According to a new Consumer Reports Best Buy Drugs report, parents should be skeptical if their doctors offer them free prescription drug samples, especially for the treatment of attention deficit hyperactivity disorder (ADHD). Free samples can hook consumers on high-priced brand name drugs that are not any better or safer than less expensive generic medicines. In addition, when doctors give out free samples, they often fail to give patients information inserts that highlight important safety and side effect information.
Consumer Reports Best Buy Drugs found that two generic ADHD drugs, dextroamphetamine and methylphenidate, are as safe and effective as well- known drugs like Adderall XR, Concerta or Strattera. By switching to one of those two generic drugs, consumers could save roughly $3,000 a year off the retail price.
"Parents want to do what is best for their children," says Dr. John Santa, director of the Consumer Reports Health Ratings Center. "But free samples and clever advertising convince them they should be shelling out thousands of dollars a year for brand name prescription drugs when equally effective generics are available."
ADHD is one of the most common behavioral problems diagnosed among school-age children in the United States and about 7 percent (about 4.5 million in 2006) of children aged 4 to 17 have been diagnosed with the disorder. When ADHD needs to be treated with medication, parents may be presented with advertisements and free samples of expensive brand-name drugs.
Drug companies gave away an estimated $16 billion in free drug samples in 2004, and doctors routinely hand out these free samples to parents. In fact, according to one October 2008 study in the journal of Pediatrics; about 1 out of every 10 kids already taking a medication got a free drug sample. According to that study, which looked at data from 2004, the ADHD drug Strattera was the 4th most common free drug sample given to children; Adderall XR was in the top 15.
A recent poll by the Consumer Reports National Research Center revealed that 80 percent of Americans who take prescription drugs have received free samples from their physicians. "The use of free samples is extremely prevalent and insidious," said Santa. "And is likely not the best first-choice treatment for a patient's condition."
"Once the samples run out, consumers are likely to end up with sticker shock when they go to fill the prescription," explained Santa. Moreover, samples often do not contain a patient package insert, which describe important safety information.
Ensure a Correct ADHD Diagnosis
Consumer Reports Best Buy Drugs notes that many young patients who take ADHD drugs either do not have ADHD or have only mild symptoms. Before starting any drug treatment for ADHD, it's essential to get an accurate diagnosis by a medical professional.
"Few children present with symptoms of ADHD that can be easily diagnosed by simple observation," said Dr. Orly Avitzur, medical adviser, Consumers Union. "Most need to be evaluated with formal testing, and questionnaires answered by the parents and teachers. A complete history and physical examination should also be performed before medication is prescribed."
Children or teens with ADHD exhibit a persistent pattern, lasting six months or more, including impulsive behavior, hyperactivity, and/or lack of focus and inability to complete a task. A pediatrician, primary care doctor or mental-health professional should always begin by ruling out other possible reasons for their behavior. Parents should question a medical professional who diagnoses ADHD on the first visit and prescribes a drug on the spot.
ADHD Drugs May Only Work for a Few Years
And there is another hitch: a recent study shows that at least one ADHD stimulant drug, methylphenidate (Ritalin), may only work for a few years. There is little evidence proving a clear benefit beyond that. Long term studies have not been done on other ADHD drugs. Parents should routinely check in with their child's doctor about whether the drugs are still working since all stimulant drugs, along with Strattera (a non-stimulant), may have long-term risks, including possibly suppressing a child's growth and a rare risk of sudden death, stroke or heart attack.
Methodology
The Consumer Reports Best Buy Drugs report on drugs to treat ADHD is based on a systematic review of hundreds of research articles and studies, where the risks and benefits of one drug or many drugs against each other are evaluated. This kind of systematic review is known as comparative effectiveness and all Consumer Reports Best Buy Drugs reports use this process as the basis for their drug Ratings.
JULY 2009
(C) Consumers Union 2009. The material above is intended for legitimate news entities only; it may not be used for commercial or promotional purposes. Consumer Reports(R) is published by Consumers Union, an expert, independent nonprofit organization whose mission is to work for a fair, just, and safe marketplace for all consumers and to empower consumers to protect themselves. To achieve this mission, we test, inform, and protect. To maintain our independence and impartiality, Consumers Union accepts no outside advertising, no free test samples, and has no agenda other than the interests of consumers. Consumers Union supports itself through the sale of our information products and services, individual contributions, and a few noncommercial grants.
Source: Consumer Reports Health
View drug information on Adderall XR; Concerta; Ritalin LA.
вторник, 7 июня 2011 г.
понедельник, 6 июня 2011 г.
ADHD: NYU Child Study Center Offers Unique Summer Experience For Children With Attention-Deficit/Hyperactivity Disorder
As parents and teachers know, children with Attention-Deficit/Hyperactivity Disorder (ADHD) can thrive in a setting that emphasizes achievement and success and maintains consistency and, therefore, predictability. To that end, NYU Child Study Center created the Summer Program for Kids (SPK), New York's first all-day, therapeutic camp exclusively for children with ADHD, which is now in its eighth year. SPK combines traditional summer camp activities, such as swimming and arts and crafts, with academic and computer activities, in an effort to improve social skills and raise self-esteem of children ages 7 to 11.
"Often, we find that our campers felt out of place at other camps where there was not a real understanding of their needs," says Karen Fleiss, Psy.D., clinical director of the NYU Child Study Center Long Island Campus and the Summer Program for Kids. "Many of the children have a very low self-esteem, so we put a lot of attention on positive reinforcement and instilling a much-needed sense of confidence."
The staff to child ratio is 1 to 1.5, allowing the children to get the individualized attention they need. The SPK counselors are advanced psychology undergraduate majors or graduate students who undergo a month-long intensive training to gain an understanding of children with special needs and to learn behavioral strategies. The counselors help kids improve social behavior; friendship skills; academic competence; problem-solving skills; self-esteem; classroom behavior; sports competence; anger control; and rule following, among others.
