As many as 10% of children suffer from attention deficit-hyperactivity disorder (ADHD), a neuropsychiatric behavioral disorder characterized by inattention, hyperactivity, and impulsivity. ADHD can cause significant functional, social, and psychological impairment in children and adults. ADHD treatment in children has been controversial, since the mainstay of treatment is stimulant medications, including methylphenidate and amphetamines. Parents are appropriately concerned about giving their children powerful medications that can lead to liver damage, addiction to stimulants, or abuse of stimulants or illicit drugs. But, untreated ADHD can have dangerous repercussions, including the development of psychiatric disorders. Now, the benefits might outweigh the risks of stimulant medications as a new study reports that stimulants are actually protective against the development of significant psychiatric disorders associated with ADHD.
The authors of a recent study published in the journal Pediatrics evaluated 140 white male children with ADHD over a 10-year period. They assessed the relationship between treatment with stimulants in childhood and adolescence and the later development of psychiatric disorders, as well as grade level retention. The subjects with ADHD were compared to a group of 120 age- and gender-matched children without ADHD. At the beginning of the study, the children were between the ages of 6 and 18 years old; at the 10-year follow-up, the mean age was 22 years. Nearly three-fourths of the children with ADHD had been treated with stimulants sometime during the 10-year study period. The authors reported that these children were significantly less likely to develop anxiety and depressive disorders or exhibit disruptive behavior in young adulthood compared to ADHD children not treated with stimulants. These children were also less likely to repeat a grade level compared with untreated children. Overall, the authors conclude that stimulant treatment decreases the risk for the development of psychiatric disorders and academic failure in children with ADHD.
Untreated ADHD is associated with the development of significant and potentially dangerous disorders: major depression, anxiety disorders, conduct disorders, oppositional-defiant disorders, and bipolar disorders. In the Pediatrics study, the only disorder for which the risk was not lowered with the use of stimulant medication was bipolar disorder. This is likely due to the fact that bipolar disorder has very different causes than the other ADHD-related conditions.
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