Effects of ADHD Stimulants on Kids Still Uncertain
> 11/20/2008 3:34:33 PM

New research appears to contradict the popular perception that the powerful stimulants currently prescribed to treat ADHD pose developmental risks to children and adolescents. The issue will undoubtedly remain controversial in the absence of further evidence, and the findings, however they’re received, will do nothing to stem concerns about the recreational abuse of these drugs by teens and young adults.

The purpose of a newly published study performed at Duke University and the National Institutes of Health was to revisit and potentially re-create the results of previous research that hinted at rapid chromosomal changes in children dosed with the psychostimulant methylphenidate (Ritalin). This earlier and far more worrisome study took place in 2005 and concerned only 12 children, all of whom displayed “chromosomal abnormalities” only 3 months after beginning standard Ritalin treatment. The major source of concern was the link between alterations in the chromosomal chain and an increased cancer risk that’s been noted in repeated animal studies. And the fact that all 12 of the children involved displayed some of these changes was particularly distressing. While the exact biochemical factors behind the results could not be determined, we’re guessing that the same stimulant properties that lead college students to abuse “R-Ball” during high-energy all-night cram sessions might interfere with the natural development of young kids’ genetic markers. The 2005 findings have, however, lost some of their weight in light of the new data.

The earlier study was very small, involved a narrower age range and concerned the use of methylphenidate only. The new, more comprehensive study used a far larger subject pool (63 kids aged 6-12), dividing the group into subsets who received either methylphenidate or amphetamine salts (Adderall), the other half of the reigning psychostimulant duo. Researchers observed the white blood cell makeup of the subjects both before the study began and after an identical 3-month treatment period. They watched for three particular disturbances in the subjects’ DNA sequences: physical breaks in the chromosomal chain; micronuclei, or groups of fragments created by the dissolution of primary nuclei during standard cell division; sister chromatid exchanges, or the unusual trade-off off genetic materials between identical chromosomes. Data drawn from the 47 children who completed the regimen contradicted earlier findings, with researchers failing to reproduce the 2005 study’s results and noting none of the reported chromosomal damage. They also noticed no statistical differences based on variables such as medication, age, gender, race or ADHD subtype.

Has the stimulant controversy been resolved? Hardly. This study only considered potential physical changes to the chromosomes of the subject pool. While the purpose of these stimulants is obviously to reduce behavioral problems, the personal changes they supposedly engender may also play a significant, unknown role in a child’s development. And the earlier study, however contradicted by the new data, implies that these drugs carry at least the potential to change the very genetic building blocks of the kids in question. These powerful stimulants are still (thankfully) illegal for prescription to those under the age of 6, so regulatory authorities obviously share our opinion that no drug carrying the potential for abuse and dependence should be available to children under the law. While researchers claim that their findings amount to “good news for parents,” they also note that the study “should not be interpreted as final proof” of the drugs’ long-term safety for growing kids. We agree. One study cannot disprove the possibility of adverse side effects – and we remain extremely skeptical of the practice at large.

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