Transcript ADHD and Over Medicating Our Youth

ADHD and Over
Medicating Our Youth
Kathryn Head
November 15, 2005
Attention-Deficit
Hyperactivity Disorder
• Attention-deficit hyperactivity
disorder (ADHD) is the most
common child psychiatric disorder in
America (Singh 2004)
• In 1994 the APA broadened the
criteria for ADHD (Dunne 2000)
• Its symptoms include hyperactivity,
impulsiveness and inattention (Singh
2004)
Medications
• For over 40 years doctors have been
prescribing stimulants to relieve the
symptoms of ADHD (Biederman &
Faraone 2005 )
• The most common drugs prescribed
are methylphenidates, brand name
Ritalin (Biederman & Faraone 2005)
• Other common prescriptions are for
Adderall and Dexedrine (Dunne
2000)
Stimulants
• These stimulants increase the
alertness of one’s nervous system by
stimulating neurotransmitters in the
brain (Dunne 2000)
• Unfortunately they do have some
side effects which include tics,
appetite and weight loss, stunting
growth and can lead to problems
later in life with substance abuse
(Biederman & Faraone 2005 )
Question Time!
• Can you name some arguments for
medicating?
• Now can you name some against
medicating them?
The debate
For Medicating Our Children
• Calms them down
• Helps them focus
• Less aggressive
The debate
Against Medicating Our Children
• Medicating seems like a “quick-fix”
• Side effects listed before
• When on medication many complain
of not being “the same person”
Evidence
The Multimodal Treatment Study of
Children with Attention Deficit
Hyperactivity Disorder (MTA) (Owens
et al 2003)
Goal “What treatment, by whom, is most
effective for this individual with that specific
problem, and under which set of circumstances?”
(Owens et al 2003)
MTA
• N = 579 (80% male)
• Age ranged from 7.0 – 9.9 years old
• Randomly assigned to one of four
groups (MedMgt, Beh, Comb, CC)
• Treatment lasted 14 months
MTA (continued)
• Initially reported on sex, prior
medication treatment, comorbid
conduct problems, comorbid anxiety
problems, and family receipt of public
assistance
• Also took note of the child’s
intelligence and initial severity of
ADHD and maternal education and
parental depressive symptomatology
Findings
• If the primary caregiver suffers from
depression the intervention is not as
effective
• The more severe the disorder to
begin with the more difficult it was to
treat
• The higher the IQ the better the
response to treatment
Cost Effectiveness of ADHD
Treatments
• In this article they used the MTA study to
see the cost these different types of
treatments versus their effectiveness
(Jensen et al 2005)
• Found that for the 14 months of treatment
the costs ranged from approximately
$1100 (CC) - $7800 (Comb)
• Carefully monitored medical treatment is
the most cost effective way to get the best
results
Graduate Studies
Who… Where… What?
• Rosemary Tannock
– University of Toronto
• Shelley Parlow
– Carleton University
• Darlene Brodeur
– Acadia University
Final Question…
• Should we or should we not
medicate our children?
References
•
•
•
•
Biederman, J., Faraone, S. V. (2005). Attention-deficit
hyperactivity disorder. Lancet, 366(9481), 237 – 248.
Dunne, D. (2000). Statistics confirm rise in childhood ADHD and
medication use. Retrieved October 13, 2005 from
http://www.education-world.com/a_issues/issues148a.shtml
Jensen, P. S., Garcia, J. A., Gleid, S., Crowe, M. (2005). Costeffectiveness of ADHD treatments: Findings from the
multimodal treatment study of children with ADHD. The
American Journal of Psychiatry, 162(9), 1628 – 1637.
Owens, E. B., Hinshaw, S. P., Kraemer, H. C., Arnold, L.
E.,
Abikoff, H. B., Cantwell, D. P., Conners, C. K., Elliott, G.,
Greenhill, L. L., Hechtman, L., Hoza, B., Jensen, P. S.,
March, J. S., Newcorn, J. H., Pelham, W. E., Severe, J. B.,
Swanson, J. M., Vitiello, B., Wells, K. C., Wigal, T. (2003).
Which Treatment for Whom for ADHD? Moderators of
Treatment Response in the MTA. Journal of Consulting and
Clinical Psychology, 71(3), 540 – 552.
• Singh, I. (2004). Doing their jobs: mothering with Ritalin in a
culture of mother-blame. Social Science & Medicine,
59(6), 1193 – 1205.