News of children dying due to an overdose of ADHD medications and antipsychotics have made more parents aware about the issue of using such drugs to “cure” behavioral problems in children.  While these tragic occurrences show the most extreme outcome of the issue, they serve as a good reminder of the decisions parents must face, especially when their children receives the ADHD diagnosis.  Should you medicate your child in the hopes of getting good behavior? Here is a straightforward look at what these stimulants can do to your child.

It’s common for parents to turn to doctors when their children exhibit out-of-control behaviors they cannot explain.  They often breathe a sigh of relief when their child gets diagnosed with a psychological condition like ADHD or childhood depression. Now that you know what’s wrong and that there are medications available for it, your child will get all better, right?

Unfortunately, a receiving a diagnosis and prescription is not a complete solution to your child’s problems. In fact, pharmaceutical drugs targeted at behavioral improvements are a shot in the dark at best.  At worst, they cause nasty side effects that exacerbate the symptoms of the behavior or introduce new health problems; stimulant medications, for instance, cause cardiovascular complications in children if taken at high doses.   While certain drugs have been considered effective for specific disorders, keep in mind that the medicine that works for one child may not work on another.  You may have to go through a period of trial and error, which will require a lot of patience and time.

The matter of receiving diagnosis is also a problematic one, especially when it comes to children. Many health conditions share the same symptoms of ADHD and require treatments that have nothing to do with psychoactive medications.  It’s easy to misdiagnose ADHD and get treated for a condition that they don’t have, which does nothing to relieve the behavioral problems they experience.

The bottom line is that such medications aren’t designed to improve behavior in children. What they can do for your child is to restore balance to some brain chemicals that may be deficit, prolonging your child’s attention span or allowing them to gain better control of their impulses. Kids who exhibit behavioral problems turn to their “fight or flight” response when they feel threatened, and often pick “fight”. ADHD medications don’t change this tendency, but it may give your child more time to assess the situation and choose a different outcome.

The important thing is this: regardless of whether or not a child takes medication for ADHD, behavioral problems are best addressed by creating structured environments where appropriate behavior can be taught.  In order to function well in school and at home, kids need to learn problem-solving skills and coping skills. You can start by formulating make a behavior plan with your child’s doctor to be implemented at home. Create a routine, make expected behaviors clear, and enforce limits. Give your child incentives to behave well and provide positive reinforcement when he or she cooperates.

If you have decided to medicate your child, do manage your expectations about their effects. ADHD medications can help your child focus and calm down, but working with your child is the only way to overcome behavioral issues.

Children with ADHD are by no means easy to deal with, even when they’re already taking ADHD treatments that will help them focus or keep them calm. When the treatments don’t quite deliver the results they promise, families and teachers get frustrated and feel at a loss as to what to do next. Let’s examine five reasons that explain why ADHD treatments sometimes fail.

Denial

You’d be surprised at how many parents come to me only when they have reached the last straw. Parents are often deny that their child has a problem until a major crisis occurs – the child has to repeat a grade, the parents shrug off the symptoms as normal childhood behavior, or perhaps they fear the ADHD stigma and would rather leave their child out of the doctor’s office. A child is more conducive to ADHD treatments when the disorder is detected early in life; kids diagnosed in late childhood or their teens are a little more complex.

Too much faith in ADHD medications

One of the most common myths about ADHD is that medications alone can treat a child.  I have had countless parents come to me saying that medications improved their child’s grades, but do nothing to improve his behavior or attitude. What most parents keep forgetting is that medications are designed to help an inattentive brain focus; they do not improve mood or teach behavioral skills. In fact, stimulants do not even treat the possible underlying causes of ADHD. That is why many children who take these drugs tend to retain many of their frustrating ADHD symptoms.

Failing to change the environment

ADHD symptoms are influenced by the child’s environment. You cannot expect an ADHD child to sit down and focus on homework when he is surrounded by video games and other distracting stimuli.   Establish a daily routine for your child, one that will minimize distractions, teach responsibility, and reinforce good behavior.  Be firm and consistent about the consequences of deviating from this routine

Leaving the child in the dark

Parents know best, but have you ever asked your child what he thinks about his treatments? It’s important that your child take a proactive role in his ADHD recovery, learn to control his own behavior, and decide what interventions work best.   Listen to your child’s needs. If your child requests for a tutor to help him at school, do it. If your child thinks that extracurricular activities will help him make more friends, encourage him.  Find solutions together and let your child have a say in his own recovery.

