Whether or not medication should be used to treat ADHD.
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Whether or not medication should be used to treat ADHD.
Attention deficit hyperactivity disorder (ADHD) is a mental disorder that affects children and can continue into adulthood. Over the past few decades, ADHD prevalence has increased. According to one news report of the USA, the medicine of ADHD has risen to more than 40% (39.5 million ADHD prescriptions) in the last 5 years ADDIN EN.CITE <EndNote><Cite><Author>Kim</Author><Year>2019</Year><RecNum>1144</RecNum><DisplayText>(Kim, King, & Jennings, 2019)</DisplayText><record><rec-number>1144</rec-number><foreign-keys><key app="EN" db-id="axzrwpxxqvwtw5evsf3xrer2arfwsa5f0e5d" timestamp="1567947471">1144</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kim, Margeum</author><author>King, Marissa D</author><author>Jennings, Jennifer</author></authors></contributors><titles><title>ADHD remission, inclusive special education, and socioeconomic disparities</title><secondary-title>SSM-Population Health</secondary-title></titles><periodical><full-title>SSM-Population Health</full-title></periodical><pages>100420</pages><dates><year>2019</year></dates><isbn>2352-8273</isbn><urls></urls></record></Cite></EndNote>(Kim, King, & Jennings, 2019). After seeing such a high prevalence, it is normal to ask questions about the treatment of this disease such as whether the treatment of ADHD is appropriate or not. The argument seems to be strong on each side but it is hard for one to believe in aspect because of extensive research done on the treatment of ADHD. Professionals around the world are concern about ADHD treatment. Fallacious arguments are usually formulated to state convincing cases like prescribing ADHD medications or maintaining their existing dose appeared as the most effective and only treatment but it is not always true. The findings of literature surveys are evidence to recognize its effectiveness in the prescribing of medications in ADHD. An argument in this essay is developed to know the effectiveness of ADHD treatment on the basis of two articles.
Historical perspective
ADHD is a condition in which imbalance occurs in the noradrenaline and dopamine (brain chemicals). Both of these chemicals are important in slowing impulses and also self-control. Due to imbalance in these chemicals ADHD patients experience hyperactive behavior, inattentiveness, and difficulties in learning. Although today physicians have more information regarding causes, diagnosis, and treatment of ADHD. An important history of this disease is present which revolves around many beliefs and theories. ADHD is not a recent disease it was discovered 100 years ago. In 1902 George Still who was an English pediatrician first describe the ADHD after observing a group of people and recognized them as overactive, inattentive and lack of control. After his discovery, many controversies occur. Previously it was believed that ADHD is caused due to the damage of the brain. After that physicians recognized that most of the children with this disease had no brain damage and this idea was rejected. After that ADHD was replaced with hyperactive child syndrome and then all the focus was given on hyperactivity. Dr. Ben Feingold developed a link between hyperactivity and diet but it was also proven to be not much authentic so this was also rejected. Today in the recent world it is a belief that this disease is strongly hereditary and occurs due to the imbalance of noradrenaline and dopamine, which causes hyperactivity, inattentiveness and other symptoms (Mahone & Denckla, 2017).
Whether medicine should be given in ADHD treatment
Psychotropic medicines that are used to regulate mood, treat the mental disorder and to control behavior in children with ADHD is another controversy. The first article ADDIN EN.CITE <EndNote><Cite><Author>Martinez-Raga</Author><Year>2017</Year><RecNum>1141</RecNum><DisplayText>(Martinez-Raga, Ferreros, Knecht, de Alvaro, & Carabal, 2017)</DisplayText><record><rec-number>1141</rec-number><foreign-keys><key app="EN" db-id="axzrwpxxqvwtw5evsf3xrer2arfwsa5f0e5d" timestamp="1567945789">1141</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Martinez-Raga, Jose</author><author>Ferreros, Amparo</author><author>Knecht, Carlos</author><author>de Alvaro, Raquel</author><author>Carabal, Eloisa</author></authors></contributors><titles><title>Attention-deficit hyperactivity disorder medication use: factors involved in prescribing, safety aspects and outcomes</title><secondary-title>Therapeutic advances in drug safety</secondary-title></titles><periodical><full-title>Therapeutic advances in drug safety</full-title></periodical><pages>87-99</pages><volume>8</volume><number>3</number><dates><year>2017</year></dates><isbn>2042-0986</isbn><urls></urls></record></Cite></EndNote>(Martinez-Raga, Ferreros, Knecht, de Alvaro, & Carabal, 2017) strongly supports the view that safe and effective medication for ADHD is available and recommended as first-line treatment for the core symptoms of inattention, over activity, and impulsiveness. In this article, authors have preferred medicated treatment for ADHD and stated that the efficacy and safety profile of these medicines are well established and can be used as a first-line treatment for the treatment of ADHD. In this first article, authors have strongly proved medication effectiveness by giving references from different literature. This article supports that treatment of ADHD patients is based on multiple approach but medicine alone can prove to be very effective. The authors in this article discuss very clearly the safety profile of ADHD medication and try to prove those people wrong who states that medicines should not be given to children and also give particular attention to adverse events and risk of its misuse.
