Effects Of Prescription Stimulants On Cognition In Adhd
Neuropsychological studies of ADHD children and adults indicate impairments in many cognitive areas including selective attention, memory, reaction time, information processing speed, and executive control function such as set-shifting, and working memory. The benefits of prescription stimulants for enhancing classroom manageability and increasing attention and academic productivity in children are well established. Prescription stimulants may increase the quality of note taking, scores on quizzes and worksheets, writing output, and homework completion. Nevertheless, they do not normalize the ability to learn and apply knowledge . In fact, it has been recognized over 30 years that there is little evidence that prescription stimulants such as MPH and AMP improve the academic achievement of ADHD-diagnosed children. Children with ADHD have a consistently lower full-scale IQ than normal controls. They score significantly lower on reading and arithmetic tests, use more remedial academic services, and are more likely to be placed in a special education class, or repeat a grade compared with controls. They also take more years to complete high school and have lower rates of college attendance . Thus, prescription stimulants have only a modest impact on these outcomes.
Parent Training And Education Programmes
If your child has ADHD, specially tailored parent training and education programmes can help you learn specific ways of talking to your child, and playing and working with them to improve their attention and behaviour.
You may also be offered parent training before your child is formally diagnosed with ADHD.
These programmes are usually arranged in groups of around 10 to 12 parents. A programme usually consists of 10 to 16 meetings, lasting up to 2 hours each.
Being offered a parent training and education programme does not mean you have been a bad parent it aims to teach parents and carers about behaviour management, while increasing confidence in your ability to help your child and improve your relationship.
Less Common Side Effects Of Adhd Medications
More serious, but less common side effects can occur with ADHD medications. They include:
- Tics. Stimulant medication may cause children to develop repetitive movements or sounds. These movements and sounds are called
- Food and Drug Administration has warned that people with ADHD who have existing heart conditions may be more likely to have a heart attack, stroke, or sudden death if they take stimulant medication.
- Additional psychiatric problems. Some people taking stimulant medications may develop psychiatric problems. These include hearing voices and seeing things that dont exist. Its important you talk with your childs doctor about any family history of psychiatric problems.
- Suicidal thoughts. Some people may experience depression or develop suicidal thoughts. Report any unusual behaviors to your childs doctor.
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Effects On Mental Health And Behavior
Several studies have tested the effects of ADHD medications on mental health, but the results are often contradictory and inconclusive.
Anxiety is one of the most well-documented symptoms. Stimulants increase activity in the brain and central nervous system, which can cause a person to feel anxious or jittery.
Researchers are still unsure whether ADHD medication influences depression, but research suggests that it does reduce a personâs risk of suicide.
Although stimulant medication can cause side effects, it is also an effective way to manage ADHD symptoms. As a result, it can significantly improve a personâs quality of life.
The potential benefits include:
- lowering criminality rates
In some cases, a person may continue to see improvements in their symptoms even after they stop taking the medication.
An older study involving more than 500 children with ADHD compared those who took medication with those who did not. Those who took medication continued to experience improved symptoms of ADHD for up to 3 years after they stopped the treatment. After that, there were no additional benefits.
People with ADHD or their parents or caregivers should discuss the pros and cons of medication with a doctor. When choosing an ADHD medication, some questions to ask include:
Stimulant Medication In Childhood Does Not Lead To Addictive Disorders Later
With my colleagues at Harvard Medical School and the Massachusetts General Hospital, I reviewed all available studies. We found no evidence that the use of stimulant medications for ADHD in childhood led to addictive disorders in adolescence or adulthood.
Instead, we found some evidence that the stimulant medications for ADHD protected patients from subsequent addictive disorders.
Additional evidence for a protective effect of stimulant medications came from a Swedish study of commercial health care claims from 2,993,887 adolescent and adult ADHD patients. The authors concluded:
These results provide evidence that receiving ADHD medication is unlikely to be associated with greater risk of substance-related problems in adolescence or adulthood. Rather, medication was associated with lower concurrent risk of substance-related events and, at least among men, lower long-term risk of future substance-related events.
This confirmed an earlier report from Sweden based on a study of 26,249 men and 12,504 women with ADHD.
So, the data are clear and unequivocal. When used therapeutically, the stimulant medications for ADHD do not cause addiction. Instead, because these medications control the symptoms of ADHD, they reduce the likelihood that a child with ADHD will, eventually, develop a substance use disorder.
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Adhd Medication Concern: Will My Child Will Become Dependent
Finding ADHD medication useful and helpful is not the same thing as developing a dependency on it. Clinicians should remind parents of this difference.
If a child finds medication useful, theyre dependent on it in the same way that a person with a broken leg depends on crutches or a wheelchair ramp. A medication is useful if it helps a child execute what they need to do not if they achieve a high off of it.
