In August the U.S. Food and Drug Administration (FDA) called for stronger warning labels for stimulant drugs used to treat attention deficit disorder (ADD). The biggest change applies to amphetamine-containing drugs for attention deficit hyperactivity disorder (ADHD)—Adderall and Dexedrine—as well as methylphenidates like Concerta and Ritalin.

Dangerous Drugs?
Although the “black box” warning on these drugs is the strongest the FDA can request, many experts say it’s not strong enough. Stating that “misuse of amphetamines may cause sudden death and serious cardiovascular adverse effects” is misleading, says Sidney M. Wolfe, MD, at the Health Research Group, since it fails to tell patients that they may suffer sudden death if they use these meds properly but have certain heart conditions.

Despite these concerns, the first long-term study of preschoolers taking Ritalin found benefits, even though it also warned of side effects ranging from slowed growth to irritability and insomnia in 40 percent of young children participating. “This is a catastrophe,” says Peter Breggin, MD, a New York psychiatrist who opposes the use of psychiatric drugs in children.

In addition to thorough physical assessments for heart disease, Dr. Wolfe advises monitoring anyone taking these stimulants for aggressive or hostile behavior. Other concerns include seizures and vision problems. Youngsters taking these drugs are also more likely to smoke, research finds, while Ritalin and amphetamines are commonly abused drugs.

The Root of the Problem
Attention problems have been linked to everything from artificial additives/colors/preservatives, an infant’s not crawling enough, heavy metal and pesticide exposure, maternal alcohol use and smoking, food allergies, celiac disease, and genes. However, “parents and teachers today seem to believe that any boy who wriggles in his seat and willfully defies his teacher’s rules has ADHD,” says Elizabeth J. Roberts, MD, a California child psychiatrist.

“Well-intentioned but misinformed teachers, parents using the Internet to diagnose their children, and hurried doctors are all part of a complex system that drives the current practice of misdiagnosing and overmedicating children. The solution lies in the practice of good, conscientious medicine that is careful, thorough, and patient-centered,” she adds.

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