Pediatricians, Researchers Divided Over ADHD Drugs’ 'Normalizing' Effects

By Paul Gaita 02/06/15

Some doctors think that the long-term benefits of stimulant medications are presumptive at best.

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A debate has grown among medical professionals who treat the more than 6.4 million children diagnosed with attention deficit hyperactivity disorder as to the impact of medication prescribed for the condition upon neural connection in the brain.

One side of the argument views stimulant medication like methylphenidate as “neuroprotective,” meaning that it could help to “normalize” not only brain function but even structure to resemble the brains of children without ADHD.

Dr. Timothy Wilens, chief of child and adolescent psychiatry at Massachusetts General Hospital, supported the neuroprotective theory in an interview with the online news site Psych Congress Network by citing a 2013 review in the Journal of Clinical Psychiatry, which looked at brain-scan studies. The review noted that stimulant medication is directly linked to the reduction of “abnormalities in brain structure, function and biochemistry in subjects with ADHD.”

But an equal number of doctors have dismissed such assertions as presumptive at best. Stimulants have been shown to provide temporary assistance to ADHD patients by increasing the amount of dopamine and norepinephrine processed in the brain, which in turn aids issues of focus and self-control.

However, researchers like Dr. James Swanson, director of the Child Development Center at the University of California at Irvine and co-author of the Multimodal Treatment of Attention Deficit Disorder study, have found that while improvement is evident in children who take medication for the disorder, no long-term benefits beyond three years have been determined.

“Sometimes wishful thinking gives us hope that the impressive short-term benefits of medications over other treatments will persist beyond childhood, but I haven’t seen it,” said Swanson in an interview with the New York Times.

Both sides of the debate also cast light on whether to prescribe medication for children at all. Dr. Peter Jensen, head of the national non-profit institute REACH, noted to the New York Times that in surveying 100 parents of children who had been diagnosed with ADHD in their adolescence, 80% advocated care and attention and empowerment of their child, as well as finding a doctor who is willing to help whether or not medication is taken.

“Only a minority of these parents mentioned medication,” said Jensen.

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Paul Gaita lives in Los Angeles. He has contributed to the Los Angeles Times, Variety, LA Weekly, and The Los Angeles Beat, among many other publications and websites.