Quitting too early

If you’re using natural interventions like ADHD diets or neurofeedback to treat ADHD, remember that they don’t deliver instantaneous results like medications do.  Treating ADHD naturally takes time and patience.  Don’t give up on a treatment after seeing no improvements in one week. Give it at least a month and if you really don’t see any positive changes, discuss a different intervention with your child’s doctor.

Pharmaceutical companies must be having a field day. A recent study conducted at the University of Pennsylvania found no support for the belief that ADHD medication like Ritalin and Adderall increased the risk of cardiovascular complications among patients. After reviewing the records of more than 241,000 children and adolescents on the drugs from five different states, Dr. Sean Hennessy and his team of researchers concluded that taking medication for ADHD did not increase the chance of heart disease or cardiac arrest among younger folk. In other words, this study effectively declared ADHD as safe for children.  But is it really as harmless as the study claims?

Many experts, including myself, remain skeptical about Dr. Hennessy’s findings. In the scope of pharmacological studies, Dr. Hennessy’s research is considered very small, and the findings may not be scientifically significant as a result. The study also does not encompass the long-term effects of drug use, as it used records from as late as 2007 for its data.

As I’ve pointed out in the past, Ritalin, Adderall and other similar drugs have consistently been found to increase blood pressure in patients taking them, as well as raise the patients’ heart rate. Both side effects could potentially lead to more harmful complications in the cardiovascular systems of those who take the medication. It is possible that early exposure to these conditions, as is the case when children take anti-ADHD medication, can significantly increase the odds of heart problems developing over time. As a result, further research is needed to confirm whether or not using these drugs will raise the chances that patients will suffer heart attacks or cardiovascular disease at an earlier age than the average.

Dr. Steven Nissen of the Cleveland Clinic is one of numerous experts who warn against the study giving parents and pharmacists false reassurance. He argues that any medication that increased both the patient’s heart rate and blood pressure was consistently found to cause long-term cardiovascular damage, and that there is no reason to think popular ADHD medications are any different. Like Dr. Nissen, I advise parents to take Dr. Hennessy’s studies with a grain of salt, and to consider the long-term health of their children before anything else.

Strattera (atomexetine), a drug initially designed to treat depression, is now a popular medication for ADHD and thought to be a safer alternative to Ritalin. Unlike Ritalin, it’s not a stimulant, which means there’s little potential for abuse. It was also thought to be safe and effective for young children, although this has not been studied until recently. A new study published in the journal Pediatrics on March 21 reviewed the use of Strattera on 5- and 6-year olds with ADHD and found mixed results.

The study, which was led by Christopher Kratochvil MD from the University of Nebraska Medical Center, sought to investigate the side effects and efficacy of atomoxetine in young children with ADHD. This double-blind, placebo-controlled, randomized trail involved the participation of 101 children with ADHD aged 5 and 6.  They took their placebo or their atomoxetine for eight weeks, and changes in their behavior were measured using scales.

Although the drug was able to reduce instances of the core symptoms inattention, hyperactivity, and impulsivity, those taking atomoxetine did not show overall functional and clinical improvement.  Many of their symptoms continued to persist despite taking the medication. Side effects of the drug include gastrointestinal problems, poor appetite, and sedation.

The authors gave a contradicting conclusion to their study – they said the medicine was effective, yet significant symptoms remained for most of the children who took atomoxetine.  How can anyone call a treatment “effective” if it failed to alleviate most of the symptoms and problems plaguing these children?

But when it comes to Strattera, its lack of overall efficacy is not the worst part. Strattera has been found to cause liver injury in children, problems passing urine, fainting, stroke, heart attack, and increased blood pressure. Several clinical studies discovered that Strattera increases the risk of suicidal thoughts and behavior among 2,200 children and teenagers with ADHD.

There can be no doubt that Strattera has helped some children and teens manage their ADHD symptoms. But for those who do not benefit from this drug, all they experience are terrible side effects and none of the relief it promises to deliver. In addition, ADHD medications are not designed for long-term recovery; as soon as their effects wear off, the symptoms return.  Studies have also shown that they lose their beneficial effects after three years of use.

