As science catches up to unknown diseases that affect our bodies, there will be times that a doctor may make a mistake. Some mistakes are minor and will not have any major impact. Other mistakes are more serious and can affect your health drastically. The reality is that doctors are human, busy and are prone to mistakes just like anyone else. They are constantly bombarded with new information that might contradict what they believed to be true for the past several years. You can add to the mix the fact that some pharmaceutical companies exaggerate what their prescription drug can do and doctors have a tough time making sense of it all. When mistakes are performed on adults, there is less of a negative effect since we can recover faster and can relay information to get the proper treatment. But what happens when it involves children? Not only are they afraid and not able to relay information but things get crazy with the emotions from parents.
One possible scenario is the diagnosis of ADHD (Attention Deficit Hyperactivity Disorder, #ADHD) in young children and the rush to medicate them. I often look back when I was growing up (1980s) and tried to remember the amount of disorders or allergies that existed back then. We watched our share of TV but most of the time, we were outside running around, playing sports or up to no good. As I watch my daughter grow up, I can’t help but wonder how much stimulus she is being bombarded with constantly. It is now not just a question of watching TV, but also smartphones, smart phone apps, online gaming, wified vehicles for constant connection, bluetooth, video advertising screens, mobile phone alerts, etc. My daughter is bombarded constantly by stimulus. Her brain doesn’t have the ability to rest and not process stimulus. Part of the blame is on me since these gadgets act as virtual babysitters, but part of the blame is also on our society for creating the need to be connected 24/7. Just try to tell your child that they can’t look at facebook or any other social app for a week and let me know how you did.
When little Johnny has trouble paying attention at school, after the parents become involved, the first consultation is with the school nurse followed by going to a specialized doctor to determine if ADHD is his problem. This is one of the most common childhood disorders that can continue into adulthood. Some of the common symptoms include difficulty staying focused and paying attention, difficulty controlling behavior, and hyperactivity (over-activity). Keep in mind that with all the stimulus available today, staying focused and paying attention is quite hard to do.
There are 3 main groupings that doctors will determine in terms of classifying as ADHD. The first group is for children who have symptoms of inattention such as being easily distracted, forget things, have trouble focusing on one thing, easily bored, trouble completing or turning in homework assignments, often losing things needed to complete tasks or activities, daydreaming, difficulty processing information quickly and accurately as others or don’t seem to listen when spoken to.
The second group are for children who seem to be hyperactive. They tend to fidget and squirm in their seats even during school, dinner and story time, talk nonstop, need to be constantly moving or touching everything and have trouble doing quiet tasks or activities. The third and final grouping are for children who are impulsive. They have symptoms of being very impatient, can’t wait for things nor wait for their turn in games, they interrupt conversations or activities, blurt out rude comments, show drastic emotional swings and act out.
If you look at each individual group you will notice that some of this behavior might seem kind of normal for children. They are growing, learning and trying to develop their social skill set through trial and error. Medications like Adderall and Ritalin might not be the best solution for them. Adults may think that their children who are classified as hyperactive or impulsive have ADHD but in reality the kids might just have emotional or disciplinary problems. It might be the behavior your child is performing to test reactions or boundaries. Keep in mind that children mature at different rates, with girls maturing faster, but the personalities will differ as well. At some point in all children’s lives, they will get distracted, act on impulse and daydream or struggle to concentrate. This doesn’t mean they have ADHD, it means they are a child.
Lets look at some important information about diagnosis and start with that no single test can diagnose ADHD. Parents don’t know enough to assume it, teachers are not licensed professionals to detect it but can provide a warning based on how a child performs in a structured environment. Even doctors and therapists have to go through various examinations to come to an accurate conclusion. Health conditions may cause similar symptoms of ADHD such as seizures, middle ear infections, vision problems, learning disabilities and depression or anxiety. Also add to the list family changes or stress such as a death of a family member, divorce or even a job loss for the parent. These events tend to temporarily affect the child and don’t require medication.
