Home Blog Page 39

Problems with Abilify for Depression

12
test
 

Abilify: way oversold

You probably have seen a TV ad recently for Abilify. I do all the time. It’s terrible.

Each time I’m amazed at the audacity of its makers, Bristol-myers Squibb.  They’re making a killingoff those ads; they sold 30% more in 2009 than in 08 of the stuff.

But what don’t they tell you?

The ads position Abilify as an option if your antidepressant doesn’t provide complete symptom relief.

(That includes pretty much everyone. Antidepressants flat out don’t work in at least 33% of people, and completely eliminate symptoms in almost no one.)

But the ads don’t mention that Abilify is a very powerful drug mainly used for schizophrenia and mania.

That it has hardly any scientific backing for its ability to treat depression. And that there are many, many other options that should be considered first when depression doesn’t fully respond to an antidepressant.

Abilify is an antipsychotic

Abilify is primarily used for schizophrenia and mania, not depression. Like most antipsychotics, it has serious side effects. Use for just 1 year can potentially cause irreversible movements like facial tics or leg twitching. It can potentially cause diabetes. And an astonishing 25% of people who use it experience akathisia, an intense feeling of being unsettled.

People who have akathisia can experience severe anxiety that prevents them from working, sleeping and daily activities. Again, there’s a 25% chance of getting some form of it from Abilify.

Other common side effects from Abilify include headaches, insomnia, and vomiting. Weight gain is pretty common too.

This is in a medication being sold to people who’re somewhat depressed.

Abilify hasn’t been tested nearly as much as it should

Based off the heavy advertising, you’d think it was scientifically established that Abilify works.  Hardly.

Two major studies commonly cited for showing its efficacy showed about 25% improvement as opposed to 15% placebo. That’s only 10% difference. So if you are taking this medication, you’re just as likely to feel better as you are to feel extreme anxiety and being unsettled. That isn’t even the worst part.

The worst part is that 25% efficacy rate was from studies that were manipulated to make the drug seem better!

To achieve this, the study makers tested for depression in several different ways. They then analyzed the results and threw out the ones that showed their drug didn’t work. If you’re curious, the ones that didn’t show they worked were the ones where people reported how they felt in self-reports.

So you could be saying “I feel horrible,” and they’d count you as a success story if some other measurement showed some improvement.

That’s not all. Even taking the 25% efficacy rate as legit, it’s almost meaningless. The measurement of mood took place on a 60 point scale, and Abilify had only a 3 point difference. Hardly impressive.

So you get a pretty small chance of getting slightly better on this drug.  Is it worth the side effects?

Other treatments are better

Other treatments for treatment resistant depression work better with less side effects. If you’re really that depressed that you are considering heavy medication (as if SSRIs weren’t that strong), you’d probably be better off considering lithium or other options first.  See this article for a discussion of those methods.

Sources:

Aripiprazole in Refractory Depression?

What is Swine Flu?

0
test

In mid February 2009, an influenza virus infecting pigs began to shift. It adopted some viral characteristics from avian, or bird, flu and started to target human-specific molecular patterns.

By the end of April, officials in Mexican began to notice that the typical influenza season wasn’t ending. On the contrary. An increasing amount of people were suffering from a type of flu dubbed “swine flu.”

Panic ensued, and tourism to Mexico plummeted. As hundreds of cases spread through America, a confused public overreacted. Entire school systems were shut down base off suspected cases, including Harvard Dental School.

The WHO declared a pandemic. Now, tens of thousands of people have been infected, and it’s starting to become clear that this flu is not so different from typical flu. But it is just a few mutations away from becoming extremely dangerous, and already has some troubling characteristics.

What is Swine Flu?

Swine flu is a new form of influenza that has become a pandemic. Importantly, it is active during a non-typical flu season, the summer. At the moment, it is gaining a lot of media attention and hysteria.

While partly derived from pigs, swine flu also contains genetic elements from types of bird flu.

Is it particularly dangerous?

The initial numbers made swine flu seem very dangerous. It seemed to have unusually high fatality and hospitalization rates, and seemed to infect mostly young people.

The numbers are much more reassuring now. Swine flu does not seem to be much worse than a normal flu. Roughly 2-5% of those infected with it in the USA require hospitalization, most of whom had existing problems.

