(CNBC) – Certain medications commonly used to treat ADHD in teens and young adults may increase their risk of psychosis, according to new research from Harvard Medical School and McLean Hospital.
The potential of developing psychosis was greater in younger patients who take amphetamines, such as Adderall or Vyvanse, than those taking methylphenidates, such as Ritalin or Concerta, according to a study published in the New England Journal of Medicine on Wednesday.
The researchers studied 13- to 25-year-olds. They defined psychosis as hallucinations, delusional disorder, schizophrenia spectrum disorder, major depressive disorder, bipolar disorder with psychotic features or unspecified psychosis.Read More
(MadInAmerica.com) – On December 18, 2018, U. S. Surgeon General Jerome Adams issued a public health advisory urging parents, teachers, and health professionals to address an epidemic of childhood e-cigarette use. The advisory emphasized repeatedly that the nicotine in e-cigarettes was addictive; was harmful to the developing brain; affected learning, memory, and attention; and exposed the lungs to harmful chemicals. In a press release, one federal health official claimed that “we have never seen use of any substance by America’s young people [to] rise as rapidly…” To address this crisis, the surgeon general’s office proposed local bans on indoor vaping and recommended retail restrictions to reduce the purchase of e-cigarettes among youth.
While the government chose to single out the rise of e-cigarette use, it has been ignoring the astronomical spread of another type of dangerous drug taken by children and youth: psychiatric medications.Read More
(RxISK.org) – After a variety of incarnations – Minimal Brain Damage – Attention Deficit Hyperactivity Disorder (ADHD) came on the radar in the 1970s in the US and exploded with its codification in DSM-III in 1980.
The general sense in most of the world in the 1980s – aside from a developing ADHD-mania in the US – was that it affected children, particularly boys, but that they grew out of it.
With growing acceptance of a role for stimulants, the marketing argument transformed the original clinical picture – all of a sudden left untreated those affected would go onto a life of crime, alcoholism, career failure, suicide, drug abuse and other nameless ills. There was a moral onus on doctors and others to pick the condition up and treat it with stimulants. And of course – its life long.
The stimulants by this point were controlled drugs. They had been restricted in the 1960s owing to growing evidence about their abuse and links to aggression and crime. But in pursuit of a disease entity and available on prescriptive only, suddenly drugs, which seemed dangerous enough to be made controlled drugs, started to be handed out to young children by the fist full.
On simple clinical grounds a case can be made for childhood ADHD. Most people looking at a very small number of young boys who are behaving like a bee in a jam jar would figure there’s something physical involved that a stimulant paradoxically seems to calm. But it was equally obvious some decades back that this is something that these boys grow out of. And it’s rare.Read More
Multiple studies have found that the youngest children in a classroom are at elevated risk of being diagnosed with, or medicated for, ADHD. This systematic review was conducted to investigate whether this late birthdate effect is the norm and whether the strength of effect is related to the absolute risk of being diagnosed/medicated.
A literature search of the PubMed and ERIC databases and snowball and grey literature searching were conducted.
A total of 19 studies in 13 countries covering over 15.4 million children investigating this relationship were identified. Three other studies exploring related topics were identified. The diversity of methodologies prevented a meta‐analysis. Instead a systematic review of the 22 studies was conducted.
A total of 17 of the 19 studies found that the youngest children in a school year were considerably more likely to be diagnosed and/or medicated than their older classmates. Two Danish studies found either a weak or no late birth date effect. There was no consistent relationship between per‐capita diagnosis or medication rates and the strength of the relative age effect, with strong effects reported in most jurisdictions with comparatively low rates.
It is the norm internationally for the youngest children in a classroom to be at increased risk of being medicated for ADHD, even in jurisdictions with relatively low prescribing rates. A lack of a strong effect in Denmark may be accounted for by the common practice of academic ‘redshirting’, where children judged by parents as immature have a delayed school start. Redshirting may prevent and/or disguise late birthdate effects and further research is warranted. The evidence of strong late birthdate effects in jurisdictions with comparatively low diagnosis/medication rates challenges the notion that low rates indicate sound diagnostic practices.
