The FDA has received reports of sudden death among children and teens who had heart problems and took Dexedrine. Any stimulant is potentially dangerous for someone with a heart condition, and most of the time a child, or teen, does not have his heart checked by a physician before he is prescribed a stimulant for ADHD. The FDA says the new warning was announced as a result of new information it has received.

GlaxoSmithKline, the makers of Dexedrine, recently announced the new labeling. The company warned physicians (and parents) that there have been cases of sudden death, myocardial infarction and strokes among adult patients talking Dexedrine at normal doses. There are also risks for patients with existing psychotic disorders when they take these drugs, such as delusional thinking, hallucinations and aggression. Whether or not other drugs, such as Concerta (Johnson & Johnson) and Strattera (Eli Lilly) will also have to have new labels remains to be seen.

This newsletter reported earlier in detail that two separate FDA panels of experts had conflicting opinions on whether these drugs warranted a ‘black box' warning - the strongest possible label warning. As a result of this disagreement, it has taken the FDA a number of months to come to a decision.

See our March 31 article: Parents and ADHD Patients Caught in the Middle as FDA Committees Disagree, archived at http://addexpert.com/fda? PHPSESSID=9befd24f603ce03acc52831079a4da26 for background information.

Editor: I have never been opposed to the use of Ritalin or Dexedrine, or other medications for ADHD, even though I helped to develop Attend as an alternative to these medications. I recommend Attend, and I sell it through the web site. I know it is a valuable treatment. But I have also seen about 1,000 children, teens, and adults benefit from the use of stimulants for the treatment of ADHD, so I have never "bad mouthed" medications as a treatment. I have only offered Attend, diet, and biofeedback as other choices to consider, and warned that stimulants must be used carefully if used at all. But I have to admit that with these FDA hearings I am "coming close" to "rethinking" my position on these medications. I guess I'm not quite there yet, but the evidence is starting to make me a bit more uncertain of my position supporting stimulants as a viable treatment.

So for now, I'll still recommend (1) making sure the diagnosis is accurate, ruling out allergies or environmental toxins, (2) ruling out depression or bipolar disorder. Then (3) trying our diet (www.newideas.net/adddiet.htm), and 45 days of Attend (see the specific Attend strategies at http://newideas.net/add_types.htm), to see if they will do the job. Then, if they don't work, (5) consider a trial of medication - but used carefully.

May we all have greater wisdom on these matters.

Doug Cowan, Psy.D.

Consider these things:

1. How old is your child? If you child is 4 or 5 years old (especially with males) and is struggling in Kindergarten, he may simply be too young for structured learning. Not a big deal. Bring him home and work with him for another year. I usually recommend that parents start their sons in Kindergarten at age 6 anyway. And many kids with ADHD are just so neurologically immature that they are not going to really be "ready" for a classroom setting until they are 8 or 9 or 10. So consider homeschooling the young ADHD kids.

2. If the child is older, and the reason cited is "immaturity," then ask yourself these questions: When did the "immaturity" become apparent? Did it just begin this year? Are there emotional issues, or learning disabilities, that need to be addressed? Or is it really "immaturity?" How long has the teacher felt that this was a problem? What other options exist to deal with the situation? Would your child benefit from being with students who were a year younger than himself if the problem is immaturity?

3. If the reason given for retaining the child is lack of academic progress, then ask yourself these questions: Why didn't my child learn more? Were there problems in school behavior? Poor attention span? Poor work ethic? Poor work skills? Too much TV watching? Too little parental supervision? Too much parent supervision?

Would any of these problems be fixed by holding him back, or would you just repeat the same situation over again?

Are there other options, such as tutoring, home schooling, summer school, school interventions and accommodations?

Look at all of your options first. There are dozens of things that can be done besides holding a student back a grade in school. Just some simple thoughts. Hope they help. You can learn a lot more about Attention Deficit Disorder in children and teens at the ADHD Information Library at http://www.ADD101.com.

With a Doctorate in Psychology, and a Master of Science degree in Marriage and Family Therapy, doctor Cowan has worked with over 1,000 children and their families with ADHD or related conditions as a licensed Marriage and Family Therapist, researcher, and author.