27 August 2012

Link between ADHD meds and smoking still unclear

Do drugs for attention deficit hyperactivity disorder (ADHD) help steer kids away from cigarettes? Or do they actually make youngsters with ADHD more likely to smoke?


Do drugs for attention deficit hyperactivity disorder (ADHD) help steer kids away from cigarettes? Or do they actually make youngsters with ADHD more likely to smoke? In a new report, researchers say they might have found some signs of the former, but they also acknowledge that the evidence is extremely weak.

"The idea of whether treatment for ADHD affects the risk for other conditions is a really interesting thing and there is a lot of back and forth," said Dr Paul Hammerness of Harvard Medical School in Boston, who led the research.

About 2.7 million children and teens in the US take stimulants for ADHD, such as Novartis' Ritalin, Shire's Adderall and Janssen's Concerta.

Studies in rats have shown that giving the animals stimulants might whet their appetite for cocaine later on. But there have been mixed findings on the link between stimulants, substance abuse and smoking in humans.

How the study was done

In the new study, which was funded by Janssen, Dr Hammerness analysed 154 adolescents with ADHD who used Concerta (extended-release methylphenidate). At a mean follow-up of 10 months, about 7% of the teens or pre-teens reported smoking.

That was a smaller proportion than the 20% smoking rate seen in a nonsimultaneous cohort of adolescents with ADHD who were not taking stimulants.

But when the researchers accounted for differences is behavioural problems between the two groups, the gap in smoking rates disappeared.

Dr Hammerness, who has ties to several manufacturers of ADHD medications, said no firm conclusions could be drawn from his study, which was published online in The Journal of Pediatrics.

"You can't conclude anything from the study, nope," he said. "This is the nature of the beast."

But he also said that placebo-controlled studies are hard to do because not treating children with ADHD for extended periods could be considered unethical.

(Reuters Health, August 2012)

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Dr. Shabeer Ahmed Jeeva is a specialist psychiatrist who has been practicing child and adult psychiatry for 30 years. He has vast experience in treating ADHD, and is also an ADHD patient himself. Dr. Jeeva trained and practiced in Canada as a child and adult psychiatrist and had lived there for 25 years. He had attended medical school at the Royal College of Surgeons in Dublin, Ireland (1970-1976). His professional experience and accreditation includes: Psychiatric residency at the University of Ottawa (Canada), Child Psychiatry fellowship at the University of Ottawa (Canada), Diploma in Psychiatry at the University of Ottawa (Canada), and Fellow of the Royal College of Physicians in Canada. Visit his website at:

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