Safety concerns over conventional pharmacologic treatments of ADHD

Stimulant medications, behavioral modification and psychosocial support are widely used conventional treatments of childhood ADHD in Western countries. Short-acting stimulants are the most frequently prescribed pharmacological treatments of ADHD however controlled release stimulants and the SSRI antidepressants are increasingly prescribed in spite of the absence of consistent research findings supporting their use. Although the American Academy of Pediatrics has approved the regulated use of stimulants in children as safe and effective, growing controversy surrounds their widespread use because of unresolved safety concerns. It is estimated that one third of children and adolescents who take stimulants experience significant adverse effects including abdominal pain, decreased appetite and insomnia, and 10% experience serious adverse effects. Chronic amphetamine use in childhood is associated with slowing in growth. Cases of sudden cardiac death in children taking mixed amphetamine salts resulted in American Heart Association guidelines recommending a baseline electrocardiogram (ECG) before starting stimulant therapy and monitoring of blood pressure and pulse and during therapy in children, adolescents and adults.

The non-stimulant medication atomoxetine has less potential for abuse but may not be as efficacious as stimulants however there are growing concerns about adverse effects of atomoxetine in children including hypertension, tachycardia, nausea and vomiting, liver toxicity and possibly increased suicide risk.

The limited efficacy of conventional pharmacologic treatments of ADHD, concerns over safety, and issues of cost and availability in many world regions, call for open-minded consideration of non-pharmacologic therapies including dietary modification, herbal medicines and other natural products, mindfulness and mind-body approaches and other complementary and alternative therapies.

To learn more about non-pharmacologic treatments of ADHD and how to use them safely and effectively to treat your ADHD symptoms or those of your child, read my recently published e-book, ADHD–the Integrative Mental Health Solution.

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