But swine flu is a novel disease. In the two vital areas of the hemagglutinin binder and neuraminidase enzyme it is considerably different from past viruses, differing by up to 25% in molecular structure. This means our immune system is not ready to fight it.

Research shows that it can infect deep into the lungs, much like past pandemic causing influenzas.

Like all influenza viruses, swine flu is capable of quickly mutating and adopting new characteristics.

What’s the future look like?

A vaccine is rapidly being made for the swine flu. But there’s only so much we can do. Avian flu is also still around, and potentially changing to eventually become a pandemic in its own right.

Barring incredible advances, it is very highly likely that the next 10 or 20 years will bring a massive influenza pandemic of one form or another.

Merck Sued Over Fosamax – is it Safe?

0
tes

Merck Sued Again

Over the past week, more lawsuits against Merck & Co, makers of the recalled drug Vioxx, gained traction.

Plantiffs claim that bone medication Fosamax caused osteonecrosis of the jaw. Merck is going to argue there’s no proof, and that they met the requirements to warn patients.

Who’s right?

What’s Fosamax?

Fosamax is a treatment for osteoporosis that promotes stronger bones to reduce risk of fractures. It’s a serious problem – the economic cost annually from osteoporosis related fractures is more than $10 billion.

The older you get, the higher the risk gets. One third of women have hip fractures by age 90.

Bones are often broken when someone falls down or trips, something that also happens more often with aging due to weakened muscles and reduced coordination.

Fosamax and its relatives prevent osteoclasts from resorbing bone tissue, which can help prevent further degeneration of bones. They were initially hailed as “miracle drugs” because they reduced risk of certain types of fracture by up to 50%.

The Claims:

Fosamax may hurt the bone in the jaw. Osteonecrosis of the jaw (ONJ) is when bone gets exposed and doesn’t heal properly. As you can imagine, it is extremely unpleasant and difficult to treat.

Does Fosamax cause it?

Merck says no. But the science almost surely points to an increased risk of ONJ. It may not be large, but it’s there, and even moreso for certain uses of the medication. Intensive use for certain acute conditions, for instance, has a very high rate of ONJ.

Upper range of estimates of ONJ sufferers puts it at 5,000, and the lower ranges less than 1,000. The lowest put it at several hundred. More than 10 million prescriptions for Fosamax alone have been filled since 1995.

But despite the small numbers, the damage is there, and Merck did not warn patients as clearly as the FDA warned them to in 2005, when the data became compelling.

Development of ONJ is typically associated with comorbid cancer. One analysis claims 46.5% of sufferers had a history of multiple myeloma, 38.8% metastic cancer, and 6.2% prostate cancer.  If true, this is important, because it makes a big difference in deciding whether or not to prescribe it.

Conclusion

It looks bad for Merck.

But they will pull out no stops in their defense and point to the general safety of the product, and attack the validity of the plaintiff’s complaints.

One of their likely tactics is to argue that the cases of ONJ developed before they knew of the risks and had an obligation to inform patients.  Considering that they didn’t fully follow the FDA’s instructions for warning, it looks like an uphill battle.

You might like:

10 Ways Scientists Lie About Drugs

Causes of Pain in the Back of the Knee

Sources:

Down to the bone
A Review of the Literature on Osteonecrosis of the Jaw in Patients with Osteoporosis Treated with Oral Bisphosphonates: Prevalence, Risk Factors, and Clinical Characteristics
Osteochemonecrosis of the Jaws due to Bisphosphonate Treatments. Update

Treatment of Autism

0
test

Noticing Autism

The first step to treating autism is recognizing it.

Parents typically become concerned with their children roughly starting at ages 1-2, when they notice certain problems. Development of speech may suddenly slow down or stop, and the child may start to become less responsive.

Doctors are often approached with symptoms like: “My child doesn’t seem to hear so well anymore, or respond to his name.” Or, “My child has stopped pointing at things and doesn’t seem to be interested in the world as much.”

An appropriate diagnosis requires extensive evaluation.

Treatment

Treatment of autism needs to be on multiple levels. There are more than a dozen therapeutic options, like speech/language therapy, social stories training and sensory integration.  Engaging with the child is the principle, but it’s harder than normal because of the autistic differences.

