Long Term Stimulant Treatment Associated with 1 inch Reduction in Height

When considering stimulant treatment for ADHD, one concern that is often voiced by parents is about height loss associated with long-term use.  Answering this question has been difficult, in part because the available literature has been inconsistent.  Some long term studies have shown no differences while other show reductions in over an inch. To help […]

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Psychiatric Medication Usage Among Vermont Medicaid-Insured Youth Drops by 42%

A new report prepared by Change Healthcare for the Department of Vermont Health Access documents a sharp drop in the number of Vermont Medicaid-insured youth who are prescribed psychiatric medications.  The report stems from a project called Improving the Use of Psychotropic Medications among Children and Youth in Foster Care. Vermont is one of six […]

Stimulant Treatment Linked to Cardiovascular Events in ADHD

The debate over whether or not stimulant medications like methylphenidate raise the risk of cardiovascular diseases and events has been going back and forth for years.  Many clinicians will remember the famous comment of Dr. Steven Nissan in a New England Journal of Medicine editorial in 2006 when he hoped that a physician’s hand would […]

Higher Guanfacine Doses Found Effective for Adolescent ADHD

While stimulants generally remain first-line medication for ADHD, alternatives are often needed due to side effects or ineffectiveness.   Of the non-stimulant medications, guanfacine and its more recent extended release preparation (trade name Intuniv) is one possible alternative.  Current FDA guidelines specify 4mg per day as the maximum dose, although much of this recommendation is based on […]

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Very High Rates of Psychotic Symptoms Linked to Stimulant Medications

(Note: portions of this review were recently published in an article in Clinical Psychiatry News) While it is known that stimulant medications used to treat ADHD might occasionally to lead to psychotic symptoms, this side effect is considered to be rare and usually associated with either medication abuse or very high dosages.  A report just released today […]

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Anxiety Risk with Stimulants Overstated

There is a widely held concern that psychostimulants when used to treat ADHD can induce or exacerbate anxiety.  This belief has led many clinicians to hesitate about using stimulants in patients who already suffer from high level of anxiety, prompting some prescribers to try, as first-line agents, nonstimulant medications that supposedly have less risk but […]

Antidepressants and Violent Crime in Youth

Antidepressants have carried a black box warning for years related to new or worsening suicidal behavior in children and young adults. A possible link, however, between SSRIs and other types of violent behavior has been more difficult to identify with studies finding inconsistent results. A recent large Swedish study, recently published in the journal PLOS […]

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Psychiatric Treatment Up, Impairing Mental Illness Down

There have been a lot of mixed messages when it comes to the state of child mental health and the amount of psychiatric treatment children are receiving. On the one hand, we hear the alarm sounded by many that too many children without significant mental illness are being diagnosed and prescribed medication.  On the other […]

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Effects of ADHD Medications on the Brain

A common and legitimate concern that is often voiced by parents when considering medication treatment for their child’s ADHD symptoms relates to the effects of these agents on the developing brain.  Raising some alarm have been findings from some animal studies that have suggested detrimental long-term changes; however, these studies often use very high doses […]

Are Doctors Following Best Practice When Prescribing Antipsychotic Meds to Kids?

(NOTE: the following is reprinted with permission from an article published in The Conversation on March 18, 2015) There’s been a lot of attention in the media about the number of children taking antipsychotic and other psychiatric medications. The assumption behind most of these stories is that these drugs are being overprescribed, and given to […]