Medication and ADHD Children

           One of the most difficult decisions parents of ADHD children will need to make will concern use of medication for their children. If parents choose to medicate will they see improvement in their child’s focusing abilities, school behavior, sleep etc.? Or, will it mean increased irritability, poor diet, stunted growth, and worse -- the possibility of future stimulant addiction?
           ISMP (Institute of Safe Medication Practices) identified 15 drugs that accounted for 41% of serious adverse events in children reported to the USA Food and Drug Administration between 2008 – 2012. One study identified 45,610 adverse drug effects reported in children under18 year of age. Of these, 64% (29,298) indicated serous injury. Reports in children grew in time from 6,320 in 2008 to 11,401 in 2012 increasing the same rate as for adult patients (ISMP – 2014).
           The list included medications commonly prescribed for ADHD, methylphenidate (Concerti, Ritalin) and atomoxetine, Strattera. Notable negative effects showed suicidal behavior, aggression and hallucinations or other manifestations of psychosis. Cardiac arrest was associated with methylphenidate, and weight loss or arrested growth was also reported for all three drugs (ISMP – 2014). *(Note: Not listed but equally dangerous is the medication, Adderall, which can cause sudden cardiac death).
           As pernicious as the side effects are that the ISMP report reveals, there is another side note to this tragedy and that includes the medical profession and/or the pharmaceutical industry. For example the rise of A.D.H.D. diagnoses and prescriptions for stimulants over the years coincided with a remarkably successful two-decade campaign by pharmaceutical companies to publicize the syndrome and promote the pills to doctors, educators and parents. With the children’s market booming, the industry is now employing similar marketing techniques as it focuses on adult A.D.H.D., which could become even more profitable. Sales of prescription stimulants have more than quintupled from 2 billion dollars in 2002 to 8 billion dollars in 2014 (IMF Health – 2014).
           One report from prescription provider Express Scripts, finds a large overall increase in the number of Americans treated for attention deficit hyperactivity disorder: a 36 percent rise in just five years. More than 4.8 million people covered by private health insurance have filled at least one prescription for ADHD (Health, 2014).
           Although there have been some positive changes for some ADHD children, overall, the trait is over diagnosed. For example, medication has proved to lower severe impulsiveness, allowing for an underlying drive and intelligence to emerge. However, according to some longtime advocates, “ the zeal to find and treat every A.D.H.D. child has led to too many people with scant symptoms receiving the diagnosis and medication.” The disorder is now the second most frequent long-term diagnosis made in children, narrowly trailing asthma. (New York Times analysis of C.D.C. data).
           In addition, accelerating this growth has been drug company marketing: comparing classic A.D.H.D. to include relatively normal behavior like “carelessness and impatience,” which often leads to overstating the pills’ benefits. Further there as been overstatement with television advertising and magazines like People and Good Housekeeping by describing normal childhood forgetfulness and even poor grades as reason for medication (Schwarz, 2013).