A new study adds further fuel to increasing concerns about overmedicating children suffering from ADHD. Many children suffering from ADHD who exhibit aggressive behaviors are currently being treated with antipyschotic medications. But recently released research published in the October issue of Pediatrics suggests antipsychotics may not always be necessary to curb aggressive tendencies.
The study, led by Dr. Joseph C. Blader, assistant professor of psychiatry at the Stonybrook University School of Medicine in New York, indicates that consistent and well-monitored use of stimulant medications alone can reduce or eliminate aggressive behaviors in at least half of ADHD cases accompanied by oppositional defiant disorder or conduct disorder.
Dr. Harold Levinson, director of the Levinson Medical Center for Learning Disabilities in Great Neck, N.Y., and author of “The All-in-One Guide to ADD and Hyperactivity,” says his own findings support the new study. “By controlling a lot of environmental factors and giving milder doses of medication, you can reduce the number of children who may need antipsychotics,” he says.
Levinson feels that a lot of the aggression some children with ADHD exhibit is the result of frustration associated with the symptoms of the disease, like inability to concentrate or learning disabilities, and that it’s best to first address those milder symptoms. If a child can perform better in school with less distraction, he might not be inclined to be aggressive.
Dr. Joseph Shrand, instructor of psychiatry at Harvard Medical School and an assistant child psychiatrist at Massachusetts General Hospital, agrees. “If a kid with ADD feels stupid, in trouble all the time, worthless and without value, then he or she becomes aggressive,” he says.
Levinson feels many children are being “sedated” by antipyschotics. “Use of these medications is only to save lives, not to sedate children,” he says. “We need to be armed with a better perspective on what the underlying causes of ADHD are.” He feels parents, teachers and even medical professionals are often too quick to treat ADHD with medication before trying other alternatives.
In his own research, Levinson has found that when he treats ADHD sufferers with inner ear-enhancing anti-motion sickness antihistamines and fish oil, he often sees improvements in concentration, coordination, balance and school performance, resulting in less disruptive and aggressive behaviors even without the use of stimulants.
That doesn’t mean, however, that all children will respond to alternative therapies. “Some kids may be overmedicated,” Shrand says, “but that does not mean medication is not useful when prescribed correctly.”
The Stonybrook study supports the idea that physicians need to monitor drug administration more carefully. With the consistent and closely monitored use of stimulants, many ADHD children with aggressive behaviors could forgo the use of antipsychotics and even reduce the dosage of their stimulants. The study followed 65 children, ages 6 to 13, suffering from ADHD as well as associated oppositional defiant disorder and conduct disorder.
“The best medicine in the world will not override bad parenting,” Levinson points out. “You have to recognize all the dynamics of the disease and not just put the kids on medication.”
source: Deborah Huso
Dr. Gnap is a family practice physician and behavioral medicine specialist in suburban Chicago. Dr. Gnap developed the Inner Control™ Program in 1970 and has worked with thousands of people to improve and correct medical, emotional, behavioral and learning problems including performance. He started the Inner Control program because so many patients asked, “what more can be done along with traditional treatment methods?”