Toddlers Being Prescribed ADHD Meds

Toddlers Being Prescribed ADHD Meds

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The Centers for Disease Control reports that Medicaid claims in Georgia reveal 1 in 225 toddlers are medicated for ADHD – that’s 760 cases in the state alone. The CDC estimates that more than 10,000 toddlers may be taking ADHD medications.

Dr. Lawrence H. Diller, a behavioral pediatrician in Walnut Creek, Calif. and author of The Last Normal Child said, “People prescribing to 2-year-olds are just winging it. It is outside the standard of care, and they should be subject to malpractice if something goes wrong with a kid.”

Dr. Ed Hallowell, a noted child psychiatrist and ADHD expert appeared on Fox and Friends. He said it’s “crazy” that toddlers are being given drugs like Adderall and Ritalin.

“People are looking for a quick solution to the age-old problem of rambunctious little toddlers,” he said. “The solution is not to give them medication. The solution is to play with them, to be with them, to take care of them. Not to give them a pill in the hopes
that’ll quiet them down.”

Prescriptions for toddlers are being granted despite the fact that ADHD medication has not been studied for this group. Indeed the American Academy of Pediatrics does not even broach the subject of ADHD medication in toddlers (children under 4 years old).

Two year olds are notably rambunctious. Most experts agree that it’s far too early to diagnose ADHD at age 2. Your opinions are welcome.

Weight Loss and ADHD Medications (part 2 of 2)

Reporting by the University of Maryland Center for Substance Abuse Research (CESAR) and Global Market For ADHD Medications Read more: (

A history of appetite suppressants

The previous submission noted that Adderall, a drug frequently used to control ADHD symptoms, was a spin off of Obetrol used for weight loss in the 1950s and 1960s.

Ritalin was tested on humans in 1954. According to the University of Maryland Center for Substance Abuse Research (CESAR), “… In 1957, Ciba Pharmaceutical Company began marketing MPH as Ritalin to treat chronic fatigue, depression, psychosis associated with depression, narcolepsy, and to offset the sedating effects of other medications.

It was used into the 1960s to try to counteract the symptoms of barbiturate overdose… Research on the therapeutic value of Ritalin began in the 1950s, and by the 1960s, interest focused on the treatment of “hyperkinetic syndrome,” which would eventually be called Attention Deficit Hyperactivity Disorder.”

Lower doses of stimulant medication do seem to temporarily improve focus and reduce hyperkinetic behaviors. One must realize that their original use was not for ADHD, but for weight reduction and as drugs that could counter chronic fatigue. They are also Schedule II substances in the same class as cocaine. Thus, weight loss as a side-effect should be expected and dealt with appropriately after consulting your healthcare provider.

The US is estimated to consume the vast majority of these medications. According to the Global Market For ADHD Medications (, “In 1993, thirty-one countries had adopted the use of ADHD medications; by 2003, the number had grown to fifty-five. Our analysis aggregated data from individual countries from the year of adoption into a global sum. Because the United States is the single largest market, we also show its use, which constitutes 83–90 percent of total market share (by volume).”

Weight Loss and ADHD Medications (part 1 of 2)

Reported by:
Knowing the history may make you lose your appetite

When you hear, “Mom, I’m not very hungry,” do you wonder why?

Stimulant medications are frequently prescribed for the control of ADHD symptoms. According to WebMD, weight loss is a common side-effect for most stimulant medications.

If you understand the history of stimulant medications, you’ll
understand how they are associated with weight loss. If we begin with Adderall, we can trace it back to it’s origins in Brooklyn, NY in the 1950s. It was known then as Obertrol and was manufactured by Obetrol Pharmaceuticals which later became a division of Rexar Pharmacal Corp.

Obetrol [perhaps a conjugation of ‘obesity control’] was used as a stimulant based diet pill to control obesity. It was popular during the 1950s and 1960s. It contained amphetamine and methamphetamine salts.

Shire Pharmaceuticals later acquired Rexar and the name was changed to Adderall when Obetrol’s use for dieting was waning and studies indicated it might be useful for controlling hyperactivity. The formulafor Obetrol has been reformulated at least once since being labeled Adderall.

While it was popular to use amphetamines (especially methamphetamine) for weight loss into the 1970s, by the 1980s, the medical community was alerted to addiction problems and began to dissuade use of these drugs for obesity control.

How did these drugs transform into ADHD medications? That’s in part 2. Stay tuned!


Misdiagnosing ADHD

According to a study released by the University of Michigan, nearly 1 million children in the United States are potentially misdiagnosed with ADHD.

The research was conducted, not by a medical group, but by economist Todd Elder  in the Journal of Health Economics (Elder et al. The importance of relative standards in ADHD diagnoses: Evidence based on exact birth dates. Journal of Health Economics, 2010; DOI: 10.1016/j.jhealeco.2010.06.003).

