Long-Term Use of ADHD Medications Changes Brain Function

Posted by Miriam on May 21st, 2013 | No Comments

What every parent and adult needs to know

Report By: Researchers at Brookhaven National Laboratory

For many years, dopamine, a neurotransmitter (a brain chemical that transmits a message from a brain cell to another brain cell), was thought to be primary culprit in ADHD. Dopamine plays a major function in the brain as it is responsible for reward-motivated behavior. A plethora of studies have shown rewards increase the level of dopamine in the brain. This is what makes us motivated to get rewarded. Many drugs, including cocaine, Ritalin, and methamphetamine, act by amplifying the effects of dopamine. Too little dopamine means greater distractability and riskier behavior as the brain constantly seeks ways to increase its dopamine levels.

Researchers at Brookhaven National Laboratory published a study in the journal PLOS One examining levels of dopamine in ADHD patients who had never taken stimulants. They reviewed dopamine transporter density. Transporters actually filter dopamine away from its receptors in the brain. More transporters means less dopamine (and therefore less bang for the reward). Transporter density was determined through PET brain scans.

Initial scans found no differences among their small population of 18 adults who suffered from ADHD but were never treated for it. This group was then treated with Ritalin. After a year, the researchers discovered that dopamine transporter density increased by 24 percent. What this study found was in fact what many parents have discovered during their child’s use of medication; taking ADHD medication may change the brain’s chemistry so that the effects of the medication are reduced over time. To accommodate this, one’s pediatrician or medical doctor will often increase the dosage due to drug tolerance.

More questions than answers arise due to this research. Here’s what’s now on the table:

* Medication is commonly taken over many years. The researchers are not sure whether the brains would return to their original state if they stopped taking the drug.

* Other studies have indicated that increased levels of dopamine transporters in the brain could be used as a diagnostic marker for ADHD — a way to screen for ADHD. This research tells us that long-term use of stimulant medications like Ritalin may actually cause these increased levels. So increase levels is not a good biomarker.

* Long-term effects are now questionable; will the medicated person constantly need more risk-associated behaviors including drug use as the effects of medication are reduced over time?

“In this study, we only proved that increased dopamine transporter levels cannot be used as a biomarker,” Wang said.

One of the patients in Wang’s study who had never received ADHD therapy was having difficulty in college and in her marriage, but she loved to paint. After taking medication she did better in school and with personal relationships, but she lost her creative drive, Wang said.

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Breastfeeding — The New Ritalin?

Posted by Miriam on May 16th, 2013 | 2 Comments

New research suggest it is
Mimouni-Bloch, A, Kachevanskaya, A, Mimouni, FB, et al. Breastfeeding May Protect from Developing Attention-Deficit/Hyperactivity Disorder.

Breastfeeding Medicine. 2013; doi:10.1089. Accessed May 14, 2013. Full study: http://online.liebertpub.com/doi/full/10.1089/bfm.2012.0145

The May 14, 2013 issue of Breastfeeding Medicine reports that breastfeeding may offer a protective effect from ADHD. The Israeli scientists performing the study say breastfeeding may keep children from developing ADHD even as they get older.

The Israeli researchers recruited 6 to 12 year-olds diagnosed with ADHD.These children were matched up with two sets of healthy control groups. The control groups were the ADHD children’s siblings who did not have ADHD, and 6 to 12 year old children with similar backgrounds. Siblings were included because they likely have similar genetic and
environmental backgrounds as the children with ADHD.

The researchers found that children who had been diagnosed with ADHD were breastfed less often than their healthy peers. Here’s the breakdown:

* At one month of age, only 63 percent of children with ADHD were breastfed.

* At one month of age, the non-ADHD kids were breastfed 86 percent of the time while the ADHD children’s non-ADHD siblings were breastfed 79 percent of the time.

* By six months of age, only 29 percent of the ADHD children were breastfed while 50 percent of their healthy siblings and 57 percent of the non-related children were breastfed.

“A stepwise logistic regression … demonstrated a significant
association between ADHD and lack of breastfeeding at 3 months of age, maternal age at birth, male gender, and parental divorce,” the researcher wrote. “Children with ADHD were less likely to breastfeed at 3 months and 6 months of age than children in the two control groups. We speculate that breastfeeding may have a protective effect from
developing ADHD later in childhood.”

