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 Renata Schoeman has been in full-time private practice as a general psychiatrist (child, adolescent and adult psychiatry) since 2008, currently based in Oude Westhof (Bellville). Renata also holds appointments as senior lecturer in Leadership (USB) and as a virtual faculty member of USB Executive Development’s Neuroleadership programme. She serves on the advisory boards of various pharmaceutical companies, as a director of the Psychiatric Management Group (PsychMG) and is the co-convenor of the South African Society of Psychiatrist (SASOP) special interest group for adult ADHD, and co-founder of the Goldilocks and The Bear Foundation ( She is passionate about corporate mental health awareness and uses her neuroscience background to assist leaders in equipping them to become balanced, healthy and dynamic leaders that take their own and their team’s emotional, intellectual, social health and physical needs into account. Renata is academically active and enjoys research and collaborative work, has published in many peer-reviewed journals, and has presented at local and international congresses. She is regularly invited to present at conferences and to engage with the media. During her post-graduate studies, she trained at Harvard, Boston in neurocognition and neuroimaging. Her awards include, amongst others, the Young Minds in Psychiatry award from the American Psychiatric Association, the Discovery Foundation Fellowship award, a Thuthuka award from the NRF, and a MRC Fellowship. She also received the Top MBA student award and the Director’s award from USB for 2015. She was a finalist for the Businesswomen’s Association of South Africa’s Businesswoman of the Year Award for 2016, and received the Excellence in Media Work award from SASOP during 2016.

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