Elder found that the youngest or often the most immature children are misdiagnosed with the ADHD label simply because of their age and exhibited maturity. Elder also found that these children are significantly more likely than their older classmates to be prescribed medications like Ritalin to control their behavior. Using a sample of 12,000 children, Elder examined the difference in ADHD diagnosis and medication rates between the youngest and oldest children in a grade. He found that the youngest kindergartners were 60 percent more likely to be diagnosed with ADHD than the oldest kindergarten children. Elder followed that group of children and found that they were more than twice as likely to be prescribed stimulant medication by the time they reached the fifth and eighth grades.

Currently, about  4.5 million children are diagnosed with ADHD. Elder concludes that about 20 percent  or about 900,000 children have likely been misdiagnosed.

In a press release from the University of Michigan, Elder said that such inappropriate treatment is particularly worrisome because of the unknown impacts of long-term stimulant use on children’s health. Elder is also concerned that misdiagnosis wastes an estimated $320 million-$500 million a year on unnecessary medication. He estimates that between $80 million-$90 million of it is paid by Medicaid.

"If a child is behaving poorly, if he’s inattentive, if he can’t sit still, it may simply be because he’s 5 and the other kids are 6," said Elder. "There’s a big difference between a 5-year-old and a 6-year-old, and teachers and medical practitioners need to take that into account when evaluating whether children have ADHD."

ADHD has no pathology, no biological marker in the brain that clearly demonstrates its existence. Thus, its diagnosis is always subjective. While teachers are not permitted to make this diagnosis, their perceptions and opinions serve as the initial step to a diagnosis made by a doctor.

"Many ADHD diagnoses may be driven by teachers’ perceptions of poor behavior among the youngest children in a kindergarten classroom," he said. "But these ‘symptoms’ may merely reflect emotional or intellectual immaturity among the youngest students."

According to Science Daily, Elder’s paper will be published in the Journal of Health Economics in conjunction with a related paper by researchers at North Carolina State University, Notre Dame and the University of Minnesota that arrives at similar conclusions as the result of a separate study.

Is ADHD all in your head?

A study published in the June 14 edition of the Journal of Developmental and Behavioral Pediatrics has sparked controversy regarding ADHD medication and the brain’s power to regulate itself.

The study was funded by the National Institutes of Health and conducted by Dr. Adrian Sandler, a developmental-behavioral pediatrician and medical director of the Olson Huff Center for Child Development at Mission Children’s Hospital in Asheville, North Carolina.  The research was performed over the course of eight years using 99 patients from Western North Carolina.

Sandler found that children with ADHD can do just as well on half their medication when the medication is combined with a placebo. They performed as well even when parents and children had full knowledge they were taking a placebo.

[Placebo –  A substance containing no medication and prescribed or given to reinforce a patient’s expectation to get well. The placebo in this research was akin to a harmless inert pill].

Previous studies have shown that common stimulant medication causes side-effects like tics, weight loss, stunted growth, and even heart complications in some instances. This often causes trepidation in parents afraid of the possible side-effects on their children.

Sandler compared fully medicated children, children on reduced medication, and children on reduced medication with a known placebo. The results were quite intriguing.  Both the fully medicated and reduced medication groups had increased side-effects while the reduced medication with placebo demonstrated decreased side-effects. Furthermore, the reduced medication group reported decreased control of their ADHD symptoms. However, the control of ADHD symptoms was no different in the reduced medication with placebo group than in the full dose group, i.e. the reduced medication with placebo performed as well as the fully medicated group with less side-effects as well.

“I’ve been getting a lot of calls and e-mails,” said Sandler,, who conducted the research with James Bodfish, a professor in the departments of psychiatry and pediatrics at UNC Chapel Hill School of Medicine, and study coordinator Corrine Glesne.

“Medications work,” Bodfish said in a statement. “The question is whether we always need to use them at the highest dose. Many parents are concerned about placing their child on medication. Some choose not to treat their child because of concerns about side effects.”

While the research doesn’t address it, the obvious question is, Why? Parents and children in this study knew they were taking a placebo. Why then did they perform as well as their peers without the side-effects — at essentially half the dose as their peers? While the placebo effect has been studied widely, the exact mechanisms are unknown. We do know that the mechanism is governed by the brain. This clearly tells us that having ADHD or not, our brain is still a powerful weapon in our arsenal.

We also cannot exclude the influence of the parents during this research. Did they expect their child to do better? The authors suggest that this was so. This dynamic cannot be overlooked in your family either.

The bottom line is that we likely have far more control over our behaviors and cognitive processes than we are given credit for. Modern medicine, as this research suggests, is just beginning to understand the brain’s role in shaping our lives. We’ve known this for years at Play Attention. Cognitive training. Memory training. Motor skills. Attention training. Behavioral shaping. It’s time to take control over our lives. We’ve all got the power to do it. It lies right behind our eyes.