One has to understand how the kid perceives the world, enter their world, and help them learn how to function as others typically do.

Many of the therapies are theoretical and hard to analyze scientifically, like music therapy or sensory therapy.

We know one thing.  Therapy for at least 20 hours a week focused on the kids strengths and weaknesses is essential. The general principal is to “teach in small steps,” have the kid master something, then generalize from there.

One approach is ABA – applied behavioral analysis. Some studies have shown that it may be among the most effective therapies for autism. It roughly consists of positively reinforcing good behaviors while understanding what situations cause problem behavior and avoiding them.

Importantly, 75% of kids with autism suffer from some other problem which also needs to be treated. Common issues include epilepsy and aggressive or destructive behavior. In less than 10% of kids, the autism is itself caused by a medical issue like Fragile X Syndrome.

Environment

There is very little scientifically valid research into the environmental causes and treatment of autism. It is possible that nutritional issues may contribute to autism, and so, as always, it is vital that children be given a diet that is balanced, healthy, and provides essential nutrients.

When in doubt, consulting with a nutritionist is the best idea

Parents

The parents need support and help. They have a great challenge; their child needs understanding and care. It’s important that they are properly trained in ways to relate to their kid best, and to possibly receive support from peers.

Medication

Autism itself is not a reason for medication, and there are no medications approved for helping with the social and communication issues associated with autism. Autistic children may also be more sensitive than normal to medications.

Up to 1/3 of parents may turn to SSRIs to treat repetitive behaviors. Unfortunately, a recent study shows that this use, especially for the medication Celexa, may not work. It may even cause side effects like reduced attention and diarrhea.

There are only two medications that have been shown to help in at least two studies with some of the behavioral problems associated with autism: risperidone, and methlyphendiate. Caution is extremely necessary, and medication can not replace the needed intensive therapy.

Autism Solution for Parents with Autistic Children

You might like:

Eat Simpler, Be Healthier!

24 Simple – But Useful – Pieces of Advice

Sources:

Clinical Assessment and Management of Toddlers With Suspected Autism Spectrum Disorder: Insights From Studies of High-Risk Infants
A Review of the State of the Science for Pediatric Primary Health Care Clinicians
Psychopharmacology of aggression in children and adolescents with autism: a critical review of efficacy and tolerability.

Do Vaccines Cause Autism?

5
test

Do Vaccines Cause Autism?

There’s nothing more scary for parents than the thought that they might hurt their children. The controversy about vaccines and autism is frightening, but seems to have little scientific backing.

It started in 1998. The Lancet reported on 12 children with gastrointestional problems that they believed were caused – at least partly – by vaccinations. They claimed those problems contributed to autism and other conditions in the children.

Initial research seemed to support their argument: Unusual levels of measles virus RNA (a type of DNA) was found in certain parts of the kid’s bodies. But on two levels their analysis was refuted: by massive analysis of hundreds of thousands of children and autism, and by carefully examining their scientific method.

Epidemiological studies

Massive amounts of evidence shows that the large increase in autism over the past few decades is not associated with vaccination.

One study in Denmark compared 500,000 children vaccinated against 100,000 who weren’t. They had pretty much the same chance of autism.

The measels, mumps and rubella (MMR) vaccine was started in 1988 in London and no correlation was found between that and an increase of autism. Additionally, the vaccination efforts initially were distributed in clusters: not everyone got it at once. No such cluster effect was found in autism rates.

Similar data show that introduction of MMR in Japan in 1993 was not correlated with increase in autism rates.  One thing is consistent: analysis of tens of thousands of kids shows again and again no risk for autism associated with vaccine use.

Refuting the science

How might vaccines cause autism? The most prominent theory was that they somehow trigged an “aberrant immune reaction” that caused damage to the brain. The gastrointestional upset, for instance, might allow toxic proteins to reach the brain that otherwise wouldn’t.

The evidence for this theory was that a few kids with autism had been shown to have measles virus RNA in parts of the body where they shouldn’t be, like inside certain blood cells.

Suspicion of this theory was raised when multiple other studies were unable to replicate the findings.

D’souza et al carefully analyzed the reports and showed that their results were most likely because of mistakes. Either because of false positives or because of mistakes in the lab with how the materials were dealt with.