If your child has ultimately been diagnosed with ADHD you have to consider that other illness that may be included, such as a learning disability in which they can’t understanding certain words or sounds, reading, spelling and writing. There are rare disorders such as oppositional defiant disorder whereby a child is really stubborn or rebellious and often argues with adults and rules. Add to the list conduct disorder in which a child may lie, steal, fight, or bully others. They act out by destroying property, using drugs and getting into trouble at school or with the police. They can also have tourettes syndrome, sleep disorders, bed wetting and bipolar disorder. As you can see that it’s not as easy as it seems.
What Happens After Diagnosis?
Once we cleared through all the possible symptoms and it has been established that ADHD is the proper diagnosis, then we need to establish the proper medication. There are various types of medications available which include stimulants, non-stimulants and antidepressants. Stimulants increase dopamine and norepinephrine in the brain to improve concentration while also decreasing fatigue. For the stimulant classifications, you have amphetamines such as Adderall, methamphetamine such as Desoxyn and methylphenidates such as Concerta and Ritalin. Non-stimulant medications affect neurotransmitters but they don’t increase dopamine levels. It also generally takes longer to see results. This group includes Strattera, Kapvay and Intuniv. The final groups are antidepressants that are used off-label and not approved by the FDA. One fact to keep in mind is that antidepressants and stimulants should never mix. We will be discussing the stimulant Adderall since it is one of the more popular stimulants for the treatment of ADHD.
Adderall (#Adderall) is a combination drug of two enantiomers of amphetamine which is a psycho stimulant. An enantiomer in science is a chemical mirror image of two chemical structures. If you look at your hands, they would be considered enantiomers since they are a mirror images of each other. Adderall is 75% dextroamphetamine and 25% levoamphetamine which act like amphetamine by increasing the activity of the neurotransmitters dopamine and norepinephrine in the brain. This activity seems to increase and improve brain development and nerve growth. Adderall is approved to treat ADHD as well as narcolepsy which is a sleep disorder. There are two types that are common which is the capsule formulation and the extended release (XR)versions. Just so you know Adderall XR side effects are the same as the capsule version.
Although the prescription drug has a lot of positive effects, we do have to discuss the negative ones associated with it. First and foremost is the drug abuse associated with this drug by athletes and academia. Athletes seem to abuse it for its performance enhancing properties such as increased physical strength, acceleration, stamina and alertness while college students use it for study time, test taking and getting through those boring classes. This has resulted in colleges and professional sports in banning its use.
The long-term side effects of Adderall can lead to death or serious cardiovascular problems. Some of the cardiovascular events can include high blood pressure, reduced blood flow to the extremities and increased heart rate. With the different changes in blood flow, I know men are wondering if there are any Adderall sexual side effects. To put it simply, yes. Adderall side effects in men can vary from erectile dysfunction to frequent erections to prolonged erections probably lasting more than 4 hours. Adderall side effects in women are based on pregnancy. Amphetamine has been found in the mother’s milk and can be transferred to a child and can impair growth.
If we look at other less serious side effects they will include bladder pain, bloody urine, frequent and painful urination, lower back pain, fever, chills, abdominal pain, loss of appetite, nausea, acne, blurred vision, excessive sweating, tics and weight loss. From a psychological side you can see symptoms of anxiety, insomnia, restlessness, delusions, paranoia, irritability and mood changes. Since this is a stimulant, over time, your body will build a tolerance of Adderall and abusers will just increase the amount they use. Amphetamine poisoning will involve convulsions, comas and eventually death.
So before the rush to have your children medicated on the theory that they have ADHD, make sure that everyone is correct in the assessment. Once a child is on this medication, chances are as he enters adulthood, he will become reliant on it to perform everyday functions and increases the chances of abuse and addiction. One of the most important things to do is to use stimulants as temporary relief until your child can grab hold of the issues affecting him or her. Do you have any regrets with your child using ADHD medications?