Remedies for Attention Deficit Disorder
When diagnosed with Attention Deficit Disorder (ADD) or Attention Deficit Hyperactive Disorder (ADHD) you are given medication to solve the problem. You have so many choices of medications to take; herbal or stimulants? I was diagnosed with ADD when I was in third grade and have grown up on and off medication because of personal preference. I think a solution may help others who have been diagnosed with ADD and are looking for alternate solutions to handling their disorder. If one solution doesn’t work then they should be knowledgeable of what else there is out there and what the best solution might be.
I do not know the details of each solution for treating Attention Deficit Disorder, but I do know some of the solutions. From my initial research I know all the symptoms that need to be addressed by the solution. A high percentage of children in America are diagnosed with ADD/ADHD and scientists have done many studies to find what helps children and adults solve this problem. It is a behavioral disorder with the symptoms being developmentally inappropriate levels of attention, concentration, activity, distractibility, and impulsivity. From personal experience, I have used only one remedy being the medicated stimulant, and have been possibly weighing in other choices. Attention Deficit Disorder or Attention Deficit Hyperactivity Disorder can be treated with the use of medicated stimulants, psychosocial therapy, and cognitive -behavioral therapy.
The first treatment for ADD had always been known to be stimulants or some kind of drug medication. Wender writes “Approximately two thirds of ADD children respond well to one of these drugs” (60). This means that they respond to the stimulants given by a physician believed to aid in their problem. The medications used to treat ADHD are psychoactive. This means they affect the chemistry, and thus the functioning, of the brain. The most well known stimulant drugs used to aid in ADD or ADHD are methylphenidate (Ritalin, Concerta, Methylin, Metadate CD), dextroamphetamine (Dexedrine or Dextrostat), and Dextroamphetamine and amphetamine mixture (Adderall). Other medications used to treat ADHD are Pemoline (Cylert), and Atomoxetine (Strattera). (Wiley) For many people, these medicines dramatically reduce their hyperactivity and improve their ability to focus, work, and learn. Studies have found that stimulant medication improves ADHD symptoms in 75% to 80% of ADHD children. The side effects usually resolve and do not take away from the overall positive influence (Wiley). The uses of each stimulant and nonstimulant tend to vary in treatment and effects.
Methylphenidate is believed to be the most well known and widely used drug of choice. Safer and Krager states “93% of medication used to treat hyperactivity and inattention was methylphenidate” (260). A study of ADHD children by Pelham, Bender, Caddell, Booth and Moorer describes the results to be “demonstrated to lead to a dramatic reduction in negative behaviors with a concomitant increases in classroom on-task behaviors” (948). The medication has also been known to affect peer relationships, family relationships, self-esteem, and academic achievement. The negative effects are described by Wender, “In both children and adults the stimulant drugs decrease appetite and tend to interfere with sleep” (67). These problems can be resolved through the timing of taking the medication and ignoring the decrease of appetite. The only negative part of this medication is the mindless zombie-like state in which a child is sub-due being on Ritalin (Wiley). Sometimes if the medication does not aid the individual, then they can turn to an amphetamine.
The most widely prescribed amphetamine would be Adderall. Its description is to solve the core impairments of ADHD being inattention, hyperactivity, and impulsivity. It is believed to aid in solving the challenges of poor performance, troublesome peer relationships, and low self-esteem by directly acting on dopamine and/or nor epinephrine in the brain. The efficiency of Adderall XR (a long lasting 12 hr stimulant) in the treatment of ADHD was established on the two controlled trials in children ages 6 to 12 and one controlled trial in adults who met DSM-IV criteria for ADHD, and the immediate release Adderall. The most common childhood side effects were loss of appetite, difficulty falling asleep, abdominal pain, and emotional liability. The most common for adults were dry mouth, loss of appetite, insomnia, headache, and weight loss. This medication can lead to dependency and misuse can cause serious cardiovascular side effects (Shire Inc.) It is believed to be a better choice than Ritalin because it seems less harsh and with less mood swings from medication.
Pemoline is said to improve attention while decreasing distractibility and levels of restlessness. The negative side affects were considered similar to other stimulants and included anorexia and insomnia. Wiley explains “Pemoline has the disadvantages of two-to-four week delayed onset of action and worrisome reports of liver function abnormalities in a few children” (266). Recently they have discovered the side effects in the liver and it is now being discontinued in the US market because of declining sales. Jaffe “would interpret this information to indicate that liver function tests should be done before and periodically when using pemoline and that history of liver disease/dysfunction should be a contraindication”(458). Pemoline is not considered a first-choice therapy for ADHD due to the reports of severe acute liver failure. Pemoline has previously been removed from the market in the United Kingdom and Canada. The bright side to the medication was the less restrictive government regulations.
