ADHD Meds Linked to Double the Psychosis Risk in Kids, Young Adults

A type of commonly-used medication prescribed to treat attention-deficit hyperactivity disorder (ADHD) has been linked to a higher risk of psychosis. The study suggests that another type of ADHD medication carries a far lower risk, but doctors are reluctant to prescribe safer medications over riskier drugs. [1]

Study leader Lauren V. Moran, MD, a psychiatrist at McLean Hospital, said:

“We looked at new users, people who are being prescribed these medications for the first time.

We compared amphetamines, which is Adderall and Vyvanse, to people who were prescribed methylphenidates, which is Ritalin or Concerta. We found that Adderall-type drugs had an increased risk of psychosis.”

Rates of ADHD have climbed sharply in recent years. More than 6 million children and teens in the U.S. have been diagnosed with the disorder, which causes difficulty concentrating, hyperactivity, and impulsiveness.

In the U.S., 5 million people under the age of 25 are prescribed ADHD medications.

For the study, Moran and her colleagues looked at data from two large commercial insurance claims databases on patients ages 13 to 25 years old with an ADHD diagnosis who began taking amphetamines or methylphenidates between 2004 and mid-2015. The sample included more than 220,000 patients.

Read: ADHD Meds Are Screwing Up Kids’ Sleep

One out of every 486 patients who started taking an amphetamine developed psychosis which required an antipsychotic medication, the analysis revealed. By comparison, just 1 in 1,046 patients taking a methylphenidate developed the condition.

Psychosis can best be described as a mental condition characterized by a disconnection from reality. People with psychosis may hallucinate, hear voices in their head, and experience delusions, such as the false belief that the government is following them or that they are in danger.

Moran explained:

“Often, when people develop psychosis, they don’t have insight so they don’t even realize that they are impaired. They think these things are really happening. It’s very scary.”

Related Read: Top 10 Legal Drugs Linked to Violence

The researchers say the increased risk of psychosis associated with amphetamine use is low, but it is no less significant, as the use of amphetamine medications in adolescents and young adults has more than tripled in recent years.

Moran said:

It seems that doctors are choosing to start people on Adderall even though existing guidelines suggest that both stimulants have similar effectiveness. So there needs to be a dialog between patients and doctors about why they’re choosing Adderall over Ritalin-type drugs.”

The findings are not entirely shocking to the scientific community. The U.S. Food and Drug Administration (FDA) required stimulant manufacturers in 2017 to add a warning to their products about the risk of psychotic episodes or manic symptoms. [2]

However, the team says that people who have been taking Adderall or Vyvanse for quite some time without any problems shouldn’t worry. The study only looked at new users, and most of the psychotic episodes occurred in the first few months of treatment. [1]

Moran said: [2]

“If someone has been on Adderall, they’re tolerating it well, it’s helpful for their symptoms, and they’re taking it as prescribed, there’s really not much cause for concern.”

The increased risk is more of a concern for those with a family history of bipolar disorder or a psychotic disorder. [1]

Moran said:

“I might shy away from Adderall in patients with that kind of history.”

The next step is for the team to “identify risk factors that actually increase one’s risk, so we can narrow down who really is at increased risk with Adderall,” Moran added. [2]

Read: Marijuana may be “More Effective than Adderall at Treating ADHD”

Chemically speaking, Adderall and meth are very similar. If that’s a concern for you or someone in your family who has ADHD, other treatments – including behavioral therapy and training for parents – are also available. [1]

The study is published in The New England Journal of Medicine.

Sources:

[1] CBS News

[2] Reuters

Study: Dad’s Smoking Habit Could Affect Future Generations

Dads who smoke could be sentencing their offspring – and the offspring of generations to come – to cognitive problems, according to a new study of mice.

When male mice were exposed to nicotine, their offspring showed signs of a mouse version of attention-deficit hyperactivity disorder (ADHD), as well as abnormal behavior and learning impairments. [1]

Study leader Pradeep Bhide, of Florida State University, said:

“Until now, much attention has been focused on the effects of maternal nicotine exposure on their children. Not much had been known about the effects of paternal smoking on their children and grandchildren. Our study shows that paternal nicotine exposure can be deleterious for the offspring in multiple generations.”

To investigate paternal nicotine exposure’s effects on offspring, Bhide and his colleagues added nicotine to the drinking water of male mice in the lab for a total of 12 weeks. They then bred those mice with unexposed females, and mated the offspring to produce a 3rd generation.

The researchers subjected the 2nd- and 3rd-generation mice to a series of cognitive and behavioral tests to see if their father’s or grandfather’s nicotine exposure had any effect.