One can’t help but ask if the child’s propensity to be distracted, fussy, or moody could have a difference in the outcomes of this study. In other words, were they breastfed less because of ADHD like symptoms early on, or does the act of breastfeeding actually act as a protective effect.

Mimouni-Bloch, A, Kachevanskaya, A, Mimouni, FB, et al. Breastfeeding May Protect from Developing Attention-Deficit/Hyperactivity Disorder.

Breastfeeding Medicine. 2013; doi:10.1089. Accessed May 14, 2013. Full study: http://online.liebertpub.com/doi/full/10.1089/bfm.2012.0145

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The Voice Judge, Will.i.am Battles ADHD

Posted by Miriam on May 9th, 2013 | No Comments

Offers his voice to the community

Reported in Britain’s Sunday Mirror

If you’ve got kids, you probably know Will.i.am from the popular TV show called The Voice and his band, The Black Eyed Peas featuring Fergie. He struggles with ADHD.

He told Britain’s Sunday Mirror, “I have ADHD. I’ll admit it… I’ve got all this stuff in my head at the same time as I’m doing stuff and I don’t know how to stop or slow down. But it’s all good because I know how to control it.

“For every obstacle there’s some type of solution. So if you have ADHD it’s your passion point. One thing I learned about ADHD is that it’s hard to keep your attention and you can’t sit still and you’re always moving and thinking about a whole bunch of things.

“But those traits work well for me in studios and in meetings about creative ideas… If I was stuck at a different job I’d be horrible and wouldn’t survive. Music is my therapy… Music keeps me sane and keeps my mind on something. It’s fragile up there.

“My mind would wander, and if it wanders then that’s not good because I could scare myself thinking of weirdo stuff. Music brings control to my thoughts. It’s not escape – it’s just order. I’m making order out of a disorder.”

Will.i.am’s insights are helpful. He’s found a way to take his ADHD and turn it into something creative. Good strategy!

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Study Says Most Doctors Don’t Follow ADHD Treatment Guidelines for Preschoolers

Posted by Miriam on May 6th, 2013 | No Comments

Does yours?

Published in the American Academy of Pediatrics (AAP)
Study presented Saturday at the Pediatric Academic Societies’ annual meeting in Washington, D.C.
author Dr. Andrew Adesman

New treatment guidelines were published recently by the American Academy of Pediatrics (AAP). These guidelines now allow for an ADHD diagnosis in children as young as 4-years old. The new guidelines are somewhat controversial because three out of the four common medications used to treat ADHD patients are not FDA approved for use among children that young.

Much like the guidelines in the United Kingdom, the new AAP guidelines recommend that behavior therapy be the first treatment approach for preschoolers with ADHD. Treatment with medication is a last resort option used when behavior-management is unsuccessful.

A study presented Saturday at the Pediatric Academic Societies’ annual meeting in Washington, D.C. reports that about 90% of the pediatric specialists who diagnose and treat preschool children do not follow those treatment guidelines. According to study author Dr. Andrew Adesman, chief of behavioral pediatrics at Cohen Children’s Medical Center in New Hyde Park, NY, some pediatric specialists prescribe medication too soon and some do not offer them as a second line treatment.

In a medical center news release, Adesman noted, “It is unclear why so many physicians who specialize in the management of ADHD — child neurologists, psychiatrists and developmental pediatricians — fail to comply with recently published treatment guidelines.”

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ADHD and Driving

Posted by Miriam on April 29th, 2013 | No Comments

Is it really more dangerous?
Meta-analysis by: the National Institutes of Health (NIH)

Many studies have attempted to correlate ADHD and driving habits. While outcomes have been varied, a trend clearly emerges: ADHD drivers are at greater risk for accidents. This seems especially true for young ADHD drivers.

According to a meta-analysis by the National Institutes of Health (NIH), “In high income countries [such as the United States and many European countries], MVCs [motor vehicle collisions] are the leading cause of death among children, adolescents and young adults (ages 4–29) (WHO, 2002b) and therefore, are considered a major cause of premature death and long-term disability. In the United States in 2004, there were close to 6.2 million MVCs that resulted in 42,636 deaths and close to three million injuries (National Highway Traffic Safety Administration [NHTSA], 2004). The economic burden of MVCs is extremely high and in the year 2004, traffic collisions alone cost the United States 230.6 billion dollars (NHTSA, 2004).”

