Focusing on A.D.D
Looking for a New Drug
Understanding what causes ADD is child's play compared with knowing how to treat it. There is no cure, so learning how to control the condition is the focus of treatment. And when it comes to ADD treatment, medication has long been accepted as the best medicine.
Stimulant drug use for hyperactivity dates to 1937, when Charles Bradley, M.D., discovered the therapeutic effects of the amphetamine Benzedrine on behaviorally disturbed children. In 1948, Dexedrine was introduced and shown to be just as effective, without such high dosages. This was followed by Ritalin in 1954. Ritalin had fewer side effects and, since it's not an amphetamine, less potential for abuse. It soon became the best-known and most prescribed psychoactive drug for ADD children—as well as the most scrutinized: By now hundreds of studies have backed its safety and effectiveness.
But nowadays, Ritalin has taken a back seat to generic versions of methylphenidate—Ritalin's active ingredient—and ADDerall. A "cocktail" drug of amphetamines, ADDerall offers greater dosage flexibility, works more gradually and on a broad spectrum of symptoms, and eliminates the peaks and valleys of methylphenidate.
Still, these drugs are what continue to make ADD treatment controversial. The greatest fallouts with any stimulant medication are lifelong dependency and possible side effects from such long-term use. General use of ADD drugs can trigger some immediate reactions, such as loss of appetite, insomnia, weight loss, delayed puberty, irritability, and the unmasking of latent tics.
Yet these symptoms are said to be manageable with dosage modifications or by discontinuing the use of medication. And although several studies have shown most side effects are mild and short-term, many researchers add that there are insufficient long-term studies to confirm the safety of these drugs over an extended period.
Then there is the ongoing debate regarding the effectiveness of ADD medication beyond a certain time frame. Enid Haller, Ph.D., a specialist in ADD and director of Behavioral Arts in New York City, considers psychopharmaceuticals a short-term intervention at best. "These drugs stop working after six months to a year, and you have to switch medications or change the dosage," she says. "Unless the individual with ADD learns to compensate for their deficiencies and exploit their mental strengths, medication alone won't help in the long term."
Today, more health-care professionals recommend a multidisciplinary, multimodal approach to the treatment of ADD, which includes medication but also therapy and dietary changes as well as a host of mind-body approaches, such as biofeedback, neurofeedback, and yoga. These treatments work to help ADD sufferers learn how to control their symptoms and relieve both emotional and physical stress. But as is the case with most complementary treatments, lack of scientific evidence keeps them from being more accepted and widely used. They tend to get stuck in a gray area: Either they have strong testimonials but no clinical trials to support them, or they have encouraging preliminary research to back their claims but no follow-up studies.