Child and Adolescent Clinical Psychopharmacology Made Simple by John D. Preston & Mary C. Talaga & John H. O'Neal

Author:John D. Preston & Mary C. Talaga & John H. O'Neal [Preston, John D.]
Language: eng
Format: epub
ISBN: 9781626251939
Publisher: New Harbinger Publications
Published: 2015-03-01T06:00:00+00:00

A few words about Stimulants

Stimulants, in general, increase alertness, reduce drowsiness (ask any truck driver or college student), and help people to maintain focused attention. This is true for almost everyone. The effects on psychologically normal functioning individuals are moderate and transient (usually lasting 3–6 hours). In children with the inattentive specifier, there may be only a slight improvement. In those with accurately diagnosed ADHD, the impact is robust.

Increasingly, stimulants are being used by those without psychiatric disorders as a sort of “performance enhancing” drug (i.e., to improve academic and occupational outcomes). However, in some individuals stimulants can provoke significant anxiety or precipitate panic attacks, and stimulants can increase psychotic symptoms in those with psychotic illnesses.

Prescription stimulants are sometimes abused by those predisposed to substance abuse. However, it is important to note that children and adolescents with ADHD typically do not abuse these drugs. In fact, especially with teenagers, it is often difficult to get them to take the medications. Rather than getting a “buzz,” most adolescents with ADHD report that stimulants make them feel somewhat “slowed down” (decreased spontaneity) and at times dysphoric. Some research suggests that the use of stimulants can reduce substance abuse in ADHD adolescents. It should be noted, however, that study results are mixed overall. Although most show significant protective effects (Biederman, Willens, Mick, Spencer, & Faraone, 1999; Kuczenski & Segal, 2002; Mannuzza, Klein, & Moulton, 2003; Groenman et al., 2013), some show no difference in substance abuse rates when comparing treated and not treated ADHD teenagers (Sinclair, 2013). And one major exception is that there are high rates of nicotine use among ADHD adolescents, whether treated or not.

In any case, the issue most important to be alert to is abuse by parents, siblings, and the child’s friends (who may buy or steal the child’s stimulants).

The prescription stimulants that have the lowest incidence of abuse are Concerta and Vyvanse. The antidepressants with ADHD efficacy (Strattera and Wellbutrin) and alpha-2 agonists (e.g., Kapvey, Intuniv, Catapres) are non-habit-forming.

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