The ADHD link to social dynamics

If I told you that women who received only basic education were 130 % more likely to have a child on ADHD medication than women with university degrees, you’d see a link, wouldn’t you? 

Well, that’s what a  study published this month in Acta Paediatrica found.  That implies that nearly half of the serious cases of ADHD  in children are closely tied to social factors. The study reveals that factors like single parenting and poor maternal education were directly tied to ADHD medication use.

While we know that a genetic propensity likely exists, the human brain develops based on a complex interplay between nature and nurture; between genetic endowment (nature) and environment/social factors (nurture). Epigenetic theory tries to explain this relationship.

Curiously, few large-scale studies have tried to determine the impact of social and family influences on ADHD. Researchers at the Karolinska Institute in Stockholm, Sweden assessed data on 1.16 million school children and examined the health histories of nearly 8,000 Swedish-born kids, aged six to 19, who had taken ADHD medication.

"We tracked their record through other registers … to determine a number of other factors," said lead author Anders Hjern.

Here’s what the researchers found:

  • Living in a single parent family increased the chances of being on ADHD medication by more than 50 percent.
  • A family on welfare upped the odds of medication use by 135%.
  • Boys were three times more likely to be on medication than girls.
  • Social dynamics affected both sexes equally.

"Almost half of the cases could be explained by the socioeconomic factors included in our analysis, clearly demonstrating that these are potent predictors of ADHD-medication in Swedish school children," Hjern said.

It’s clear that this study found a link between socioeconomic factors and ADHD medication use/diagnosis. Other US studies have found that minority children and children of low socioeconomic status were more likely to receive ADHD medication.

Factors like low income and diminished quality time are more common in single-parent families. These typically lead to stressors like family conflict and a lack of social support, Hjern said.

While more research must be done, one has to ask, is medication the answer to social stressors like lack of time and money? Sounds too silly to ask, but it seems that our answer, ridiculously, is a resounding, YES!

We are the masters of our lives. We can make significant personal changes, but we must have the tools to do so. That’s why I began Play Attention ( years ago.

Immediate rewards and the ADHD brain

A Nottingham University research team in the United Kingdom found that the brains of children with ADHD appear to respond to immediate rewards in the same way as they do to medication. Their research was published in the journal Biological Psychiatry.

“Our study suggests that both types of intervention [medicine and immediate reward/reinforcement] may have much in common in terms of their effect on the brain,” said Professor Chris Hollis, the lead investigator of  the study.

The research team used an EEG (electroencephalograph) to measure the brain activity of children as they played a computer game that provided extra points for less impulsive behavior.

The researchers devised a computer space game which rewarded the ADHD children when they caught aliens of specific colors  while avoiding aliens of designated colors. The game design actually tested the children’s ability to resist the impulse to grab the wrong colored aliens.

To test whether immediate reward/reinforcement made a difference, one iteration of the game rewarded the children fivefold for catching the right alien and penalized them fivefold for catching the wrong one.  All of this was done while activity in different parts of their brains was monitored with an EEG.

Hollis found that the immediate rewards helped the children perform better at the game. This was verified by the EEG which  revealed that both medication and immediate reward/reinforcement were "normalizing" brain activity in the same regions.

Many parents of ADHD children are aware that giving a reward to an ADHD child a week after their good behavior is insignificant to that child. ADHD children respond better to immediate reward, not delayed reward.

"Although medication and behavior therapy appear to be two very different approaches of treating ADHD, our study suggests that both types of intervention may have much in common in terms of their effect on the brain. Both help normalize similar components of brain function and improve performance,"  said Hollis.

"We know that children with ADHD respond disproportionately less well to delayed rewards – this could mean that in the ‘real world’ of the classroom or home, the neural effects of behavioral approaches using reinforcement and rewards may be less effective."

It’s obvious that providing immediate rewards/reinforcement 24 hours a day and 7 days a week would be impractical and impossible. But what does this research tell us? It tells us that if we are to train an ADHD student, feedback, reward, and reinforcement need to be immediate if we are to get their brain to rewire.

We at Play Attention have known this for many years. This is why we integrated immediate feedback/reinforcement for attention training, cognitive training, memory training, and behavioral shaping by using feedback technology. We patented this method years ago because of its inherent strength. While we knew this was the best way to achieve success, we feel research like this rather reinforces our approach. It’s about time the world caught up!

ADHD is Big Business

Generics don’t produce income for the pharma giants. Giant pharma’s manipulation of pricing affects users – perhaps more now that the economy is a mess. It also affects health and health related decisions. Ethically, this is wrong.

