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Spotlight on ADHD drugs

Big drop in drug abuse among ADHD patients
Sep 27, 2007 6:00pm AEST

Mr Carpenter hopes the creation of two new clinics to treat teenagers with ADHD will lead to a further decline in prescription and abuse rates. (ABC)
The State Government says there has been a significant decline in drug abuse among teenagers due to a drop in the number of prescriptions for amphetamines to treat attention deficit hypoactivity disorder.

About 7,000 teenagers were prescribed with medication for ADHD last year, compared to 18,000 in 2002.

The Premier Alan Carpenter says statistics show the level of amphetamine abuse has also dropped.

Mr Carpenter has told Parliament he hopes the creation of two new clinics to treat teenagers with ADHD will lead to a further decline in prescription and abuse rates.

"Whilst medication may still be required for severe cases of ADHD, this new approach will ensure that stimulant medication is not the first line of treatment," he said.

"If our recent history is any guide, reducing ADHD prescription rates will reduce abuse rates."
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ABC Online
 
Taxpayers foot ADHD pill bill
By Kelvin Bissett
October 01, 2007 12:00am

THE bill to taxpayers for attention deficit disorder drugs is surging towards $1 million a month as thousands more children are placed on costly tablets added to the Pharmaceutical Benefits Scheme this year.

Driving up the cost are three longer-lasting methylphenidate drugs, marketed under the brand Concerta, listed on PBS on April 1.

These drugs generated 7882 subsidised scripts in May alone.

Estimates by The Daily Telegraph, based on Department of Health and Ageing data, show the monthly subsidy for treating ADHD has blown out from about $360,000 in June 2006 to about $900,000 in May this year.

The estimate is based on about 50 per cent of the new scripts being for concession-card holders, who pay just $4.90, with the remainder paying the $30.70 standard PBS payment.

Taxpayers face even bigger bills with yet another drug, atomoxetine, marketed under the brand name Strattera, placed on the PBS subsidised list in July.

Children and adults diagnosed with ADHD have symptoms including difficulty paying attention, controlling impulsive behaviours and keeping their thoughts on track.

The Federal Government is subsidising the new drugs despite Prime Minister John Howard in April stating he was "very worried" about the rate of prescription of ADHD drugs.

The Government is also yet to hear from a working party established by the Royal Australasian College of Physicians at its request to devise diagnosis and treatment guidelines.

The Government has announced these guidelines have been delayed until the second quarter of 2008, despite being timetabled for October.

Figures released by the Department of Health and Ageing under Freedom of Information show a total 52,608 scripts were issued in May for all ADHD drugs, up from 48,336 in May 2006.

The medications added to the PBS from April 1 were methylphenidate 18mg, 36mg and 54mg tablets, each marketed under the Concerta brand. The 54mg costing $93.24 per script.

The other two drugs on the PBS, methylphenidate 10mg - marketed as Ritalin 10 - and dexamphetimine sulphate, cost about $22.

Opposition health spokeswoman Nicola Roxon attacked the Federal Government for delays in the guidelines.

"Parents and doctors have been left in the dark for almost two years - and now another delay," she said.

Referring to the fast rising PBS bill, Ms Roxon said that without guidelines "it is impossible to know if this money is being spent wisely".

ADHD expert Dr Jon Jureidini, head of psychological medicine at the Adelaide Women's and Children's Hospital, said there was "no good evidence" to support the use of long acting drugs saying they should not be subsidised.
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Daily Telegraph
 
Doubts over attention deficit disorder drug
Charles Miranda
November 13, 2007 12:00am

DRUGS used to treat attention deficit hyperactivity disorder have no long-term effectiveness and could stunt children's growth.

And scientists have conceded test results that prompted the parental craze to dole out the drugs to their children may have been exaggerated.

In what is sure to generate debate, Britain's Panorama program has aired the results of an influential long-term monitoring program of 600 children across the US since the early 1990s.

The Multimodal Treatment Study of Children with ADHD concluded that while drugs such as Ritalin and Concerta worked in the short term, there was no demonstrable improvement in children's behaviour after three years of medication.