What did they find?

Compared to the offspring born to unexposed fathers and grandfathers, these rodents struggled more with certain learning tasks. The 2nd-generation mice also showed signs of ADHD and had lower levels of certain neurotransmitters in the brain.

The findings suggest that a father’s tobacco use may prime the brains of his children and grandchildren not only for ADHD, but for autism as well.

The authors think that nicotine causes epigenetic changes in the key genes of sperm cells. They observed epigenetic changes to key genes in the exposed mice’s sperm, including 1 that is vital to brain development. [2]

What scientists need to figure out next is how many generations can be affected by a father’s nicotine use.

Bhide said:

“It is possible that some of the epigenetic changes caused by nicotine in the sperm DNA are temporary, and go away with time, which would mean that children conceived after a certain period of abstinence from nicotine use might not be affected.

Other epigenetic changes may be permanent, and may result in deleterious effects on the offspring. More studies are needed.”

Bhide and his team wonder how smoking might have affected generation after generation

“Cigarette smoking was more common and more readily accepted by the population in the 1940’s, 50’s, and 60’s, compared to today. Could that exposure be revealing itself as a marked rise in the diagnoses of neurodevelopmental disorders such as ADHD and autism?”

Source: Medical Daily

Autism was first described in a scientific journal in 1943 when Johns Hopkins researcher Leo Kanner described 11 children who had an apparently rare syndrome of “extreme autistic aloneness.” These children were so young that Kanner dubbed the disorder “infantile autism.” [3]

Late onset autism (starting in the 2nd year of life) was “almost unheard of” in the 1950’s, 60’s, and 70’s. It wasn’t until 1991 that autism was listed as a separate entity under the Individuals with Disabilities Education Act of 1975.

Today, 1 in 59 children have autism spectrum disorder (ASD), and the U.S. Centers for Disease Control and Prevention (CDC) said in April 2018 that autism diagnoses are on the rise.

The study is published in the journal PLOS Biology.

Sources:

[1] The Scientist

[2] Boston Globe

[3] Journal of the American Physicians and Surgeons

Medical Daily

This Unhealthy Daily Habit may be Fueling ADHD Rates

In a study published July 17 in the medical journal JAMA, researchers warn that the more time teens spend on social media and streaming videos, the more likely they are to develop symptoms of attention-deficit hyperactivity disorder, or ADHD. [1]

ADHD is a unique condition in that millions of children and teens have been diagnosed with the disorder, yet scientists don’t fully understand what causes it. About 6.1% of American children are being treated for ADHD – a 42% increase over the past 8 years. [2]

(Some scientists don’t believe that ADHD is a real condition at all – merely symptoms influenced by a child’s environment and other factors.)

Lead study author Adam Leventhal, a licensed clinical psychologist and a professor of preventive medicine at the University of Southern California Keck School of Medicine, remarked:

“If we can determine if there is a potential causal link that is consistent across studies, then we can design interventions to curb media exposure. Even simple educational information to let teachers, parents, and pediatric health professionals know that there could be an increased risk when they talk with their teens about digital media use might be helpful.”

Read: 1 in 5 Children are Improperly Diagnosed with ADHD

The symptoms of ADHD include inattention, hyperactivity, restlessness, or impulsivity. That might sound like normal teenage behavior, but in kids diagnosed with ADHD, the symptoms occur more frequently and severely.

He added:

“If we can identify any potential risk factor that is implicated in this disorder then that’s important, especially ones that are modifiable like digital media use.”

Findings from the Study

For the study, researchers monitored the ADHD symptoms of nearly 2,600 high-schoolers who were surveyed about their digital media use. Teens who used multiple types of digital media multiple times a day were approximately twice as likely to report new symptoms of ADHD over the course of 2 years compared to teens who were less digitally-active. [3]

  • More than half of the teens surveyed reported checking social media sites and texts “frequently.”
  • More than 40% said they also looked at pictures or streamed videos frequently.
  • 38% streamed or downloaded media frequently. [4]

The study doesn’t show that digital media use causes ADHD, nor does it go into detail about how the symptoms affected teens’ lives. But it does show that the students in the study were using digital media before their symptoms started. In fact, none of the teens had ADHD symptoms at the beginning of the study. [3] [4]

  • Those who spent the most time using digital media were 53% more likely to develop ADHD symptoms, according to the researchers.
  • Teens who spent a lot of time texting were 21% more likely than infrequent texters to show symptoms.
  • Students who reported looking at pictures and streaming media were found to be 45% more likely to have ADHD symptoms.
  • Video chatting wasn’t especially popular among teens – just 8.8% said they chatted with friends via video – but those students were more than twice as likely to report ADHD symptoms, the study shows.

