our oldest was diagnosed in 1997, I knew nothing about it. I immediately went to the bookstore, searched the Internet, scoured through parenting forums, spoke to psychologists, psychiatrists, family practitioners and pediatricians. Opinions? Seconds, thirds, Fourths, etc.
When medication was first presented to me, I researched and at first was horrified. "You want to prescribe my child a stimulate (like speed? Uppers?) for a child that can't sit still for more than 2 seconds? He's like a freight train 24/7 and you want to give him fuel?"We just said no. We tried everything else there was available at the time including neurofeedback, diet, holistic, and many, many more.
Our third child was diagnosed in 2nd grade, our fourth child also in 2nd grade (but I already knew) and our fifth in Kindergarten. Yes, Kindergarten. At that point, I had a small meltdown.
Only two of our children take medication for school. Why? For the simple fact, that it works for them. One I wasn't convinced that was the remedy the other experienced adverse side effects.
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