Thimerosal

Another theorized problem was the presence of thimerosal in vaccines. Superficially, it seems insane to include it; it is, after all, mercury, and we all know how dangerous that is.

Thimerosal, however, is a specific type of mercury called ethyl mercury, which is biodegradable and does not cause toxic build up in the body. Similarly large epidemiological studies have shown that it is not associated with autism.

Finally, all vaccines are now available without thimerosal.

Conclusion

There is no denying that diagnoses of autism have really, really increased over the last few decades. But it’s hard to say why. Increased recognition must play a large part, as well as diagnosing milder cases that would have previously been ignored.

It is also possible that other environmental issues play a role.

Vaccines are extremely important to protect children from diseases.

Next Article: Treatments of Autism

You might like:

50 Ways to Make Friends

Do Antidepressants Really Work?

Sources:

Vaccines and Autism: Evidence Does Not Support a Causal Association
No Evidence of Persisting Measles Virus in Peripheral Blood Mononuclear Cells From Children With Autism Spectrum Disorder
Has the Measles-Mumps-Rubella Vaccine Been Fully Exonerated?

What is Autism?

5
test

Autism:

You’ve definitely heard of autism.

What you might not know is what it is, and what causes it. Or why it’s become increasingly common over the past ten years. And could the MMR vaccine be responsible for causing it?

This blog will explore these issues over the next week or so.

What is it?

Autistic behaviors are typically noticed in young children when they behave oddly and fail to reach important landmarks in social development.

The main three ways that children behave on the autistic spectrum is 1) Restricted and focused interests 2) difficulty communicating and 3) difficulty with social interactions.

Any one of those behaviors taken by itself does not mean autism. It’s when they are combined, persistent and extreme, however, autism is indicated.

We don’t know what causes autism. The old school theory was to blame the parents, similar to how parents used to be blamed for schizophrenia.  Emotional environment can play a role in autistic development – but typically only if it is extremely bad.  Serious emotional deprivation, for instance, or trauma can cause behaviors indistinguishable from autism as seen in studies of Romanian orphans.

The vast majority of parents are loving and caring.

Research shows that genetic factors play an important role. Some of the most important information we have on autism’s genetic link comes from studies of twins. Twins can be either monozygotic or dizygotic. That sounds complicated but it’s really quite simple.

The twins can be from one egg that splits into two fetuses, or from two separate eggs. If they come from the same egg, they are identical genetically. Otherwise, they are genetically as similar as any two siblings.

The data show that if one of two twins from the same egg, and thus has the exact same DNA, is autistic, the other has a 60% chance of being autistic. This roughly means that 60% of autism can be explained by pure genetics.

Other factors

Autistic children seem to have difficulty with processing and recognizing faces. This difficulty arises as they age and start to miss developmental landmarks. Almost all children are born with the instinctual ability to recognize human faces. Autistic kids, however, don’t learn to recognize facial features as quickly as they should.

That is just one of many developmental landmarks that are challenges for these children.

Part of the problem may be in low levels of Oxytocin. Oxytocin is a neuropeptide that plays a role in developing emotional bonds. Levels of oxytocin, for instance, increase during sex and after having a baby (presumably to create a bond with the child). People dosed with oxytocin are also more trusting of strangers in experiments.

Low levels of oxytocin can be caused by genetic factors and may play a role in autism.

Autistic kids have differences in how their senses handle information, but we don’t know why, and what that means for their development – and how to help them.  One such difference is hypersensitivity to noise. Noise sensitivity can vary wildly – from completing ignoring what people say and possibly getting labeled as deaf, to cringing at quiet noises.

Next article:  Do Vaccines Cause Autism?

You might like:

24 Simple Life Tips

Sources:

The Elusive Etiology of Autism: Nature and Nurture?

Treating Treatment Resistant Depression

13
test
 

At least 1/3 of the time depression doesn’t respond to the first medication tried.  If another attempt doesn’t work, it becomes “treatment resistant depression.”

If your depression isn’t lifting, here are ten ideas you might want to consider:

1) It might not be depression proper.  Bipolar depression – depression associated with the mood disorder Bipolar – does not respond like unipolar depression to antidepressants, and may instead require mood stabilizers.

