Thursday, February 23, 2006
Side effects of AHDH medicine rare but deadly

By Dr. Anthony Policastro
Nanticoke Memorial Hospital,
Medical director

Recently a group from the FDA agreed that new warnings should be placed on prescriptions for Ritalin and other stimulants. This included most drugs that are used to treat ADHD. The vote was eight in favor of the warning to seven against the warning. It was based upon a rare side effect. Over the last few years about one in a million children taking these medications has had a heart related death. The question is whether the deaths are related to the medication. That is the reason the vote was so close. With the incidence being only one per million, it is hard to be sure. However, for the time being, the FDA will likely add that warning to the label. This is the latest in a series of concerns about drugs used to treat ADHD. In the past, one of the alternative drugs to stimulants was Cylert. It caused three children to die from liver failure. The drug was not used very much after that. It has now been taken off the market. Another drug was an antidepressant caused desipramine. It resulted in some problems with heart rhythms in children. Three children died. We stopped using it. The most recent drug that was released for use in ADHD was one called Strattera. It was originally tested on a small group of children. As more children used it, we found that it caused liver failure in three children. We found that it increased the chance of manic-depressive behavior. We found an increased risk of suicide. It is not used as much any more. Some of the newer antidepressants also have an effect on ADHD. They too have recently been shown to have an increased risk of suicide. They are not used as much any more.

In all cases, the risks are relatively rare. However, they are also relatively serious. The question is, what do you do if your child has ADHD. We do know some things about untreated ADHD. The risks of that are many. Children with untreated ADHD are more likely to drop out of school. They are more likely to use drugs as adolescents. They are more likely to wind up in jail. They are more likely to commit suicide. The result is that we have to weigh the risks of medication against the risks of the disease. In some cases, children have mild cases of ADHD. In those children the risks of the medication might not be worth it. In other instances, children have severe cases of ADHD. The risks of not treating the condition become an issue. We have to balance the rare serious side effect of the medication against the common serious outcomes of the ADHD itself. It becomes a decision specific to each child. The FDA can tell us about the risk of the medication. It cannot tell us much about the risk of the condition. That is something each parent must discuss with his or her child's physician. I have been treating ADHD since 1976. I have certainly not gotten to a million cases. Fortunately, I have not had one of the more serious reactions to the medication over that period of time. Given the fact that it is so rare, I expect that I will not see it in the future as well.

Health fair set for March at CHEER Center in Georgetown
The CHEER Community Center, 20520 Sand Hill Road, Georgetown, is hosting a health fair on Friday, March 31. The health fair will be open from 10 a.m. until 2 p.m. The health fair will focus on health screenings and senior issues. Any service-oriented businesses that cater to the senior community are invited to set up displays. Some of the venders that will be participating in the fair are Apple Discount Drugs, Diabetes Supply Service Inc., CHEER Home Services (diabetes screening), Harbor Health Care & Rehab Center, Office of the state bank commissioner, Rockford Center, Beebe Medical Center (osteoporosis screening), Berlin Nursing & Rehabilitation Center, Mercantile Mortgage, Peninsula Home Care (blood pressure), Delaware Hospice, Sussex Eye Care (visual acuity and intraocular pressure checks), CHEER caregiver resources, CHEER Nutrition (nutrition screenings) and CHEER marketing. Admission to the health fair is free. Any organization or businesses that is interested in setting up an exhibit at the fair may call Nicole McCready at 854-9500.