The parents who get program done are the parents who believe it must be done (no ifs, ands, or buts) - and fully expect it to work. And I mean non negotiable - like wearing a seatbelt, eating, sleeping, or getting an education. Partial commitment - doing program if we have enough time today, or when everything else is done (school, homework, social events, after school activities, other therapies etc.)-- does not work as well because there are always going to be other things competing for your attention, time, and resources.  

Once you have decided you are going to get program done, you need a plan. The families who consistently get program done are those who schedule it into their day in some way--using the NACD planner, a fifteen-minute schedule, a daily checklist of activities, index cards with program activities written on them, and timers that go off every fifteen, twenty, thirty minutes. Your planning can be as flexible or rigid as you need it to be to suit your and your child's personalities. Do what works; but have a plan. Your coach can help you find the best way to schedule/organize your time, as well as alternate plans for the days that plan A does not work. It might take you a few tries to get it just right; so be willing to fine-tune it till you find a system that works best.  

This report outlines common side effects of drugs prescribed for ADHD, many of which are extremely serious even if they are considered "rare." If parents do not tolerate a child running across a neighborhood street without looking for cars because there is a "rare" chance they will be hit, then why should they be okay with taking the risk that their child may be hit with heart dysfunction, liver failure, suicide, or even sudden death? ADHD is not a lethal "condition," but the current drugs being prescribed for it can certainly cause one. 

 

Please note that most of the statistics on the side effects reported here are for clinical populations that often include many adults. Side effect prevalence and severity are generally even more substantial for populations of just children [1-3]. Furthermore, it is important to note that the long-term, chronic side effects of these drugs have not been adequately researched. Therefore, the current children prescribed these drugs are "guinea pigs" by default of a continuing medical experiment. For example, does heavy stimulant use throughout a child's life increase their chance of a heart attack or stroke when they are 50 or 60 years old? The data do not exist yet to answer that question. But the current side effects already known are not looking too pretty. Let's take a look. 

 

Psychostimulants

  

Psychostimulants are the most frequently prescribed drugs given to children and adults diagnosed with ADHD. Here is a list of psychostimulant drugs commonly used for ADHD [4]:

• Methylphenidate (Ritalin, Concerta, Metadate, Daytrana)
• Dexmethylphenidate (Focalin)
• Amphetamine-Dextroamphetamine (Adderall)
• Dextroamphetamine (Dexedrine, Dextrostat)
• Lisdexamfetamine (Vyvanse)

Side Effects

  

All stimulants have many potential side effects that include the following: fast, pounding, or uneven heartbeats; the feeling that one might pass out; fever, sore throat, and headache with a severe blistering, peeling, and red skin rash; aggression, restlessness, hallucinations, unusual behavior, or motor tics (muscle twitches); easy bruising, purple spots on the skin; dangerously high blood pressure (severe headache, blurred vision, buzzing in the ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure; stomach pain, nausea, vomiting, loss of appetite; vision problems, dizziness, mild headache; sweating, mild skin rash; numbness, tingling, or cold feeling in hands or feet; nervous feeling, sleep problems (insomnia); weight loss; and others [6,7]. In fact, one type of stimulant drug, Pemoline (Cylert), had to be withdrawn from the market in 2005 because of repeated reports of liver failure [4]. 

  

Out of all the psychostimulants, methylphenidates are the most commonly prescribed [8]. A review of 10 different studies on the adverse effects of these drugs found that 31% of users reported dry mouth, 27% decreased appetite/anorexia, 18% moodiness, 22% jitteriness, 21% depression, 11% weight loss, and 12.5% reported vertigo. Furthermore, 7.4% had to drop out of the studies because of adverse effects that were too harsh [9]. It should also be noted there is a lack of research on the long-term effects of using these drugs [9]. Therefore, not much is understood about the chronic side effects of taking these drugs over a prolonged amount of time. 

  

Drug Abuse

 

Perhaps the worst "side effect" of all is the abuse potential and addictive nature of these drugs. The U.S. Drug Enforcement Administration (DEA) classifies many of these psycholstimulants as schedule 2 drugs, which are substances with a large potential for misuse [10,11]. A review of studies that report the addictive effects of some of the most common stimulants prescribed for ADHD states, "[In] 10 out of 11 studies for which comparative data were reported, the reinforcing effects . . . were generally similar to those of cocaine and D-amphetamine" [12]. A recent study found that 40% of those with prescriptions misuse these drugs [13]. Another study reported on the different types of misuse within a clinical sample and found that 22% took too much of their prescribed stimulants, 10% used the stimulants to "get high," and 31% used their drugs with alcohol or other drugs [14].

  

Street Use

  

The most common "street uses" include partying, getting high, cramming for tests, improving concentration, enhancing alertness, and decreasing fatigue [15-17]. All the prescribed stimulants are abused, but Ritalin appears to be the most commonly abused [17]. One study found 13% of high school students, not just those prescribed Ritalin, had abused the drug [18], and 4% of all middle school students had abused Ritalin at some point in their lives [19]. Also about 1 out of 4 children and adolescents prescribed a stimulant will be solicited to sell, trade, or give away their medication [20]. The statistics are even scarier when the individual prescribed stimulant medication enters college. Approximately 54% of college students prescribed stimulants for ADHD have been solicited to divert their medication [21]. Essentially, the prescribing of these drugs is subjecting our youth to a drug dealer's role. 

 

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UPCOMING EVALUATIONS
 

March 2013