One analysis says that up to one fourth of treatment resistant depression may be bipolar in nature.

2) Physical factors absolutely must be checked for, something that many doctors miss.  One study showed that perhaps half of people with depression have low levels of folic acid. Deficiency of Vitamin B12 is another common nutritional reason for depression.

A wide variety of digestive disorders may also cause depressive like symptoms or contribute to resistance to medications.  Evaluation of nutritional intake and very importantly how the body processes it is essential.

3) Thyroid problems often cause depressive like symptoms.  Even when treated, hypothyroidism can contribute to depression if the replacement hormones aren’t carefully chosen.  Adrenal problems are also very common along with conditions like hypoglycemia.

Treatment resistant depression is a strong reason to undergo testing for physiological issues that are implicated in depression.

4) Your depression may not go away if you still experience stressful life events and/or feel a lot of pressure.  Remember, depression can be a natural response to what’s going on in your life, and in that case, the only way to help it is by dealing with the root causes.

5) Switching medication is very common, especially considering how often initial treatments fail.  SSRIs are the first used medications, then alternative modern medications like SNRIs or DNRIs.  If those fail, tricylcic or MAO inhibitors are used.

It’s almost normal for your first try to not work.  Don’t give up or get discouraged.  Try different types of medication in different combinations.

It’s essential to have a doctor who understands the details of the antidepressants and give you proper guidance.

6) For very serious depression that doesn’t respond to treatment, electroconvulsive therapy might be worth considering. ECT, though it has side effects, may be the most effective treatment for depression with efficacy rates around 75%.

7) Lithium or other mood stabilizers alongside antidepressants might help.  They’ve shown excellent results in some studies – 45% response versus 11% for placebo. Patience is key; it takes 3-4 weeks and careful monitoring to achieve results.

8) Anti-psychotics also increase recovery rates, but they have significant side effects such as sedation, weight gain and possibly irreversible tics, so use is cautioned.

9) Stimulants like Ritalin and Adderall have shown mixed results. Theoretically, someone who is depressed and lacks energy might get a motivating kick from stimulants. In one study of 60 patients, 40% on Ritalin improved as opposed to 23% not, a statistically insignificant difference.

10) Don’t forget therapy.  An increasing amount of people just take antidepressants without seeing a therapist.  This means they miss the chance to work on the issues causing them to be depressed.

11) Extra point:  Exercise can help revitalize you.

Remember: Never give up

Never give up.  With the right combination of therapy, medication, exercise and dietary modification, things will improve.  Depression can rob you of the ability to see that there is hope.  There is a future, and you have the power to make it better, but you need to get the right help.

If you are experiencing suicidal thoughts right now, or do in the future, please consider getting immediate help. You can call 1-800-273-TALK or other hotlines to talk to someone right now.

You might like:

50 Tips to Make Friends

Agomelatine: A New Treatment for Depression

Sources:

Treatment-Resistant Depression: Recent Development And Future Directions
Treatment-Resistant Depression, Souery, Papakostas and Trivedi

20 Facts About Antidepressants

12
test

1) 1/10 people in America are currently taking an antidepressant (AD)

2) Michael Jackson was reportedly taking Zoloft and Paxil when he died.  Antidepressants have been shown to contribute to heart disease.

3) Luvox was being taken by a shooter in the Columbine High School shootings.

4) We have no idea how antidepressants actually work

5) Effexor’s side effects include vomiting and nausea, while Zoloft is associated with diarrhea

6) Almost all of the new ADs work similarly well (or badly) – the only significant difference is what side effects they have

7) ADs can cause extreme anger in some people, and there are many lawsuits against AD drug companies for resulting violence

8) Prozac is the best recognized AD with the most references to it in music and popular culture

9) Anna Nicole Smith’s son was taking Lexapro when he died

10) Paxil is one of the hardests ADs to quit.

11) ADs can be extremely hard to quit.  Withdrawal, which is a very common problem, can involve “brain zaps” and general horrible feelings.

12) Some antidepressants work only 50% of the time.  Placebo?  That works about 30%.  Big difference?