Of the thousands of students researchers followed, only 495 were infrequent digital media consumers. About 4.6% of those who said they weren’t regular digital media users developed ADHD symptoms over the next 2 years. Only 114 of the young respondents said they used technology for 7 different activities frequently, but 9.5% of them developed ADHD symptoms.

Leventhal said in a statement:

“This study raises concern whether the proliferation of high-performance digital media technologies may be putting a new generation of youth at risk for ADHD.”

The study suggests that more research is needed to determine whether ADHD symptoms can be caused by social media use.

Sources:

[1] CNN

[2] Healthline

[3] The Verge

[4] NBC News

ADHD Rates Have Skyrocketed in the Past 2 Decades?

Rates of attention-deficit hyperactivity disorder (ADHD) have skyrocketed in the United States over the past 2 decades, with a new study showing that 1 in 10 children are now ‘diagnosed’ with the condition. [1]

The study used data from the National Health Interview Study to examine children between the ages of 4 and 17. From 1997 to 1998, 6.1% of people in this age group were diagnosed with ADHD. The researchers found that this had increased to 10.2% between 2015 and 2016.

So, do more children have ADHD? Not necessarily, according to Dr. Wei Bao, study co-author and assistant professor at the University of Iowa. Bao said that better awareness of ADHD has led to more diagnoses, as more doctors and health professionals have familiarized themselves with the condition and are therefore better at recognizing and diagnosing it.

Bao said:

“Second, the public is more aware of this condition, increasing the possibility of affected kids being screened and diagnosed. Third, biological factors may also play a role. For example, infants born early or small survive, but they are at higher risk for developing ADHD.”

Dr. Neha Chaudhary, a child psychiatrist at the Massachusetts General Hospital/Harvard Medical School and co-founder of Stanford Brainstorm, added: [2]

“The diagnosis and assessment for ADHD has evolved over the past few decades. The diagnostic criteria that we use is now a little more liberal and captures cases that the older criteria would have left out.”

For example, under the new criteria, a child can be diagnosed with ADHD if he or she has symptoms of either hyperactivity or attention-deficit that interfere with his or her quality of life. In the past, a diagnosis could only be made if symptoms were present in multiple environments.

Or Could the Increase be Due to Misdiagnosis?

Some experts chalk the increase up to rising numbers of misdiagnoses of ADHD in children. [1]

Amie Bettencourt, an assistant professor at Johns Hopkins University School of Medicine, explained:

“The increased rigor of kindergarten is leading to a lot of false identifications of ADHD.

This is a time when children are still developing the capacity to sit still. Years ago there was not so much sitting still. Learning was more play and experiential based.”

‘Play Time’ is Essential

In fact, last August the American Academy of Pediatrics (AAP) released an updated guidance urging pediatricians to “prescribe play.” The group stressed that playing with parents and peers is vital to a child’s healthy development, and is critical for learning life skills and reducing stress. [3]

The authors of the report make it clear that play is one of the things young children need most for future success.

They wrote:

“Play is not frivolous: it enhances brain structure and function, and promotes executive function.”

Read: Younger Kids 50% More Likely to get ADHD Drugs than Older Peers

Both the AAP and the U.S. Centers for Disease Control and Prevention (CDC) recommend children get 1 hour of physical activity per day, as well as 1 hour of simple, creative play. As more schools abandon recess and physical education classes, the onus is often on parents to make sure their children get enough play and physical activity.

However, when researchers accounted for race and gender, disparities emerged. Data from 2015-2016 show black children saw the highest rate of diagnoses (12.8%), followed by white children (12%), and Hispanic children (6.1%). When it came to gender, 14% of boys were diagnosed with ADHD, compared with only 6.3% of girls. [1]

Bao said:

“Boys are usually more active than girls, therefore boys are more likely to be recognized due to hyperactivity.”

On the other hand, girls with ADHD tend to display attention-deficit traits, according to Bao.

In July, a study was published in the Journal of the American Medical Association that showed a link between ADHD in teenagers and social media use. It wasn’t clear whether smartphones and other electronic gadgets led to the disorder, but the association was strong enough to warrant further research.

It’s not clear why some races are more likely to be diagnosed with ADHD than others.

Or maybe the increased rates of ADHD is false since the mental disorder may not even be real.

Mic drop.

Sources:

[1] Medical Daily

[2] ABC News

[3] CBS News