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For parents of kids with ADHD, medication can often seem like a godsend. Recent studies have shown that kids who take these drugs specifically for a diagnosed condition perform better in school, for example. But a new study released this week in the online edition of the "American Journal of Psychiatry" is raising red flags: The study found that teens and children taking ADHD medications are seven times more likely than their peers to die suddenly.
That's disheartening news for many kids and their parents.
An estimated 2.5 million American children take ADHD medication; in the early 1990s there were several cases of sudden unexplained deaths of children taking these meds. But because the cases were so rare, scientists were unable to gather a large enough sample to draw any real conclusions.
This new study compares 564 cases of sudden death in children ages 7 to 19 which occured between 1985 and 1996. Those cases were compared with an equal number of deaths of children who died in car accidents. The scientists sifted through data to weed out any complications that might have caused the unexplained deaths, including asthma and heart problems. Once they did that, they were left with ten unexplained deaths. Those ten cases were compared to cases of kids the same ages who had died in car crashes; the children on the stimulant medication were found to be 7.4 percent more likely to die suddenly.
Dr. Madelyn Gould, the study's author, was stunned by the findings. "What we found -- to our surprise -- is that even if you take out confounding factors, the association between stimulant use and sudden death was still significant," she says. But Dr. Gould, a professor of clinical epidemiology in psychiatry at Columbia University/New York State Psychiatric Institute in New York City, sees no need for parents to panic. "I'm confident the association is real and significant, but it's very rare. I don't want our findings to change prescribing patterns or for a parent to change their willingness to use stimulant medications if they're called for, but physicians should monitor patients with any new medication you give a young person."
So how concerned should parents be? The study authors suggest that parents should be vigilant but not frightened. "No medication is free of risk or side effects. Any time we prescribe any medication, we have to balance its benefits and risks," said Dr. Diego Chaves-Gnecco, a developmental-behavioral pediatrician at Children's Hospital of Pittsburgh. "The most important point is to make sure that everyone is well-educated and that a conscientious screening has been done." Currently, physicians prescribing ADHD meds are directed to take a detailed family history, with special attention to any history of heart disease, before putting a patient on medication.
What should you do if your child is currently taking ADHD medication? Talk to the prescribing doctor if you have concerns. But the study's authors warn parents not to suddenly stop a child's meds. Always call your doctor before you change doses or stop any medication. And remember: These are serious drugs that your child is taking, and the process of prescribing and monitoring them should be taken very seriously.
Dr. Benedetto Vitiello, a psychiatrist and chief of the child and adolescent treatment intervention branch at the U.S. National Institute of Mental Health, summed it up this way: "We need to keep in mind that even though these drugs are commonly used, they still have the potential for adverse events. We shouldn't approach them lightly."
That's disheartening news for many kids and their parents.
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An estimated 2.5 million American children take ADHD medication; in the early 1990s there were several cases of sudden unexplained deaths of children taking these meds. But because the cases were so rare, scientists were unable to gather a large enough sample to draw any real conclusions.
This new study compares 564 cases of sudden death in children ages 7 to 19 which occured between 1985 and 1996. Those cases were compared with an equal number of deaths of children who died in car accidents. The scientists sifted through data to weed out any complications that might have caused the unexplained deaths, including asthma and heart problems. Once they did that, they were left with ten unexplained deaths. Those ten cases were compared to cases of kids the same ages who had died in car crashes; the children on the stimulant medication were found to be 7.4 percent more likely to die suddenly.
Dr. Madelyn Gould, the study's author, was stunned by the findings. "What we found -- to our surprise -- is that even if you take out confounding factors, the association between stimulant use and sudden death was still significant," she says. But Dr. Gould, a professor of clinical epidemiology in psychiatry at Columbia University/New York State Psychiatric Institute in New York City, sees no need for parents to panic. "I'm confident the association is real and significant, but it's very rare. I don't want our findings to change prescribing patterns or for a parent to change their willingness to use stimulant medications if they're called for, but physicians should monitor patients with any new medication you give a young person."
