Study of Kids with ADHD Raises Questions About Drug Treatments

A study of Attention Deficit Disorder among Finnish children reinforces the idea that children outgrow some of their symptoms, but also raised some questions about the long-term effectiveness of medications as a treatment for the condition.

Dr. Susan Smalley, of the University of California/Los Angeles, used data from a longitudinal Finnish study begun in 1986. Researchers from Finland's University of Oulu and Imperial College in London collected information on 9,432 children from the time of their mothers' pregnancies until adolescence. About 457 of the children were evaluated for ADHD and other psychiatric disorders.

Dr. Smalley found that symptoms of hyperactivity and impulsivity decreased as the children grew older, but symptoms of inattention continued into adolescence. Only about half the adolescents diagnosed with ADHD had cognitive deficits in working memory, inhibition, etc that are commonly associated with ADHD. Those with cognitive defects did not show increased levels of inattention or hyperactivity compared to others with ADHD.

Youth in Finland rarely take medications for ADHD. Dr. Smalley found that when she compared children with ADHD in Finland who did not take drugs to those in the United States who did, she could conclude that prevalence, symptoms, psychiatric comorbidity and cognition was equivalent for both groups.

"We know medication is very effective in the short-term, but the study raises important questions concerning the efficacy of ADHD treatment," she said.

Two genes labeled DBH and DRD2 that regulate dopamine were associated with ADHD in the Finnish population of adolescents.

This study appears in the Journal of the American Academy of Child and Adolescent Psychiatry.

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New Study Launched by Norwegian Institute of Public Health

Though it's relatively easy to find information on how to treat ADHD, information for making an accurate diagnosis is harder to come by. To that end, the Norwegian Institute of Public Health has launched what's being called an "unprecedented" study to find causes and early warning signs of ADHD among pre-school age children.

"ADHD is frequently diagnosed but little is known about the causes, despite all the published research. Today there are no diagnostic criteria for ADHD in children under 6 years of age. The ADHD study intends to address many unanswered questions around the causes of this condition."

What makes the study unique is that researchers have access fetal and early infancy biological information, including blood samples from both parents and the child's umbilical cord. The samples will allow for testing of both genetic and environmental links to ADHD. Read more at MediLexicon.com.

Iron May Aggravate ADHD

A team of French researchers has discovered a possible link between iron deficiencies and ADHD. Lead researcher Eric Konofal, MD, PhD was curious about iron and its role in ADHD after several other studies found correlations between it and general restlessness and inattentiveness.

"...Konofal and colleagues measured blood levels of the protein ferritin in 53 children with ADHD and 27 children without ADHD but who had a mild reading disability. Ferritin allows the body to store iron and is used as a measure of iron levels. Eighty-four percent of children with ADHD appeared to have abnormally low ferritin levels, compared with 18% of children without ADHD."

Konofal says that, while the link between iron deficiency and ADHD symptoms is clear, it's too soon to recommend that kids with ADHD start taking iron supplements. The reason for the deficiency has yet to be determined.

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OCD in Kids Often Stays Hidden for Years and Years

More teachers and school administrators should familiarize themselves with Obsessive/Compulsive Disorder (OCD), an anxiety-causing disease that affects between 1% and 2% of all children.

Dr. Kathleen Rupertus, a specialist in OCD, spoke before the OCD National Conference this week in Dallas, Texas. She said that the disease is often not diagnosed until adulthood. Persons with the disorder often wash their hands hundreds of times a day, chant to themselves, count things, and otherwise engage in repetitive behaviors. Unless a parent informs his child's teacher about the condition, it usually goes undetected and causes the child undue suffering. For example, children with OCD may constantly rearrange their pens or do their homework thirty times over. They usually have trouble making friends.

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Treatments for Kids with ADHD Work, but Need Monitoring

A new study from the National Institute of Health suggests that treatments for Attention Deficit Disorder can help youngsters, but doctors need to monitor them from time to time.

Researchers assigned 600 children ages 6 to 9 years randomly to one of four treatment groups. The first group received medications from ADHD specialists. The second received medications and behavioral therapy. The third group received drugs from their family doctors, and finally the last group received only therapy. After fourteen months, the first two groups improved the most. However, three years later, all four groups showed similar improvements and the advantages of medications waned.

"Many kids do better over time," said Peter Jensen, director of Columbia University's Center for the Advancement of Children's Mental Health. "They should start drugs and stop as needed."

This study appears in the August issue of the Journal of the American Academy of Child and Adolescent Psychiatry.

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Children's Programming may be Linked to ADHD

Dr. Dimitri Christakis, a pediatric researcher at Children's Hospital in Seattle, recently conducted a study on the effects of television on young children. He found that children between the ages of 1 and 3 who watch an hour of TV per day are 10% more likely to develop attention problems by the time they're 7-years-old.

"Children's programmers use a technique called the 'orienting reflex', known as OR, to capture and keep a child's attention. OR works this way: If we see or hear something the brain doesn't recognize as the correct sequence or a typical life event - such as a dancing alphabet or quick zooms and pans, we focus on it until the brain recognizes that it doesn't pose a threat. The problem with watching too many programs that rely on OR is that real life becomes slow and boring by comparison."

