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ADHD and Medication: Balancing Risks and Benefits

By Dr. Sharon Witkin |
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Attention Deficit Hyperactivity Disorder (ADHD) has been one of the most hotly debated mental health conditions of recent times, with some researchers warning of overdiagnosis, while others point to the very real challenges faced by children with the condition. In the past decade, the number of children and adolescents diagnosed with ADHD has risen by 41%, leading to a growing concern that diagnostic procedures are inconsistent and flawed. This article provides an overview of ADHD, the medications commonly used to treat it, and the controversy surrounding their use.

ADHD is a condition that affects both children and adults, with an estimated worldwide prevalence of 5.29% in children and 4.4% in adults. While the symptoms of ADHD, which include inattention, hyperactivity, and impulsivity, can be difficult to manage, it is important to remember that the condition is not a life-threatening illness. However, the widespread use of medications like amphetamines, methylphenidate, and lisdexamphetamine has raised concerns among mental health professionals, parents, and educators.

One of the key concerns with ADHD medication is that it is often prescribed too readily, without sufficient consideration of the child's individual needs and circumstances. Studies have found that the youngest children in each grade are more likely to be diagnosed with ADHD than their older peers, suggesting that many children are being diagnosed simply because they are being asked to perform beyond their neurocognitive maturity. Additionally, there is significant variation in the rate of ADHD diagnosis and medication use between different regions and states, suggesting inconsistent diagnostic practices.

The medications commonly used to treat ADHD, which are all stimulants, work by increasing the concentration of certain signaling molecules in the brain, leading to increased alertness and focus. The two most commonly prescribed medications are amphetamines (Adderall) and methylphenidate (Ritalin), both of which can cause side effects such as insomnia and decreased appetite. Lisdexamfetamine (Vyvanse) is a newer medication that is considered safer and more resistant to abuse than its predecessors.

While there is evidence to suggest that ADHD medication can be effective in improving neuropsychological functioning, academic performance, and reducing the risk of substance misuse and other negative outcomes, it is important to remember that there are potential risks associated with their use. Children taking medication may experience growth slowing in the short term, and some complain of stomach upset and/or feeling “not themselves”. It is also important to consider non-medication interventions such as academic accommodations, increased physical exercise, and good sleep hygiene.

The rise in ADHD diagnoses and medication use has led to concerns about the medicalization of childhood and the potential for overdiagnosis and overtreatment. It is important for mental health professionals, parents, and educators to work together to ensure that children are diagnosed accurately and receive appropriate care that takes into account their individual needs and circumstances.

In conclusion, while ADHD medication can be an effective treatment option for some children and adults, it is important to consider potential risks and to explore non-medication interventions as well. It is also crucial to ensure that diagnostic procedures are consistent and accurate, and that children are not being overdiagnosed or overtreated. By working together, we can ensure that children with ADHD receive the care and support they need to thrive.

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Dr. Sharon Witkin

Before leading Polygon’s clinical practice, Sharon was an assistant clinical professor at UC Berkeley, a researcher at MIT, and served on the clinical leadership team at the Stanford-affiliated Children’s Health Council. Sharon received her PhD from the California School of Professional Psychology and completed her postdoctoral training at Stanford University.

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