Atomoxetine, also known as Stratterra, is not a stimulated medication, a newer preference that has unknown long-term side effects. It is not a controlled substance and is not considered a drug of potential abuse by the US Food and Drug Administration (FDA). The effectiveness is questionable pertaining to the individuals but it has less frequent dosage and does not have side effects that affect sleeping or eating appetite. Eli Lilly, owner of the productions of Strattera explains “The most common side effects were upset stomach, decreased appetite, nausea or vomiting, dizziness, tiredness, and mood swings.”(Internet) The side effects are less prominent in this medication then the others and this is a simpler medication. Although recently during a conversation with Dr.Swenson at Richland Creek Psychiatric Center, he mentioned that in late December 2004 a study came to show that there was a high risk of liver damage and patients were urged to have liver transplants. The medication is now being carefully studied to discover what can be done to prohibit this side effect.
The results of taking the medications has proven to help treat ADHD/ADD symptoms but not completely solve the problem. The medications can’t solve the problem but temporarily for a solution to help aid the individual until they grow out of it or whatever their physician may advise. Wender explains “Medication is necessary until the brain, through its own growth and development, begins producing adequate amounts of the required chemicals” (57). Medications are used to solely to produce more neurotransmitters in which the brain tends to lack. Wender comments “Many ADD children do need medicine to control their problems.” The results of the medications that rarely occur are severe depression, toxic psychosis with delusion or hallucination, and 1% of treated children develop tics. Other concerns are permanent growth suppression and an increase likelihood of drug addiction, criminal behavior, and suicide or mental illness (Wiley). Even with the predominate side effects of medication, it seem to be the best solution to aiding the symptoms of ADD/ADHD.
Psychotherapy is ADHD coaching, a kind of support group to help feel normal and provide peer feedback and coping skills. The counselors such as psychologists, child and adolescent psychiatrists, behavioral/developmental pediatricians, clinical social workers, and advanced practice nurses, can be invaluable to both the ADHD/ADD patient and their families. It is counseling in which is necessarily in a greater understanding of their ADD/ADHD children who experience failures leading to feelings of helplessness and an inability to understand the expectation by the environment in which they can’t meet (Wiley). Usually the counseling is to help cope with the feelings of having ADHD, and others reactions to the behavior of ADHD. “Constant criticism can lead to low self-esteem, and a person who has been feeling self-loathing for many years is likely to respond defensively to current interactions in unhelpful ways. The therapist will explore past and current feelings and work with the individual to forge new ways of interacting” (helpguide internet). The main point of therapy is for the individual to like and accept themselves with this disorder. The first component in the psychological treatment of the ADD adult is education. The patient has to learn the symptoms of his or her that cause him or her problems in daily life by self-recording themselves (Wender). Although they have found that the group therapy is sometimes a better aid because it provides a variety of benefits. It provides support, reassurance, freedom to express feelings, assessments of interpersonal behavior, experimenting with behavioral changes, praise for behavioral modification and learning from other at various levels of treatment. (Wender) The behavior modifications and family therapies are usually necessary for the best non-medicated outcome. Wiley mentions that non medication intervention programs are more costly than medication, both in terms of the financial resources required to support the therapy and also in terms of personal resources required by the family.
Cognitive-behavioral therapy helps people work on changing or modifying their behavior. Than focusing on their feelings or actions, and making an effort to be responsible for the individuals own behavior. Wiley explains, “Through different thinking, children gain self-control and the ability to modify their behavior as they interact with the environment” (268). It is believed that over time the consistency of reinforcement of negative and positive behavioral change will produce more long term behavioral improvements. The only problem is there will be no immediate results and it may be very difficult with the ADHD/ADD individual will have off and on days.
The treatment of ADD/ADHD can be found in medication, psychosocial therapy and cognitive-behavioral therapy. The dominate solution for treatment is stimulant medication like Ritalin, and Adderall. Pemoline and Stratterra seem to be possibilities but have negative side effects of damaging the liver. Another alternative to medication would be psychosocial therapy in which the individual seeks counseling or some kind of help to discuss problems and feelings to become more equipped with understanding their symptoms. On the other hand, cognitive-behavioral therapy seems to try and help the individual form a systematic approach to learning responsibility for their behavior and not their actions. Medication can be aided in either therapy and is recommended but may also be absent from the therapy. The most widely and positive remedy for ADD/ADHD has been the stimulant medication to which decrease inattention, hyperactivity and other behaviors. There are some side affects of insomnia and decrease in appetite but they seem minimal to the contributed benefit of the medication. The medication may not help long term but can be combined with both therapies and is recommended. Overall, there is always hope to survive with ADD/ADHD and live normal lives like your peers.
Works Cited
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Lilly, Eli. Strattera - Side Effects. 13 Feb. 2003. Lilly and Company. 25 Apr. 2005 <http://www.strattera.com/1_2_taking_strattera/1_2_2_effects_children
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Pellham, W. E., Bender, M. E., Caddel; J., Booth S., & Moorer, S. H. Methylphenidate and children with Attention Deficit Disorder: Dose effects on classroom, academic and social behavior. Archives of General Psychiatry, 1985
Swenson. Personal interview. 28 Apr. 2005.
Safer, D.J., & Krager, J. M. A survey of medication treatment for hyperactive/inattentive students. Journal of the American Medical Associations, 1988
Wender, Paul H. The Hyperactive Child, Adolescent, and Adult. 1973, 1978. New York: Oxford University Press,1987.
