Synopses of various ADHD related articles
The aim of this study is to educate. We are neither for nor against medication as a means of treatment of ADHD symptoms. Please note that medications have been proven to be one of the most effective means for treating ADHD. However, for a small number of people, ADHD medications have had serious side effects. The following journal articles, published by health professionals, may be beneficial in educating you regarding some of the more serious medication side facts.
Pharmocotherapy and ADHDThe literature clearly documents that treatment with stimulants improves not only abnormal behaviors associated with ADHD but also self-esteem and cognitive, social, and family function. Stimulants have been demonstrated to improve cognitive function in children with ADHD as measured by tests of vigilance, impulsivity, reaction time, short-term memory, and learning of verbal and nonverbal material. Also, despite previous concerns, doses that improve behavior rarely constrict attention or cause "over focusing”
Concerns about the effects of long-term administration of stimulants on growth persist. Stimulants routinely produce anorexia and weight loss, but their effect on growth in height is much less certain. Rebound phenomena can also occur in some children between doses, creating an uneven, often disturbing clinical course. In those cases, consideration should be given to alternative treatments.
The Drug Effectiveness Review
The Drug Effectiveness Review Project was formed in 2003 to give consumers and state insurance plans trustworthy information about pharmaceuticals. It states that drugs for ADHD are not necessarily unsafe or unhelpful, but the sound scientific proof is lacking to support how safe or helpful they are. They found that evidence to choose one drug over another for safety or effectiveness is “severely limited” by a lack of studies measuring “functional or long-term outcomes”. Until better research is done, the findings mean that choosing the right ADHD medication is a matter of trial and error.
Death
An agency looked at reports from The Food and Drug Administration of more than 300 people who died while they were taking stimulant medications. The agency concluded that in 25 of the cases -- 19 children and 6 adults -- the stimulant appeared to be strongly related to the deaths, many apparently from heart problems.
Benedict Carey, New York Times, Feb 21, 2006. pg. F.1
Health Canada cited results from a review of safety information provided by Shire US, the manufacturer, which indicated that there were 20 reports of sudden death in patients taking either Adderall or Adderall XR worldwide. None of the deaths occurred in Canada, nor were any deaths associated with overdose, misuse, or abuse of the medication. Fourteen of those who died were children. There were 12 reports of stroke, 2 of which occurred in children. Significantly, autopsies in 5 of the 12 pediatric sudden death cases revealed underlying cardiac risk factors, including previously undiagnosed cardiac abnormalities.
Other drugs have also been speculated by the Food and Drug Administration. In a presentation done by the FDA, warning labels were given for methylphenidate (Ritalin) and amphetamine (Adderall) stating that sudden death has been reported in children that had pre existing cardiac conditions. Sudden death was present with children that had no diagnosis of heart condition until post mortem and who were on regular doses of the medication.
Suicide
According to the Food and Drug Administration, Strattera can cause some suicidal thinking in children and teenagers. A large study combined the results of 12 different studies of children and teenagers with ADHD. In these studies, patients took either a placebo (sugar pill) or Strattera for 6 to 18 weeks. No one committed suicide in these studies, but some patients experienced suicidal thinking. On sugar pills, no patients developed suicidal thinking. On Strattera, 4 out of every 1000 patients developed suicidal thinking.
There is an overlap between attention-deficit/ hyperactivity disorder and alcohol or drug abuse or dependence - Timothy Wilens, M.D. | Psychiatric Times, | 2006-01-01 | 33 |