Medication might seem like an efficient and simple solution to ADHD, but this complex disorder requires much more than a pill. Instead of medicating your child, consider a holistic treatment program that will get to the root of the symptoms and give you child a proactive role in his or her treatment.

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As students struggled to study for their final exams before the holidays, I noticed that news reports about Adderall use in campus began to appear more frequently. Adderall is a long-acting amphetamine used to treat ADHD, with effects that last up to 10 hours.  It’s ability to boost focus, concentration, memory, and energy levels make it a popular drug among young professionals and college students, who need them to enhance performance. But does Adderall really work for this purpose?

Probably not, says findings from a study done by the University of Pennsylvania.  The paper, which was presented at the Society of Neuroscience’s annual conference last month, discovered that Adderall doesn’t always provide the effects desired by the user.

This study recruited the participation of 47 people, all in their twenties and without an ADHD diagnosis.  Various cognitive functions were tested, from raw intelligence, to memories of specific events, to working memory (the ability to hold information needed for tasks like reasoning and comprehension).  Every subject received a placebo and an Adderall, and they did not know which pill they were taking.

The results were very fascinating to say the least. Previous research has nothing but glowing things to say about Adderall’s effects on cognitive performance; effects include improved focus and alertness, even better judgment.  However, the University of Pennsylvania study reports that while most participants felt the inflated sense of productivity, others did not experience this boost.  In fact, many of the smarter participants showed reduced performance in some cognitive tests.  On the tasks that involved impulsivity and working memory, Adderall leveled the playing field, allowing the below-average performers to perform just as well as the others.

The most interesting finding was the final question they asked the participants – “How and how much did the pill influence your performance on today’s tests?” Those who took Adderall were more likely to say that the pill made them do better on the tests, even though the actual test scores do not reflect an improvement over the placebo score.

It is not known why Adderall benefits some and does not work for others, but the bottom line remains – do not take Adderall, Ritalin, or other ADHD medications unless prescribed by a doctor, especially if you suffer from high blood pressure, mood disorder, or psychosis.

News source and photo credit

It’s hardly surprising to learn that more children receive the ADHD diagnosis today.  A new report from the US Centers for Disease Control and Prevention (CDC) discovered that the number of ADHD diagnosis among children in the United States went up 22% in four years – from 7.8% in 2003 to 9.5% in 2007. These findings are certainly consistent with other research on the rapid rise of the ADHD diagnosis around the world. However, I’m more interested in finding out why this is happening. What could be causing this so-called ADHD epidemic? Here, I posit four possible reasons.

Better ADHD awareness

Increased awareness about ADHD may have contributed to the rise of the diagnosis.  Most parents are already familiar with the hallmark symptoms of ADHD, and are quick to see a doctor if they think their child might have the disorder.  If not, it is usually a teacher who notices the symptoms and suggests that the child be taken for an evaluation.

However, this increased awareness is a double-edged sword. On one hand, children whose ADHD symptoms interfere with their family life, school performance, and peer relationships will finally receive the help they need. On the other hand, this cultural acceptance of ADHD is something pharmacological companies can exploit. After all, stimulant medications are still the most popular treatment for the disorder, and it is certainly in their interest to increase the diagnosis and treatment of ADHD.

Over-eager doctors

The CDC’s data was based on parents who said that their doctor told them that their child has ADHD. However, the researchers did not note how thorough the assessment was. This leads me to my second point.  ADHD is almost certainly over-diagnosed, and doctors are often too quick to medicate hyperactive children.  The rapid increase in the ADHD diagnosis does not necessarily reflect a real rise in the actual condition; rather, it could suggest an increase in the number of children who receive the ADHD label.  It’s not enough to slap this label onto children and give them a one-size-fits-all treatment. For long-term improvement, doctors need to find out what’s causing the symptoms and treat the cause – not the symptoms themselves.

Accessibility of consumer electronics

Virtually all teenagers and adolescents have their own mobile devices, computers, video game consoles, and television sets. Studies show that these gadgets can decrease attention span and aggravate sleep problems, which makes a child lethargic, hyperactive, or aggressive the following day. What may seem like ADHD to a parent or teacher may actually be exposure to too much technology.

