Steven Pavlakis MD -Chief of Pediatric Neurologyat the Maimonides Medical Centers, talks about ADD medications
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Male Speaker: People that need stimulants to keep their lives, marriages, and work environment together? One of the side effects of these stimulants could be lack of sleep and maybe they don't gain weight as well, is that true? Male Speaker: Yes, and in children that are very small that can be an issue. In bigger kids it's not usually a major problem. Male Speaker: There seems to be a phenomenon going on in colleges, a lot of kids who are normal are trying to take these kind of medicines; is that somewhat of a danger? Male Speaker: Sure. Sometimes kids in college will take lots of it. They will take it to stay up to study. They may even take it recreationally, if you take 100 of these pills and squeeze them down and take it all at once. So there is a real risk for abuse of these medications, some more than others. The major risk is if you take a lot of this stuff, it can have cardiovascular effects, meaning it can increase heart rate and blood pressure, which can be bad for you. Male Speaker: If a kid had an underlying cardiac problem undiagnosed, is there any risk of taking these medicines? Male Speaker: Taking it properly, there is probably very, very, very little risk. There is some data that even taking a regular dose may increase your blood pressure just a little bit. There is really right now no clear data that giving this to a large population, that it increases risk in any individual patient. I think it's more of a theoretical risk. So if a child does have a heart problem that we know of, we certainly would have that patient cleared before giving these medications. Male Speaker: Well, several months ago there was some report of 25 kids allegedly died taking a stimulant. Do you feel this just happened to be 25 kids that died and happened to be on the medicine, or there is a risk? Male Speaker: Well, I think every medicine has every risk known in the world, and we know the people can die from Tylenol and Motrin and everything else, including Benadryl. But the patients that I have seen are no worse than people not on the medications. One of the medications, specifically Adderall, was actually banned in Canada for a short period of time, because they had a few children that died. But when they looked at the data, as far as could be determined, the risk of death in children on Adderall was not higher than the risk of death in children not on medication. Male Speaker: Is there any medicine that doesn't stimulate the body and controls kids who have this? Male Speaker: Yes, there are several. These are what I term second-line medications. The best studied honestly is -- well, there are probably two best studied, is Clonidine or Catapres, which is an old blood pressure drug, but that actually was studied for safety and for effectiveness, with Ritalin, in a study sponsored by the NIH about five years ago. And was found to be safe for the heart and blood pressure, with Ritalin and without Ritalin, and also did work. So this is a second-line drug that I sometimes give as a patch. Other second-line medications are Strattera, which is related a little bit to an antidepressant. Strattera came out about four years ago. But this medication has certain advantages in certain subgroups and certain disadvantages in others, and sometimes people have used other medications, including Wellbutrin, which some of you may know as a medication that's used to stop smoking in adults. There has been some data that this can be helpful. But the best studied second-line drugs really are Clonidine or Catapres, and Strattera, the newer medication that was developed just for ADHD. Male Speaker: So in other words, it's a problem that can be controlled somewhat with medicine; there are failures obviously, and any doctor who gives that medicine has to monitor the kid very, very carefully. Is that true? Male Speaker: That's correct. Furthermore is, one shouldn't be rushing to give medicine to any child. I think one warning for a parent is that if you go t
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