The SPK format is based on the Summer Treatment Program, which was a behavior therapy component of the Multimodal Treatment Study of ADHD (MTA), the largest clinical trial of children with ADHD funded by the National Institute of Mental Health. The MTA study consisted of 579 children who were treated at six university medical centers across the United States and one in Canada. Each child was randomly assigned to one of four treatment conditions for 14 months - medication, usually Ritalin; behavior therapy; a combination of both behavior therapy and medication; or regular community care, which included in most cases Ritalin prescribed by community doctors instead of MTA staff.
"From this initial trial, we found that the two MTA treatment conditions that involved medication management were equivalent, and superior to the other treatments in reducing the symptoms of ADHD; that lower doses of medication were needed to obtain symptom reductions in the combined treatment condition; and that the effects of behavior therapy were roughly equivalent to medication treatment provided in the community," according to Howard Abikoff, Ph.D., a principal investigator of the MTA and director of the Institute for Attention Deficit/Hyperactivity and Behavior Disorders at the NYU Child Study Center. "We continued to monitor - although not treat - these children after the original study and found that at one-year follow-up the medication management and combined medication and behavior therapy treatment options maintained their superiority in reducing symptoms, indicating that initial treatment effects do continue."
Parents of the campers are encouraged to take part in weekly training sessions offered throughout the summer. These sessions tie together what kids are learning in the program to what is happening at home. Parents are able to share their experiences with each other and learn effective behavior management techniques that help encourage their children to follow the rules and promote independence and positive self-esteem.
Parents of children who participate in the camp report that the progress their kids make during the summer carries through to the school year. The full-day camp runs for eight weeks, beginning June 26 and ending August 18. The camp is located in Throggs Neck on the campus of SUNY Maritime.
ADHD is a group of related childhood problems that cause difficulties with behavior, academic performance, and peer relationships in about five percent of school-aged children. In the United States alone, it affects between one and two million children.
Watch "A Summer in Paradise" - a online video on the NYU Child Study Center's Summer Program for Kids - at http://mc-rms01.med.nyu/ramgen/realmedia/summer_paradise.rm. Learn more about SPK, ADHD, and the NYU Child Study Center at aboutourkids/.
NYU Child Study Center
The NYU Child Study Center is dedicated to the understanding, prevention and treatment of child and adolescent mental health problems. The Center offers expert psychiatric services for children and families with emphasis on early diagnosis and intervention. The Center's mission is to bridge the gap between science and practice, integrating the finest research with patient care and state-of-the-art training, utilizing the resources of the New York University School of Medicine. The NYU Child Study Center offers a variety of mental health services for children, adolescents, young adults and their families. Child and Family Associates is the clinical arm of the NYU Child Study Center and the point of entry for all clinical programs. Its goal is to bring together the most research-supported evaluations and treatments with an individualized and family-centered approach.
Contact: Kari Root
New York University Child Study Center
View drug information on Ritalin LA.
"Often, we find that our campers felt out of place at other camps where there was not a real understanding of their needs," says Karen Fleiss, Psy.D., clinical director of the NYU Child Study Center Long Island Campus and the Summer Program for Kids. "Many of the children have a very low self-esteem, so we put a lot of attention on positive reinforcement and instilling a much-needed sense of confidence."
The staff to child ratio is 1 to 1.5, allowing the children to get the individualized attention they need. The SPK counselors are advanced psychology undergraduate majors or graduate students who undergo a month-long intensive training to gain an understanding of children with special needs and to learn behavioral strategies. The counselors help kids improve social behavior; friendship skills; academic competence; problem-solving skills; self-esteem; classroom behavior; sports competence; anger control; and rule following, among others.
The SPK format is based on the Summer Treatment Program, which was a behavior therapy component of the Multimodal Treatment Study of ADHD (MTA), the largest clinical trial of children with ADHD funded by the National Institute of Mental Health. The MTA study consisted of 579 children who were treated at six university medical centers across the United States and one in Canada. Each child was randomly assigned to one of four treatment conditions for 14 months - medication, usually Ritalin; behavior therapy; a combination of both behavior therapy and medication; or regular community care, which included in most cases Ritalin prescribed by community doctors instead of MTA staff.
"From this initial trial, we found that the two MTA treatment conditions that involved medication management were equivalent, and superior to the other treatments in reducing the symptoms of ADHD; that lower doses of medication were needed to obtain symptom reductions in the combined treatment condition; and that the effects of behavior therapy were roughly equivalent to medication treatment provided in the community," according to Howard Abikoff, Ph.D., a principal investigator of the MTA and director of the Institute for Attention Deficit/Hyperactivity and Behavior Disorders at the NYU Child Study Center. "We continued to monitor - although not treat - these children after the original study and found that at one-year follow-up the medication management and combined medication and behavior therapy treatment options maintained their superiority in reducing symptoms, indicating that initial treatment effects do continue."
Parents of the campers are encouraged to take part in weekly training sessions offered throughout the summer. These sessions tie together what kids are learning in the program to what is happening at home. Parents are able to share their experiences with each other and learn effective behavior management techniques that help encourage their children to follow the rules and promote independence and positive self-esteem.
Parents of children who participate in the camp report that the progress their kids make during the summer carries through to the school year. The full-day camp runs for eight weeks, beginning June 26 and ending August 18. The camp is located in Throggs Neck on the campus of SUNY Maritime.
ADHD is a group of related childhood problems that cause difficulties with behavior, academic performance, and peer relationships in about five percent of school-aged children. In the United States alone, it affects between one and two million children.
Watch "A Summer in Paradise" - a online video on the NYU Child Study Center's Summer Program for Kids - at http://mc-rms01.med.nyu/ramgen/realmedia/summer_paradise.rm. Learn more about SPK, ADHD, and the NYU Child Study Center at aboutourkids/.