So how concerned should parents be? The study authors suggest that parents should be vigilant but not frightened. "No medication is free of risk or side effects. Any time we prescribe any medication, we have to balance its benefits and risks," said Dr. Diego Chaves-Gnecco, a developmental-behavioral pediatrician at Children's Hospital of Pittsburgh. "The most important point is to make sure that everyone is well-educated and that a conscientious screening has been done." Currently, physicians prescribing ADHD meds are directed to take a detailed family history, with special attention to any history of heart disease, before putting a patient on medication.
What should you do if your child is currently taking ADHD medication? Talk to the prescribing doctor if you have concerns. But the study's authors warn parents not to suddenly stop a child's meds. Always call your doctor before you change doses or stop any medication. And remember: These are serious drugs that your child is taking, and the process of prescribing and monitoring them should be taken very seriously.
Dr. Benedetto Vitiello, a psychiatrist and chief of the child and adolescent treatment intervention branch at the U.S. National Institute of Mental Health, summed it up this way: "We need to keep in mind that even though these drugs are commonly used, they still have the potential for adverse events. We shouldn't approach them lightly."
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ReaderComments (Page 5 of 8)
6-16-2009 @ 9:49PM
a thought said...ok, ssi amounts depend in which state you live in. 700 try 400.00 a month. That is unemployed parent. Child disabled.
SSI is based on parent/parents income per month under age 18.
How many kids are no ADHD but give drugs anyway.
Remember use to kids were just hyper around a certain age.
Todays kids just sit no activity.So will be hyper.
Over use of ADHD.
Reply
6-16-2009 @ 9:57PM
Rich said...The FDA hard at work keeping those drugs in your cabinet and keeping the population down.
Reply
6-16-2009 @ 9:54PM
ICK said...TIM with ADHD says That is exactly ONE more death in the study group as opposed to the control group (one out of MILLIONS). This is statistically INSIGNIFICANT to the point of being meaningless.
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What if that ONE death was your kid? Would it be INSIGNIFICANT and meaningless then?
Reply
6-16-2009 @ 9:53PM
hal32 said...ADHD is nothing more than a made up illness so drug companies can continue to bleed us of more money. The problem is most parents today are pussies and the drug companies seized that opportunity to make up the illness. When I grew up there was no such thing as time out. You got one warning(unless it was really bad) and the next time the whooping came. If parents would start punishing their kids the way they should be doing it 99% of the problems with bad kids would go away. How do I know this. I was an evil teenager and it took my father finally beating me almost senseless to turn me around. That said, a spanking now and then is not illegal or wrong. It is needed because kids these days are spoiled beyond belief. One good thing is I don't have to worry about my son being like that because he knows what'll happen if I get a hold of him.
Reply
6-17-2009 @ 12:23AM
ang said...I wish it was made up and that kids could focus and learn. My husband and I are very strict parents. And during short spurts (church, funerals, etc) they can actually behave human. But they are trying so hard during these times. The impulses still come out even then, but a firm talking to sometimes helps. Even so, sometimes NOTHING works. Since my kids lose so uch weight during the school year, I take them off meds thru the summer and on weekends. The weekends are hell for us at times. Staying really busy helps. BUt as summer has just started, I am already pulling my hair out. So if this was a made up condition I could just pretend they don't have it and save myself a lot of money and time.
I hope that you don't ever have a kid with it, but sometimes life isn't that lucky. And when it does, you will have to eat your words. Most parents would do anything to have their kid be 'normal' (typical) with normal learning patterns and behaviors and not be embarassed by their outbursts in public. I am not a ditzy parent, I don't ignore my kids. I do not contribute to any behavior they exhibit. At times, people tell me that nothing is wrong with them. Then other times people are telling me that I don't know how to parent. How would you feel if someone told you that? Please don't spout nonsense about something you know nothing about.
