Has your kid's physician said anything about possible long-term side effects of ADHD meds?
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Anonymous
Sax is still alive, but in my opinion, he’s a bit of a quack. Don’t just read his opinion on medication - read one of his books, like Boys Adrift, and see if any of it resonates with you. (None of it resonated with me.) Our psychiatrist said the long term risks of not medicating are greater than the risks of medicating. (Anxiety, depression, substance use, car accidents. We were already seeing some of these things when we started medication.) |
Anonymous
| You are thinking of Oliver Sacks, perhaps? |
Anonymous
Oh absolutely! Total senior moment! Oliver Sacks also had some kooky views on ADHD meds, I think. Leonard Sax is less brilliant, more quack, IMHO. Also he’s a psychologist, not a paychiatrist, so really has no credentials to talk about medication side effects. |
Anonymous
| When I was reluctant to start my child on stimulants due to concerns about side effects, the doctor told me that people with ADHD whose symptoms are not controlled by prescription meds are more likely to self-medicate with drugs and alcohol. |
Anonymous
| There is strong evidence that stimulant use affects physical growth (height and weight) and also that there is abuse potential. Don’t trust a doctor who says there is no evidence for any negative side effects |
Anonymous
Our well read psychiatrist says this happens when it causes appetite suppression ... he tracks weight gain very very carefully - my kid is still 99.99th percentile for height so no effect yet but we know others where their kids don’t eat when taking it |
Anonymous
Yes, and remember comparison groups, too. The difference isn't between a potential small effect on height and a typical kid. It's between a potential small effect on height and a kid struggling in school, MORE likely to turn into substance abuse, less likely to go to college, more likely to get in a car crash while driving, etc ... Sure, maybe a half inch shorter, but there is a reason people consider medication. It's not usually because they don't love their kids or want to parent them -- it's because they have come to the end of their rope and the kid feels bad about themselves and is crying every night, angry all the time, or both. |
Anonymous
When we made the decision to medicate our child, the relevant professionals (there were several) all generally dismissed the possibility of long-term side effects on brain development, largely on the same basis discussed up thread: “no evidence.” (They did acknowledge the potential risk on growth.) In their defense, this is a true statement, because—shockingly to me—the question appears to be basically unstudied, I spent a huge amount of time looking and found very little on the question of long-term effects on brain development (which, if i recall correctly boiled down to one recent study that found detectable differences of uncertain significance). What long-term studies have been done, at least that I found, focused on efficacy (debatable over the long-term) or studying potential increased risk of drug abuse, cardiac events, etc. (which didn’t seem like a serious risk to me based on what I read). My bottom-line take-away, from the perspective of a lay parent who actually had to make the decision, is that there is a lot more uncertainty than people typically acknowledge, but no obvious red flags. There doesn’t seem to be much evidence for any kind of gross physical or mental risk from the drugs; to the extent there are side effects, it seems they must be relatively subtle or rare (again, based on what I read). That may be sufficient for population-level treatment recommendations, so I am not making any kind of conspiratorial claim here; but it was unsatisfying when trying to understand the kinds of risks an individual child may face from these drugs. If you are facing this decision, it sucks, but that is basically the state of human knowledge you will need to use to decide, and it isn’t going to change anytime soon. Ultimately, I decided it was worth the risk, but was and still am a bit conflicted about it. The most helpful reference I ever found was a blog post on the blog Slate Star Codex called something like “Adderall Risks: Much More Than You Wanted to Know” (the blog has since been deleted, but you could try to find the post archived somewhere, it is written by a psychiatrist and is extremely exhaustive in terms of summarizing the research, much better than anything I found anywhere else.) I’ve tried to mitigate the risk to the extent possible by going with the medication with the longest track record (e.g. Ritalin), keeping the dosage down to the extent possible and taking frequent breaks. It has been effective in the short-term (three years or so), so there has been a benefit. The bottom line is that nobody knows whether there are long-term side effects on brain development. You pays your money and you takes your choice. |
Anonymous
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I'm going to echo what the immediate PP said. We also did all the research and found unsatisfactory answers -- basically exactly as laid out by the above PP. We also decided to medicate because didn't really have a choice if we wanted DS to attend school. But we also do breaks as often as we can.
