Ask the Pharmacist: Stimulant Safety

Mar 13, 2014
More than 30% of children carry ADHD into adulthood.
  • Attention Disorders
  • Children
  • Teenagers

In a new report from Express Scripts, Turning Attention to ADHD: U.S. Medication Trends for Attention Deficit Hyperactivity Disorder, the number of Americans who use medication to treat attention deficit hyperactivity disorder (ADHD) rose 36% between 2008 and 2012. While the greatest increases in use during the study period were among adults, children and young adults are still the primary users of ADHD mediations. 

In 2012, 7.8% of boys ages 4 to 18 were taking an ADHD medication, more than twice the number of girls the same age (3.5%). Teenage boys, 12 to 18 years old, are by far the most prevalent users. In 2012, 9.3% of that population took an ADHD medication – up from 7.9% in 2008. 

However, the trend seems to flip after age 18 – the number of males using ADHD medications plummets, while women ages 19 to 25 surpass younger girls’ use of these medications, 4.4% vs. 3.5%, respectively in 2012.

ADHD females males

Treating ADHD

According to the report, more than 80% of children taking ADHD medications use a stimulant form. Nonstimulants are considered easier to tolerate because they do not cause a number of the side effects associated with stimulants. However, they may not be as effective as stimulants in treating ADHD in some patient populations. 

Stimulants are extremely effective in reducing ADHD symptoms, but there are risks associated with their use, including addiction and adverse reactions in patients with cardiovascular disease or related conditions. If taken in high doses, stimulant ADHD medications also can stunt growth in children, increase risks of other psychiatric conditions and cause seizures. 

Also of concern is a lack of awareness among young adults of the risks associated with using stimulant medications. In our Neuroscience Therapeutic Resource Center®, we often hear college-age students talking about drinking energy drinks while they are using their ADHD medication, which could put them at risk for sudden cardiac arrest. Some also seek stimulant medications for weight loss, because they are known appetite suppressors.

Attention to Safety

With more than 30% of children carrying ADHD into adulthood, it’s important to ensure the safe use of these medications when used long term. Here are some things parents should consider when their child is using an ADHD medication: 

  1. Understand the risks  – All prescription medications come with safety risks. It’s important to teach your children about the safe use of medications, including not sharing their medication with others and knowing that some other medications or supplements, such as energy or highly caffeinated drinks, can cause serious, life-threatening interactions with their ADHD medication
  2. Discuss drug holidays Drug holidays (for example, discontinuation of stimulant medication on weekends or during the summer) are not routinely recommended because ADHD is a chronic disorder. However, if ADHD medication side effects or growth issues are significant, then drug holidays are an important option. Discuss with your physician about the need for a drug holiday before stopping the medication.
  3. Limit screen time While there is no conclusive evidence that screen activities actually causes ADHD or makes it worse, video-game playing – especially among young children whose brains are developing – trains them to respond to quick stimuli. Limiting screen time and encouraging other forms of play can help children manage their symptoms.
  4. Watch for addiction or misuse – Stimulant medications can be abused when a person uses these medications for reasons or in dosages other than prescribed, or by taking a stimulant medication that is not prescribed for that individual. Stimulants also are known to suppress a person’s appetite, which makes them attractive for weight loss. Keep an eye on any major changes in your child’s mood or personality, or any sudden or drastic weight loss, particularly in teens and young adults. This may indicate misuse of the medication. Also emphasize that giving controlled substances to a friend is illegal and can cause significant harm.
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