NYU Child Study Center
The NYU Child Study Center is dedicated to the understanding, prevention and treatment of child and adolescent mental health problems. The Center offers expert psychiatric services for children and families with emphasis on early diagnosis and intervention. The Center's mission is to bridge the gap between science and practice, integrating the finest research with patient care and state-of-the-art training, utilizing the resources of the New York University School of Medicine. The NYU Child Study Center offers a variety of mental health services for children, adolescents, young adults and their families. Child and Family Associates is the clinical arm of the NYU Child Study Center and the point of entry for all clinical programs. Its goal is to bring together the most research-supported evaluations and treatments with an individualized and family-centered approach.
Contact: Kari Root
New York University Child Study Center
View drug information on Ritalin LA.
воскресенье, 5 июня 2011 г.
Inconsistent Performance Speed Among Children With ADHD May Underlie How Well They Use Memory
Children with attention-deficit hyperactivity disorder (ADHD) show more variable or inconsistent responses during on 'working' or short-term, memory tasks when compared with typically developing peers, a study by UC Davis M.I.N.D. Institute Julie Schweitzer has found.
"We think poor working memory is a characteristic present in many children and adults with ADHD," said Schweitzer, an associate professor in the Department of Psychiatry and Behavioral Sciences.
"Our study helps explain why working memory may be fine at one moment and poor at another, just as one day a child with ADHD seems to be able to learn and focus in class and on another day seems distracted and not paying attention," Schweitzer said.
According to the national Centers for Disease Control and Prevention (CDC), an estimated 4.4 million youth, ages 4 to17, have been diagnosed with ADHD by a healthcare professional. In 2003 nearly 8 percent of school-aged children were reported to have an ADHD diagnosis by their parent. The current study, published online in February in the journal Child Neuropsychology, supports the idea that what underlies impaired working memory is a problem in how consistently a child with ADHD can respond during a working memory task.
"We have known for some time that children with ADHD vary in how fast they are able to complete working memory tasks when compared to normally developing control subjects," Schweitzer explained .
Previous studies have suggested that children with ADHD might be slower at responding to tasks. The current study took a closer look at their performance using a relatively newer statistical analytical approach, to determine whether the children with ADHD were indeed faster, slower, or if perhaps another, more complicated process was occurring. The hypothesis was that children with ADHD were actually mostly responding at the same rate as healthy children, but with more frequent very slow responses than the control subjects.
To test this hypothesis, the study authors presented 25 children with ADHD and 24 typically developing peers with the Visual Serial Addition Task, a computerized program that presents children with a number on one screen and then asks them to mentally add it to another number shown on a second screen. The children are then asked to decide whether or not a given sum is correct. From session to session, the task is presented at different speeds and at different levels of difficulty.
"We found that the children with ADHD were much less consistent in their response times," said Wendy Buzy, study lead author and a graduate student when the experiments were conducted.
Schweitzer and Buzy were both at the University of Maryland at the time. Buzy said that the children with ADHD had more frequent longer response times when compared with their typically developing peers, but the responses they did give were just as accurate.
"Once we controlled for omission errors, the accuracy of the two groups was the same," she said.
Buzy and Schweitzer pointed out that one of the unique things about their study was the way in which their data were analyzed. Previous studies compared only the range of reaction times and average reaction times for children with ADHD and controls. The method used in the current study allowed researchers to compare variation in response times within and between individuals, as well as within and between the two groups. The researchers also showed that working memory variability correlated with ADHD symptoms as scored by parent surveys (using the Conners' ADHD rating scale) prior to testing.
"We found that higher levels of hyperactivity and restlessness or impulsivity correlated with slower reaction times," Schweitzer said.
The current results led another Schweitzer laboratory member, postdoctoral fellow Catherine Fassbender, to design a study looking at variability in response time during a working memory task in the brains of children with ADHD using functional magnetic resonance imaging (fMRI).
"This study increases our understanding of what might be happening at a physiological level that underlies the inconsistency in responding in ADHD," she said.
Schweitzer also hopes to look at whether behavioral interventions and/or medications can help reduce the kind of variability observed in the current study. Variability in working memory, she said, means children cannot generalize what they learn in one situation to another.
"Improving consistency in how children with ADHD respond to the environment should help them generalize what they learn in clinical interventions improving their skills across situations."
The study was supported by grants from the National Institutes of Health and the University of Maryland. Deborah Medoff, Ph.D. from the University of Maryland, Baltimore also contributed to this study.
UC Davis Children's Hospital is the Sacramento region's only comprehensive hospital for children. From primary care offices to specialty and intensive care clinics, pediatric experts provide compassionate care to more than 100,000 children each year and conduct research on causes and improved treatments for conditions such as autism, asthma, obesity, cancer and birth defects. For more information, visit the UC Davis Children's Hospital Web site.The UC Davis M.I.N.D. Institute, in Sacramento, Calif., was founded in 1998 as a unique interdisciplinary research center where parents, community leaders, researchers, clinicians and volunteers collaborate to study and treat autism and other neurodevelopmental disorders.
Source
UC Davis Children's Hospital
"We think poor working memory is a characteristic present in many children and adults with ADHD," said Schweitzer, an associate professor in the Department of Psychiatry and Behavioral Sciences.
"Our study helps explain why working memory may be fine at one moment and poor at another, just as one day a child with ADHD seems to be able to learn and focus in class and on another day seems distracted and not paying attention," Schweitzer said.
According to the national Centers for Disease Control and Prevention (CDC), an estimated 4.4 million youth, ages 4 to17, have been diagnosed with ADHD by a healthcare professional. In 2003 nearly 8 percent of school-aged children were reported to have an ADHD diagnosis by their parent. The current study, published online in February in the journal Child Neuropsychology, supports the idea that what underlies impaired working memory is a problem in how consistently a child with ADHD can respond during a working memory task.