The other article ADDIN EN.CITE <EndNote><Cite><Author>Currie</Author><Year>2014</Year><RecNum>1140</RecNum><DisplayText>(Currie, Stabile, & Jones, 2014)</DisplayText><record><rec-number>1140</rec-number><foreign-keys><key app="EN" db-id="axzrwpxxqvwtw5evsf3xrer2arfwsa5f0e5d" timestamp="1567945690">1140</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Currie, Janet</author><author>Stabile, Mark</author><author>Jones, Lauren</author></authors></contributors><titles><title>Do stimulant medications improve educational and behavioral outcomes for children with ADHD?</title><secondary-title>Journal of health economics</secondary-title></titles><periodical><full-title>Journal of health economics</full-title></periodical><pages>58-69</pages><volume>37</volume><dates><year>2014</year></dates><isbn>0167-6296</isbn><urls></urls></record></Cite></EndNote>(Currie, Stabile, & Jones, 2014) which is included in this essay shows that little evidence is present on the effectiveness of the use of ADHD medication in the medium and long run. This study had stated that using ADHD medicine had less positive and more harmful effects on the community. This article discusses the concerns associated with ADHD treatment. The drug is prescribed for ADHD treatment but is associated with several long and short side effects. In this article, the authors stated that the medicines are not suitable to treat ADHD. Authors give strong arguments by stating that most of the studies which are conducted in the past focus on efficacy of these medications for a short term such as between 1or 2 months after treatment ADDIN EN.CITE <EndNote><Cite><Author>Buoli</Author><Year>2016</Year><RecNum>1143</RecNum><DisplayText>(Buoli, Serati, & Cahn, 2016)</DisplayText><record><rec-number>1143</rec-number><foreign-keys><key app="EN" db-id="axzrwpxxqvwtw5evsf3xrer2arfwsa5f0e5d" timestamp="1567946018">1143</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Buoli, Massimiliano</author><author>Serati, Marta</author><author>Cahn, Wiepke</author></authors></contributors><titles><title>Alternative pharmacological strategies for adult ADHD treatment: a systematic review</title><secondary-title>Expert review of neurotherapeutics</secondary-title></titles><periodical><full-title>Expert review of neurotherapeutics</full-title></periodical><pages>131-144</pages><volume>16</volume><number>2</number><dates><year>2016</year></dates><isbn>1473-7175</isbn><urls></urls></record></Cite></EndNote>(Buoli, Serati, & Cahn, 2016) Therefore, authors stated that there is a lack of evidence regarding its long-term benefits and this is a key element controversy. The authors stated that controlled studies that are carried out suggested that these medications usually improve attention and performance. But all these studies were for a short time and there are only a few studies that follow children for a longer period. Therefore, authors argue that these positive short-term effects on child behavior and attention are over-estimated. Another concern which authors show in this article is that the doses which yield the most desirable behavior are not well calibrated. therefore, in this article, the author does not support the use of medicine in treating ADHD.
In the first article, authors stated that there is a clear opinion about the effectiveness of stimulant for the treatment of ADHD and it is stated that proper use of ADHD medicine is safe and effective. They stated that there are no scientific meetings which mention any kind of controversies about this disorder, its validity and about the importance of using medicines like Ritalin for its treatment. Science is overwhelming and answers to all these questions are affirmative. ADHD is a real disorder and can be managed by giving stimulants medicines in combination with other therapy. In the second article there is present authentic disagreement on the use of stimulant medication in treating ADHD, Even more, controversial is the question when to use medicines such as Ritalin which are classified schedule II drugs according to drug enforcement law authority. Is it right to place children on these drugs especially when the brains are still developing? In the US these medicines are widely accepted in the treatment of children with ADHD. Physicians prescribe these medicines even the patient is not being diagnose by the psychiatrist. It is of great argument here that without proper diagnosis, prescribing psychotropic drugs can cause complications.
