Stimulant medication and attention deficit-hyperactivity disorder: the child's perspective

Article Abstract:

Children with attention deficit-hyperactivity disorder (ADHD) are often treated with stimulant medications, with resulting improvements in the condition. Although this treatment strategy has been used for over 50 years, its use is often debated. Ideally, children should be active participants in their treatment, yet drug therapy is usually adjusted according to parents' and teachers' responses. The limited number of studies that have been performed have found that while children are knowledgeable about the purpose of therapy, they often dislike it even if it is helpful. This may lead to compliance problems, which may affect the long-term effectiveness of stimulant treatment. To better determine the factors that influence children's attitudes toward stimulant therapy, 58 children receiving such therapy and their parents were surveyed. Of the 45 responders, 89 percent felt that medication was helpful. Thirty-three percent liked taking medication, and 44 percent had neutral feelings toward it. Most children understood the reason for therapy, with up to 82 percent listing poor concentration, difficulty with school work, difficulty sitting still, and trouble getting along at home as contributing problems. At least one positive benefit of therapy was reported by 98 percent of the children, and 82 percent reported at least one adverse effect such as difficulty going to sleep, decreased appetite, and less energy. Thirteen children were aware of adverse media reports about therapy, and three were negatively affected by these reports. Children who disliked stimulant therapy were significantly likely to fell embarrassed about receiving medication and to feel as if something was wrong with them. Children who disliked therapy tended to be using a standard rather than long-acting preparation, which was taken during school hours and which provided a relatively low dose. The study suggests that sustained-release preparations may be more acceptable to children with ADHD, and that their perceptions of treatment should be considered by physicians. (Consumer Summary produced by Reliance Medical Information, Inc.)

Attention deficit hyperactivity disorder, Hyperactive children

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Methylphenidate in children with seizures and attention-deficit disorder

Article Abstract:

Children with attention-deficit disorder (ADD) can be treated with the central nervous system stimulant methylphenidate. The drug is effective in quieting hyperactivity and improving attention and classroom behavior in ADD children. The use of methylphenidate for children with seizure disorders has not been approved by the drug manufacturer. In the days before the levels of antiseizure drugs could be measured and adjusted properly, many physicians used methylphenidate to counteract the sedative effects of seizure drug therapy. The safety and efficacy of methylphenidate in children with a combined diagnosis of seizure disorder (epilepsy) and attention-deficit disorders were studied in 10 children. The performance of school children was assessed by a teacher rating scale, finger tapping test, matching familiar figures test and tests measuring reaction time. The children receiving seizure control medication did not have any episodes or changes in brain wave patterns during the study period. Methylphenidate drug therapy in combination with antiseizure medication appeared to be safe and effective treatment for ADD. Physicians should be aware that the children in the study had good seizure control during this short-term study, which used the lowest dose of methylphenidate possible. Since results may not be applicable to all children, the use of seizure control medications in combination with methylphenidate therapy for ADD should be exercised with caution. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Evaluation, Anticonvulsants, Methylphenidate, Epilepsy in children, Pediatric epilepsy

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Child maltreatment and the development of posttraumatic stress disorder

Article Abstract:

Children who have been abused or who have witnessed abuse of family members may be at risk for posttraumatic stress disorder (PTSD). This mental disorder can cause the child to re-experience traumatic events, lose interest in activities, or become anxious and agitated. Researchers interviewed 101 severely abused children between 6 and 12 years old and determined that 39 of them could be diagnosed with PTSD. These children included 63% of the sexually abused children, 52% of the children who witnessed family violence, and 48% of the emotionally abused children. It was also found that a longer duration of abuse or exposure to violence increased the risk of developing PTSD.

Causes of, Abused children, Post-traumatic stress disorder in children, Childhood post-traumatic stress disorder

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