ADHD, Conduct Disorder, Drugs, & Alcohol

ADHD, Conduct Disorder, Drugs, & Alcohol
New study sheds light on this alarming link

Read More: http://psychcentral.com/news/2014/12/11/young-teen-adhd-conduct-disorder-substance-abuse/78495.html

It’s not difficult to find ADHD teens who participate in risky behavior that includes excessive alcohol, drug, and tobacco use. Throw in conduct disorder and lives can spin even further out of control.

Conduct disorder is an emotional/behavioral disorder that (PsychCentral.com) involves specific repetitive behaviors. “These behaviors fall into four main groupings: aggressive conduct that causes or threatens physical harm to other people or animals, nonaggressive conduct that causes property loss or damage, deceitfulness or theft, and serious violations of rules time and time again.”

A new study by The Cincinnati Children’s Hospital Medical Center and published in the journal Drug and Alcohol Dependence links ADHD with conduct disorder, drugs, and alcohol.

They study examined data on more than 2,500 teens between the ages of 12 and 15. The scientists found that a teen with both ADHD and conduct disorder was 3 to 5 times more likely to use drugs and alcohol, and begin use at an earlier age than a teen without either disorder.

If the teen had ADHD alone, they had an increased likelihood of tobacco use, but not alcohol use.

“Early onset of substance abuse is a significant public health concern,” says William Brinkman, MD, a pediatrician at Cincinnati Children’s Hospital Medical Center and the study’s lead author. “Adolescents who use substances before the mid-teen years are more likely to develop dependence on them than those who start later. This is why prevention is so important.”

What Causes ADHD?

What Causes ADHD?
After much research, the answer is…

Read More: http://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml

We’ve all heard that ADHD is caused by chemical imbalance. That’s really just a theory. ADHD may be related to a neurotransmitter called dopamine. After much research, it’s still impossible to determine if ADHD is caused by a malfunctioning or slow dopamine system.

How about genetics? Likely, but there’s no absolute certainty about a genetic link either because in some cases, no genetic link has been found.

Other research has indicated that smoking, the use of acetaminophen, or drinking during pregnancy, might be linked to ADHD in children.

The National Institute of Mental Health says:

“Scientists are not sure what causes ADHD, although many studies suggest that genes play a large role. Like many other illnesses, ADHD probably results from a combination of factors. In addition to genetics, researchers are looking at possible environmental factors, and are studying how brain injuries, nutrition, and the social environment might contribute to ADHD.”

Some studies have indicated that children with ADHD have reduced brain mass or delayed maturation of certain areas of the brain. Recent research published in the Proceedings of the National Academy of Sciences indicate that delayed brain maturation may be related to the underdevelopment of brain connections related to attention in ADHD children.

Let’s get to the heart of the matter. There is no certain cause of ADHD. It is likely to be caused by a variety of factors.

What do we do as parents, educators, and other concerned people if we don’t know the cause? One of the greatest conundrums in life is thinking that knowing the cause affects the outcome. As far as ADHD is concerned, knowing the cause won’t likely affect your outcomes; knowing that you smoked, used acetaminophen, were exposed to lead, or used alcohol during pregnancy will not change the fact that your child has ADHD.

You’ve got a variety of weapons against it in your arsenal ranging from medicine, to cognitive training, parental training, dietary change, behavioral training for your child, to exercise, and more.

No matter the cause, we know the brain can change and be changed through proper training. There is hope.

Are You a Better Parent if You’re Medicated?

Are You a Better Parent if You’re Medicated?
Penn State researchers say YES!

Read More: http://news.psu.edu/story/321808/2014/07/30/research/parenting-skills-improve-adhd-parents-medication

Penn State News reports on a small study done at Penn State and funded by Shire Inc., the manufacturer of lisdexamfetamine, (aka Vyvanse) where ADHD parents received medication to help them cope with their children.

One of the lead researchers, Dr. James Waxmonsky noted, “Parents with ADHD are at increased risk to engage in problematic parenting techniques, including inconsistent disciplinary practices, making ineffectual commands and diminished use of praise. Having a parent with ADHD also decreases the chances that children with ADHD will respond to typically effective medication or counseling treatment.”

So, the solution? Medicate the parents! The researchers selected 20 parents who had children age 5 to 12. Both parents had a diagnosis presenting ADHD. The researchers then gave the parents ‘optimal’ doses of lisdexamfetamine (Vyvanse).