Is it more than just distraction? Yes. According to available research, ADHD drivers also experience negative driving outcomes for a variety of reasons:

*Poor risk perception; they don’t perceive risky situations as being risky.

* Impaired judgment or failure to make good decisions and use reasoning while driving.

* Inattention and impulsivity were found to be higher in ADHD drivers.

* Longer reaction times and a reduced capacity for flexible response to changing road conditions.

* Decreased neural motor control over the vehicle — motor skills are brain functions that allow us to control the response of our bodies.

* Increased aggressiveness and anger were identified in some ADHD drivers.

* Deficits in cognitive abilities were associated with inattentiveness, particularly visual inattentiveness and impulsiveness correlating with problem driving outcomes.

All of these findings indicate that a variety of factors make ADHD drivers less safe. It’s important to start a program where cognitive performance, behavioral shaping, and motor skills performance are increased.

Play Attention. 800.788.6786.

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Is It More Than Just ADHD?

Posted by Miriam on April 26th, 2013 | No Comments

New study sheds some light
Reported in the journal Science
Study author: Brian Butterworth. Butterworth is a professor at the Institute of Cognitive Neuroscience of the University College London

Research in the journal Science reports that up to 10 percent of all children are thought to have learning disabilities. This would amount to two or three kids per classroom.The researchers found that the disabilities have complex causes.

It’s estimated that nearly 10% of all children have ADHD, but it usually doesn’t occur by itself according to the researchers. They cited that 33 percent to 45 percent of children with ADHD also have dyslexia and 11 percent also have dyscalculia.

Dyslexia is a reading, writing and spelling disability frequently associated with auditory processing issues. Dyscalculia is a math learning disability.

The researchers stated that learning disabilities are the result of abnormal brain development caused by complicated genetic and environmental factors.

“We now know that there are many disorders of neurological development that can give rise to learning disabilities, even in children of normal or even high intelligence, and that crucially these disabilities can also co-occur far more often that you’d expect based on their prevalence,” said study author Brian Butterworth in a university news release. Butterworth is a professor at the Institute of Cognitive Neuroscience of the University College London

Butterworth’s team noted that if a child has multiple learning disabilities, they may be overlooked when one gets an ADHD diagnosis. The diagnosis may overlook dyslexia for example. Not knowing may lead to frustration by both student and teache as well as inadequate instructionr. Knowing a student has both learning disabilities would allow the teacher to properly accommodate the student’s needs.

The study reinforces the fact that one needs to get a good evaluation form a specialist, not just a short 20 minute visit to one’s pediatrician. Proper instruction can come only when one has full knowledge of student needs.

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Mom, My Greatest Advocate

Posted by Miriam on April 24th, 2013 | No Comments

Reported by: http://www.additudemag.com/adhdblogs/17/10068.html
www.additudemag.com

If you’ve been kicked in the shins by school administration, you should read this. Schools will help. You have to know how to be an advocate.

“While it’s true that some of teachers and administrators may have been the experts when it came to knowing more about educational policies and strategies, they never knew more about my child. It’s taken 12 years of IEP meetings, being kicked in the shins by administrators, and laughed at for my ideas to help me realize that when it comes to my kid, I am the expert. I only wish I had the same strong feeling about myself many years ago. ”

http://www.additudemag.com/adhdblogs/17/10068.html

ADHD IEPs and School Accommodations: Coming into My Own as an Advocate for My Child
www.additudemag.com

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ADHD in Children & Cell Phone Use

Posted by Miriam on April 22nd, 2013 | No Comments

Is there a link?

Reported by University College of Medicine in Korea
Survey by: NIT DOCOMO’S Mobile Society Research Institute

Researchers at the University College of Medicine in Korea hypothesized that children who use cell phones may be at a greater risk of developing ADHD. Cell phones emit low dose electromagnetic fields(EMF). They discovered a link.

NIT DOCOMO’S Mobile Society Research Institute reveals that nearly 70% of all children surveyed use a cell phone. In some countries, use exceeded more than 80%.

Since it’s obvious that cell phone exposure is nearly impossible to avoid, it is important to know if cell phone EMF can cause ADHD. To determine if a connection exists, the researchers analyzed data from more than 2,400 elementary school children for ADHD symptoms and cell phone exposure. These data were acquired through the use of parental reports.

