Ask the Pharmacist: Expert advice for managing ADHD medications

(BPT) – Attention Deficit Hyperactivity Disorder (ADHD) is no longer just a condition impacting school-aged boys. In fact, ADHD diagnosis rates are exploding among the adult population – climbing 53 percent overall and an alarming 84 percent for those ages 26-34.

In Express Scripts’ new report, “Turning Attention to ADHD: U.S. Medication Trends for Attention Deficit Hyperactivity Disorder” the number of Americans who use medication to treat ADHD rose 36 percent between 2008 and 2012. Women’s use of these drugs has been on the rise and they now far outnumber men taking ADHD medications.

“Adults may spot their own struggles with attention as they watch their child show signs of ADHD,” says Teresa Tran, an Express Scripts specialist pharmacist in the Neuroscience Therapeutic Resource Center. “We’ve identified this trend specifically among women, since they tend to be the parent who attends doctor’s visits and is oftentimes more open to seeking help.”

While there have been drastic increases among adults, children are still the dominant users of these medications. Teenage boys, 12 to 18 years old, are still, by far, the leading users. In 2012, more than 9 percent of that population took an ADHD medication – up from 7.9 percent in 2008.

“Some factors that may be pushing these numbers upward include increased pressure on schools and students to perform well on high-stakes standardized tests,” says Tran. “Additionally, more ‘screen time’ could also be playing a part: frequent video game playing, especially by young children, has been shown to increase disruptive or distracted behaviors that can be confused with ADHD symptoms or may make the condition worse.”

According to the report, more than 80 percent of children taking ADHD medications use a stimulant form. Stimulants are extremely effective in reducing ADHD symptoms, but there are risks associated with their use, including addiction and adverse reactions in patients with cardiovascular disease or related conditions. If taken in high doses, stimulant ADHD medications also can stunt growth in children, increase risks of other psychiatric conditions and cause seizures.

Tran offers parents the following tips to consider when their child is using an ADHD medication:

* Understand the risks: All prescription medications come with safety risks. It’s important to teach your children about the safe use of medications, including not sharing their medication with others and knowing that some other medications or supplements, such as energy or highly caffeinated drinks, can cause serious, life-threatening interactions with their ADHD medications.

* Watch for addiction: Stimulant medications can be abused when a person uses these medications for reasons or in dosages other than prescribed, or by taking a stimulant medication that is not prescribed for that individual. Stimulants also are known to suppress a person’s appetite, which makes them attractive for weight loss. Keep an eye on any major changes in your child’s mood or personality, or any sudden or drastic weight loss, particularly in teens and young adults. This may indicate misuse of the medication. Also emphasize that giving controlled substances to a friend is illegal and can cause significant harm.

* Discuss drug holidays: Drug holidays (for example, discontinuation of stimulant medication on weekends or during the summer) are not routinely recommended because ADHD is a chronic disorder. However, if ADHD medication side effects or growth issues are significant, then drug holidays are an important option. Discuss with your physician about the need for a drug holiday before stopping the medication.

* Limit screen time: While there is no conclusive evidence that screen activities actually cause ADHD or make it worse, video-game playing – especially among young children whose brains are developing – trains the brain to respond to quick stimuli. Limiting screen time and encouraging other forms of play can help a child manage their symptoms.

For more information and additional ways to become a more engaged and empowered patient, visit Express Scripts’ Healthcare Insights blog at

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