Psychoactive Medications

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Psychoactive Drugs for Children and Adolescents with ADHD

Diagnosing and treating children and adolescents with ADHD can be a daunting task, even for the most experienced child and adolescent psychiatrist. Two decades ago, it was rare for a child or adolescent to be diagnosed with bipolar disorder and ADHD was almost unheard of. However, once uncommon, the proportions of children who are receiving multiple psychotropic medications have increased, and continue to do so. In addition, many children receive both antidepressants and stimulants, the clinical rationale and consequences of this practice is of particularly importance to public health and practice-based research. There is paucity in the data available to support advantageous efficacy for drug combinations that are being used to treat co-morbid conditions. Medication management requires the informed consent of the parents or legal guardians and must address benefits vs. risks, side effects and the potential for drug interaction (AACAP, 2010).
Discussion

The magnitude of the problem
Today, in the United States, Attention-deficit/hyperactivity disorder (ADHD) is the most common psychiatric disorder among children and adolescents. More than 5 million children ages 3-17, and approximately one in 11 -- have been diagnosed with ADHD. With an epidemiologic prevalence of 3-7% in school-aged children, the condition is now at epic and gastronomic proportions and is now a major clinical and public health problem .Especially, because of its association with morbidity and disability in youths and adults. The Centers for Disease Control and Prevention, characterizes the disorder by poor concentration, distractibility, hyperactivity, impulsiveness and other symptoms that are inappropriate for the child's age. Usually, interventions include evidence-based treatment, stimulant medications and other forms of behavior therapy (Hinshaw, 2012). ADHD tend to be more common among boys than girls with a ratio of range that is roughly 3:1 to 5:1 in epidemiological studies (Hinshaw, 2012).
The disparity could be as a result of different identification rates. Since the disruptive component of the disorder may be less prominent in girls in an educational setting. This type of ADHD where the inattentive component is predominant and the hyperactivity component not present is called attention-deficit disorder (ADD). In a twist, the increased use of stimulants has led to many debates as to whether the use of stimulants is addictive and might facilitate the abuse of other substances. The verdict that is out as of 2012, suggests that no cases of addictive effects of methylphenidate, when used as prescribed (key words), have been reported so far. In fact, children with ADHD who have been treated with stimulants have been shown to develop fewer tendencies towards substance abuse than untreated children (Hinshaw, 2012). That said however, we must not get too comfortable, there is still sufficient literature to suggest that stimulants themselves are misused by individuals both with and without ADHD. Two of the most prescribed drugs (Adderall and Ritalin) have been misused for weight control, sold on campus to pull off "all-nighters" and parties, improve concentration and alertness, experiment, just 'get high,' and 'become smart'. This is not smart thinking at all.

Deadly Side Effects
Despite the frequent and overuse of stimulants, there is still a lack of clarity on the effects of long-term use on growth and nutritional status of children. Although cardiovascular effects of both stimulants and Atomoxetine are rare, they can be extremely severe. In addition, the literature suggests that Atomoxetine may be associated with suicidal ideation in children. Although pharmacotherapy is increasing common in the treatment of ADHD in both children and adults, there are still a lot of questions regarding side effects and how best to counter them. This ...