Continued exposure to this type of input conditions causes the mind to expect it all the time. When a child's mind has been conditioned in this way, but doesn't receive the high-intensity input, the child becomes bored and inattentive. Read more at MSNBC.MNS.com.

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Slow Growth in Children taking ADHD Medication

Samar Rahha is an MD at Riley Hospital in Indiana who's recently discovered an unusual trend among children being treated for ADHD; they're shorter. Nearly 25% of young patients who were seen by a pediatrician because of slow growth were also on some type of ADHD medication.

"Children on ADHD medications may grow slowly, but most of them eventually experience catch up growth and reach normal adult heights. Strikingly, this study finds that short children medicated for ADHD were just as likely as those who are not on these medications to have other hormonal disorders contributing to their short stature."

What does this mean? Dr. Rahhal believes her findings call for further study, but she also wants to reassure parents that if their children are taking ADHD medication and aren't growing quickly, that the slow growth may not be a side effect of the medication. Read more at EMaxHealth.com.

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Scientists Discover How People Pay Attention

A group of researchers from Australia have conducted a breakthrough study that may help explain what causes things like ADHD and schizophrenia. The study was published today in Science and shows that there are complex interactions taking place between two areas of the brain when an object catches the eye.

"It seems that a high part of the brain... stimulates activity in a lower area responsible for processing visual information... This interaction between the two areas helps to select those signals from the visual world which should be processed further..."

The research team hope this is a first step toward better understanding how different parts of the brain work together to influence attention. Read more at News.com.au.

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Nicotine to Treat ADHD?

Researchers at the University of California, Irvine think they've found an unexpected treatment for cognitive disorders associated with things like Alzheimer's and ADHD: nicotine.

"The compounds target receptors in the brain that are activated by nicotine. They impart the beneficial effects of nicotine - specifically enhanced cognition - without the numerous health threats associated with smoking."

The three-year study focused mainly on treating schizophrenia and was conducted using rodents. Further animal work will be done before the compounds are testing on humans. Read more at ScienceDaily.com.

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Study will Compare ADHD Medications Effects on Sleep and Moods

University of Illinois researchers will be conducting a 10-week study on two of the most popular stimulant medications used to treat ADHD. The study will focus on the medications effects on sleep and overall mood.

"According to [Dr. Mark] Stein, short-term studies have found that ADHD patients often experience success with stimulant medications, but they discontinue treatment prematurely, perhaps due to common side effects that include sleep problems, decreased appetite and mood swings."

Patients in the study will range from ages 10 to 17, and will be monitored on a weekly basis. Some patients will receive medication, while others will receive placebos. Read more at News-Medical.com.

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Different Regions of the Brain Determine Distractibility & Focus

Scientists at the Massachusetts Institute of Technology have discovered that one part of the brain "pays attention" and another part of the brain "gets distracted" at the same time.

Their research has implications for helping people with Attention Deficit Disorder.

"The ability to willfully focus your attention is physically separate in the brain from distracting things grabbing your attention," Earl Miller, the neuroscientist who led the study, said.

Miller's team trained monkeys to pick out red triangles on a video screen in return for a treat. However, sometimes the monkeys were deliberately distracted from their task by flashing bright rectangles. During times of concentration, the executive centers of the monkeys' brains in their prefrontal cortexes were in charge. However, when they were distracted, their parietal cortexes near the back of their brains took over. This study is the first time that scientists got a good look at how these regions of the brain work.

Miller said that it is their hope to find treatments to boost attention. This study appears in the March 30, 2007 edition of Science.

Children in Hospitals Harmed by Off-Label Drugs

Doctors routinely prescribe drugs to hospitalized children that have not been tested on children, according to a new study by the U.S. Pharmacopeia. About 12% of the children taking such medications suffer harmful effects.

Researchers with Pharmacopeia, an agency that sets drug industry standards, reviewed records of 11,000 medical errors from 500 hospitals between 1998 and 2005. The errors involved 700 different drugs, causing 165 harmful effects – including the death of one child.

In another study of 31 children's hospitals for the year 2004, 79% of the hospitalized children received "off label" drugs or those that had not been tested on pediatric patients.

Only a small number of drugs are tested on children, because it is not required by law. Children with bi-polar disorder, conduct disorder, autism and other conditions routinely take "off label" drugs.

ADHD Not Just an American Condition

The use of ADHD medications is growing worldwide, which dispels the idea that it's a condition unique to Americans. Currently, usage rates are increasing faster in countries like France and Japan.

"A lot of people are saying this is an American problem and that medications are over prescribed in this country. This (study) shows other countries are finding they have the same problems."

The study looked at the use of psycho-stimulant medications globally and found that the number of countries using these medications increased from 31 to fifty-five.

Read more online.

Study Shows Near-Tripling of Global ADHD Drug Use

The use of drugs to treat attention-deficit/hyperactivity disorder, or ADHD, has more than tripled worldwide since 1993, U.S. researchers reported on Tuesday. And spending on such drugs rose nine-fold between 1993 and 2003, the team at the University of California, Berkeley reported. Read more online.