"We have known for some time that children with ADHD vary in how fast they are able to complete working memory tasks when compared to normally developing control subjects," Schweitzer explained .
Previous studies have suggested that children with ADHD might be slower at responding to tasks. The current study took a closer look at their performance using a relatively newer statistical analytical approach, to determine whether the children with ADHD were indeed faster, slower, or if perhaps another, more complicated process was occurring. The hypothesis was that children with ADHD were actually mostly responding at the same rate as healthy children, but with more frequent very slow responses than the control subjects.
To test this hypothesis, the study authors presented 25 children with ADHD and 24 typically developing peers with the Visual Serial Addition Task, a computerized program that presents children with a number on one screen and then asks them to mentally add it to another number shown on a second screen. The children are then asked to decide whether or not a given sum is correct. From session to session, the task is presented at different speeds and at different levels of difficulty.
"We found that the children with ADHD were much less consistent in their response times," said Wendy Buzy, study lead author and a graduate student when the experiments were conducted.
Schweitzer and Buzy were both at the University of Maryland at the time. Buzy said that the children with ADHD had more frequent longer response times when compared with their typically developing peers, but the responses they did give were just as accurate.
"Once we controlled for omission errors, the accuracy of the two groups was the same," she said.
Buzy and Schweitzer pointed out that one of the unique things about their study was the way in which their data were analyzed. Previous studies compared only the range of reaction times and average reaction times for children with ADHD and controls. The method used in the current study allowed researchers to compare variation in response times within and between individuals, as well as within and between the two groups. The researchers also showed that working memory variability correlated with ADHD symptoms as scored by parent surveys (using the Conners' ADHD rating scale) prior to testing.
"We found that higher levels of hyperactivity and restlessness or impulsivity correlated with slower reaction times," Schweitzer said.
The current results led another Schweitzer laboratory member, postdoctoral fellow Catherine Fassbender, to design a study looking at variability in response time during a working memory task in the brains of children with ADHD using functional magnetic resonance imaging (fMRI).
"This study increases our understanding of what might be happening at a physiological level that underlies the inconsistency in responding in ADHD," she said.
Schweitzer also hopes to look at whether behavioral interventions and/or medications can help reduce the kind of variability observed in the current study. Variability in working memory, she said, means children cannot generalize what they learn in one situation to another.
"Improving consistency in how children with ADHD respond to the environment should help them generalize what they learn in clinical interventions improving their skills across situations."
The study was supported by grants from the National Institutes of Health and the University of Maryland. Deborah Medoff, Ph.D. from the University of Maryland, Baltimore also contributed to this study.
UC Davis Children's Hospital is the Sacramento region's only comprehensive hospital for children. From primary care offices to specialty and intensive care clinics, pediatric experts provide compassionate care to more than 100,000 children each year and conduct research on causes and improved treatments for conditions such as autism, asthma, obesity, cancer and birth defects. For more information, visit the UC Davis Children's Hospital Web site.The UC Davis M.I.N.D. Institute, in Sacramento, Calif., was founded in 1998 as a unique interdisciplinary research center where parents, community leaders, researchers, clinicians and volunteers collaborate to study and treat autism and other neurodevelopmental disorders.
Source
UC Davis Children's Hospital
суббота, 4 июня 2011 г.
Curemark To Present At BioPharm America™ 2010
Curemark, LLC, a drug research and development company focused on the treatment of neurological diseases, will present at BioPharm America™ 2010, to be held September 15-17 in Boston at the Marriott Boston Copley Place, the company announced.
Dr. Joan Fallon, Curemark's founder and CEO, will provide an overview of the company's enzyme replacement therapy targeted to autism. Curemark is now in Phase III clinical trials for CM-AT, its autism treatment. She will also discuss the Investigational New Drug (IND) authorization Curemark recently received from the U.S. Food and Drug Administration (FDA) for the use of the company's compound CM-4612 to treat attention deficit hyperactivity disorder (ADHD). The FDA has given clearance to Curemark's Investigational New Drug (IND) application for a Phase III clinical trial to study the use of CM-4612 in the treatment of ADHD.
"We are very pleased to be able to give a presentation at this year's BioPharm America," Fallon said. "We welcome the opportunity to discuss our momentum with therapies that address neurological conditions for which there are currently no viable, physiologically-based treatments."
CM-AT, Curemark's autism treatment, targets enzyme deficiencies in autistic children that affect the availability of amino acids, the building blocks of chemicals essential for brain function. The company is currently conducting Phase III CM-AT trials at 13 sites nationwide with a planned total of 170 children. If approved, CM-AT, which has been granted Fast Track status from the FDA, will be one of the first therapies to address the underlying physiology of autism.
Organized by EBD Group, a leading partnering firm for the global life sciences industry, BioPharm America is intended as a forum where biotech and pharma executives from around the world can meet, and identify and enter strategic relationships. BioPharm America 2010 is the third annual international partnering conference.
Safe Harbor Statement
This news release contains forward-looking statements that involve risks and uncertainties that could cause our actual results and experiences to differ materially from anticipated results and expectations expressed in such forward-looking statement. These forward-looking statements include, without limitation, statements regarding the mechanism of action of CM-AT, its potential advantages, its potential for use in treating autism, as well as the timing, progress and anticipated results of the clinical development and regulatory processes concerning CM-AT. These statements are based on our current beliefs and expectations as to such future outcomes, and are subject to known and unknown risks and uncertainties that may cause actual future experience and results to differ materially from the statements made. Factors that might cause such a material difference include, among others, risks that the results of clinical trials will not support our claims or beliefs concerning the effectiveness of CM-AT, our ability to finance our development of CM-AT, regulatory risks, and our reliance on third party researchers and other collaborators. We assume no obligation to update these statements, except as required by law.