(The New York Times) – The rate of diagnosis of attention deficit hyperactivity disorder among children has nearly doubled in the past two decades. Rates of A.D.H.D. diagnoses also vary considerably across states, with nearly three times as many children getting the diagnosis in Kentucky (where one in five children are said to have the condition) as in Nevada. More than 5 percent of all children in the United States now take an A.D.H.D. medication. All this raises the question of whether the disease is being overdiagnosed.
Diagnosing A.D.H.D. is difficult. Unlike other childhood diseases — such as asthma, obesity and diabetes — the diagnosis of A.D.H.D. is inherently subjective and depends on the assessment of parents, school personnel and health care providers. For a child who is easily distracted, an assessment of normal, inattentive behavior by one could be a formal diagnosis of A.D.H.D. by another.
It turns out that although diagnosing A.D.H.D. requires a subjective interpretation of facts, the month in which a child is born can be a strong, objective predictor.Read More
(Psychiatric Times) – Psychiatrists and other mental health professionals are often asked about the role that diet and nutrition play in ADHD etiology and symptom management. This article examines the contributory role of diet on ADHD symptoms, including how the elimination of certain foods and additives, as well as the consumption of other foods or nutrients, may impact symptoms. The role of nutrient supplementation will be reviewed as well, including the potential mechanisms behind why nutrient supplementation may alleviate some symptoms of the disorder.Read More
(Psychology Today) – A just published study by a team of researchers (which I am part of) has shown that it is the youngest children in the classroom who are most likely to be diagnosed with ADHD. The systematic review was published in the Journal of Child Psychology and Psychiatry. Seventeen studies covering more than 14 million children from various countries were examined. Lead author Martin Whitley commented in the Daily Mail that “It appears that across the globe some teachers are mistaking the immaturity of the youngest children in their class for ADHD.” The study contributes to the central debate about ADHD and the question of medicalization: Do children diagnosed with ADHD have a brain disease?
Medicating the younger children in the classroom suggests that the medical community has mislabeled normal brain development as a pathology. If the ADHD children are simply the youngest children in the classroom, this would explain why researchers have not been able to develop an object test such as a brain scan, blood test, or genetic test to diagnose ADHD.
In spite of the fact that there are no biological markers that can be used to diagnose ADHD, official outlets can give the impression that this is the case. A recent brochure on ADHD from The National Institutes of Mental Health(NIHM) states that: “Brain-imaging studies have revealed that in youth with ADHD, the brain matures in a normal pattern but is delayed by about three years.” It continues, “More recent studies have found that the outermost layer of the brain, the cortex, shows delayed maturation overall.” It would be hard to fault the general public for concluding that brain scans can be used to identify ADHD. Not mentioned by NIMH is that the studies they refer to detected miniscule differences in a small group of children, and that the scans cannot be used in a doctor’s office to determine if a child should be diagnosed with ADHD.Read More
(Medscape) – Having attention-deficit/hyperactivity disorder (ADHD) may raise the risk developing Parkinson’s disease (PD) and related disorders, results of a population-based study suggest.
Investigators found that patients with ADHD were more than twice as likely to develop early-onset Parkinson’s and PD-related disorders relative to matched individuals who did not have ADHD. The risk was sixfold to eightfold higher in ADHD patients prescribed stimulant medications.
“This link between ADHD and its treatment with psychostimulants and Parkinson’s disease–like disorders (PDLDs) has not been shown before,” senior author Glen Hanson, PhD, professor of pharmacology and toxicology, University of Utah, Salt Lake City, told Medscape Medical News.
“That there is a link between pediatric mental health problems (eg, ADHD) and their treatment (eg, stimulants) and neurodegenerative diseases (eg, PDLDs) that typically express in older, and even geriatric, populations is a relatively new and somewhat disturbing concept,” said Hanson.
The study was published online September 12 in Neuropsychopharmacology.Read More
Sometimes 11-year-old B. comes home from school in tears. Maybe she was taunted about her weight that day, called “ugly.” Or her so-called friends blocked her on their phones. Some nights she is too anxious to sleep alone and climbs into her mother’s bed. It’s just the two of them at home, ever since her father was deported back to West Africa when she was a toddler.
B.’s mood has improved lately, though, thanks to a new set of skills she is learning at school. (We’re using only first initials to protect students’ privacy.) Cresthaven Elementary School in Silver Spring, Md., is one of growing number of schools offering kids training in how to manage emotions, handle stress and improve interpersonal relationships.Read More