In Australia, the use of the prescription drugs has been treated by some as a panacea for disruptive behaviour by their children. The popularity of ADHD drugs doubled during the past few years and had caused medical authorities some concern.

Eight years ago, studies found one year of medication worked better than behavioural therapy in a finding that influences medical practice.

But the report's co-author from the University of Buffalo in the US, Professor William Pelham, said he now believed the findings were overstated.


"I think that we exaggerated the beneficial impact of medication in the first study," he said yesterday.

"We had thought that children medicated longer would have better outcomes. That didn't happen to be the case.

"The children had a substantial decrease in their rate of growth so they weren't growing as much as other kids both in terms of their height and in terms of their weight. And the second was that there were no beneficial effects - none.

"In the short run (medication) will help the child behave better, in the long run it won't. And that information should be made very clear to parents."

The influential BBC Panorama television program found last year that ADHD drugs had cost the public health system in Britain more than $60 million.

The program aired disturbing footage of a 14-year-old Briton who had been on ADHD medication for a decade. His family kept a video diary of his behaviour and he had recently assaulted three school teachers.

Dr Tim Kendall, of the UK's Royal College of Psychiatrists, said: "A generous understanding would be to say that doctors have reached the point where they don't know what else to offer."

Professor Pelham believes behavioural therapy such as concentration tests in the first instance and a simple diet of omega-3 helped.
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Courier Mail
 
This is the same article and known stuff every month for yuears and years now. Just get rid of the stuff. Shouldnt be giving speed to kids.

Do we see anxious children being put on valium for their whole life?
 
I'm suprised to see read your answer Splatt.

Wjile I do agree to some extent that it has been misdiagnosed for some time, there is also a difference between 'giving a kid speed' to shut him up, and having to lock one up for bad behviour caused by diagnosed add/adhd that could easily be treated with stimulants.
I believe the stims should be a last effort medication with add/adhd, thereare alot of other things they can try first, like cognitive behaviour, effalex (fish oil supplements) and whatnot.
But if it came to the crunch and my kids couldn't have a normal childhood without being on stims, then I would agree for them to be on them.

That report has probably been written by the Scientologists, they've been harping that shit for years.
 
Anyone seen the BBC documentary: Secrets of the drug trials?
It shows how the giant Pharmaceutical companies manipulate results of drug trials in order to market out the so called "benefits" to the medical comunity. It's all about money making, they don't give a shit about the kids.

IMHO, most of the psychological disorders in kids are actually projections of the parents onto the children. The child shows symptoms, while the adult can live happily with their abnormal behaviours.

To really treat these problems the parents would have to look into their unconcious minds, understand what is happening and seek ways to change...
Once the parents change the child would probably change as well without needing any medication or psychotherapy.

However, modern medical trends are moving insight and self knowledge further and further away from it's proposed line of work. Psychoanalysis is something from the past. Science seeks desparately to prove everything is related to genes and genetics. Psychiatry seeks to claim everything is related to neuro transmiters. Freud and Jung are dead... Why seek understanding when you can just dumbly pop a pill ?
 
rm2x said:
While I do agree to some extent that it has been misdiagnosed for some time, there is also a difference between 'giving a kid speed' to shut him up, and having to lock one up for bad behviour caused by diagnosed add/adhd that could easily be treated with stimulants.
I believe the stims should be a last effort medication with add/adhd, thereare alot of other things they can try first, like cognitive behaviour, effalex (fish oil supplements) and whatnot.
But if it came to the crunch and my kids couldn't have a normal childhood without being on stims, then I would agree for them to be on them.

