ADHD column raises concerns about student health

In regards to Anna Claire Conrad's article questioning the legitimacy of a diagnosis of attention deficit hyperactivity disorder (ADHD) (The Auburn Plainsman, July 26, 2012), she has done a wonderful job of providing an option for every student struggling with grades. They need only go to a physician, describe a similar history and receive a prescription for stimulants. Alternatively, they can simply seek out an independent supply of "study buddies" and unfortunately for the student, that cost will not be covered by their parents insurance.

ADHD is a legitimate disorder. However, it is likely overdiagnosed and overtreated, but this fault can be shared with physicians as well as demanding patients (or their parents). Adult ADHD also exists, but is very rare without childhood symptoms although those may not have been recognized until the patient was subject to a thorough medical history.

It is incumbent upon you and your physician to agree to a treatment plan. My issue is not with accuracy/appropriateness of an ADHD diagnosis, but with the cavalier approach to a class of drugs that while effective when properly used, is very dangerous when taken out of the context of legitimate medicine.

Ms. Conrad provides all positive effects, such as increased focus, enhanced multi-tasking, increased energy, better grades and weight loss (which she seems to view as even more important than good grades). The only downsides she mentioned were the expense to her parents and the negatives mentioned by her physician which she neglected to provide in the article.

Please, let us help with that. Serious side effects of these stimulants may include significant heart reactions (ie, sudden death in people with unknown heart problems), increased blood pressure, psychiatric problems (new psychotic problems or aggression), long-term suppression of growth (related to weight loss), seizures, visual disturbances, and tics. Taking these medications in higher doses or routes other than prescribed may come with more severe consequences. Chronic overdose may cause psychosis so severe it may be indistinguishable from schizophrenia.

Risk of these side effects increases if these drugs are taken without a physician's supervision who has screened their patient for physical/psychological warning signs

Withdrawal symptoms, particularly after chronic use, may include fatigue, depression, and disturbed sleep patterns due to physical dependence.

The inappropriate use of amphetamines/stimulants, particularly as "study buddies" is very much akin to the "steroid abuse" in athletics. Taking "steroids" in conjunction with rigorous training increases an athlete's natural strength and abilities, perhaps beyond the reasonable and certainly, unfairly relative to other athletes. The steroids commonly have adverse health effects, sometimes disastrous and once the steroid is stopped, the body regresses to its more natural state.

For an athlete who stops competing, this may not be a concern, but in the case of someone inappropriately reliant on stimulants, when is the right time to stop? And if you find that time, can you? Amphetamines are among the most psychologically addictive substances known which accounts for the Drug Enforcement Agency's classification of this class of drugs as C-II, the highest addictive potential of all drugs legitimately marketed.

Ms. Conrad has described several indicators of potential problems: loss of appetite and weight loss (yes, these are adverse drug reactions), no longer exhausted may indicate lack of sleep, dependence on the medication for daily functioning, and escalating dosages. Long term lack of sleep and poor diet will ravage even the best immune system.

The tree has fallen and it has made a noise, you just have to recognize the sounds.

Bernie R. Olin, Pharm.D.

Associate Clinical Professor

Alicia Lenkiewicz

P4 Student Pharmacist

Kimberly Triplett

P4 Student Pharmacist

Lauren Woller

P4 Student Pharmacist