ADHD Medications for Children and Whether they are Overprescribed

What started with Ritalin has exploded into a billion dollar industry. Today’s pharmaceutical companies have poured substantial resources into developing and marketing a collection of ADHD medications for children. With the internet abuzz with conspiracy theories about companies and doctors make big profits off overmedicated kids, it is no wonder that many parents think twice before filling their child’s prescription.

Are ADHD Children Overmedicated?

Conventional wisdom seems to be that ADHD medications are overprescribed and that classrooms are filled with students turned zombies. However, evidence suggests that the majority of children with ADHD are not on medication.

A 1999 study published in the Journal of the American Academy of Child and Adolescent Psychiatry concluded that the vast majority of children with ADHD do not receive medication for the disorder. The community-based study found that 5.1 percent of children in four communities met the full criteria for an ADHD diagnosis. Of those children, only 12.5 percent had received stimulant ADHD medications for children in the previous 12 months. The study results indicated that children were more likely to receive counseling or school-based services instead of medication to address attention issues.

In 2007, the Archives of Pediatrics and Adolescent Medicine published a cross-section survey of the U.S. population. Researchers examined data from 2001-2004 to determine how many children had ADHD and how they were treated. The survey concluded that 8.7 percent of 8-15 year olds met the criteria for ADHD and 32% of those children were consistently treated with medications.

Stimulant ADHD Medications for Children

Once a parent and doctor agree that medication may be beneficial for a child with ADHD, it is likely that a stimulant medication will be prescribed first. These are the most popular of the ADHD medications and include brand names include:

  • Ritalin
  • Concerta
  • Adderall
  • Vyvanse

It is estimated that 70 percent of children will experience improvement in ADHD symptoms when using a stimulant medication. Stimulants work by increasing certain chemicals in the brain that improve communication between nerves. Side effects include headaches, decreased appetite, upset stomach, nervousness and increased blood pressure. For many individuals, side effects diminish as the body acclimates to the medicine.

Non-stimulant ADHD Medications

For children who do not respond to stimulant medications or who have significant side effects, non-stimulant ADHD medications are available. These medicines also affect receptors in the brain, but they do not have the same unpleasant restlessness or agitation sometimes experienced on stimulant medications. Current nonstimulant ADHD medications are sold under two brand names:

  • Strattera
  • Intuniv

Many parents prefer nonstimulant medications because they are not controlled substances like stimulant drugs. However, non-stimulant medications can also have side effects including upset stomach, mood swings, nausea, headaches, fatigue and abdominal pain.

Antihypertensive ADHD Medications

In some cases, a doctor may prescribe an antihypertensive medication for a child with ADHD. These are often used in conjunction with a stimulant medicine. Children are generally only prescribed hypertensive medications if they have extreme hyperactivity or aggression that is not improved with the use of stimulants alone.

Antihypertensive ADHD medications include:

  • Clonidine
  • Guanfacine

These medicines often cause initial drowsiness and dizziness, but the side effects seem to disappear once the body becomes acclimated to the medications.

Antidepressant ADHD Medications

The final group of medications sometimes prescribed for ADHD children are antidepressants. The use of antidepressants to control ADHD is an “off-label” use of the medicine, meaning that the Food and Drug Administration has not approved use the medication for attention disorders.

Wellbutrin is most often used by doctors to treat ADHD in children. It appears to affect brain neurotransmitters in a way that improves focus and decreases impulsivity. However, extreme care should be used when antidepressant ADHD medications are prescribed. These drugs can, in some cases, cause suicidal tendencies. Therefore, antidepressants are often turned to as a last resort when all other medical options have been exhausted.

Regardless of whether a parent chooses to treat their child’s ADHD with a prescription, diet modifications or alternative therapies, it is important to remember that every case of ADHD is unique. Not every child responds the same way to treatment, and there is no generic, cookie-cutter approach to ADHD that works for everyone. Parents should be well-informed of the benefits and side effects of ADHD medications for children to pick the right option for their son or daughter.

References:

“Attentive Deficit Hyperactivity Disorder (ADHD) – Medications” WebMD https://www.webmd.com/add-adhd/tc/attention-deficit-hyperactivity-disorder-adhd-medications (Accessed September 24, 2010)

“ADD/ADHD Medications” HelpGuide.org https://www.helpguide.org/mental/adhd_medications.htm (Accessed September 24, 2010)

Jensen, PS et al. (1999) “Are stimulants overprescribed? Treatment of ADHD in four U.S. communities.” Journal of the American Academy of Child and Adolescent Psychiatry

Froehlich, Tanya et al. (2007) “Prevalence, Recognition, and Treatment of Attention-Deficit/Hyperactivity Disorder in a National Sample of US Children” Archives of Pediatrics and Adolescent Medicine