That report has probably been written by the Scientologists, they've been harping that shit for years.
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i read a fantastic book (new age) called the indigo child that claims that during the mid 70s-80s a generation of human beings were born with enhanced gifts and were given the name " the indigo children". they are children of light and love (similar to the ashtar command) and were sent to earth to bring a dawn of peace. apparently their aura possesses a strong indigo/purple shade than can be clearly seen by the trained eye. links between indigos and ADD/ADHD has been a long standing argument; as the correlation between the two is uncanny and modern day meds just dont seem to work with these children/adults (generally).

there has been a kelp based alternative (which i will rifle through my books to find the name of) discovered for treatment; that has a HUGE success rate, and little side effects.

im not anti modern day medicine; although believe that you should exhaust all of your natural therapies and or diet/lifestyle adjustments BEFORE contemplating pharmaceutical alternatives.

...kytnism...:|
 
Lol. Blutty Hell! He was a hippy wasn't he. </rik mayal voice>

But seriously i've thought several things like this (although more to do with evolution) with mental disorders including ADD/ADHD, schizophrenia, even down syndrome....
 
Kids' $10m ADHD drug habit
By Kate Sikora and Kelvin Bissett
January 05, 2008 12:00am

TAXPAYERS will be forced to pay almost $10 million a year to treat children suffering behavioural problems with ADHD drugs.

Federal Government documents reveal Australia's reliance on the controversial drugs has already cost taxpayers almost $5 million in the past six months.
As thousands of children are placed on the expensive tablets, it can be revealed the cost to taxpayers has quadrupled since last March - before Concerta and Strattera were added to the Pharmaceutical Benefits Scheme.

Those drugs, with Ritalin and dexamphetamine, have cost taxpayers $4.8 million in subsidies between April and August, according to the health department.

Despite concerns over the nation's rate of overprescribing, doctors wrote 50,701 scripts for the two new drugs in August alone. Previously, parents whose children were on Concerta were forced to pay about $150 per script, but now only pay about $30 through the PBS.

Concerta and Strattera are fast becoming many parents preferred ADHD drug due to their longer-lasting effects.

Instead of teachers having to dole out pills up to three times a day during school, children can take the slow-releasing capsules containing a higher dosage.

Despite controversy surrounding Strattera due its side effects - including suicidal tendencies, nausea and tiredness - it has already clocked a $364,910 bill since August.

Australia's dependency on ADHD drugs is now the subject of two reviews by both the NSW and Federal governments.

It is expected guidelines into how the drugs are prescribed will be overhauled.

Federal Health Minister Nicola Roxon yesterday refused to comment on the drug bill taxpayers are footing.

However, last year when she was in Opposition, Ms Roxon attacked the Government for keeping parents in the dark over the use of the stimulants.

Many believe GPs rely too heavily on prescribing, rather than helping families with better parenting skills.

The University of NSW's Florence Levy has been studying ADHD for the past 30 years.

Professor Levy said yesterday there was a need for medication but also recommended alternative treatment.

"Nobody likes using medication in children," Professor Levy said. "There are certainly a number of children who are helped by medication.

"I think the reason it's an area of interest is because people have very strong views on how to raise children."

Australian Childhood Foundation CEO Joe Tucci said the figures were alarming, especially the rate of prescriptions.

"It reflects that many prescribing doctors are still medicating for ADHD," Dr Tucci said. "They are not treating the cause of the behaviour, just the symptoms."

The State Government's report into ADHD was expanded to include an audit of prescriber's medical records to ensure compliance with guidelines. It is due to be handed down at the end of this month.
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Daily Telegraph
 
dexies ruined my life.

from 13 till i was 17 and i believe it done me severe damage....then i went and caused even more damage by using opiates to stop my head screaming at me and to sleep....im now turning 24 this year and in rehab, full of naltrexone implants...

dont even get me started on this shit.
 
Depone said:
dexies ruined my life.

from 13 till i was 17 and i believe it done me severe damage....then i went and caused even more damage by using opiates to stop my head screaming at me and to sleep....im now turning 24 this year and in rehab, full of naltrexone implants...

dont even get me started on this shit.
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I really doubt dexies ruined your life, although they might have had some part in it. Chances are you ruined your own life for abusing the Dexedrine and using opiates. No offense.
 