Source: Curemark, LLC
Dr. Joan Fallon, Curemark's founder and CEO, will provide an overview of the company's enzyme replacement therapy targeted to autism. Curemark is now in Phase III clinical trials for CM-AT, its autism treatment. She will also discuss the Investigational New Drug (IND) authorization Curemark recently received from the U.S. Food and Drug Administration (FDA) for the use of the company's compound CM-4612 to treat attention deficit hyperactivity disorder (ADHD). The FDA has given clearance to Curemark's Investigational New Drug (IND) application for a Phase III clinical trial to study the use of CM-4612 in the treatment of ADHD.
"We are very pleased to be able to give a presentation at this year's BioPharm America," Fallon said. "We welcome the opportunity to discuss our momentum with therapies that address neurological conditions for which there are currently no viable, physiologically-based treatments."
CM-AT, Curemark's autism treatment, targets enzyme deficiencies in autistic children that affect the availability of amino acids, the building blocks of chemicals essential for brain function. The company is currently conducting Phase III CM-AT trials at 13 sites nationwide with a planned total of 170 children. If approved, CM-AT, which has been granted Fast Track status from the FDA, will be one of the first therapies to address the underlying physiology of autism.
Organized by EBD Group, a leading partnering firm for the global life sciences industry, BioPharm America is intended as a forum where biotech and pharma executives from around the world can meet, and identify and enter strategic relationships. BioPharm America 2010 is the third annual international partnering conference.
Safe Harbor Statement
This news release contains forward-looking statements that involve risks and uncertainties that could cause our actual results and experiences to differ materially from anticipated results and expectations expressed in such forward-looking statement. These forward-looking statements include, without limitation, statements regarding the mechanism of action of CM-AT, its potential advantages, its potential for use in treating autism, as well as the timing, progress and anticipated results of the clinical development and regulatory processes concerning CM-AT. These statements are based on our current beliefs and expectations as to such future outcomes, and are subject to known and unknown risks and uncertainties that may cause actual future experience and results to differ materially from the statements made. Factors that might cause such a material difference include, among others, risks that the results of clinical trials will not support our claims or beliefs concerning the effectiveness of CM-AT, our ability to finance our development of CM-AT, regulatory risks, and our reliance on third party researchers and other collaborators. We assume no obligation to update these statements, except as required by law.
Source: Curemark, LLC
пятница, 3 июня 2011 г.
Antipsychotic Prescribing For Children Has Risen Sharply
A research team set out to investigate the epidemiologic features of antibiotic prescribing to patients under the age of 18 by GPs (general practitioners, primary care doctors) in Great Britain. They gathered data from the UK General Practice Research Database, involving 384 participating general practices, to identify how many child/adolescent patients were prescribed at least one antipsychotic drug between the beginning of 1992 to the end of 2005. They calculated age-specific prevalences and incidences of antipsychotic prescribing.
You can read about this in the journal Pediatrics.
The researchers found that:
-- In 1992 there were 0.39 users per 1,000 patient-years
-- In 2005 there were 0.77 users per 1,000 patient-years
-- Prescribing prevalence for 7-12 year-old patients nearly tripped between start 1992 to end 2005, from 0.23 users per 1,000 patient-years to 0.61 users per 1,000 patient-years.
-- Atypical antipsychotic prescribing rose 60-fold during the same period, from 0.01 users per 1,000 patient-years to 0.61 users per 1,000 patient-years.
-- Typical antipsychotic prescribing fell from 0.44 users per 1,000 patient-years in year 2,000 to 0.18 users per 1,000 patient-years in 2005.
Although incidences for typical and atypical antipsychotics showed trends similar to those of the respective prevalences "the overall incidence (number of new starters) for all antipsychotics was relatively stable between 1992 and 2005, which suggests that patients remain on treatment longer. " the researchers wrote.
The researchers concluded that the overall prevalence of antipsychotics nearly doubled during 1992-2005. The increase in the USA during the same period was much greater. Despite lack of conclusive evidence that atypical antipsychotic drugs are superior to older conventional antipsychotics the prescribing of them has increased. The scientists say more research is needed to find out how efficacious and safe these drugs are for children and adolescents.
According to some US newspapers today (Associated Press) children in the United States are prescribed antipsychotic drugs at approximately six times the rate of UK children. Many report that both US and UK kids are probably being over-prescribed.
Most commonly used medications are for treating ADHD (attention deficit hyperactive disorder) and Autism.
Possible reasons for higher US rates, compared to the UK:
1. Prescription drug advertising to non-health care professionals is not allowed in the UK, while it is in the USA. Perhaps US consumers are more aware of available prescription drugs and influence their doctors' prescribing behavior.
2. The UK has a universal health care system which encourages doctors to keep prescription rates low.
3. UK doctors tend to be more conservative than their American counterparts about prescribing psychiatric drugs (quote from Associated Press, Wayne Ray, Vanderbilt University researcher).
"Epidemiologic Features of Antipsychotic Prescribing to Children and Adolescents in Primary Care in the United Kingdom.
Fariz Rani, BPharm, Macey L. Murray, BSc, Patrick J. Byrne, FRCPsych and Ian C. K. Wong, PhD
PEDIATRICS Vol. 121 No. 5 May 2008, pp. 1002-1009 (doi:10.1542/peds.2007-2008)
Click here to view Abstract online
Sources - Pediatrics, AP, BBC and American Academy of Pediatrics.
Written by - Christian Nordqvist
You can read about this in the journal Pediatrics.
The researchers found that:
-- In 1992 there were 0.39 users per 1,000 patient-years
-- In 2005 there were 0.77 users per 1,000 patient-years
-- Prescribing prevalence for 7-12 year-old patients nearly tripped between start 1992 to end 2005, from 0.23 users per 1,000 patient-years to 0.61 users per 1,000 patient-years.
-- Atypical antipsychotic prescribing rose 60-fold during the same period, from 0.01 users per 1,000 patient-years to 0.61 users per 1,000 patient-years.
