Stimulant Medications

Stimulants are often used in the treatment of ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD). RITALIN (methylphenidate) is most commonly prescribed. Other stimulant medications that are frequently prescribed include Dexedrine (dextroamphetamine), Adderall (amphetamine and dextroamphetamine), and Cylert (pemoline).

For more than 50 years, these drugs have been used to treat the behavior of children with hyperactive symptoms; as many as 80 percent of students with ADHD respond to these drugs. Exactly what makes these medications effective against ADHD is unknown, although experts suspect they affect the rate and balance of specific neurotransmitters in certain areas of the brain. This results in a greater ability to pay attention and stay focused, and a decrease in hyperactivity. Since these children also tend to become less impulsive, aggressive, and destructive, the drugs also help improve social acceptance. These medications are often used in combination with behavioral and educational interventions.

Children who respond to stimulant medications generally show improvement in their academic work and in their interactions with others right away. (However, there is a lag before Cylert achieves its maximum effect in children.) Several studies have found that after students with ADHD started taking stimulants, their test scores and accuracy and speed in completing homework improved. The long-term gains are less clear.

Because most stimulant medications are metabolized quickly, often several doses a day are necessary. Stimulant medications are taken for as long a period of time as is helpful or necessary. Some children find that in adolescence the medication is no longer necessary; others find the medication less necessary as their situation changes, for example a change in environment or academic demands. Many find that they face the frustrations of ADHD through adolescence and adulthood and some of these individuals may benefit from using stimulant medication on a long-term basis.

Successful treatment with stimulants lies in finding the right drug at the right dosage. It is important to remember that the child with ADHD will still remain impulsive and energetic even while taking stimulants, but their ability to pay attention should improve.

Treatment with stimulants for ADHD is a longterm therapy; the government estimates that 80 percent of those who need medication for ADHD in childhood will still need drugs as teenagers, and 50 percent will be helped by stimulants as adults.

Side Effects
The most common side effects include weight loss and appetite loss, together with problems in falling asleep, although these problems may fade away as a student becomes used to the drug. Some studies have found that a child’s growth begins to lag, although this usually rebounds after the first year in those who are on low or moderate doses. Children taking Dexedrine or high doses of Ritalin may experience prolonged growth lag as long as they remain on the medication, but once the drug is stopped growth begins again. For this reason, some experts recommend “drug holidays” during vacation to allow a child’s growth to catch up.

Less common side effects include stomach problems, headaches, lethargy, irritability, nausea, euphoria, depression, nightmares, dry mouth, constipation, anxiety, hallucinations, nervous tics, and tremors. In children at risk for TIC disorders such as TOURETTE’S SYNDROME the medication may trigger the condition. Because individual reactions and needs change, it is very important that the use and result of the medication be monitored.

Addiction
While some stimulants can be addictive if abused, low doses seem to be safe for children, who do not become addicted nor become likely to be addicts when they are older. On the other hand, some studies suggest that untreated students with ADHD are at higher risk for developing substance abuse in adolescence.