Adrenochrome said:
They're never going to replace Dex, it is never going to happen, what is going to happen though is the prodrug (and if daytrana sells and proves to be bettet than Vyvanse they'll reopen their trials for dex patch), dex is the MOST effective drug for ADHD the only thing i see replacing it is Desoxyn, but not anytime soon, they are NEVER going to take away dex
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Well, considering 28 x 5mg dexedrine = x in the UK (ergo a 28 day supply at 20mg would be x), Strattera is x for a 28 day supply of 60mg tablets and Concerta is x (for 30 x 36mg - in many cases the rx would be 60x18mg tablets taken twice daily and therefore x).


I know MY surgery keeps an eye on their costs and in my case, I only require 10mg of dexedrine a day, so x Vs. x Vs. x...no question which he went for.

Concerta and Strattera sucked for me. Strattera was useless and made me nervy and worried about leaving the house. Concerta made me wired/euphoric for 40 minutes, then terrrible nausea and an awful comedown. No ADD-reducing benefits.

Dexedrine isn't fun but it isn't anything other than beneficial. I don't become an arrogant, self-opinionated asshole (as I'd expected to be). I can read, I can focus and I can happily do something dull.

Strangely enough, none of these drugs have more side effects for me than a couple of strong coffees. Dexedrine in particular is just life having your dopamine side stroked without the adrenaline excessively pumped up.

[EDIT: Please read the guidelines, no prices. hoptis]
 
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Role of stimulants in ADHD 'limited'
February 3, 2008 - 12:29PM

Stimulant drugs can no longer be considered the mainstay of treatment for hyperactivity disorders, warns an Australian psychiatrist who is urging doctors to review their patients' need for the controversial medications.

Sydney University professor Joseph Rey, a specialist in child and adolescent psychiatry, said the Australian medical community should take notice of new findings from a major US study which suggest Ritalin and dexamphetamine, the drugs most commonly used to treat ADHD, are of limited use.

The study of almost 600 children revealed that while those on stimulants did better than kids on behavioural therapy or no treatment at 14 months, there was no difference between the groups after three years. It also confirmed the drugs could stunt growth.

Prof Rey said the results of the US National Institute of Mental Health (NIMH) study should change attitudes to ADHD treatment.

"While results of one study rarely justify drastic changes of practice, the findings underscore the complexity of ADHD, show that stimulant drugs are far from being a silver bullet and that there is much we do not yet know," Prof Rey wrote in the latest Medical Journal of Australia.

"This does not mean that stimulants no longer have a place in the treatment of ADHD.

"However, that place has shrunk and clinicians should be circumspect when assessing the need for ongoing treatment, (for example) through medication breaks."

Research shows up to 11 per cent of Australian children aged six to 17 have the chronic condition, which is characterised by symptoms of inattention, hyperactivity and impulsive behaviour.

Stimulant drugs are used widely, with prescribing rates increasing almost tenfold over the past decade. Rates are highest in Western Australia where almost five in every 100 children are on the medication.

Initial results from the NIMH study released in 1999 showing the short-term benefits of medication were influential in driving up prescription rates.

But the results of the two-year follow-up showed children in the other treatment groups - those on tailored psychosocial treatment or routine community care - had essentially "caught up" to those on medication taken alone or combined with behavioural therapy.

Prof Rey said this leaves long-term benefits in doubt and suggests there might be a certain amount of "growing out" involved with the condition.

"Much needs to be done to clarify who benefits the most from medication, at what developmental point stimulants are most useful and for how long they should be taken," he said.
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The AGE
 
Too many kids given ADHD label, medication: doctor
20th February 2008, 7:30 WST

Too many children are being given stimulant medication for ADHD when many may just be going through delayed development or missing out on essential vitamins and omega-3 fatty acids in their diet, according to a Perth GP.

Dr Joe Kosterich said there was an over-use of medication because in the short term it appeared to help children, making them calmer and better-behaved.

Speaking ahead of a seminar tonight organised by the group Drug Free Attention Difficulties Support, he said recent studies threw serious doubts on the benefit of ADHD medication in the medium to long term.