6-16-2009 @ 10:46PM
concerned said...I've considered putting my son on these medication, but I'm more concerned about the side effects of them than anything. Every one of them have scary and potentially permanent and dangerous side effects. I know each of us have our reasons why we do or don't medicate, but educate yourself before you do. And know what to look for when it comes to side effects. We all want our kids to have a better life, and we all want our kids to LIVE.
Reply
6-16-2009 @ 10:05PM
parent said...I have two children with ADHD. Neither requires medication as we've had great luck with diet changes and supplements. Several books on Amazon available that can help parents try this path before turning to prescription medications. Search ADHD cookbooks or ADHD diets. Meds aren't evil, but some of these children can be helped without them, thus avoiding the side effects.
Reply
6-16-2009 @ 10:06PM
KATHY said...I am an adult with adhd and have NEVER gotten any government check, SSI or SS. A lot more kids who do not get med's die from self medicating with drug and alcohol. I have no attention span to drive or work without medication. As long as the doctor is doing his job and monitoring you they are safe.
Reply
6-16-2009 @ 10:22PM
Lisa said...I have a grandson on Adderol, and now he is thin as a rail, and wants to just sit like a zombie. We had a party this weekend, and he wouldn't play with the other kids, or play on the slip and slide. This stuff scares me. Sometimes I think schools tell parents thier kids need meds because they don't want to do thier jobs and teach all children, they only want the paper doll children that sit quietly and wait to be told when it's time to go home. He's not the same little boy that I love so much. Now he's just a shell of a child. I miss him, the real little boy he once was.
Reply
6-17-2009 @ 3:25PM
Mary said...Hi Lisa,
Your grandson is over medicated! He also does not need to take it when he is off from school or weekends! Good Luck!
6-17-2009 @ 3:17AM
Stephanie said...Lisa, it sounds as if your grandson has too high a dose. While your son/daughter would probably not be willing to hear that he shouldn't be on medicine at all, they might be willing to think about checking for dosage. A child on the right dose of Ritalin will be quieter than when on no meds. My daughter is actually quite shy. Sometimes I miss the active child she is without medicine, but I remember that all the meds do is give her control over her thoughts, focus, and impulses, so that the shy child is who she chooses to be or actually is. The other kid is the one who is slave to a brain that drives her to move when she would rather sit still.
However, zombie-like behavior is not good, and a doctor should be told about it.
6-17-2009 @ 10:40AM
ellen said...Not so fast you $700.00/month junkies, this is getting cut next month due to the tax revamps! (my daughter works for a senator, and was just informed of this...write to your legislators!)
Reply
6-17-2009 @ 12:33PM
Grey said...I'm completely against ADHD medicine. What these kids need is an old-fashioned discipline, that is, a smack on the butt. It worked for me. End of the story.
Reply
6-17-2009 @ 7:40PM
amykfallen said...Are you kidding me? Spanking a child that has ADHD will not control them. In fact it makes things worse. A child with uncontroled ADHD has a much higher tendency for violent out bursts. Know the facts before you make recommendation.
6-18-2009 @ 12:46AM
ellengari said...i totally agree with amy. been there done that. i was getting suspended at least twice a trimester in jr high because my parents were constantly yelling at me at home.
in elementary school, i would overturn desks and hit kids and myself because i would be spanked at home or my teachers would yell and shake me so i would behave. violence does not help kids with mental disorders....it makes us worse. i had to spend a year away from my parents, while being on a constant medication routine to become mature and handle myself.
6-25-2009 @ 12:02AM
Jonathan Quist said...I was diagnosed with ADD six months ago, at the age of 48.
Once I learned a bit about this neurological disorder, I realized that the first informal "diagnosis" was made in a school report card, by my kindergarten teacher.
I've got news for you. "Old-fashioned discipline", whether
self-imposed or external, is generally not helpful in true
cases of ADD or ADHD. Structure can help, yes, but
threats, no. The three words I came to fear above all others
were "just try harder".
