According to a peer reviewed study carried out by the Cochrane: Developmental, Psychosocial and Learning Problems Group, researchers are claiming that the drug Methylphenidate, commonly known as Ritalin is used to treat ADHD in children is linked to non-serious adverse effects, particularly problems with having an appetite and sleeping. The study was a randomized control study that included 12, 245 children and or adolescent’s that had ADHD. One confounding variable among-st these participant’s is that most came from a high socioeconomic status, which is very odd. I say that, because it’s people from low socioeconomic backgrounds who face prolonged health effects. This is especially true when we learned in class that kids who are infested with worms “wormy kids” come from poor countries from areas of Africa and south East Asia, because the livelihood of kids with worms living in third world countries is based on their low socioeconomic status. Saying this, you would think that these 12, 225 participants would refrain from continuing to use methylphenidate, but it could be that they can’t realize that for themselves since many of them are so young and that they associate sleeplessness and dietary problems as being a part of their lives just like the kids with worms in developing countries do unfortunately. However, in all of the 185 randomized control trials, researchers found that all of them were at high risk for bias. As we learned in class, bias studies are designed to spread a cause many times coming from the funder of a study. In this particular study, Copenhagen University Hospital was one funder along with Region New Zealand, and the University of Southern Denmark. One indication that the funders of this study had an impact in the level of bias in this study, is that it was impossible to assess the long-term effects of methylphenidate because those randomized trials were too small and of low quality.
However, primary and secondary outcomes were present in the study. Findings from the primary outcome of if Methylphenidate can improve ADHD symptoms from the prospective of a teacher show that Methylenidate can help to improve hyperactivity and impulsivity in ADHD children. Findings from the secondary outcome which were the group of children prescribed with Methylenidate show that Methphenidate doesn’t increase the risk of developing a life threatening disease only taking the drug for six months, but it’s linked to ADHD children developing sleeping problems and a deceased appetite. I personally agree to this because I’ve seen my ex room-mate who had ADHD at times display a decrease in his appetite, and complain about sleeping patterns. In a similar study, one study linked ADHD medications to lower bone density. This study was led by Dr. Jessica Rivera, an orthaepedic surgeon with the US Army of Surgical Research and her fellow researcher’s. Dr. Rivera and her collegeues assessed 5,315 children in the CDC’s National Health and Nutrition Examination Survey (NHANES) by comparing the children who were taking ADHD medications with children who were not ADHD medications. The ADHD medications that the ADHD children were using were lisdexamfetamine (Vyvanse), methylphenidate (Ritalin), atomoxetine (Strattera), dexmethylphenidate (Focalin), and dextroamphetamine (Dexedrine). From their assessment on these children, Dr. Rivera and her medical colleugues found that 25% of the children who took ADHD medications met the necessary guidelines for osteopenia, which is characterized by low bone density in the body. Specifically, those 25% on ADHD medications who met the criteria for Osteopenia, had lower bone density in the lumbar spine, femur, and femoral neck compared to the children who were not on ADHD medications. From the findings of these results, Dr. Rivera says that the even though a connection between Osteopenia in childhood and osteoporosis in later life hasn’t been confirmed; the issue is that low bone density in ADHD children could have adverse long term effects as these children age. This is because increases in bone mass and strength is primarily obtained in childhood. The possible biological mechanism as to why ADHD children who take ADHD medications experience low bone density is because the medications that they use can cause gastrointenstinal problems. These gastrointenstinal problems result in some experiencing a decrease in appetite, and therefore an upset stomach, which can lead to some children having a poor diet and a decrease in calcium intake. This study reminds me of topic discussed in class about corticosteriods being proscribed to head injury patients in order to prevent the swelling of the skull, and about anti-arrhythmic medications being prescribed to patients experiencing heart problems. In both situations, the corticosteriods as well as the anti-arrhythmic medications did more harm than good for patients, to the point where it was killing them. In the same way, ADHD medications are having more adverse effects on users than good effects, many are experiencing sleeping problems, a decreased appetite, and therefore a low bone density.
American Academy of Orthopaedic Surgeons news release, accessed 3 March 2016 via EurekAlert.
CDC, ADHD, accessed 3 March 2016.
Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD), Ole Jakob Storeb et al Cochrane Review, doi: 10.1002/14651858.CD009885.pub2, published online 25 November 2015.