Shire hikes Adderall price as rumors fly

Amid new speculation that Pfizer might snag Shire in a buyout deal, the specialty pharma is following through on its strategy to switch patients to its newest ADHD med Vyvanse as blockbuster Adderall XR nears the end of its patent. Shire is hiking the price of Adderall by 20 percent, a boost that confounded analysts expecting a smaller increase.

The idea, of course, is that by making Adderall more expensive, Shire will shine the spotlight on Vyvanse, whose price is rising by a mere 7 percent. Cost-conscious patients will then switch to the cheaper brand, or so the theory goes. Then, firmly entrenched as Vyvanse users, the patients won’t move to generic Adderall when it hits the market.

Analysts apparently expect the switching to stick; Citigroup upgraded Shire stock on the prospect. But with insurers increasingly vigilant about drug prices, generic Adderall might woo away more Vyvanse users than Shire wants to lose. We’ll have to wait and see how that plays out.

In the meantime, though, investors are bidding up Shire stock on fresh rumors that Pfizer is kicking tires there. The U.K. company surfaces as a rumored Pfizer target from time to time, however, so it’s tough to know whether Pfizer is actually looking, or whether the habitual talk simply got stirred up when Pfizer chief Jeff Kindler made his “open to big deals” statement earlier this week.

Shire Launches Nationwide Adult ADHD Mobile Awareness Tour

The worldwide adult ADHD market holds a potential for billions of dollars for the pharmaceutical industry. In a brilliant marketing effort guised as a benevolent informational/screening initiative, Shire pharmaceuticals, the makers of Adderall for ADHD, launched a “screening initiative” in Atlanta. Shire’s press release states that they “…expect up to 20,000 adults to self-screen for ADHD in 13 cities” over 90 days.

Shire’s press release further states that:

The screening initiative, launched in Atlanta, GA, is designed to help raise awareness that ADHD is not just a childhood disorder. Research shows it is estimated that up to 65 percent of children with ADHD will continue to exhibit symptoms into adulthood. Adults who think they may have ADHD can take the first step toward recognizing the symptoms of the disorder by answering the 6-question World Health Organization (W.H.O.) adult ADHD screener. The screening initiative, known as the "RoADHD Trip," is housed, transported and anchored by the RoADHD Trip Tractor Trailer which expands into a tented area housing eight self-screening stations.

“Shire developed this mobile screening initiative as a forum to educate the public about ADHD in adults and provide information and resources to individuals about this disorder," said Gerardo Torres, M.D., Vice President and Scientific Lead, of Shire’s ADHD Business Unit. "This program demonstrates Shire’s on-going commitment to providing information for those who may be struggling with the symptoms of ADHD."

In each of the 13 cities, Shire is partnering with the Attention Deficit Disorder Association (ADDA), a leading adult ADHD patient advocacy organization, in an effort to assist up to 20,000 adults to self-screen for this disorder. Volunteers from ADDA will also be on-site to answer questions about ADHD in adults and to provide information about their organization. The W.H.O. adult ADHD screener, a questionnaire that is used to help recognize the symptoms of ADHD, will be available via on-site computers to help facilitate self evaluations. The W.H.O. screener is not designed to provide a diagnosis of ADHD but may provide information to participants regarding the symptoms of ADHD. Participants should discuss any questions they have regarding the W.H.O. screener results and other concerns about ADHD with their physician.

"Seeking information and speaking to qualified health care professionals are critical steps to diagnosis and management of ADHD," further explained Dr. Torres. "This initiative is an important first step to encourage that dialogue between patients and their physicians."

This should leave Shire’s competitors slapping their foreheads saying, “Why didn’t I think of this!”

Aderall & Vyvanse: Shire Pharmaceutical May Be The ADHD Top Earner By 2017

Decision Resources Pharmacor report reveals that the UK’s Shire may be the ADHD top earner by 2017.

Shire currently markets ADHD stimulant medication, Adderall. Adderall’s instant release formula is now available as a generic drug. The report states that Shire´s ADHD drugs will be dominate this market by 2017. The report attributes this, at least in part, to Shire’s launch of Vyvanse´s, a new ADHD drug which has been approved for both children and adults. Vyvanse may lower abuse potential compared with other psycho-stimulants on the market. The Pharmacor report predicts that Vyvanse will generate almost $ 1.2 billion dollars in sales in 2017.

Shire’s ability to take the lead, according to the report, will be because of Shire’s Vyvanse and its patch sold as Daytrana. Additionally, Shire is pursuing a non-stimulant medication called Intuniv that will compete with Lily’s Strattera and secure dominance in the burgeoning international ADHD market projected to be worth $4 billion.

To facilitate continued sales increases and increased market share, all major pharmaceutical companies are marketing heavily in countries that traditionally have not accepted ADHD as a neurobiological disorder or treated it with medication.