Tuesday, February 26, 2013

Stimulant Medications: Friend or Foe?

Parents of teenagers with Attention Deficit Disorder (ADD) were likely terrified by the recent NYT article (http://www.nytimes.com/2013/02/03/us/concerns-about-adhd-practices-and-amphetamine-addiction.html?pagewanted=all)  about Richard Fee, a 24-year-old who became addicted to the stimulant medication which eventually contributed to his death by suicide. Although he was prescribed the medication by licensed professionals, Fee took the medications in a self-destructive way, and misled those who were attempting to treat him. And the psychiatric evaluation he received appears to have been inadequate and unlikely to pick up his addictive response to the medication.
To my mind, the stimulant medications for ADD - most commonly Adderall and Ritalin - are both under-prescribed and over-prescribed. That is, some people who desperately need treatment for their ADD never even receive an evaluation because of poverty, ignorance, or both. But others are haphazardly prescribed these potentially dangerous medications by physicians trying to satisfy parents, or teachers, or a demanding patient.
So what should you look for if your child is being evaluated for ADD and the potential prescription of a stimulant medication?
First, look for a physician or psychologist who is trained and experienced in the evaluation of ADD. Ask for credentials! Legitimate practitioners will be delighted to give you their curriculum vitae. Second, make sure that your child has a full evaluation including family informants (you!), teachers, and anyone who is a close observer of your child. Third, make sure that the physician or psychologist at least considers non-stimulant treatments for ADD: organizing strategies, cognitive-behavioral psychotherapy, and non-stimulant medications like Wellbutrin or Strattera. Finally, make sure that you and your child know the potential benefits of any prescribed medication, as well as the potential side effects and risks. With this knowledge  you can make the best decision possible about the these  effective but potentially dangerous medications. Also, you will recognize any side effects long before they become harmful!

1 comment:

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