Though I graduated from high school with an A average, it was a mixed struggle. I skated through honors math and science classes without breaking a sweat - they challenged me. General classes, like a required Consumer Ed class, were a struggle, and I don't think I turned in a single term paper on time. As an adult, problems which I now know to be ADD-related have affected every aspect of my life. Sometimes in positive ways, but mostly not.
I have been on Concerta, a time-released stimulant medication, for about 4 months. The prescribing physician has taken a very conservative approach, and ramped up the dose gradually, to
assess the benefit and evaluate side effects. In my professional life
as an IT engineer, the past two months have been among the most productive I have had in the past 25 years.
I wish it had been available 35 years ago. As a general rule, ADD medications are more effective in teens than in adults, because there is less history of learned behavior to overcome. I will likely be on some medication for the rest of my life. Some kids can get off it in early adulthood.
Kids getting high on ADD meds? It's possible - if they are not suitably monitored. But these medications are all controlled substances in the U.S. - if the kids are taking more than
prescribed, the parents share the responsibility.
There are non-pharmaceutical therapies available for ADD, some of which have shown great promise. I would encourage parents of children with ADD to explore these with your doctor. I would also encourage anyone with a new diagnosis of ADD or ADHD, particularly in children, to be sure the diagnosis is correct before pursuing medication. Because many of the common symptoms of ADHD are similar to "kids being kids", misdiagnosis is a possibility. If there is any doubt in your mind, get a second opinion, from a psychiatrist or diagnostician specializing in ADD.
Some information on alternative therapies may be found on Dr. Ned Hallowell's web site. For those unfamiliar with ADD, Dr. Hallowell's book "Driven to Distraction" is a good starting point. Though some of the information is dated, it's still a great introduction. If you happen to be an adult with ADD, you will find many of the case histories strangely familiar.
Enough rambling for now. What can I say? It's late, and the effect of my medication ended several hours ago.
6-16-2009 @ 10:23PM
Jan said...My son is 30 yrs. old now and was diagnosised with ADHD around 20 yrs. ago. Of course many teachers wanted him on medication as early as 5 years old. But, we went through all types of alternate options, such as child behavior clinics, counseling, and finally agreed to medication. It made such a world of difference in his behavior and his ability to concentrate and stay focused. I do not regret this decision! He is a wonderful young adult today. And no money is being collected from SS for his ADHD. He works 5 days a week as a web designer.
Reply
6-16-2009 @ 10:37PM
Lisa said...I have a grand son on adderol, and he has lost so much weight, he looks like a rack of bones. He's not the same little boy he used to be. We had a party this weekend, and he didn't want to play with the other kids, or play on the slip and slide. He's 7 and only wanted to sit in the house. I miss the little boy he used to be. Funny, playful, interactive, now he's just the shell of a child. I think schools have gotten lazy and tell parents that thier kids need meds because they just want to wait unil they can tell the kids to go home, and collect a check. I miss my grandson.
Reply
6-16-2009 @ 10:25PM
drvarnick said...Inkling you are doing things the correct way. It should be mandatory that extensive testing be done along with consultation with a child psychiatric MD. before any drugs are prescribed. I am a Pharmacist and am forced to fill many prescriptions written by your average Pediatrician where no testing has been done. The Dr writes out 4 or 5 prescriptions at a time so the patient doesnt have to come back every month. This is wrong. These are very dangerous drugs if not monitored properly. I feel we havent begun to see the side effects of long term use of these drugs.
Reply
6-16-2009 @ 10:27PM
amaire said...wow. kids who have severe ADHD are at risk of severe injury and death as a direct result of the behaviors that present due to the body's lack of ability to control impulsive behavior. every medication has its risks as do "natural" remedies. ADHD symptoms range from mild to severe enough to cause a child to be institutionalized to keep the child and others safe. ADHD is a qualifying diagnosis for SSDI, however it has to be severe and impair a child's ability to function in multiple settings. i'm not a strpng advocate for providing SSDI for children who are not losing an income or do not have a condition severe enough that the parents lose income as a result of missed work for caring for the child's needs.
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