Drugs are one of the most common, if not the most common, treatment for ADHD. They can help individuals be more productive, calm, and in control of themselves, at least while the drugs are active. ADHD drugs are similar to prescription eye glasses. They help an individual function while they are in use, but they do not cure the underlying condition.
The Coursera class on ADHD takes the standard medical line that if used as prescribed and not abused, ADHD drugs, in most cases, cause no significant or long-term ill effects. Dr. Rostain cites statistics that stimulants are not over-prescribed for ADHD and that untreated ADHD leads to much worse outcomes than medical treatment of ADHD. Most studies on drugs for ADHD last just months, not years. Given that many individuals with ADHD take drugs for 5 years or more, and start at a young age, it is troubling that there aren’t better long-range studies on their effects.
Dr. Rostain covers many myths about stimulant drugs for ADHD. One stood out to me. The myth is that these drugs do not improve academic achievement. He states that stimulant treatment of ADHD improves work productivity, classroom conduct and rule-following, peer interactions, grades, and leads to reduced punishment, fewer days absent, and makes repeating grades less likely. So yes, on stimulants a child with ADHD will appear to be a better student and will certainly be easier for the teacher to have in class. Dr. Rostain didn’t mention that some studies have shown that psychostimulants have not been shown to achieve long-term positive changes in peer relationships, social or academic skills, or school achievement. He also did not mention that there is evidence that stimulant treatment of ADHD in juveniles can damage their developing brains. Long-term use of ADHD can also create a loss of motivation. Students, especially college students, may feel that their success is due to the drugs and a shift of agency may create a dependence on the drugs and low self-esteem.
There are three basic types of drugs used to treat ADHD: stimulants, non-stimulants, and antidepressants. Each affects the signaling of neurons in the brain in a slightly different manner and the lectures on them were too detailed to easily summarize. The comprehensive “What we know” brochure on Managing Medication for Children and Adolescents with ADHD from the National Resource Center on AD|HD is a good place to start. The last couple pages have suggested readings and then a handy reference chart for the drugs which includes the generic names, the brand names, the duration of action for each drug, the form the drugs come in, the dosage ranges, and the common side effects.
Even though there is a great deal of evidence that drugs can help treat ADHD symptoms in the short-term, they still carry risks. Risks that your pediatrician or health services provider may not mention. The best approach if you are considering ADHD drugs for your child is to learn all you can about the various drug options and then carefully, with the help of your child, monitor both the short-term and the long-term effects of any drug you give your child. Pay attention to both the physical side effects, such as stomach aches and sleep problems, and the more subtle psychological effects that may include decreased drive and motivation. Ask yourself, are you trading their initiative and innate personality for a child that is easier to live with and more compliant?