ADHD and Over Medicating Our Youth Kathryn Head November 15, 2005

Attention-Deficit Hyperactivity Disorder Attention-deficit hyperactivity disorder (ADHD) is the most common child psychiatric disorder in America (Singh 2004) In 1994 the APA broadened the criteria for ADHD (Dunne 2000) Its symptoms include hyperactivity, impulsiveness and inattention (Singh 2004)

Medications For over 40 years doctors have been prescribing stimulants to relieve the symptoms of ADHD (Biederman & Faraone 2005 ) The most common drugs prescribed are methylphenidates, brand name Ritalin (Biederman & Faraone 2005) Other common prescriptions are for Adderall and Dexedrine (Dunne 2000)

Stimulants These stimulants increase the alertness of one’s nervous system by stimulating neurotransmitters in the brain (Dunne 2000) Unfortunately they do have some side effects which include tics, appetite and weight loss, stunting growth and can lead to problems later in life with substance abuse (Biederman & Faraone 2005 )

Question Time! Can you name some arguments for medicating? Now can you name some against medicating them?

The debate For Medicating Our Children Calms them down Helps them focus Less aggressive

The debate Against Medicating Our Children Medicating seems like a “quick-fix” Side effects listed before When on medication many complain of not being “the same person”

Evidence The Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder (MTA) (Owens et al 2003) Goal “What treatment, by whom, is most effective for this individual with that specific problem, and under which set of circumstances?” (Owens et al 2003)

MTA N = 579 (80% male) Age ranged from 7.0 – 9.9 years old Randomly assigned to one of four groups (MedMgt, Beh, Comb, CC) Treatment lasted 14 months

MTA (continued) Initially reported on sex, prior medication treatment, comorbid conduct problems, comorbid anxiety problems, and family receipt of public assistance Also took note of the child’s intelligence and initial severity of ADHD and maternal education and parental depressive symptomatology

Findings If the primary caregiver suffers from depression the intervention is not as effective The more severe the disorder to begin with the more difficult it was to treat The higher the IQ the better the response to treatment

Cost Effectiveness of ADHD Treatments In this article they used the MTA study to see the cost these different types of treatments versus their effectiveness (Jensen et al 2005) Found that for the 14 months of treatment the costs ranged from approximately $1100 (CC) - $7800 (Comb) Carefully monitored medical treatment is the most cost effective way to get the best results

Graduate Studies Who… Where… What? Rosemary Tannock –University of Toronto Shelley Parlow –Carleton University Darlene Brodeur –Acadia University

Final Question… Should we or should we not medicate our children?

References Biederman, J., Faraone, S. V. (2005). Attention-deficit hyperactivity disorder. Lancet, 366(9481), 237 – 248. Dunne, D. (2000). Statistics confirm rise in childhood ADHD and medication use. Retrieved October 13, 2005 from Jensen, P. S., Garcia, J. A., Gleid, S., Crowe, M. (2005). Cost- effectiveness of ADHD treatments: Findings from the multimodal treatment study of children with ADHD. The American Journal of Psychiatry, 162(9), 1628 – Owens, E. B., Hinshaw, S. P., Kraemer, H. C., Arnold, L. E., Abikoff, H. B., Cantwell, D. P., Conners, C. K., Elliott, G., Greenhill, L. L., Hechtman, L., Hoza, B., Jensen, P. S., March, J. S., Newcorn, J. H., Pelham, W. E., Severe, J. B., Swanson, J. M., Vitiello, B., Wells, K. C., Wigal, T. (2003). Which Treatment for Whom for ADHD? Moderators of Treatment Response in the MTA. Journal of Consulting and Clinical Psychology, 71(3), 540 – 552.

Singh, I. (2004). Doing their jobs: mothering with Ritalin in a culture of mother-blame. Social Science & Medicine, 59(6), 1193 – 1205.