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ADHD

27 July 2019

Are you reluctant to give your kids medication for their ADHD?

While many parents don't like the idea of giving their children medication to treat the symptoms of ADHD, new research shows medication can be beneficial.

Some parents may be reluctant to give their kids powerful stimulants to treat the symptoms of attention-deficit/hyperactivity disorder (ADHD), but a new review shows the medications bring significant benefits.

In addition to helping kids calm down and concentrate in school, the review also found that the drugs help children avoid a lot of long-term negative consequences associated with ADHD, including depression, substance abuse and even driving problems.

Importance of ADHD treatment

"Treating ADHD can help children avert some of the serious complications associated with ADHD," said study author Dr Joseph Biederman. He's chief of clinical and research programmes in paediatric psychopharmacology and adult ADHD at Massachusetts General Hospital, in Boston.

Specifically, the study suggested that early use of ADHD stimulant medications was linked to a lower risk of:

  • Major depression
  • Anxiety
  • Oppositional defiant disorder
  • Conduct disorder
  • Bipolar disorder
  • Smoking
  • Substance abuse
  • Driving problems, such as car accidents
  • Poor performance in school

Although the current study can't prove a definitive cause-and-effect relationship, Dr Alan Geller, a psychiatrist from Gracie Square Hospital in New York City who treats children and adolescents, said it makes sense that treating ADHD symptoms can help prevent other problems.

"A hyperactive child who interrupts and disrupts class is annoying. They end up getting marginalised, which can lead to substance abuse or conduct disorders, or depression and anxiety if they're constantly frustrated," he explained.

Problematic without treatment

Geller said adults with ADHD can have trouble at work and have difficulty in their personal lives.

"It can start around seven or eight, when they're not able to navigate life the way other kids do. They end up feeling alone and like no can help. It's a major problem without treatment," he said.

But, Geller said, this research shows that if you treat a child with medications that help them control their ADHD symptoms, there's less risk of marginalisation or of seeking stimulation in things like cigarettes or driving recklessly.

Geller said the findings point to the benefits of ADHD medications outweighing their risks. Adverse effects from these drugs include a slight height suppression, appetite suppression and a potential risk of addiction.

The review included three studies. Two were long-term prospective studies of children with and without ADHD. Some of the children diagnosed with ADHD were treated with stimulant medications and some were not.

The average age of the youngsters in the study was 11 when the study began. They were 20 at the follow-up.

Future research

The third study looked at young adults (18 to 26) with ADHD. Researchers checked the volunteers' performance on a driving simulator before they started taking stimulant medication and then again six weeks after they had started treatment.

The researchers calculated the number of people who needed to be treated with medication for a benefit to be seen. They found:

  • Three people needed to be treated with ADHD medication to prevent one child from repeating a grade or developing anxiety, conduct disorder or oppositional defiant disorder.
  • Four people needed treatment to prevent one person from having major depression or an accident during the driving simulation.
  • Five people needed treatment to prevent bipolar disorder.
  • Six people had to be treated to prevent one person from smoking cigarettes, and 10 people needed treatment for one person to avoid a substance use disorder.

The researchers are planning future research to see if treating ADHD with medications can help lessen the risk of post-traumatic stress disorder, traumatic brain injuries and suicide. They also plan to study if ADHD treatment is linked to work success, Biederman said.

The review was published in the Journal of Adolescent Health.

Funding for the studies in the review came from several places, including the US National Institutes of Health, and for one study, pharmaceutical manufacturer Shire. Shire is now part of Takeda, and manufactures ADHD stimulant medications such as Adderall XR, Mydayis and Vyvanse. Research funders had no role in the design, implementation or reporting of the review, the study authors said.

Image credit: iStock

 

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ADHD Expert

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 (www.gb4adhd.co.za) 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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