Study raises questions about long-term effect of ADHD medication
A Western Australian study has raised concerns about the long-term effects of stimulant medication used to treat children with Attention Deficit Hyperactivity Disorder (ADHD).
The ADHD Study, the first of its type in the world, found that long-term use of drugs such as Ritalin and dexamphetamine may not improve a child’s social and emotional well-being or academic performance.
Chair of the Ministerial Implementation Committee for ADHD in WA Professor Louis Landau said WA was in a unique position to carry out the research because of access to data collected by an internationally renowned Child Health Study*, which is looking at the long-term health and well-being of almost 3,000 WA children.
"There are 131 children within the child health study diagnosed with ADHD and health and development data for these children was analysed over an eight year period," he said.
"While there was no significant difference in health or ADHD symptoms in the children at five years of age, the study revealed a number of differences in children who were treated with stimulant medication by the time they were 13.
"We found that stimulant medication did not significantly improve a child’s level of depression, self perception or social functioning and they were more likely to be performing below their age level at school by a factor of 10.5 times."
Prof Landau said the study also suggested that a child’s heart function may be affected by long-term stimulant use and may remain affected even after stopping medication.
"While these differences were small, the results suggest that doctors should look at a child’s cardiovascular risk symptoms before starting treatment with stimulant medication," he said.
"While the study was limited by a relatively small sample size, it was larger than those in many short-term studies that supported the use of stimulants as a safe and effective treatment for children with ADHD.
"This research cannot indicate whether or not individual children may benefit from stimulant medication, but what it does suggest is that the benefit:risk balance needs to be considered for each child for whom stimulants are considered.
"At the very least, these findings certainly demonstrate the need for continued comprehensive management for all children with ADHD."
The study was commissioned by the Ministerial Implementation Committee for ADHD in Western Australia (MICADHD). It was funded by the WA Department of Health in response to a recommendation by the 2004 Western Australian Parliamentary Inquiry into ADHD that the Department of Health examine the safety and efficacy of the long-term treatment of children with stimulant medication.
The study is available on the Department on Health website: http://www.health.wa.gov.au/publications
*The Child Health Study is funded by the RAINE Foundation and Commonwealth and State government research grants. The study began in 1989 when 2,900 women at about 18 weeks of pregnancy were recruited at King Edward memorial Hospital in Perth Western Australia to examine ultrasound imaging. The study has continued to collect longitudinal data on the health and development of this mother and child cohort. More information on this study is available at www.rainestudy.org.au
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