The researchers waited two years and interviewed the participants again. They found that children who used cell phones for voice calls were more likely to develop symptoms of ADHD than those who didn’t. However, ADHD symptoms were only statistically significant in children who also had high levels of lead in their blood.

Significantly, the researchers found that children who stopped using cell phones during the study period had a much sharper decline in ADHD symptoms than those who continued using cell phones.

Some nations around the world are either banning or limiting cell phone use by children, and some by those under the age of 12 years-old. The United Kingdom, Israel, Belgium, Germany, and India have discouraged use of cell phones by children. France is considering law which would make it illegal to market cell phones to children. Russia has recommended that children under the age of 18 years not use cell phones at all.

What cannot be determined by the Korean study is reverse causality. Other studies indicate that ADHD children are compelled to use their cell phone more frequently. So, the study cannot say whether cell phone use causes ADHD or whether ADHD children just use their phones more frequently.

Also, prior studies have exposed a connection between lead levels and ADHD. So, while there may be a connection between cell phone use and ADHD, that link cannot be determined specifically through this study. Based on current research, it is intelligent to limit cell phone use or use the cell phone with a wired headset to keep the cell phone away from the head.

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Weight Loss and ADHD Medications (part 2 of 2)

Posted by Miriam on April 19th, 2013 | No Comments

Reporting by the University of Maryland Center for Substance Abuse Research (CESAR) and Global Market For ADHD Medications (healthaffairs.org)

A history of appetite suppressants

The previous submission noted that Adderall, a drug frequently used to control ADHD symptoms, was a spin off of Obetrol used for weight loss in the 1950s and 1960s.

Ritalin was tested on humans in 1954. According to the University of Maryland Center for Substance Abuse Research (CESAR), “… In 1957, Ciba Pharmaceutical Company began marketing MPH as Ritalin to treat chronic fatigue, depression, psychosis associated with depression, narcolepsy, and to offset the sedating effects of other medications.

It was used into the 1960s to try to counteract the symptoms of barbiturate overdose… Research on the therapeutic value of Ritalin began in the 1950s, and by the 1960s, interest focused on the treatment of “hyperkinetic syndrome,” which would eventually be called Attention Deficit Hyperactivity Disorder.”

Lower doses of stimulant medication do seem to temporarily improve focus and reduce hyperkinetic behaviors. One must realize that their original use was not for ADHD, but for weight reduction and as drugs that could counter chronic fatigue. They are also Schedule II substances in the same class as cocaine. Thus, weight loss as a side-effect should be expected and dealt with appropriately after consulting your healthcare provider.

The US is estimated to consume the vast majority of these medications. According to the Global Market For ADHD Medications (healthaffairs.org), “In 1993, thirty-one countries had adopted the use of ADHD medications; by 2003, the number had grown to fifty-five. Our analysis aggregated data from individual countries from the year of adoption into a global sum. Because the United States is the single largest market, we also show its use, which constitutes 83–90 percent of total market share (by volume).”

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Weight Loss and ADHD Medications (part 1 of 2)

Posted by Miriam on April 18th, 2013 | No Comments

Reported by: www.webmd.com

Knowing the history may make you lose your appetiteWhen you hear, “Mom, I’m not very hungry,” do you wonder why?

Stimulant medications are frequently prescribed for the control of ADHD symptoms. According to WebMD, weight loss is a common side-effect for most stimulant medications.

If you understand the history of stimulant medications, you’ll
understand how they are associated with weight loss. If we begin with Adderall, we can trace it back to it’s origins in Brooklyn, NY in the 1950s. It was known then as Obertrol and was manufactured by Obetrol Pharmaceuticals which later became a division of Rexar Pharmacal Corp.

Obetrol [perhaps a conjugation of 'obesity control'] was used as a stimulant based diet pill to control obesity. It was popular during the 1950s and 1960s. It contained amphetamine and methamphetamine salts.

Shire Pharmaceuticals later acquired Rexar and the name was changed to Adderall when Obetrol’s use for dieting was waning and studies indicated it might be useful for controlling hyperactivity. The formulafor Obetrol has been reformulated at least once since being labeled Adderall.

While it was popular to use amphetamines (especially methamphetamine) for weight loss into the 1970s, by the 1980s, the medical community was alerted to addiction problems and began to dissuade use of these drugs for obesity control.

How did these drugs transform into ADHD medications? That’s in part 2. Stay tuned!