A study of 3,000 randomly selected kids ages 8-15 was funded by the National Institute of Health (with no pharmaceutical company support). The main author was Tanya Froehlich, a developmental behavior pediatrician.
Originally the objective was to see if ADHD in kids was being over diagnosed and over treated. Actual findings showed only 3% of those without ADHD were receiving medical treatment – and they could have represented kids who had improved so no longer met criteria. They also found that 9% of the 3,000 kids had ADHD of which only 1/3 were consistently being treated.
That finding or worse has been repeatedly found – the question is, WHY?
I believe the most common reason is that the patient has not taken “the right medication at the right dose”.
In consulting with physicians in their offices a frequently mentioned problem is getting kids to take their meds. My approach is to first redefine the problem for kids and their families.
ADHD is a type of personality that makes it difficult to focus on things that aren’t interesting.
Like what? Like school mostly. The cause is genetic (polymorphism). Mother Nature doesn’t want ADHD kids or adults spending time with boring, repetitive stuff. ADHD people are the explorers, challengers, and changers of the world.
One of the problems with being ADHD is that in order for us to go to the best schools and get the best jobs, starting with the 9th grade we need to perform well in school and keep up with boring details (and at work boring reports, etc.)
The GOOD news is that medication – especially stimulants make our lives better by giving us the ability to do well on the boring stuff. It also helps us stay calm and still when appropriate, and in control.
THE GOAL
The goal is to find a medication that kids, teens, and adults like. Their lives are easier – they’re getting things done effectively and side-effects from the meds if any, are minimal. HINT: The medication probably isn’t Strattera.
If medication makes kids feel bad they shouldn’t take it. I worry more about kids/teens who take meds that make them feel bad or detached or flat or racy. I worry about parents who keep giving kids the wrong medication or the wrong dose.
Another reason for poor consistent compliance with treatment is that usually at least one of the parents is also ADHD. Only 10% of ADHD adults are being treated. So the parents forget, lose the med, are running late, or don’t have time. They can’t stay organized to keep up with getting refills, scheduling and keeping follow-up appointments, much less filing insurance forms, etc.
Again this year at the American Psychiatric Association annual meeting a group of loud marchers picketed the main conference center. “Stop poisoning our children” and other banners were being waved. They were mostly Scientologists who are a blend of idiocy and nuttiness. They should be sentenced for life to be locked up with a hyperactive kid like our son was in childhood.
Unfortunately, some patients give up too quickly on one or more meds because they don’t understand all the nuances of dosing and side-effects. But, fortunately, we keep getting better and better medications that are more effective and last all day and are safer with less side-effects.