-- Typical antipsychotic prescribing fell from 0.44 users per 1,000 patient-years in year 2,000 to 0.18 users per 1,000 patient-years in 2005.
Although incidences for typical and atypical antipsychotics showed trends similar to those of the respective prevalences "the overall incidence (number of new starters) for all antipsychotics was relatively stable between 1992 and 2005, which suggests that patients remain on treatment longer. " the researchers wrote.
The researchers concluded that the overall prevalence of antipsychotics nearly doubled during 1992-2005. The increase in the USA during the same period was much greater. Despite lack of conclusive evidence that atypical antipsychotic drugs are superior to older conventional antipsychotics the prescribing of them has increased. The scientists say more research is needed to find out how efficacious and safe these drugs are for children and adolescents.
According to some US newspapers today (Associated Press) children in the United States are prescribed antipsychotic drugs at approximately six times the rate of UK children. Many report that both US and UK kids are probably being over-prescribed.
Most commonly used medications are for treating ADHD (attention deficit hyperactive disorder) and Autism.
Possible reasons for higher US rates, compared to the UK:
1. Prescription drug advertising to non-health care professionals is not allowed in the UK, while it is in the USA. Perhaps US consumers are more aware of available prescription drugs and influence their doctors' prescribing behavior.
2. The UK has a universal health care system which encourages doctors to keep prescription rates low.
3. UK doctors tend to be more conservative than their American counterparts about prescribing psychiatric drugs (quote from Associated Press, Wayne Ray, Vanderbilt University researcher).
"Epidemiologic Features of Antipsychotic Prescribing to Children and Adolescents in Primary Care in the United Kingdom.
Fariz Rani, BPharm, Macey L. Murray, BSc, Patrick J. Byrne, FRCPsych and Ian C. K. Wong, PhD
PEDIATRICS Vol. 121 No. 5 May 2008, pp. 1002-1009 (doi:10.1542/peds.2007-2008)
Click here to view Abstract online
Sources - Pediatrics, AP, BBC and American Academy of Pediatrics.
Written by - Christian Nordqvist
четверг, 2 июня 2011 г.
Children With Attention Deficit Hyperactivity Disorder At Risk For Alcohol Problems
Parental alcoholism and family stress can also facilitate the development of alcohol problems
* Prior research has shown that children with ADHD can develop alcohol problems later in life.
* Two studies confirm this association, indicating that drinking problems begin around age 15.
* Parental alcoholism and family stress appear to add to the risk of children with ADHD developing alcohol problems themselves.
Researchers believe that children with attention deficit hyperactivity disorder (ADHD) are at risk for alcohol- as well as other substance-related problems as they grow older. Yet the research is not always consistent. Two new studies help to confirm that ADHD is a risk factor for alcohol problems; adding that parental alcoholism and stressful experiences in the family play an important role in this risk.
Results are published in the April issue of Alcoholism: Clinical & Experimental Research.
"Children with ADHD are believed to be at risk for alcoholism because of their impulsivity and distractibility, as well as other problems that often accompany ADHD such as school failure and behavior problems," explained Brooke Molina, associate professor of psychiatry and psychology at the University of Pittsburgh, and corresponding author for both studies.
In the first study, on "Age specificity," Molina and her colleagues interviewed participants in the larger Pittsburgh ADHD Longitudinal Study. Children diagnosed with ADHD (n=364) were interviewed either as adolescents (11 to 17 years of age) or as young adults (18 to 28 years of age). Demographically and age-matched individuals without ADHD were also recruited as adolescents (n=120) or as adults (n=120) to serve as a comparison. Alcohol use was determined through questionnaires and interviews.
"We found that the children with ADHD were more likely than the comparison group to drink heavily and to have enough problems related to their drinking that they were diagnosed with alcohol abuse or dependence," said Molina. "This means that their drinking caused problems such as fights with their parents or friends, a drop in their grades at school, or difficulty with controlling the amount of alcohol that they drank."
Drinking problems began around age 15, said Molina. "The 15-to-17-year olds with childhood ADHD reported being drunk an average of 14 times in the previous year, versus only 1.8 times for 15-to-17-year olds in the study who did not have childhood ADHD. Whereas 14 percent of the 15-to-17-year olds with childhood ADHD were diagnosed with alcohol abuse or dependence, none of the 15-to-17-year olds without childhood ADHD were."
"It appears that one of the reasons for the past inconsistencies in research is that the ADHD-alcohol relationship does not become solid until at least mid-adolescence," observed Stephen Hinshaw, professor and chair of the department of psychology at UC Berkeley. "Later on, it may be that only a subset of kids with ADHD - namely, those with more aggressive or antisocial behavior patterns - are at risk by young adulthood."
Molina says her findings support this theory. "For example, 42 percent of those children with ADHD who also had serious, persistent behavior problems [later] had alcohol abuse or dependence by the age of 18 to 25." Molina also says, however, that researchers know little about the risk for alcoholism for children with ADHD beyond this age range. "Most young adults drink less after they settle into jobs and family life," she said. "We will be following the young adults in the Pittsburgh study to see if this happens or not."
In the second study, on "Life stress," Molina and her colleagues interviewed 142 adolescents (133 males, 9 females) who had been diagnosed with childhood ADHD, as well as 100 demographically matched adolescents without childhood ADHD. All participants were asked about their drinking behavior and negative life events; in addition, parents reported their drinking histories.
"One of the reasons that children with ADHD might be at risk for alcohol problems is that alcoholism and ADHD tend to run together in families," said Molina. "We found that parental alcoholism predicted heavy problem drinking among the teenagers, that the association was partly explained by higher rates of stress in these families, and these connections were stronger when the adolescent had ADHD in childhood. So, the bottom line is that when the child has ADHD and the parent has suffered from alcoholism, either currently or in the past, the child will have an increased risk for alcohol problems himself or herself."
