By Hugh C. McBride
Intense fidgeting. An inability to pay attention. A tendency to interrupt, ignore, or otherwise disobey.
For families of children with Attention Deficit Hyperactivity Disorder (ADHD), life without the drugs that suppress many of the more severe symptoms is virtually unthinkable.
But a recently released study that was funded by the U.S. Food and Drug Administration (FDA) and the National Institute of Mental Health (NIMH) has caused many parents to fear that the medications they give their children to improve the quality of their lives may be putting those same lives at risk.
However, the FDA has cautioned parents that the study's small sample size, and the fact that the benefits of ADHD meds outweigh the risks, should not cause them to change their child's ADHD medication regimen without first consulting with their family physician.
ADHD Medications and Unexplained Deaths
According to a June 15 article by Dan Childs and Todd Neale of the ABC News medical unit, the concerns are the result of reports of sudden and unexplainable deaths among apparently healthy young people:
In the study of 564 children and teens who died suddenly, researchers led by Madelyn Gould of the New York State Psychiatric Institute and Columbia University in New York City found that those who died suddenly were 7.4 times more likely than not to have been taking the stimulant medications. The results of the study are reported online in The American Journal of Psychiatry.
"Although sudden unexplained death is a rare event," the researchers said, "this finding should be considered in the context of other data about the risk and benefit of stimulants in medical treatment."
A June 16 article by Washington Post staff writer Shankar Vedentam provided the following details from the Gould study:
Gov't Groups Move to Ease Parents' Minds
In the aftermath of the ADHD medication study's publication, officials with both the FDA and the NIMH, as well as the leader of the study herself, advised parents not to make any changes in their children's medication regimens without first consulting with their physician.
“We don’t want to make parents so scared that they would take their children off ADHD medications,” Gould told Nancy Shute of U.S. News & World Report's On Parenting blog. "The very last thing we would want is for a parent to take a child off medication that is working for them.” Instead, Gould told Shute, her study should encourage physicians to pay increased attention to cardiac screenings for ADHD patients.
In a June 15 statement, the FDA echoed Gould's advice, telling parents that this study does not mean that their children are at risk:
Given the limitations of this study's methodology, the FDA is unable to conclude that these data affect the overall risk and benefit profile of stimulant medications used to treat ADHD in children. Therefore, the FDA believes that this study should not serve as a basis for parents to stop a child's stimulant medication. Parents should discuss concerns about the use of these medicines with the prescribing healthcare professional.
Because ADHD medications are known to increase heart rate, doctors have long been advised to screen patients for cardiac problems before prescribing drugs such as Ritalin, Adderall, and Concerta. According to Shute's June 16 post, the FDA and the American Academy of Pediatrics already encourage doctors to take the following steps before prescribing ADHD medications:
About ADHD Meds
Attention Deficit Hyperactivity Disorder cannot be "cured" by medication, but certain drugs have been found to suppress some of the more severe ADHD symptoms. According to a information on the WebMD website, between 70 and 80 percent of patients who take ADHD medications achieve the following results:
The three most commonly prescribed ADHD medications are Ritalin, Adderall, and Concerta. Health care experts estimate that about 2.5 million U.S. children take these or other drugs to treat symptoms of ADHD.
Because individuals with ADHD often appear to be overly stimulated, many people mistakenly assume that ADHD medications are depressants. However, Ritalin, Adderall, and Concerta are all stimulants. Ritalin and Concerta contain methylphenidate, a stimulant that is derived from amphetamine, while Adderall consists of a combination of amphetamine and dextroamphetamine.
Stimulants affect the brain by triggering increased release of dopamine, a brain chemical that is associated with pleasure and movement. Though researchers do not completely understand why stimulants such as Ritalin, Adderall, and Concerta are as effective as they are, recent studies indicate that the drugs target the prefrontal cortex, the area of the brain that is associated with paying attention, making decisions, and expressing one's personality.