The typical Western diet

Medical professionals are quick to attribute ADHD to genetics or a neurotransmitter deficiency. However, little attention is paid to the fact that the brain needs nutrient in order to function properly. The typical Western diet provides very little of the vitamins, minerals, amino acids, and essential fatty acids needed for proper brain function.  In addition, most processed foods contain artificial additives that trigger ADHD.  Several studies have confirmed that children who depend on fast food and processed foods for their daily nourishment are more likely to have ADHD than those whose diets contain a lot of fruits, vegetable, meat, and fish.

ADHD is not a fad – it is a real disorder that affects the well-being of children and their families.  And there’s certainly nothing wrong with taking your child to a doctor to find out if he or she is really suffering from a problem. However, it is likely that many children diagnosed with ADHD today are mistakenly thought to have the condition by a worried parent or teacher.  And many parents are quick to believe that ADHD medications are the solution, without considering other safer, more effective treatments for the disorder.

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If ADHD medications like Ritalin are chemically similar to substances like cocaine and amphetamines, does that mean they are addictive? Technically, the answer is no.  Although both Ritalin (methylphenidate) and cocaine stimulate the production of dopamine, Ritalin takes longer to metabolize while cocaine works instantly. For pleasure-seeking recreational users who want the immediate gratification of stimulants, this makes all the difference in the world.  The effects of cocaine wear off faster than Ritalin, causing the user to crave for more drugs to sustain the high. Based on this major difference, experts conclude that ADHD medications metabolize too slowly to be habit-forming – as long as kids and teens take their pills as instructed by their doctor, that is.

But as it turns out, not all teens that use ADHD medications take them as prescribed.  In fact, many of them might not even have ADHD. According to a new study published in the journal Pediatrics, the number of teens who overdosed on ADHD medications rose 76% over the last seven years.

Researchers looked at data gathered by American Association of Poison Control Centers, which was based on calls from 13- to 19-year olds between the years 1998 and 2005. Throughout this time, nationwide calls for ADHD drug misuse increased from 330 to 581 yearly.  Around 42% of affected teens experienced moderate to severe side-effects such as aggression, seizures, personality changes, and psychosis. Most had to be rushed to the hospital for emergency treatment, while four of these cases resulted in death.

Indeed, abuse of Ritalin and other prescription drugs is a phenomenon college guidance counselors struggle with every year.  From the point of view of a teenager, the short-term side effects of ADHD medications are very desirable. Not only does Ritalin suppress appetite and cause weight loss; the drugs help students stay up all night while they frantically finish papers or study for exams. It’s common practice for teens to crush the tablets and snort the medicine as though it were cocaine; this makes the methylphenidate metabolize faster. Unfortunately, ADHD medications do have a strong potential for abuse if they are taken this way.

The study’s authors did not have information as to whether the abusers were diagnosed with ADHD or not. However, anecdotal evidence and previous research suggests that many of these teens did not have ADHD. According to a study by the University of Miami, students who were prescribed ADHD medications were least enthusiastic about taking them. On the other hand, non-prescribed students were more eager to use these drugs, which can be obtained from ADHD peers who are more than happy to sell or trade extra pills. It’s not uncommon for teens without ADHD to fake the symptoms so that they can obtain a prescription from a doctor.

Even though there are only hundreds of overdose cases compared to the millions of children who take Ritalin and other stimulants, the rising numbers are consistent and reflect a major increase in teenage substance abuse problems.  If your child or teen is taking medications for ADHD, make sure that you’re aware of where the pills are stored, how many there are, and who has access to these drugs.  Better yet, keep them in a place where your child can’t sneak them out.  Watch out for signs of abuse, which include difficulty focusing and increased agitation. You may also want to consider trying a non-medical approach to manage ADHD, especially if your child no longer shows improvements after years of taking medication.

Stimulant medications are not the only drugs used to treat ADHD in children.  Over the last several years, doctors have been turning to antidepressant medications like Desipramine and Imipramine for various reasons. Sometimes, these drugs are prescribed because of a co-morbid mood disorder like depression or anxiety.  In other cases, anti-depressants are given when stimulants fail to yield positive results.  Many believe that the increase in the use of anti-depressants for ADHD is a response to popular media’s criticism of stimulant medications and its harmful side effects. But are anti-depressants necessarily more effective and safe than stimulant medications? Can mood disorders and behavioral problems be treated naturally?