"In other words," added Hinshaw, "when a youngster has ADHD, he or she is more likely to either provoke higher rates of drinking in parents, exacerbating overall stress levels; or be more confused and upset by parental drinking, then reverting to this pattern himself or herself."
However, noted Molina, "we need to put these findings in perspective; it is important to recognize that not all children with ADHD will have problems with alcohol."
Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. Co-authors of the ACER paper called "ADHD Risk for Heavy Drinking and Alcohol Use Disorder is Age-Specific" were: William E. Pelham, Jr. and Elizabeth M. Gnagy of the Departments of Psychology & Pediatrics at the State University of New York at Buffalo; Amanda L. Thompson of the Department of Psychology at the University of Pittsburgh; and Michael P. Marshal of the Department of Psychiatry at the University of Pittsburgh School of Medicine. Co-authors of the ACER paper called "ADHD Moderates the Life Stress Pathway to Alcohol Problems in Children of Alcoholics" were: Michael P. Marshal of the Department of Psychiatry at the University of Pittsburgh; William.E. Pelham, Jr. of the Departments of Psychology & Pediatrics at the State University of New York at Buffalo; and JeeWon Cheong of the Department of Psychology at the University of Pittsburgh. The studies were funded by the National Institute on Alcohol Abuse and Alcoholism, the National Institute on Drug Abuse, the National Institute on Mental Health, and the National Institute of Environmental Health Sciences.
Contact: Jocelyn Uhl Duffy
University of Pittsburgh
Stephen Hinshaw, Ph.D.
University of California Berkeley
Alcoholism: Clinical & Experimental Research
* Prior research has shown that children with ADHD can develop alcohol problems later in life.
* Two studies confirm this association, indicating that drinking problems begin around age 15.
* Parental alcoholism and family stress appear to add to the risk of children with ADHD developing alcohol problems themselves.
Researchers believe that children with attention deficit hyperactivity disorder (ADHD) are at risk for alcohol- as well as other substance-related problems as they grow older. Yet the research is not always consistent. Two new studies help to confirm that ADHD is a risk factor for alcohol problems; adding that parental alcoholism and stressful experiences in the family play an important role in this risk.
Results are published in the April issue of Alcoholism: Clinical & Experimental Research.
"Children with ADHD are believed to be at risk for alcoholism because of their impulsivity and distractibility, as well as other problems that often accompany ADHD such as school failure and behavior problems," explained Brooke Molina, associate professor of psychiatry and psychology at the University of Pittsburgh, and corresponding author for both studies.
In the first study, on "Age specificity," Molina and her colleagues interviewed participants in the larger Pittsburgh ADHD Longitudinal Study. Children diagnosed with ADHD (n=364) were interviewed either as adolescents (11 to 17 years of age) or as young adults (18 to 28 years of age). Demographically and age-matched individuals without ADHD were also recruited as adolescents (n=120) or as adults (n=120) to serve as a comparison. Alcohol use was determined through questionnaires and interviews.
"We found that the children with ADHD were more likely than the comparison group to drink heavily and to have enough problems related to their drinking that they were diagnosed with alcohol abuse or dependence," said Molina. "This means that their drinking caused problems such as fights with their parents or friends, a drop in their grades at school, or difficulty with controlling the amount of alcohol that they drank."
Drinking problems began around age 15, said Molina. "The 15-to-17-year olds with childhood ADHD reported being drunk an average of 14 times in the previous year, versus only 1.8 times for 15-to-17-year olds in the study who did not have childhood ADHD. Whereas 14 percent of the 15-to-17-year olds with childhood ADHD were diagnosed with alcohol abuse or dependence, none of the 15-to-17-year olds without childhood ADHD were."
"It appears that one of the reasons for the past inconsistencies in research is that the ADHD-alcohol relationship does not become solid until at least mid-adolescence," observed Stephen Hinshaw, professor and chair of the department of psychology at UC Berkeley. "Later on, it may be that only a subset of kids with ADHD - namely, those with more aggressive or antisocial behavior patterns - are at risk by young adulthood."
Molina says her findings support this theory. "For example, 42 percent of those children with ADHD who also had serious, persistent behavior problems [later] had alcohol abuse or dependence by the age of 18 to 25." Molina also says, however, that researchers know little about the risk for alcoholism for children with ADHD beyond this age range. "Most young adults drink less after they settle into jobs and family life," she said. "We will be following the young adults in the Pittsburgh study to see if this happens or not."
In the second study, on "Life stress," Molina and her colleagues interviewed 142 adolescents (133 males, 9 females) who had been diagnosed with childhood ADHD, as well as 100 demographically matched adolescents without childhood ADHD. All participants were asked about their drinking behavior and negative life events; in addition, parents reported their drinking histories.
"One of the reasons that children with ADHD might be at risk for alcohol problems is that alcoholism and ADHD tend to run together in families," said Molina. "We found that parental alcoholism predicted heavy problem drinking among the teenagers, that the association was partly explained by higher rates of stress in these families, and these connections were stronger when the adolescent had ADHD in childhood. So, the bottom line is that when the child has ADHD and the parent has suffered from alcoholism, either currently or in the past, the child will have an increased risk for alcohol problems himself or herself."
"In other words," added Hinshaw, "when a youngster has ADHD, he or she is more likely to either provoke higher rates of drinking in parents, exacerbating overall stress levels; or be more confused and upset by parental drinking, then reverting to this pattern himself or herself."
However, noted Molina, "we need to put these findings in perspective; it is important to recognize that not all children with ADHD will have problems with alcohol."
Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. Co-authors of the ACER paper called "ADHD Risk for Heavy Drinking and Alcohol Use Disorder is Age-Specific" were: William E. Pelham, Jr. and Elizabeth M. Gnagy of the Departments of Psychology & Pediatrics at the State University of New York at Buffalo; Amanda L. Thompson of the Department of Psychology at the University of Pittsburgh; and Michael P. Marshal of the Department of Psychiatry at the University of Pittsburgh School of Medicine. Co-authors of the ACER paper called "ADHD Moderates the Life Stress Pathway to Alcohol Problems in Children of Alcoholics" were: Michael P. Marshal of the Department of Psychiatry at the University of Pittsburgh; William.E. Pelham, Jr. of the Departments of Psychology & Pediatrics at the State University of New York at Buffalo; and JeeWon Cheong of the Department of Psychology at the University of Pittsburgh. The studies were funded by the National Institute on Alcohol Abuse and Alcoholism, the National Institute on Drug Abuse, the National Institute on Mental Health, and the National Institute of Environmental Health Sciences.
Contact: Jocelyn Uhl Duffy
University of Pittsburgh
Stephen Hinshaw, Ph.D.
University of California Berkeley
Alcoholism: Clinical & Experimental Research
среда, 1 июня 2011 г.
UVA Researchers Find Not All Drugs Are Equal In Treating Teen Drivers With ADHD
Researchers at the University of Virginia Health System have found that teenage drivers with attention deficit hyper activity disorder (ADHD) drive better when they
took OROS methylphenidate (OROS MPH), a controlled-release stimulant,
rather than extended release amphetamine salts (se-AMPH ER). The findings,
which reinforce the use of OROS MPH to improve driving performance in teens
with ADHD, will appear in the Sept. issue of "Pediatrics."
"Car collisions are two to four times more likely to occur among teens
with ADHD. Past studies have shown that stimulants commonly used to treat
ADHD can help improve driving performance among this group," said Daniel
Cox, Ph.d., lead author and professor of psychiatric medicine at the
University of Virginia Health System. "However, there are many different
formulations of stimulant drugs to treat ADHD and parents need to know
which ones will have the best positive effect."
In previous studies, Cox and his team set out to determine whether
immediate-release and extended release drug formulations influence driving
performance throughout the day. They found that OROS MPH (Concerta)
compared with immediate-release methylphenidate (Ritalin) was better at
improving driving performance. The OROS technology uses osmotic pressure to
deliver the drug at a controlled rate.
In this study, researchers compared Concerta to se-AMPH ER (Adderall
XR). Both are long-acting stimulants used to treat ADHD. Using a driving
simulator, teen drivers between 16 and 19 years of age, displayed their
driving skills after taking Concerta, Adderall XR or placebo. Study
participants took their medications at 8 a.m. They came to the driving
simulator laboratory and completed 15-minute simulated drives at 5 p.m., 8
p.m. and 11 p.m. Driving performance was determined by sophisticated
computer algorithms.
Researchers found that treatments with Concerta led to fewer
inattentive driving errors and less hyperactive or impulsive driving
errors, such as speeding and inappropriate braking, compared with Adderall
XR and placebo.
"This was the first study of its kind to demonstrate that OROS
methylphenidate has therapeutic benefits among teens for up to 15 hours,"
said Cox. "We hope these results encourage teens to be vigilant in taking
their medication as prescribed to help contribute to their driving safety
and help them appreciate the benefits of stimulant therapy."
"The study suggests that Concerta should be the initial treatment of
choice for teen drivers with ADHD, though teens already on Adderall XR
should not necessarily switch medications if they demonstrate a robust
therapeutic response," according to Cox.
In addition, accidents occur most frequently in the evenings and on
weekends, meaning parents should not necessarily limit medication use to
school days.
University of Virginia Health System
healthsystem.virginia/
View drug information on Adderall XR; Concerta; Ritalin LA.
took OROS methylphenidate (OROS MPH), a controlled-release stimulant,
rather than extended release amphetamine salts (se-AMPH ER). The findings,
which reinforce the use of OROS MPH to improve driving performance in teens
with ADHD, will appear in the Sept. issue of "Pediatrics."
"Car collisions are two to four times more likely to occur among teens
with ADHD. Past studies have shown that stimulants commonly used to treat
ADHD can help improve driving performance among this group," said Daniel
Cox, Ph.d., lead author and professor of psychiatric medicine at the
University of Virginia Health System. "However, there are many different
formulations of stimulant drugs to treat ADHD and parents need to know
which ones will have the best positive effect."
In previous studies, Cox and his team set out to determine whether
immediate-release and extended release drug formulations influence driving
performance throughout the day. They found that OROS MPH (Concerta)
compared with immediate-release methylphenidate (Ritalin) was better at
improving driving performance. The OROS technology uses osmotic pressure to
deliver the drug at a controlled rate.
In this study, researchers compared Concerta to se-AMPH ER (Adderall
XR). Both are long-acting stimulants used to treat ADHD. Using a driving
simulator, teen drivers between 16 and 19 years of age, displayed their
driving skills after taking Concerta, Adderall XR or placebo. Study
participants took their medications at 8 a.m. They came to the driving
simulator laboratory and completed 15-minute simulated drives at 5 p.m., 8
p.m. and 11 p.m. Driving performance was determined by sophisticated
computer algorithms.
Researchers found that treatments with Concerta led to fewer
inattentive driving errors and less hyperactive or impulsive driving
errors, such as speeding and inappropriate braking, compared with Adderall
XR and placebo.
"This was the first study of its kind to demonstrate that OROS
methylphenidate has therapeutic benefits among teens for up to 15 hours,"
said Cox. "We hope these results encourage teens to be vigilant in taking
their medication as prescribed to help contribute to their driving safety
and help them appreciate the benefits of stimulant therapy."
"The study suggests that Concerta should be the initial treatment of
choice for teen drivers with ADHD, though teens already on Adderall XR
should not necessarily switch medications if they demonstrate a robust
therapeutic response," according to Cox.
In addition, accidents occur most frequently in the evenings and on
weekends, meaning parents should not necessarily limit medication use to
school days.
University of Virginia Health System
healthsystem.virginia/
View drug information on Adderall XR; Concerta; Ritalin LA.
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