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Attention Deficit Hyperactivity Disorder

Attention Deficit Hyperactivity Disorder: Stimulant or Non-Stimulant Medication to treat
Jennifer Meadows
Axia College of University of Phoenix
COM 220 Research Writing
February 28, 2010

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Attention Deficit Hyperactivity Disorder: Stimulant or Non-Stimulant Medication to Treat
With so many children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) today and even though the media believes ADHD is a myth and just another way for doctors to make a buck (Jaska, 2000), many studies have been done on different ways to treat the disorder. Along with a diagnosis of ADHD comes the controversial decision of how to treat ADHD. While testing done on certain medications indicates that they could be harmful to children, there are many different medications used to treat ADHD, which one should parents chose for their child
What is ADHD and how is it diagnosed
ADHD is a disorder that affects millions of children and can even continue into adulthood. Children diagnosed with ADHD have problems paying attention, are hyperactive, and may also have impulsive behavior. The main causes of ADHD are not known but doctors say that the disorder has inherited genetic factors.
In order for a child to be diagnosed with ADHD they must meet criteria set by the Diagnostic and Statistical Manual of Mental Disorder (DMS), which is a manual that is published by the American Psychiatric Association (Mayo Clinic, 2010). According to Wiener (1999), ???Being able to tell if a child has ADHD is much harder than diagnosing mumps or chickenpox??? (p.1). One way doctors are able to diagnose ADHD in children is by using an imaging test. The most common way of diagnosing ADHD in children is to gather information from teachers and parents of the child. This information comes from a questionnaire that is given to the parents and teachers of the child to answer (Wiener, 1999).
Some in the media have said that ADHD is a myth and it is believed that doctors are diagnosing children with this disorder without taking the time to make an accurate diagnosis (Jaska, 2000). If left undiagnosed, ADHD can leave children feeling as if they are not as smart as other children their age. For this reason alone, it is important that parents who believe their children may have ADHD to consult with their child??™s teacher and his or her pediatrician to receive a true diagnosis and start treatment.
What are the Common Treatments of ADHD
There are several different types of treatments that can be used to help children diagnosed with ADHD. The most common treatment of ADHD is for the diagnosing doctor to prescribe children with medication. These medications break down into two main sections, which include stimulant and non-stimulant medications (Watkins, Brynes, & Preller, 2004). One form of medication is stimulant medications, which include but are not limited to: Ritalin, Concerta, Daytrana, Adderall, and Dexadrine. Another form of Medication used to treat ADHD is a Non-Stimulant medication. The most common non-stimulant medication is Strattera. Other non-stimulant medications include but are not limited to: Tricyclic Antidepressants, Bupropion, and Antipsychotic medications (Watkins, Brynes, & Preller, 2004).
Some children with ADHD are often put in counseling and/or therapy to help them cope and learn to deal with their symptoms. Some of the other treatments currently being used are child management strategies, behavior managements, and antidepressant medications.
What are Stimulant Medications
Stimulant medications are believed to improve signs and symptoms of inattention, impulsive behavior, and hyperactivity. Stimulant drugs come in the form of short-acting and long-acting treatments. Short-acting stimulants will last around four hours. Long-acting stimulants will last from six to 12 hours long. Below one will find a table showing stimulant medications and how long the effects of each medication will last.

Stimulant Medications and Duration of Effects
Long Acting Stimulant Medications (once a day)
Medication Brand Name Duration
Dexedrine Dexedrine Spansules 6-9 Hours
L&D Amphetamine Adderall XR 9 Hours
Methylphenidate Concerta 12 Hours
Short Acting Stimulant Medications
Methylphenidate Ritalin 3 ? to 4 Hours
Dexedrine Dexedrine Tablets 1-3 Hours
(Retrieved from Mayo Clinic, 2010)
Side Effects of Stimulant Medications
Stimulant drugs have side effects like: loss of appetite, weight loss, insomnia, and irritability when the medication begins to wear off, upset stomach, and in rare occurrences heart-related deaths have occurred in children who take stimulant medications (Mayo Clinic, 2010). Some studies have shown that methylphenidate (Ritalin and Concerta) alters the brain similar to the way that cocaine alters the brain (Higgins, 2009).
Loss of appetite is worse in younger children taking these medications. In some cases this symptom can last one or more months, but for most will improve in a few weeks. One way to lower the risk of having a loss of appetite is to lower the dosage of medicine taken. As with many medications one could take this medication with food.
If stimulant medications are taken late in the afternoon insomnia can occur. Insomnia is more frequent in the long-acting stimulant medication Dexedrine Spanules. Children who experience problems with insomnia should have their caffeine in take monitored. By keeping the amount of caffeine low that a child on a stimulant medication takes in, this will help lower the risk of insomnia. Medication is not always to blame for insomnia, but if it is the medication causing the insomnia problem, then the last dose of medication should be taken no later than lunch time (ADHD Medications: Benefits and Risks. n.d.). If children taking stimulant medications begin to experience any irritability as a side effect there are a couple of options available to help ease this symptom. One option is to take a lower dose of the medication, or to change to another stimulant medication altogether and add clonidine/guanfacine, which are typically used to treat high-blood pressure; that can help ones body to wind down for the day. The other option is to try a different medication used to treat ADHD altogether.
Children taking stimulant medications may sometimes experience an upset stomach. By eating smaller meals, eating more frequently, or taking his or her medication with food, the risk of an upset stomach could be lowered (Jaska, 2000).
Depression can be a belated cause of stimulant medicine. Depression could possibly be more regular with one of the long-acting stimulants. Doctors should check for any previous depression in the history of the child and his or her family. If depression is, in fact, connected to stimulant medication, one may need to switch to a different class of medication in order to treat the ADHD. An example of a different class of medication would include Tricyclic antidepressants and Bupropion.
If a child becomes anxious, stimulant medications can increase the symptoms. This side effect is treated much like the depression side effect.
Stimulants can also cause high blood pressure and it can cause a high pulse in patients. Most people do not see this when medications are taken at normal doses. People with blood pressure issues must be monitored much closer, especially if they are taking high doses of the medications. The adults on the medication may want to take a high blood pressure medication if they wish to stay on the stimulant medication (Parker, n.d.).
Rare side effects include paranoia or psychosis (Jaska, 2000). These side effects are more common if the ADHD person has a bipolar disorder or another kind of psychotic disorder. An overdose of a stimulant medication can also cause psychosis. Parents should ask their child??™s doctor to screen them for other disorders before starting the stimulant medications.
Benefits of Stimulant Medications
Stimulant medications have shown many beneficial effects. The amount of hyperactivity can improve to typical amounts and impulsivity can be notably reduced. Children who react positively to stimulants show major academic improvements in the quality and quantity of their completed work. Another benefit that stimulant medications have revealed is the difference in relationships between children and their parents along with their siblings and other peers.
Children taking stimulant medications versus children not taking any medication for the treatment of their ADHD is as different as night and day. In today??™s world, children need to feel they fit in with other children. If they do not feel like they fit in because they do not understand things the way other children do; major consequences can come about.
What are Non-Stimulant Medications
Non-stimulant medication is typically considered only when stimulant medications have failed or their side effects have become unbearable. Strattera is the only Non-stimulant medication that has been approved by the FDA for treatment of ADHD (Mayo Clinic, 2010). Strattera last for about 24 hours, which makes this medication last longer than any stimulant drug on the market. Below one will find a table of non-stimulant medications and how long the effects of each medication will last.

