Should Stimulant Medications Be Used to Treat Our Children?

Attention Deficit Hyperactivity Disorder:

Should Stimulant Medications be used to treat our Children?

What is Attention deficit Hyperactivity Disorder?

With no cure for ADHD, stimulant medication should be considered for the overall management of the disruptive symptoms associated with the Attention Deficit Hyperactivity Disorder Attention Deficit Hyperactivity Disorder (ADHD) is the most common mental health problem in children. Children with ADHD often have problems with attention span, hyperactivity, and impulsive behavior. It is often called by an older name, attention deficit disorder (ADD). The disorder begins in the preschool years and may either continue or fade away during the teenage years. About one-third of children with ADHD also have learning problems such as a reading disability. About half of ADHD children and teenagers have behavior problems, which may include breaking rules, talking back, and hitting other children. ADHD is 7 times more common in boys than girls. Girls are more likely to have troubles with attention and less likely to have hyperactivity. (Wiener, 1999)

What causes ADHD?

In about 70% of cases, ADHD is inherited. It runs in families, especially through the males in the family line. Research continues in an effort to find out why it occurs in those without a family history. Parker (n.d.) says, ADHD can be caused by development problems during pregnancy or delivery. The medical explanation for ADHD is that neurotransmitters help the human brain to form thoughts, store and recall information, and translate thoughts into physical actions. One of these neurotransmitters, dopamine, is abnormally low in children diagnosed with ADD and ADHD. Another key neurotransmitter that may play a role in ADHD is acetylcholine, which is responsible for signaling and helping to control memory, attention, awareness, perception, reasoning and judgment. Since problems with memory and attentiveness are attributes of those with ADD and ADHD, researchers believe that low dopamine levels may be responsible.

How is ADHD diagnosed?

To diagnose ADHD, it must be clear that the symptoms persist and interfere in a major way with daily life. According to Wiener (1999), being able to tell a child has ADHD is much harder than diagnosing mumps or chickenpox. (p.1). You and your child's teachers, may be asked to complete questionnaires or rating forms about ADHD symptoms. Your child may be asked to see a psychologist or other mental health professional for tests of attention and self-control. There are no useful physical tests such as blood tests or brain scans for diagnosing ADHD.

There are 3 forms of ADHD:

Ð'* Combined ADHD. Your child has all of the main symptoms: distractibility, poor impulse control, and hyperactivity.

Ð'* Predominately inattentive. Your child has problems with focus and attention. This form of ADD is often missed because there may be very little hyperactivity or impulsivity. This form is especially common among girls.

Ð'* Predominately impulsive-hyperactive type. Poor self-control is the main problem.

There are 2 main treatments used to treat ADHD symptoms.

Ð'* Non-Stimulant Medication: There are 4 types of non-stimulant medications; Strattera is a fairly new medication that acts like a stimulant but is not. Strattera has a 24 hour coverage period, less weight loss, also you're able to call this medication in versus going to pick up the prescription every month from the doctors office. (Watkins, C., Brynes, G., Preller, R., December, 2004)

Tricyclic Antidepressants (TCA) have been found effective for treating major depressive disorders, anxiety disorders, and panic disorders in adults. Most TCA's are relatively safe, effective, and easy to administer. Within children and adolescents, however, they have not proven as effective. TCA's are metabolized by the liver and loosely bind to protein. As in all substances with primary hepatic (liver) metabolism, TCA's are metabolized more rapidly in children and adolescents than in adults. For example, children and adolescents treated with similar doses of TCA's controlled for body mass can have blood levels of the drug that can differ by 30-fold within the active life of the medication. TCA's block the reuptake of neurotransmitters such as norepinephrine and seratonin. This seems to increase their concentration in the brain and thus compensates for a presumed deficiency that appears to cause depression in some people. Bupropion (Wellbutrin) stimulates the effects of dopamine and may reduce hyperactivity and aggressiveness, which makes it especially useful for children. It is a non-Tricyclic antidepressant with a primary pharmacological action of monoamine uptake inhibition. The drug resembles a psycho stimulant in terms of its neurochemical and behavioral profiles in vivo, but it does not reliably produce stimulant-like effects in humans at clinically prescribed doses. Bupropion binds with modest selectivity to the dopamine transporter, but its behavioral effects have often been attributed to its inhibition of norepinephrine uptake.

Ð'* Stimulant Medication: There are many kinds of stimulants used today. These stimulants help many children have a much happier life through school and at home.

Treatments that have not been found effective include diets limiting sugar, food additives, or food colorings; and herbal supplements and health foods. Despite much research into this area since the 1970s, little has been found that relates diet to hyperactivity, impulsive behavior, or poor attention. Although there are claims that many health foods benefit children with ADHD, there are almost no data to back up or refute those claims. Omega fatty acid supplements and certain vitamins and minerals may help symptoms of ADHD.

What are Stimulant medications?

Stimulants and Non-Stimulants are the longest acting form of treatment for ADHD. Watkins, Brynes, & Preller (December, 2004) says, "Stimulant medications either increase the release or block the reassertion of dopamine and norepinephrine, which are the two brain neurotransmitters." Watkins also stated that "stimulants increase the transmission between certain neuron in the brain." (p. 1)

Stimulants that decrease impulsivity and hyperactivity and increase attention are commonly used to treat ADHD. These medications are used with careful monitoring and compliance and improve symptoms in approximately 70Ð'-90% of