Use of Stimulants to Treat ADHD: Interdisciplinary Research at the HDC Bill Frankenberger These studies represent collaborations with students and faculty at UW-Eau Claire

Significance of the Topic Growth of ADHD in the 90’s 700% increase in Ritalin production % increase in Amphetamine production (Dexedrine and Adderall), 65% increase One half million children, aged 3 to 6, were treated (1995) Increasing use of multiple medications Increasing abuse in schools

Amphetamine Production Quotes

Changes in types of stimulants produced from 1990 to 1999 DEA Quotas Ritalin %62% Dexedrine & Adderall % 38%

Target effects of stimulant medication Better attention in class Better behavior in class Better seat work Better grades Better relationship with teachers Better relationship with parents

Side effects of stimulants Insomnia (  REM sleep) State dependent effects Decreased appetite Slowed rate of growth Tic development Increased heart rate & blood pressure Rebound effect

Fourteen years of research on ADHD at the Human Development Center Changes in types of stimulants being used Incidence for general and special education Long-term effects on achievement Student’s self-reports of effects Professionals’ knowledge and attitudes

Incidence of stimulant use Elementary level (Frankenberger et al., 1990; Runnheim et al., 1996; Snider et al., 2000) Before 1990Mid to late 1990s General ed1.5% ED8% LD5% General ed 5% ED40% LD16%

Interaction Plot for ITBS Complete Composite Scores (Frankenberger & Cannon, 1999)

Student Self-Reported Effects of Stimulant Medication Doherty, Frankenberger, Fuhrer & Snider (2000) 925 students, WI, MN 86 receiving Meds for ADHD Moline & Frankenberger (in press) 651 students, WI, MN 50 receiving Meds for ADHD

Mean Cluster Ratings (Moline & Frankenberger, in press)

Student reported side effects (Moline & Frankenberger, in press) 64% of students reported side effects at least sometimes (2 or higher) 30% reported side effects almost always or always 55% felt sleepy after taking medication 53% reported some difficulty sleeping 43% reported headaches 54% reported not feeling like eating lunch 40% reported tics not present before meds

Student reported side effects (Doherty et al., 2000) 58% did not feel like themselves 43% did not feel like eating lunch 35% had difficulty sleeping 36% reported tics Not feeling like themselves was related to wanting to discontinue use of medication

Non-ADHD Student reports of Medication Abuse (Moline & Frankenberger, in press) 53% of students reported seeing some students give away or sell their medication at least some of the time 28% of students reported that students give away or sell their medication almost always or always

ADHD Student reports of Medication Abuse (Moline & Frankenberger, in press) 34% of students reported being approached to give away or sell their medication at least some of the time 11% of students reported being approached to give away or sell their medication almost always or always

Other Findings: Positive Correlations (Moline & Frankenberger, in press) Doctor visits related to increased dosage Dosage related to increased side effects Dosage related to giving away or selling

If it were up to you, would you continue taking your medication? (Doherty et al., 2000; Moline & Frankenberger, in press) Stop NowContinue

Do you need meds to pay attention to activities that you find interesting? (Moline & Frankenberger, in press) NeverAlways

Type of Medication used to Treat Children with ADHD (Frankenberger et al., 1990)

Type of Medication used to Treat Children with ADHD (Moline & Frankenberger, in press)

Comparison of Professionals’ Knowledge, Attitudes, & Experience (Frankenberger et al., submitted) School Psychologist Return Rate (n=414) –national 47%, state 53% Majority female 61%

Comparison of Professionals In your experience, who most frequently recommends students for AD/HD assessment? Teachers 77% Parents15% School Psychologists 3% Physicians 1%