July 20, 2010 -- More than 80% of children who are diagnosed with attention deficit hyperactivity disorder take prescription medications at some point to treat their symptoms, according to a new nationwide survey of parents by Consumer Reports Health.
Among the survey's major findings:
- 67% of parents identify drug therapy as being beneficial, while 45% feel that switching their kids to schools better suited to help ADHD kids helps considerably.
- More than half of the children whose parents were questioned had tried two or more medications in the past three years.
- 37% of parents say having a learning specialist or tutor work with the child helps "a lot."
- 35% of parents say providing structure by maintaining a schedule of activities helps "a lot."
Consumer Reports National Research Center conducted an online survey in July-August 2009 of 934 parents of children under 18 who had been diagnosed with ADHD. Treatment findings come from 785 reports of youths who had visited a professional for ADHD treatment within the past 12 months, and 676 children whose parents said they had tried medication within the past three years.
The high percentage of parents who reported that their kids had taken medications doesn't mean that's what helps children the most or makes parents happiest, because 44% said they wished there were another way to help their children.
Medication Side Effects
Consumer Reports' experts write that although medications can help children concentrate, feel calmer, and think before acting, side effects can be a problem. Side affects reported most often were decreased appetite, sleep problems, weight loss, upset stomach, and irritability.
The survey finds that 35% of parents believe that drugs help most when it comes to improving academic performance and behavior at school. It finds that 26% think medications helped their kids with social relationships and 18% say it improved their self-esteem.
Other findings from the survey of parents:
- 65% say their children see a pediatrician for treatment of ADHD.
- 22% say their children are treated by psychiatrists.
- Nonmedical treatment providers including psychologists and learning-disability specialists. were involved in treatment of many of the children.
The Consumer Reports Health special report says two classes of drugs are available for treatment of ADHD:
- Stimulant medications, such as dextroamphetamine-based drugs, including Adderall, Vyvanese, and methylphenidate-based medications, including, Concerta, Daytrana and Ritalin. Generic medications are also available.
- Non-stimulant medication, such as the anti-depressant bupropion (Wellbutrin and generic) or atomoxetine (Strattera).
Michael Goldstein, MD, a child neurologist with Western Neurological Associates in Salt Lake City and a former vice president of the American Academy of Neurology, is quoted as saying that there are no definitive comparison studies to show which medications work best in specific circumstances.
"We asked parents to rate how helpful each medication was in the following areas: academic performance, behavior at school, behavior at home, self-esteem, and social relationships," the authors write. "Both amphetamines and methylphenidates were equally likely to be helpful in all areas with the exception of behavior at school, where amphetamines were rated as slightly more helpful."
Tips for Parents
Consumer Reports Health offers these tips for monitoring medications.
- Keep a log of your child's progress and "down" times to make sure dosing is correct and side effects are manageable.
- Help your family manage stress by being patient and understanding during new experiences and around unfamiliar people.
- If side effects seem overwhelming, talk with your doctor about switching drugs or dosing.
- Talk with your physician about having time off - for example, a drug holiday -perhaps during vacations.
- Keep good records to create a baseline for your child. Document not just test results and dates but also notes about practitioners, dosages, and frequencies.
The report also says that although drugs can help treat ADHD, medications can also be used for purposes other than those for which they are intended.
Consumer Reports' medical advisor, Orly Avitzur, MD, says students and professionals sometimes are seeking out drugs to help them improve work or test performance.