Heres another helpful analogy: Sleep is incredibly important and healthy because thats what keeps us functioning. If we did not sleep, we would notice the difference, and we would crave sleep it but that doesnt mean were hooked on it. Its that our brain and our body need it. Thats what medication aims to do by buffering the parts of an individuals neurology that arent working in ways that are ultimately helpful.
Its also important to tell parents who are concerned about negative dependency that medication does something very different to an ADHD brain than it does to a non-ADHD brain.
Can Medicine Cure Adhd
There is no cure for ADHD. Medications only treat and help control symptoms. However, the right combination of medicine and therapy can help your child lead a productive life. It may take time to find the right dose and best medicine. According to the , regular monitoring and interaction with your childs doctor actually helps your child receive the best treatment.
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How Can Ritalin Make Adhd Worse
Dopamine is the brain chemical largely thought to be responsible for reward-motivated behavior, and ADHD is often associated with low dopamine activity. In your brain, synapses are the places where neurotransmitters like dopamine stimulate action. Dopamine transporters are responsible for clearing dopamine from the synapse into surrounding cells once the dopamine has fired its signal. The more quickly dopamine gets cleared from the synapse, the less dopamine is available to do its work. Methylphenidate gets results by blocking dopamine transporters, giving your brain more opportunity to get the benefit of the dopamine.
You dont want excessive amounts of dopamine transporters hanging out in your brain, or whatever dopamine you do have gets cleared quickly.
This study, done by noted neuroscientists Gene-Jack Wang and the National Institutes of Drug Abuse Director Nora Volkow and others, dealt with adult sufferers of ADHD who had never before been treated with medication.
They took 18 never medicated ADHD adults and did PET scans on them before and one year later. They compared the ADHD adults to 12 normal control subjects, also scanned at baseline and then a year later. The ADHD subjects treated with the drug showed a 24% average increase in dopamine transporters, while the control subjects showed no increase in transporters.
Reasons Why You Shouldnt Medicate Your Child With Adhd
Parenting is just like any other job. To do it right, you need the right tools. Finding the right tools, however, can be a challenge for parents whose children struggle with Attention-Deficit Hyperactivity Disorder . ADHD often feels like a battle yet comes with many gifts. However, these children and teens can be frustrating because their Central Nervous System leads them to being maybe impulsive, hard to motivate, unfocused, and emotional. All of these ADHD symptoms can create peer and academic issues., etc., which parents need the right tools to help support their kids.
Because our whole mental health system has broken down and medication is often the first and only treatment offered, a parents first step really should be meeting with a psychologist, who can offer parents support and obtain resources. A push toward medication usage is the norm in every facet of mental health. The typical provider simply doesnt know about biomedical approaches and thus isnt conveying that information. In2012, the American Academy of Pediatrics gave Neurofeedback a Level 1 effectiveness rating in the treatment of ADHD in children, which is the same effectiveness as medication, yet most physicians arent telling parents this.
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How Misusing Stimulant Medication Can Affect Kids
Theres a difference in how stimulant medication affects kids and young adults who have ADHD and those who dont. For those who dont have ADHD, it can offer a quick, short-term boost in focus and alertness.
Most kids with ADHD who take stimulant medication as prescribed have good results. When the medication is active in the body, it can help reduce ADHD symptoms by improving the way parts of the brain communicate with each other. This can help improve executive functioning skills, such as working memory.
When that happens, kids with ADHD are more focused and better able to stay organized and on-task. Theyre also more motivated to complete tasks they have little interest in, but need to do.
But taking more medication than is prescribed, or taking it more often than is prescribed, can create unpleasant side effects. Thats true for kids with or without ADHD. It can make them feel jittery or cause their heart rate to increase temporarily.
Those sensations can make it hard to concentrate on work. Too much medication can also keep kids awake much longer than they want to be at night, causing them to be exhausted the next day.
For most kids, this experience is enough to keep them from taking high dosages in the future. But there are some kids who may actually like the sensation and continue to seek it out. These are the kids who may be at risk of becoming addicted.
Adhd Medication For Kids: Is It Safe Does It Help
- By Ellen Braaten, PhD, Contributor
ARCHIVED CONTENT: As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date each article was posted or last reviewed. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
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Attention deficit hyperactivity disorder is one of the most commonly diagnosed psychiatric disorders, with prevalence rates around 3%-4%. Medication is frequently used to treat the symptoms of inattention, impulsivity, and hyperactivity that are associated with the disorder. Its a developmental disorder, meaning that the symptoms start in childhood, before the age of 12. The symptoms can impair functioning in school and at home, and interfere with forming and keeping friendships.