13) Remeron has been linked to immune system failure

14) Antidepressants can cause suicidal thinking in children and perhaps adults

15) Celexa is used in autistic children who have OCD-like behavior, but it doesn’t seem to help

16) Antidepressants can possibly cause birth defects

17) Tricylcic antidepressants are poisonous and can be deadly if an overdose happens

18) The SSRIs (including Zoloft and Prozac) cause sexual dysfunction in most people who take them

19) Kids as young as two have been put on antidepressants

20) Wellbutrin very often causes extreme anxiety and can rarely make the taker lose touch with reality

21) Bonus: Women who take antidepressants are at a 45% increase risk of having a stroke.

You might like:

Do Antidepressants Work As Promised?

10 Ways Scientists Lie About Drugs

What did you think about this post?

Ads:

Eliminate Anxiety & Depression

10 Ways Scientists Lie About Drugs

4
test

Does the FDA keep us safe?

Research into new medications is how we learn if they work and if they’re safe.  It’s the only protection we have against snake oil and worse.  But disasters like Thalidomide and Vioxx – not to mention the dozens of products recalled monthly – remind us that the FDA screws up every now and then.

That’s because drug companies often pretty much lie to get their drugs approved.  Here’s how.

1) Report results that didn’t happen

Amazingly enough, some drug companies take studies that show their product doesn’t work, and they report that it does!  This has happened at least 11 times with studies into antidepressants.

Another form of this is to write a conclusion that’s different from what the actual results show.  Because of time pressure, doctors don’t have time to actually read all the papers thrown at them, and often just read the abstract, which contains the pro-drug message like:  “Conclusion:  Fake drug has been shown to be safe and efficacious in treating extreme bladder discomfort.”

2) Use faulty statistics

There’s a reason Benjamin Disraeli said “there are lies, damn lies, and statistics.”  The sheer amount of ways to manipulate the data from studies by statistics is mind-boggling.  The simplest is to report that something is statistically significant when that doesn’t mean anything.

For instance, a drug can have a statistically significant effect on blood pressure – but that effect is tiny and meaningless.

3) Use inappropriate measuring systems

Some things are easy to measure, like someone’s height or weight.  Others, like mental states and attitudes, are a lot harder.  Psychological assessments range from solid to extremely shaky, like the infamous Rorschach blotch test.

Thank God no drug has been approved because of results of a Rorschach blotch test.  But drug companies always use the measuring system that puts their drug in the best light, even if it doesn’t mean it actually works.

4) Don’t use placebo

When you don’t test your treatment against placebo, absurd things happen.  Like the gastric freezing procedure to treat ulcers, which consists of putting a balloon full of frozen liquid into the stomach to cool it off.  It worked great – until it was tested against a placebo, or a fake treatment.

Guess what?  The placebo worked better.

5) Don’t test against other drugs

You’d have to be crazy to forget about testing against a placebo.  But what drug companies almost never do is test their drugs against other drugs that already exist.

Vyvanse, for instance, is a new medication for ADHD that is chemically identical to Dexedrine.  It’s a hell of a lot more expensive, so there’s no way that it’s ever going to be tested if it’s actually better to the treatment that already existed.

6) Ignore the FDA

This is by the far the stupidest thing a drug company can do.  You’d have to be crazy to ignore what the FDA tells you to do in testing your medication.  But that’s exactly what Sam Waksal did with the breakthrough cancer drug Erbitux.

They told him to conduct certain studies and change some of his protocols.  He didn’t.  The worst part is, Erbitux was a drug that could help treat cancer in some of the worst cases.  Then Sam was surprised when his drug was rejected!

7) Pressure patients to give the results you want

If you give patients a test at the start of the trial, like a mood inventory scale, and then again at the end of the trial, they won’t answer the same.  Their past experience biases how they respond the second time around.

Also, you can subtly pressure participants to give results you want by leading questions.

8)  Test it for short periods of time

Take a drug that needs to be taken for months if not years, like an anti-depressant.  Why not just test it for a few weeks?  Not only will you save money, you won’t have to learn about the nasty side effects caused by long term use.

Everyone wins, except the patients.

9) Test it on a few people

Who cares if your drug will be taken by millions?  Test it on only several hundred people.  That makes it even easier for you to run the test again if you are so unlucky as to get bad results.

10) Test it on people who’re different

Test your drug on people who are healthier than those who will eventually take it.  You’re almost guaranteed better results.