One of the reasons I am skeptical of the blanket statements "there are no long term side effects associated with stimulants" is because another frequently cited statement about stimulants (that they are out of your system within 24 hours and therefore have zero effects on you after 24 hours) is patently false in our case. I understand this statement is based on the molecular science (that, after 24 hours there are no traces of the medication in the body). But I don't believe anyone has ever done a broad study to determine whether there are lingering impacts on the body or brain after the drug is gone. In our case, DS is a bit more hyper the next day or two, and on day 3 and 4 after stopping stimulants he is out of control hyper. Starting on day 5, he starts to get slightly better -- but it takes until at least day 10 to fully come down. Others on this site have cited similar experiences. I have found a couple journal articles discussing one or two patients with this effect. And zero articles doing a broad scale study of this question. But thousands of sources citing the fact that, since the medicine is out of your system within 24 hours, there are zero effects after 24 hours. So to believe that there are zero impacts on taking a medication long term.... it seems naive. Even just taking a pill every day long term has an impact on your liver. |
Anonymous
| I discussed the issue with the correlation between medication and height with our pediatrician. He said long-term studies showed that several boys have delayed growth but then reach the height the most likely were going to be within an inch. However, and this was the deal breaker for us- some boys have delayed growth in puberty and begin puberty later than other boys so they are short in junior high and the beginning of high school. Our son is short to begin with and we just didn't want to risk he would be the shortest kid in his grade until junior or senior year. |
Anonymous
Does your kid truly have ADHD? Because if so, that seems like an awfully superficial and sorry to say dumb reason to withhold medication. |
Anonymous
Not pp but I am in a similar situation, with a girl. She was diagnosed at Children's with combined ADHD at the end of 3rd grade. She compensates very well, but she still have terrible impulse control. I got her some accommodations through a 504 plan and they have been working well at school, but I worry about MS when demands of school and peer pressure increases a lot. So far we have been able to manage without medication though -but it is hard for her. She has no problems academically and excels. I chose not to medicate and wait it out because she was under the charts for height, and right now, at 10, is 52" tall. Pre-puberty has began and I think she will have her 1st period within a year. She is accompanied by a ped endo and I will wait out for ADHD meds the longest we can, hopefully until her growth plates close. |
Anonymous
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It is not surprising that there are no studies finding negative long term side effects. Are there really people that naive that they think drug companies would allow that?
Of course it is not healthy to take these drugs long term. It's just common sense. |
Anonymous
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The issue is that if the tests are looking at behavioral markers there are a lot of confounding variables.
The newer research is using brain scans to look for differences but the tech just hasn’t been good enough for long enough to have really solid results. Also, we just don’t know enough about how the brain works and how ADHD affects the brain. As I recall, one early study seemed to show increased activity in one area of the brain related to endorphins, but because people with ADHD have deficits in that area generally (causing them to seek out stimulation through movement etc.) changes in that area may actually be beneficial—like a blind person who develops enhanced hearing to help compensate for a deficit. Tbis isnt the study Im thinking of, hut here’s a similar one: https://www.sciencedaily.com/releases/2020/01/200117100257.htm |
Anonymous
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To follow up on above, this is why its inportant not to take ADHD medication if you don’t have adhd (especially as a kid). If it makes your dopamine receptors more sensitive, that could be really great for a person who has deficient dopamine receptors but terrible for a person who has normal dopamine receptors or receptors that are already more sensitive. Maybe a better analogy is braces on legs—good and necessary if you have a medical issue with your legs but really hamrful if you have properly developing or even superior legs.
It’s why no one should try medication as a first option. You wouldnt want to put leg braces on a kid that just needs to get out and run around more. |