The second article suggests that medicine is not effective in treating ADHD whereas the first article authors argue that medical therapy is very effective to treat ADHD, as medicine is based on benefit vs risk ratio and medicine therapy for ADHD outweighs the risk. Authors stated that although counseling is also very effective but not as compare to medication therapy. Some studies support the first article logics of the effectiveness of medicines in ADHD treatment. In the second article, the authors argued that medicines should not be given to ADHD patients as valid diagnosis is not present. Mark Fineman in one study also stated that stimulants are the drug of abuse and dangerous ADDIN EN.CITE <EndNote><Cite><Author>Iversen</Author><Year>2016</Year><RecNum>1139</RecNum><DisplayText>(Iversen, 2016)</DisplayText><record><rec-number>1139</rec-number><foreign-keys><key app="EN" db-id="axzrwpxxqvwtw5evsf3xrer2arfwsa5f0e5d" timestamp="1567945642">1139</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Iversen, Leslie L</author></authors></contributors><titles><title>Drugs: A very short introduction</title></titles><volume>52</volume><dates><year>2016</year></dates><publisher>Oxford University Press</publisher><isbn>0198745796</isbn><urls></urls></record></Cite></EndNote>(Iversen, 2016). The first article finds this argument irrelevant and stated that if most of the prescription drugs are used improperly then they can cause an adverse effect. On the other hand, usefulness of these medicines can’t be ignored in treating ADHD. However, there are some points in the second article which fully support the argument raised in this study. There are some relevant concerns regarding the pharmacological treatment for ADHD. The studies which are conducted on the effectiveness of treatment of medicine for ADHD are short term. There is a need to conduct long term studies to fully assess the impact of these medicines. Secondly, there are very few studies that are conducted to determine the effect of stimulants on children.
In the second article, authors have stated that parents have the authority to decide whether medicines should be given to children but in the first article, it is stated that behavioral and dietary modification does not seem as effective as ADHD medication. Medication in ADHD proves to be a life-changer as the goal of these medicines is to help children to reduce impulsivity, helps them to focus and function effectively in a social environment. Those people who deny this fact of not treating their child with medicines, their children face consequences of not receiving appropriate care. Studies have shown that there is more chance that they drop out of their school and later in their life become unsuccessful ADDIN EN.CITE <EndNote><Cite><Author>Keilow</Author><Year>2018</Year><RecNum>1138</RecNum><DisplayText>(Keilow, Holm, & Fallesen, 2018)</DisplayText><record><rec-number>1138</rec-number><foreign-keys><key app="EN" db-id="axzrwpxxqvwtw5evsf3xrer2arfwsa5f0e5d" timestamp="1567933936">1138</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Keilow, Maria</author><author>Holm, Anders</author><author>Fallesen, Peter</author></authors></contributors><titles><title>Medical treatment of Attention Deficit/Hyperactivity Disorder (ADHD) and children’s academic performance</title><secondary-title>PloS one</secondary-title></titles><periodical><full-title>PloS one</full-title></periodical><pages>e0207905</pages><volume>13</volume><number>11</number><dates><year>2018</year></dates><isbn>1932-6203</isbn><urls></urls></record></Cite></EndNote>(Keilow, Holm, & Fallesen, 2018).This article also stated that ADHD children are being abused by this type of treatment and it is an outrage, as not getting treatment is neglected.
One of the fundamental areas of controversy regarding the treatment of ADHD is whether medicines should be given to ADHD patients or not. With all facts and literature, it is still not easy to decide whether ADHD medications are effective in treating ADHD or not. If it is not sure then the decision regarding ADHD medicine should be based on the risk-benefit ratio. Increase prevalence of ADHD is seen among children in; last few years. According to the Centers for Disease Control in 2011, almost 8.7% of children were diagnosed with ADHD as compared to 7% in 2007. Children with ADHD also deserve to live a normal life and that treatment should be followed in which behavioral, educational, and psychological status of a child improves so that they can live a better life. ADHD treatment in children can create a great difference between their success and failure. Arguments from these studies suggest that research should be conducted on a large scale regarding the effectiveness of treatment in ADHD.
References
ADDIN EN.REFLIST Buoli, M., Serati, M., & Cahn, W. (2016). Alternative pharmacological strategies for adult ADHD treatment: a systematic review. Expert review of neurotherapeutics, 16(2), 131-144.
Currie, J., Stabile, M., & Jones, L. (2014). Do stimulant medications improve educational and behavioral outcomes for children with ADHD? Journal of health economics, 37, 58-69.
Iversen, L. L. (2016). Drugs: A very short introduction (Vol. 52): Oxford University Press.
Keilow, M., Holm, A., & Fallesen, P. (2018). Medical treatment of Attention Deficit/Hyperactivity Disorder (ADHD) and children’s academic performance. PloS one, 13(11), e0207905.
Kim, M., King, M. D., & Jennings, J. (2019). ADHD remission, inclusive special education, and socioeconomic disparities. SSM-Population Health, 100420.
Martinez-Raga, J., Ferreros, A., Knecht, C., de Alvaro, R., & Carabal, E. (2017). Attention-deficit hyperactivity disorder medication use: factors involved in prescribing, safety aspects and outcomes. Therapeutic advances in drug safety, 8(3), 87-99.