“I worry about kids being labelled with ADHD unnecessarily when for some they’re just behind where other kids are at and we’re imposing certain expectations about how they should behave,” he said.

“You’ve got to ask why we have this explosion of kids being diagnosed and medicated and what else is going on in terms of schooling because every second kid now seems to be going to these out-of-school tutorial groups.”
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The West
 
Having used a variety of ADD drugs myself (ritalin, dex, strattera) I'd have to say that the biggest problem is actually confirming wether a patient actually needs the drugs or not. If you give anyone dex or ritalin, more than likely they will perform better, regardless of if they have ADD or not. What would be best would probably be a more thorough way of testing wether or not someone has ADD.

As for strattera, get rid of the shit I say. Having only used it for a short amount of time, I noticed many side effects and no positives. It was also very powerful but not in a way that enchances concentration or mental performance. I've been sensitive to any stimulant since (caffeine, meth, mdxx etc) in a way that just amplies the negative effects of those substances.
 
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National ADHD plan needed to standardise use: report
16th March 2008, 12:45 WST

Only a handful of ADHD kids are being prescribed stimulant drugs by a trained psychiatrist, with the vast majority getting treated by paediatricians who dish out varying doses, a report has found.

Population health experts are calling for a national plan to standardise treatment of the controversial condition after a new study showed “significant inconsistencies” in prescribing by psychiatrists and paediatricians.

A new report published in the Medical Journal of Australia today shows major differences in prescribing patterns between, and even within, the two clinical specialities that treat children with Attention Deficient Hyperactivity Disorder.

The study from Western Australia, where prescribing rates are 3.5 per cent higher than the national average, showed that the vast majority of ADHD children, 92 per cent, are treated by paediatricians, who have less mental health training than psychiatrists.

They generally prescribe lower doses of stimulant drugs Ritalin and dexamphetamine, though levels varied significantly from doctor to doctor.

Child and adolescent psychiatrists were more likely to give higher stimulant doses, and partner them with other medications like anti-depressants and anti-psychotic drugs.

Lead researcher David Preen, director of the Centre for Health Services Research at the University of Western Australia, said the results show significant inconsistencies in treatment for children with the disorder.

Differences in medication prescription between the two specialties may be because psychiatrists are more often referred children with psychiatric or behavioural disorders requiring multifaceted medication regimens, Dr Preen said.

“It is also feasible that the observed differences are due to fundamental variations surrounding ADHD diagnosis and treatment as a result of differing levels of mental health training.”

A WA parliamentary review in 2004 suggested that paediatricians were largely responsible for soaring prescribing rates because they had inadequate training on ADHD diagnosis and alternative non-drug treatment.

Dr Preen said there was a strong case for a federal plan to standardise treatment.

“A case could be made for the standardisation of diagnosis and treatment of ADHD within and between specialities,” he said.

“A state or national ADHD plan with consistency across clinical disciplines appears to have merit.”

The medical field has come under fire for supposed over-diagnosis and over-prescribing of stimulants to create a so-called “Ritalin generation”.

However, a NSW government review released last month stated that prescribing in the state mirrored international best practice and most of clinicians were “thoughtful and cautious” in their approach.
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The West Australian
 
hey all just had to share my experience,, back in the day (we were about 10 or 11) one of my more troublsome friends was perscribed thes dexamphetimine for so called ADD, these seemed to calm him somewhat but his deviousness and state of mind did not change, he was just able to do the shit schoolwork we all hated.. anyways he also used to hand em out, i have taken from what i can remember a quite"herioc dose" maybe 6 pills with coffie was the way he told me to do it, calmed him but made me and my other friends..(me in piticular) speed like demons no bad side sffects and although i aknowledge these reactions can happen, iv'e never known of anyone 2 have these probs with this... maybe in younger still children its mor higher to be a likley outcome, i think i saw references to kids as young as 7,,, iv'e got an 8 yr old and as much as she has troubs concertrating in class, would NEVER put her on dexies or ritilin... there uppers 4 god's sake. i'd have trouble stayin away from em=D
 
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