Psych Drugs for Kids Under Review
By Jamie Talan, Newsday, Melville, N.Y.
Mar. 24–Robert Stevens was a whirlwind of a child. At 3, doctors diagnosed attention deficit hyperactivity disorder and oppositional defiant disorder. By 5, he was swallowing stimulant medicines to quell his behavior.
But the medicine brought equally unwanted problems, including vomiting, headaches, pasty white skin, and dark circles under his eyes from lack of sleep. Psychiatrists added another medicine to balance these side effects. When he became wilder, and even more moody, the doctors wanted to add a third drug.
And that’s when his father, Rob Stevens of Garden City, said “no” to drugs.
His son is now 16 and shows no evidence of his former out-of-control self. He’s attentive, athletic, happy and does well in school. “He’s doing great,” his father said. “You’d never think that he ever had ADHD.” What finally worked for their son was a drastic change in diet – addressing an old and controversial theory that certain substances such as wheat, dairy and artificial food coloring and flavoring trigger mood and behavior problems – and sensory integration training, to treat auditory imbalances.
Amanda Rose of Sachem is now 14 and has spent virtually all of her school years taking stimulant medication for ADHD. “It really helps me,” Rose said. “I can focus and it keeps me on track.”
Two kids, two different experiences.
Throughout its 50-year history, stimulant medicines have been extolled and defamed, but they have become the mainstay for millions of children with problems staying focused and in control of behavior.
As other psychiatric medicines for children have come under attack, doctors and federal regulators are taking a new look at the side effects of the very popular ADHD drugs.
The Food and Drug Administration held two days of hearings this week – Wednesday, to discuss the psychiatric side effects of stimulant medicine and yesterday to decide whether medicine already approved for narcolepsy in adults can be used for ADHD in children.
According to the FDA’s Dr. Robert Temple, the experts who weighed in on the studies on Provigil, the narcolepsy drug, found it worked for ADHD, but safety issues remained. One patient in a trial of 1,000 children developed a potentially fatal skin condition. The panel recommended that the company, Cephalon, conduct a larger trial of 3,000 people.
Regarding the other ADHD medicines, Wednesday’s panel decided to recommend strengthening warnings on package inserts and include with every prescription a medication guide. One study reported 13 cases of hallucinations in 2,000 patients.
In very rare cases, patients can also experience cardiac problems, including sudden cardiac arrest. While the numbers were small, the committee agreed that these medicines should not be prescribed to patients with structural heart defects.
The bottom line, said Dr. Thomas Brown, associate director of the Yale clinic for attention and related disorders, is that “some people have huge benefits from taking these medicines, others modest ones. We always need more than one tool in the toolbox.”
A good clinical evaluation is key, he said.
Dr. Andrew Adesman at Schneider Children’s Hospital in New Hyde Park, said it’s important for parents to talk to their doctors. “These medicines are the single most effective treatment for ADHD,” he said. “They can make a profound difference.”
Early signs
Symptoms of Attention Deficit Hyperactivity Disorder will appear over the course of many months, and include:
Impulsiveness: a child who acts quickly without thinking first.
Hyperactivity: a child who can’t sit still; walks, runs, or climbs around when others are seated; talks when others are talking.
Inattention: a child who daydreams or seems in another world; is sidetracked by things going on around him.
The “H” for hyperactivity is not found in most children.
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Copyright (c) 2006, Newsday, Melville, N.Y.
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