The lowdown on anti-depressants

The type of anti-depressants used on children with ADHD is called serotonin reuptake inihibitors (SSRIs). SSRIs promote the circulation of serotonin, the feel-good neurotransmitter, by preventing certain nerve cells from re-absorbing (reuptake) this chemical.   By increasing the level of serotonin in the brain, moods and emotions become more stable. However, because some of the neurotransmitters are contained in neural pathways in other parts of the nervous system, antidepressants can have side effects.  Antidepressants can also interfere with other functions like sleep and appetite.

Research shows that in between 1995 and 1999, the use of Ritalin for children under 7 increased by 23% and the use of SSRIs went up by 580% – even though these drugs were not approved for anyone younger than 18.  Like stimulant drugs, SSRIs contain a lot of harmful side effects.  According to Dr. Ann Blake Tracy, author of the book Prozac: Panacea or Pandora, SSRIs can do more damage than good. The high levels of serotonin caused by these drugs can produce an “initial euphoria, psychosis, mania, aggression, organic brain disease – especially mental retardation at a greater rate in children.”  Ely Lily, the manufacturer of the SSRI Prozac and a number of pharmaceutical drugs, also reports that ADHD patients who take Prozac are twelve times more likely to commit suicide than ADHD patients who are not taking it.  It doesn’t get better when the child stops taking this drug; the withdrawal symptoms of SSRIs usually cause violent side effects.

Drug-free alternatives to SSRIs

Knowing that SSRIs aren’t good is just half the battle. The tricky part is to come up with effective drug-free solutions to the depression, anxiety, and behavioral problems experienced by children with ADHD. The good news is that there are a lot of options – it’s all a matter of finding one that will work best on an individual child.

Children and adults with ADHD have been able to overcome depressive symptoms and mood problems with the right diet. Allergic reactions to certain foods often manifest themselves as bad behavior and mood swings. In fact, you can see this at work through Dr. Doris Rapp’s videos, where she shows how the wrong foods can make a dramatic change in a child’s personality.

The herb St. John’s Wort has not been found to be of any help in treating ADHD symptoms, but studies show that it can alleviate co-morbid depression in individuals from ADHD. Ask your doctor for advice on the right dosage.

Other options that might help include cognitive-behavioral therapy, sports, play therapy, and chiropractic care.

While stimulant medications have helped some children reduce their hyperactivity and inattention, we cannot ignore the fact that a number of children need a more comprehensive treatment for ADHD. Not only do ADHD medications fail to work in the long run, but they also carry serious long-term side effects. Unfortunately, it’s a lot easier to get children and parents to agree to use stimulant drugs. According to a study published in Pediatrics, one in 20 American children received free drug samples from their doctors a year. As for those who decided to take prescription medications that year, almost one in 10 received a free sample. However, the study points out that these free samples may be unsafe.

These conclusions were drawn based on data from 10,295 children and adults in the2004 Medical Expenditure Panel Survey. Four of the fifteen most distributed drug samples were identified by the United States Food and Drug Administration as having serious safety concerns. Among the top four were are Adderall (amphetamine/dextroamphetamine), Strattera (atomoxetine), and Ritalin (methylphenidate) – stimulant medications used to treat ADHD. These stimulants belong to the same drug family as cocaine and pose the same long-term risks as this drug. While they are not addictive by themselves, free samples don’t usually come with clear instructions on how to take them, giving them lots of potential for abuse or recreational use.

Some physicians argue that free drug samples are a cost-effective way to provide medications to those who could not otherwise afford them. However, the study’s findings indicate that most of these free samples never reach their intended market. Only 16% of those who got free samples had no health insurance, and less than a third of these children came from families with low incomes (less than $38,000 a year for a family of four).

Another concern worth noting is that free samples tend to be for new medications that have just been introduced to the market. These new drugs have been released even though their safety profile has yet to be fully studied. And with stimulant ADHD medications, you can’t be too careful about their short-term and long-term side effects.

Treating ADHD with medication seems like the most convenient and practical approach to this disorder and free samples only encourage the casual use of these drugs. But we have to remember that medications alone are not enough to address the full spectrum of ADHD’s causes. In the long run, a comprehensive and holistic approach to ADHD management can circumvent the side effects of stimulants while providing results that last.

Chiropractic and dietary changes are possible alternatives, according to Dr. Ashton

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