Im a psychologist and I dont prescribe medication, but despite that fact, parents often ask me, Should my child with ADHD be on medication? followed by, What are the downsides of medication? and then frequently follow up with, Arent there too many kids on medication anyway? A study published last fall in BMJ can help parents and professionals with answers to these questions in terms of the drug methylphenidate, in particular.
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Three Top Adhd Medication Pitfalls And How To Avoid Them
One of the most effective management strategies for minimizing the challenges and symptoms of ADHD is medication.
This might not be the most popular statement I have ever made, but research over and over again has shown that ADHD medications can level the playing field for both adults and children with ADHD. Medications can be effective in helping people with ADHD increase their focus on less interesting tasks, reduce impulsivity of actions and words and calm inner restlessness. I often hear clients describe the experience of being on the right medication as similar to having the fog clearing, the water globe settling or a light switch being turned on. They feel more focused, energetic, calm and productive. However, many people never have the chance to experience the full benefits of ADHD medication due to three problem areas that I call ADHD medication pitfallsthe wrong medication, the wrong dose or taking medications at the wrong time.
Medication Pitfall #1
Medication Pitfall #2
Medication Pitfall #3
Let me know what your experiences are with ADHD medications by responding to this blog!
Other Adhd Medications And Cannabis
Other medications for ADHD, such as Vyvanse and Focalin , have no research examining their interactions with cannabis. So it is important to exercise extra caution if you are currently using these options and considering cannabis, but in general you may be able to consider them to carry similar risks.
Perhaps the most important side effects of this combination would be cardiac stress from the stimulant combined with THC, which could result in a racing heart, changing blood pressures, or worsening heart problems. In addition, with the wrong dose of either stimulants or cannabis, anxiety can be a real problem. Remember to take deep breaths, get fresh air, and remember these tricks to help get you away from the edge of being too high.
With these, and all medications for ADHD, it is important to consult with a physician before adding cannabis to your regimen. Research shows side effects like increased cardiac stress, gastrointestinal problems and increased addictive responses are possible when combining cannabis and ADHD medications. Even if cannabis is a good treatment for ADHD, it is sure to be a medication where finding the right dose to suit your individual needs is important.
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What You Should Think About Adhd Medication
With these pros and cons of the medication in mind, you can easily decide whether these will help a parent like you to handle your kids with ADHD or any of your love with the condition. You can now understand whether such medications are made to give a person with ADHD the opportunity to control his or her abilities or not.
Adhd Medication Concern: Treatment Is Too Much Work
ADHD medication is a large commitment and investment. Apart from refilling tightly controlled prescriptions for stimulant medication, a parent must bring their child for many medical appointments and endure several medication trials even before finding the right drug and dosage.
Clinicians should prepare parents and patients for the possibility that the first medication wont work an outcome more common than not.
If parents are particularly struggling with investing resources, remind them that one long month of appointments and trials can yield a solution that ends up working for years, or a lifetime.
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What Are The Warnings/precautions When Using Adhd Drugs
Before starting any medication, a doctor should know a patient’s full medical history such as drug allergies, medical conditions, current medication use, and whether the patient is pregnant, trying to get pregnant, or nursing.
Contraindications and Black Box Warnings for Stimulants
Black Box Warnings
- Dexmethylphenidate and methylphenidate should be used cautiously in patients with a history of alcoholism because prolonged administration can lead to physical and psychological drug dependence.
- Dextroamphetamine/amphetamine, dextroamphetamine, and methamphetamine should not be used in patients with cardiac disease. These stimulants can increase blood pressure and heart rate and lead to myocardial infarction and sudden unexplained death .
- Dextroamphetamine/amphetamine, dexmethylphenidate, lisdexamfetamine, and methylphenidate should be used cautiously in patients with a history of substance abuse because prolonged administration can lead to physical and psychological drug dependence. Dextroamphetamine/amphetamine has a high potential for abuse and is contraindicated for use in this setting.
- Methylphenidate and atomoxetine have been associated with priapism.
- Patients should be counseled on the signs and symptoms of priapism and seek immediate medical attention if an erection lasts more than 4 hours.
Your Adhd Child Is Diagnosed Incorrectly
No definitive test diagnoses ADHD, and often professionals diagnose children after just a clinical interview. However, your childs impaired attention may occur for a variety of reasons with ADHD being only one.
ADHD symptoms in kids often look the same as the ones for children with anxiety,OCD, learning difficulties, depression, Autism, sensory processing, birth trauma, PTSD, nutritional deficiencies, and genetic issues because they might be having a hard time focusing or controlling impulses. A child or teen may not even have a clinical issue and instead may be reacting to developmentally inappropriate school work or the wrong classroom or peer environment. Prescribers listen to the symptoms and give you a medication based on that which often leads to a trial and error approach to see if the medication works or not.
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