Prozac, for instance, while now used for dozens of reasons including pain management, was initially tested on mild-to-moderately depressed people – not people who were extremely depressed.  Stuff like that explains why antidepressants don’t work nearly as well as they’re supposed to.

You Might Like:

Eat Simpler, Be Healthier

50 Ways to Make Friends

Do you trust the drug companies?  Why or why not?

Is Stimulant Treatment for ADHD Safe?

9
test

ADHD is most often treated by stimulants like Ritalin, Adderall, and Dexedrine. I’m sure you’ve heard of these medications – but what are they? What do they do?

And most importantly – are they safe?

Are Stimulants Safe?

Stimulants are powerful medications, potentially addictive, and can have very serious side effects.

They’re commonly used because they’re effective.  Up to 70% of people experience significant symptom relief on them.  And the majority of the millions of people who use them are fine.  But they do have common side effects, and can rarely cause some quite nasty things.

The most common issues with stimulant use include increased anxiety, nausea or loss of appetite, and insomnia.

The rarer and very serious side effects?  To quote an ad for Vyvanse, an ADHD medication, “new psychosis, mania, aggression, growth suppression and visual disturbances” are possible.

Heart Damage?

Stimulant use might cause heart damage over time. Stimulants typically increase heart rate by ~3-5 beats per minute and also raise blood pressure.  One study of more than 50,000 children using stimulants showed an 20% increase in risk of emergency treatment for heart problems.

Use of stimulants by someone with a preexisting heart condition is a big no-no, as they may increase risk of cardiac failure or sudden death.

Psychological problems

As mentioned, a rare but serious side effect is that stimulants can cause psychosis, or a break with reality such as paranoia, delusional thinking and hallucinations.  Most psychosis occurs in people who were already at risk – but stimulants can cause psychosis in normal people at normal doses.

Stimulants can also cause serious problems with regulating or controlling mood. They can trigger mania in bipolar patients, and cause extreme mood variation even in people not normally at risk for bipolar.

Stimulants change the brain

Do stimulants cause brain damage?  Maybe.

Studies in rats have shown that extremely high doses of amphetamines given over a short period of time cause serious damage to the production of dopamine and its transport in the brain.  This happens by causing build up of radicals and reactive oxygen species.  Methylphenidate, or Ritalin, does not cause this damage, possibly because it only blocks the receptors for reception of dopamine.

But what about normal use?

The rats did not experience neural changes or damage from doses in the normal range.  The news isn’t all good, though. Baboons and monkeys, however, did experience brain damage at normal doses, showing a significant reduction in natural production and handling of dopamine.

It’s not clear what this means.  Children who take ADHD medication, after all, have larger white brain matter than unmedicated children, indicating a neuro-positive effect.

Remember: use of stimulants in children requires extreme caution and psychological analysis because they are young, more susceptible to side effects, and still developing.

Do stimulants like Adderall and Ritalin stunt growth?

This question is extremely contentious. A number of studies have shown that stimulant use is associated with slightly reduced growth, and, on the other hand, a number have shown that they aren’t.

The evidence, in my opinion, seems to be in favor of a slight reduction in height associated with long term use.

Both sides agree  that stimulant use initially slows growth somewhat; the question is if that delay is made up for in the long run.

Stimulant use is, however, associated with some degree of weight loss in the long run.

Conclusion:

Stimulants are extremely commonly used for a reason. They work. That said, they are potent substances, and often require supportive psychological therapy on the side to achieve best results.

For someone with a history of anxiety or other psychological problems, or someone with cardiac issues, use of stimulants should be exceptionally cautious if at all.  Use in children should also be done with extreme caution and only after appropriate psychological evaluation.

Natural ADHD Medication

ADHD Treatment Without Side Effects

Professional ADHD and ADD Online Diagnostic Test

ADHD/ADD Natural Remedy Report

You might like:

50 Ways to Make Friends

Vyvanse Vs Adderall XR

Sources:

Potential Adverse Effects of Amphetamine Treatment on Brain and Behavior: A Review
Comparative Efficacy of Adderall and Methylphenidate in Attention-deficit/Hyperactivity Disorder: A Meta-Analysis
Cardiac Safety of Methylphenidate Versus Amphetamine Salts in the Treatment of ADHD