Tuesday, February 24, 2009

Are we Drugging our Kids with ADD Medications?

Today it seems as though there have been more cases of Attention Deficit Disorder (ADD) than ever before. I know I see commercials all the time about new and improved medications that can be used to treat ADD, but is it worth it? Do the pros really outweigh the negatives when placing a child on such a strong medication?
Many of the drugs used to treat ADD have very serious side effects like: dizziness, nausea, weight loss, loss of appetite, depression, and anxiety. In addition, many common drugs for ADD (such as Ritalin, Methylphenidate, Cylert), which have the same Class 2 classification as cocaine and morphine. So, is this really a safe way to treat ADD in children? I mean, I know that parents are probably concerned about their children and want them to be able to improve in school by paying better attention and concentrating more but are they willing to risk their child's health just to have them get better grades?
Damon Hafner is a tenth grader who was placed on Strattera at an early age and has seen the dramatic effects it has had, physically and emotionally. His teachers told Suzanne that he suffered from ADD because he was not concentrating at school and was not completing his work. Immediately she thought, “How can this be, he isn’t a problem at all. He’s a good kid”.
Right away, the doctors wanted to place him on either Concerta or Strattera even though he had never been given an Individual Education Plan Test (IEP), which is the test given to diagnose a learning disability in children.
After much debate, Suzanne decided to go ahead and place Damon on Dexedrine. She saw an immediate change in Damon. “He had a tremendous loss in appetite, became more moody, and still was not able to finish his school work”.
Even though these medications are being prescribed to children in order to help them concentrate at school, it is astounding to find that these drugs can sometimes cause serious issues in children who are still developing. Strattera is an FDA approved non-stimulant medication but yet the FDA sent out an advisory for the warning signs to be aware of. The FDA reported:
-Strattera increases the risk of suicidal thinking in children and adolescents with ADHD.
-Anyone considering the use of Strattera in a child or adolescent for ADHD must balance the increased risk of suicidal thinking with the clinical need for the drug.
-Patients who are started on therapy should be observed closely for clinical worsening, suicidal thinking or behaviors, or unusual changes in behavior.
-Families and caregivers should be advised to closely observe the patient and to communicate changes concerning behaviors with the prescriber. (fda.gov/cder/drug/advisory/atmoxetime.htm
This is just one example of a drug that could have serious implications. All of the ADD medications have very serious side effects that could result in huge changes among young children who are still developing.
I think this is just sad that we are resorting to drugging our children with these dangerous medications instead of taking the time to find a more helpful way for these students to learn. Many people learn in many different ways, that's just human nature. But let's first try to help these kids in a healthy more hands-on approach before we take risks with these dangerous medications. Drugs are already a huge problem across the world so I think it would be best if we kept these medications to a minimum.

2 comments:

Calochilus said...

Before you throw the baby out with the bathwater, get some perspectives
The incidence of ADHD is significantly greater than the diagnostic rate, the majority of ADHD people receive no diagnosis, let alone effective treatment other than non-specific counselling or talk-therapy , which , in the light of being un-targeted, is rarely effective.
Medication is not the only, or necessarily the best treatment for ADHD, it's just the cheapest, least complicated method and as a very significant number of ADHD people are in the lower socio-economic strata, price is very significant.
The availability of non-pharmaceutical interventions may be reflected in price but underlying the high price is the absolute unavailability of appropriate targeted services, necessary to meet current real demand let alone any expansion.
The DSM4 description of ADHD is fundamentally flawed, categorising ADHD people when they actually have a dimensional problem. The reality is not so much whether one has ADHD (I do) but how much (more than I want).
ADHD is multi-factorial, an issue not addressed in DSM4. There are a number of domains of dysfunction, not everyone is dysfunctional in all domains. Thus the issue of Baseball players, they may be hyperactive, hypervigilant, have auditory processing problems and have executive functioning issues but they DO NOT HAVE issues with homolaterality and eye-hand co-ordination that many others have.
ADHD has positive associations that warrant recognition. ADHD people are risk takers. They are the explorers and adventurers, the entrepreneurs, the high flying business leaders as well as the artists, musicians, actors and writers.They have a right to fully exploit their inborn capabilities without the pejorative associations currently shackled to ADHD.
Getting back to drugs, what is rarely quoted is relative risk. Does the risk of taking a medication outweigh the risk of not taking a medication. In the case of ADHD, overall, the risks associated with medication appear to be far lower than the risks of remaining unmedicated. It has been estimated that nearly three quarters of our prison population comprise ADHD people who have not been appropriately diagnosed or treated (and are denied treatment in prison).
Another thing is comparative risk, what are the risks of ADHD medications compared with things such as aspirin (around the same) or paracetamol (far less apparently).
When talking about side effects or adverse events in relation to medications (for ADHD or heart disease) it must be seen in perspective, what is the incidence of adverse events and relate this to relative risk. Most of the events you quote are relatively rare. However, anxiety and depression go hand in hand with ADHD and their reported occurrence as side effects must be viewed with some suspicion as figures are quoted that nearly a third of untreated ADHD people may have significant problems with anxiety and depression . In my opinion anxiety and depression are probably more significant than some of DSM4 core symptoms.
To take one adverse episode in isolation is pointless. It reflects the fact that the practice of medicine is less than perfect. You really need to get statistics from broad studies (or even meta-studies). You may have a leg to stand on then.
If you really are concerned about the misuse of medications then you need to understand the reality of addiction and put in perspective, the enormous toll on our health taken by alcohol, tobacco and prescription drugs other than stimulants. The prescribed stimulants are well close to the bottom of the list.

Danielle Frink said...

Kelli, you are right that a lot of educators and parents resort to medication to solve behavioral problems. But it's vitally important that people understand that psychiatric medicines can save and/or improve lives - I wouldn't be where I am today without them. While many people are horrified by the side effects listed for medications available and advertised these days, they should know that these side effects are nothing new - the only thing new is that drug companies are trying to cover their butts better by telling people all of the potential problems that could develop. The important caveat to all those warnings is to know the percentage of people who actually suffered from the side effects during the clinical trials.

Danielle