The parents were then brought to the clinic for observation on two tasks: 1] The child performs homework with parental assistance, and 2] The child plays while the parent performs paperwork.

The parent was administered either a placebo or Vyvanse for the first observation. This was then reversed for the second observation period. Neither the researchers nor participants knew when the active medication was received.

According to Penn State News, “The results of the first phase showed no medication effect was seen during the homework component. During the non-academic component, parents were less likely to make negative statements toward their children on lisdexamfetamine than on placebo.

Children showed less inappropriate behavior during the homework task when their parent was prescribed lisdexamfetamine versus placebo.

Then, in the second phase, parents had a 50 percent chance of staying on active medication or a 50 percent chance of being switched to placebo for the remainder of the study. They completed the same parent-child interaction tasks as in the first phase.”

“In the laboratory setting, lisdexamfetamine treatment of parental ADHD was associated with significant reductions in children’s negative behaviors and improvements in parenting behaviors found to be adversely impacted by ADHD,” Waxmonsky said.

Can you think of a better way to expand this market?

New Study Show Stimulant Meds Increase Cardiovascular Events

New Study Show Stimulant Meds Increase Cardiovascular Events
What every parent should know

Read More: http://consumer.healthday.com/kids-health-information-23/adolescents-and-teen-health-news-719/adhd-drugs-may-up-risk-of-heart-problems-689468.html

 

(HealthDay News) — Stimulant use in children and adolescents is associated with an increased risk of a subsequent cardiovascular event, according to a study published online June 23 in the Journal of Child and Adolescent Psychopharmacology.

Søren Dalsgaard, MD, PhD, from Aarhus University in Denmark, and colleagues conducted a longitudinal prospective study of all children born in Denmark from 1990–1999. The authors sought to examine whether stimulant users are at increased risk of a subsequent cardiovascular event. Data were collected from national health registers on psychiatric and somatic diagnoses, stimulant prescriptions, cardiovascular risk factors, and pre- and perinatal and sociodemographic covariates. Data were merged for children and their parents.

Using data for a total population of 714,258 children, contributing 6,767,982 person-years, the researchers found that stimulant use correlated with an increased risk of a cardiovascular event (adjusted hazard ratio, 1.83). Stimulant treatment also increased the risk of a cardiovascular event in children with attention-deficit/hyperactivity disorder (ADHD; 8,300 children; adjusted hazard ratio, 2.20), with evidence of a complex time-dependent, dose-response association.

“Cardiovascular events were rare but twice as likely in stimulant users as in nonusers, both in the total national population and in children with ADHD,” the authors write. “Our results suggest a safety signal with an increased risk of cardiovascular disease associated with stimulant treatment in children and adolescents, even after adjusting for a number of potential confounders.”

Surge in women taking drugs for ADHD

Surge in women taking drugs for ADHD
What’s behind this?

From Newsday: http://www.newsday.com/news/health/surge-in-women-taking-drugs-for-adhd-1.7372481

“The number of Americans taking attention deficit hyperactivity disorder medicines rose 36% in 2012 from 2008, led by a surge among women, according to drug-benefits manager Express Scripts Holding Co.

Use of the medications grew 85 percent in 2012 from 2008 for women ages 26 to 34, and women 19 and over now outnumber men in use of the medicines, according to the report released yesterday. Boys 12 to 18 years old are the most heavily prescribed, with about 9.3 percent on ADHD drugs in 2012.

Almost 4.8 million privately insured people were on ADHD medicines in 2012, the report said. Those with the disorder have problems paying attention, the U.S. Centers for Disease Control and Prevention says.”

How does one explain the incredible increase in ADHD medication use especially among women ages 26 to 34? Is it due to increased stress? The demands of home and work? Better marketing among these women? Can a pill fix these problems?

Your opinions are welcome.

Concerta Placed on FDA’s Watch List

Concerta Placed on FDA’s Watch List
Read More: http://www.medscape.com/viewarticle/823917

Medscape reports that on April 21, 2014 the US Food and Drug Administration (FDA) has placed a generic drug that treats attention-deficit/hyperactivity disorder (ADHD) on its latest quarterly list of products to monitor because of potential health risks, the agency announced today.

In the case of the ADHD drug — certain generic versions of methylphenidate hydrochloride (Concerta, Janssen Pharmaceuticals) — the issue is a possible lack of therapeutic effect, which may be linked to product quality issues, according to the FDA.

