Apr 17, 2017

Dr. Gellner: ADHD is a very common medical diagnosis in pediatrics and parents are often concerned about the medications. I hope to relieve some of those concerns on today's Scope. I'm Dr. Cindy Gellner.

Announcer: Keep your kids healthy and happy. You are now entering the "Healthy Kids Zone" with Dr. Cindy Gellner on The Scope.

Dr. Gellner: Your child has been diagnosed with ADHD and now your pediatrician is talking to you about medications. Stimulant medications have repeatedly been shown to be the most effective treatment for the symptoms of ADHD. They help kids concentrate, manage their impulsive choices, and avoid risky behavior. About 80% of kids who try stimulant medications for ADHD find that they have a positive effect on symptoms. To put that in perspective, there is no other medication for a mental health diagnosis that has such a high response rate.

It's understandable that you may have concerns about medication that affect your child's brain, especially if it's taken for a long time. First, it's important to understand how these medications work. These medications change the level of dopamine in the brain. Dopamine is a chemical that plays a critical role in attention and decision-making. Kids with ADHD don't have enough dopamine and so the medicines help increase the level of dopamine in the brain.

They only raise the level enough to help with ADHD symptoms. They should not change your child's personality like if they're really cranky, or acting like a zombie, the dose of the medication is likely too high. You will notice within a few days of starting the new ADHD medicine if it's working and you should your doctor call right away if there are issues. Problem sleeping and loss of appetite, though, are two common side effects. Still, mention any concerns to your child's pediatrician.

We get a lot of questions about long-term effects of using ADHD stimulant medications. In the over 50 years of using stimulant medications for ADHD and hundreds of studies, no negative effects of taking the medication over a period of years have been observed. Actually, in 2013, a study done by the National Institute on Drug Abuse did a number of studies to better understand how ADHD and the medication used to treat it affect the brain. It showed that some children developed tolerance to the medications, needing their doses increased, but not all of the children had this. Often, the dose increase happens in the first several years of being treated. But then, during the later teenage years, a child's body may be able to metabolize the medication more efficiently.

A big concern about ADHD meds is the worry that kids who take them will be at higher risk for substance abuse when they're older. Several studies have shown no correlation. In fact, recent research shows that while teens and young adults with ADHD are at a higher risk for substance abuse than other kids, treating them with stimulant medication neither increases nor reduces the risk. What this study shows is that the risk is linked to the ADHD diagnosis itself, not to the treatment. Addiction is a risk when these stimulants are abused, that is they're taken in doses or in ways other than that prescribed, such as being crushed or snorted.

So a history of substance abuse would be an important factor when considering whether a teenager is a good candidate for ADHD medication. So, as with any medication, speak up at your child's appointment and if you have any concerns about the treatment being prescribed, ask. You can help your child's pediatrician choose the right medication for your child's ADHD.

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