Non-Stimulant Medications
and Duration of Effects

Medication Brand Name Duration
Atomoxetine Strattera Lasts 24 hours
(Retrieved from Mayo Clinic, 2010)
Even though Strattera last 24 hours, it is hard for parents to switch their child from a stimulant to a non-stimulant medication such as Strattera because it takes up to four weeks for Strattera to show a change in children with ADHD. Many parents cannot wait as long as Strattera takes to get into their children??™s system.
Side Effects of Non-Stimulant Medications
The common side effects of non-stimulant drugs are: sleepiness, headaches, dizziness, agitation, and they can also cause nausea and vomiting. A warning label on Strattera shows that it may cause an increase in suicidal thoughts and actions in children and teenagers. Children on this medication should be carefully monitored. As with some stimulant medications, Strattera can cause insomnia and loss of appetite (ADHD Medications: Benefits and Risks. n.d.). If a child has problems with any of these side effects for a significant period of time, parents should consult their child??™s pediatrician to discuss the side effects and possibly changing their child??™s medication.
Benefits of Non-Stimulant Medications
Studies have found that the non-stimulant medication Strattera improves the symptoms that occur with ADHD and reduces defiant and oppositional behavior, and minimizes anxiety. Unlike some stimulant medications, Strattera does not have the potential for abuse. Although it may take non-stimulant medications longer to begin showing their improvements, their effects last longer than the effects of stimulant medications (Low, 2009) and the added benefit of not worrying about the possibility of dependency on the drug.
Conclusion
Studies have been done on both stimulant and non-stimulant medications, many of these studies have shown some of these medications to be harmful. With warning labels on bottles stating they can cause an increase in suicidal thoughts and actions in children and teenagers (Mayo Clinic, 2010), along with warnings that some medications have been proven to cause brain altering, in such ways that are similar to cocaine (Higgins, 2009). Is either of these types of medications safe for our children Any medication one takes comes with a warning label, and their share of side effects. Children on any medication should be monitored, especially on medications with warnings such as some medications used to treat ADHD. Ultimately, it is up to parents to do their own research on the different treatments of ADHD and to also search out pediatricians thoughts, and only then make decisions that are best for their child.

References:
ADHD Medications: Benefits and Risks. (n.d.). Mental Health, Retrieved January 9, 2010 from http://www.helpguide.org/mental/adhd_medications.htm
Higgins, E.S. (2009) Do ADHD Drugs Take a Toll on the Brain Scientific American Mind, 20(4), P38-43. Retrieved January 7, 2010 from ESBCO Database
Jaska, P. (2000). Childhood Attention Deficit Disorder Is A Serious Problem. Mental Illness. Retrieved January 6, 2010 from the Opposing Viewpoints Resource database.
Low, K. (2009). Non Stimulant ADHD Medication. About.com Guide. Retrieved February 1, 2010 from http://add.about.com/od/treatmentoptions/a/nonstimulants.htm
Mayo Clinic. (2010). MayoClinic.com. Retrieved February 1, 2010 from http://www.mayoclinic.com/health/adhd/DS000275/DSECTION=treatments-and-drugs
Parker, H. (n.d.). It??™s about Time: Promising Practices for children and Adolescents with ADHD. A.d.d. Warehouse, Retrieved January 12, 2010 from the ESBCO Database
Watkins, C., Brynes, G., Preller, R. (December, 2004). Non-Stimulant Medications for Children and Adolescents with AD/HD. Northern County Psychiatric, Retrieved January 12, 2010 from http://www.ncpamd.com/NonStimulants.htm
Watkins, C., Brynes, G., Preller, R. (December, 2004). Stimulant Medication and AD/HD. Northern County Psychiatric, Retrieved January 13, 2010 from http://www.ncpamd.com/Stimulants.htm
Wiener, J. (1999). Medication Helps Children with Attention-Deficit Hyperactivity Disorder. Current Controversies: Mental Health, Retrieved January 11, 2010, from the Opposing Viewpoints Resource database.

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