A drug’s appearance on the list, which grows quarter by quarter, does not mean the FDA has concluded that the drug actually poses the health risk reported through FAERS. Instead, the agency is studying whether there is indeed a causal link. If it establishes one, the FDA then would consider a regulatory response such as gathering more information to better describe the risk, changing the drug’s label, or mandating a risk evaluation and mitigation strategy.

The FDA also emphasizes that it is not suggesting that clinicians should stop prescribing watch list drugs or that patients should stop taking them while the jury is out.

More Drugs Added to FDA Watch List
www.medscape.com
Members of a certain class of cancer drugs, as well as a drug treating ADHD, made the list on the basis of potential signals of health risks.

ADHD Drugs Affect Growth Rates

ADHD Drugs Affect Growth Rates
Obesity? Weight loss? Both?

Read more: http://www.imt.ie/clinical/2014/04/adhd-treatment-drugs-affect-bmi-growth-rates.html

Researchers at Johns Hopkins Bloomberg School of Public Health finds that ADHD children treated with stimulant medication initially have slower body mass index (BMI) growth than their untreated peers. BMI is a measure of body fat based on height and weight. But, that’s just the tip of the iceberg.

The researchers found that the slow growth of BMI was followed by a rapid rebound of BMI that was greater than that of children with no history of ADHD or stimulant medication use and that could continue to obesity.

The researchers found that the earlier the medication was given coupled with the longer the medication was taken resulted in slower BMI growth in earlier childhood but then the more rapid the BMI rebound in late adolescence, typically after medication was discontinued. Researchers concluded that stimulant use, and not a diagnosis of ADHD, was associated with higher BMI and obesity.

“Our findings should motivate greater attention to the possibility that longer-term stimulant use plays a role in the development of obesity in children,” said study lead, Prof . Brian Schwartz of Environmental Health Sciences, Epidemiology and Medicine at the Bloomberg School of Public Health. “Given the dramatic rise in ADHD diagnosis and stimulant treatment in recent decades, this is an interesting avenue of research regarding the childhood obesity epidemic, because the rises in each of these roughly parallel one another.”

Earlier research has noted decreased appetite and weight loss as being associated with stimulant medication use. This is the first comprehensive study to find low BMI rebounding to obesity even after discontinuation of the drug.

Many stimulants used to control ADHD symptoms were once used or initially invented as weight loss drugs.

ADHD Meds Linked to Priapism

FDA Warning & Label Change
Read More: http://www.medscape.com/viewarticle/817936

Methylphenidate, also marketed as Ritalin, has been noted to cause tics, heart problems, weight loss, and sleep problems. It has now been linked to a rare risk for priapism in males taking the stimulant for the treatment of ADHD according to the US Food and Drug Administration (FDA).

The FDA disclosed in a press release that the stimulant may in rare instances cause prolonged and sometimes painful erections (priapism). In light of this, the FDA has updated drug labels to alert the public to this rare but serious side effect which may lead to permanent penis damage. The FDA warns (similar to Viagra) that patients who take methylphenidate and develop erections lasting longer than 4 hours should seek immediate medical treatment to prevent long-term problems with the penis.

The FDA also warns that nonstimulant ADHD drugs like atomoxetine (Strattera) have also been associated with priapism in young children, teenagers, and adults. Priapism appears to be more common in patients taking atomoxetine than in patients taking methylphenidate, so one has to cautiously consider atomoxetine products as alternatives to Ritalin.

Should We Be Alarmed by Current ADHD Trends?

A surprising answer from an international expert

We should be alarmed. Very alarmed. This comes from Dr. Keith Conners who has led the fight to legitimize ADHD over the last 50 years. His diagnostic checklists are still used today.

“The numbers make it look like an epidemic. Well, it’s not. It’s preposterous,” Dr. Conners, a psychologist and professor emeritus at Duke University, said in a subsequent interview. “This is a concoction to justify the giving out of medication at unprecedented and unjustifiable levels.”

A Nation of Kids on Speed

An Op Ed piece in the Wall Street Journal worth reading…
Cohen and Rasmussen: A Nation of Kids on Speed
online.wsj.com
Dr. Cohen is an a assistant professor of medicine at Harvard Medical School. Dr. Rasmussen is a professor of the history of science at the University of New South Wales in Sydney, Australia, and the author of “On Speed: The Many Lives of Amphetamine” (New York University, 2009).http://online.wsj.com/article/SB10001424127887323728204578513662248894162.html

Cohen and Rasmussen: A Nation of Kids on Speed
online.wsj.com