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Ben Vitiello on Treatment Options for ADHD in Children

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Dr. Ben Vitiello, Child and Adolescent Treatment and Preventive Intervention Research Branch, National Institute of Mental Health, talks about therapy and medication treatment for Attention Deficit Hyperactivity Disorder (ADHD) in children.

Transcript

Time: 00:03:59 | Size: 3.72 MB
Speaker: Ben Vitiello, M.D. (NIMH)
 

Description: Dr. Ben Vitiello, Child and Adolescent Treatment and Preventive Intervention Research Branch, National Institute of Mental Health, talks about therapy and medication treatment for Attention Deficit Hyperactivity Disorder (ADHD) in children.

Announcer: This is NIMH Radio.

Announcer: Dr. Ben Vitiello is with the Child and Adolescent Treatment and Preventive Intervention Research Branch at the National Institute of Mental Health and an expert on ADHD- Attention Deficit and Hyperactivity Disorder. Frequently, behavioral therapy is used in the treatment of ADHD in children. It can change behavior, help in the organization of tasks and the working through of emotionally difficult periods. Medications - often time's stimulants- are also used in ADHD treatment. A fundamental question is why are stimulants used to treat a disorder that includes hyperactive behavior? In fact, ADHD medications are designed to stimulate low functioning executive skills in the prefrontal cortex portion of the brain...

Dr. Vitiello: If you increase the stimulant or increase the dopamine you increase the motivation for that part of the brain to function better. A lot of our function, including executive functions, will improve and the child- the individual actually- will become more focused and able to perform.

Announcer: Research shows medication effectively treats ADHD in children helping a child calm down, focus and pay attention in school. But like many medications there are some associated risks. For instance, children may want to eat less, and they may have trouble sleeping. If used for a long time, their growth may be affected, so regular height and weight checks are recommended. Although very rare and not proven, stimulant use may play a role in catastrophic- sudden cardiac death. Scientists are still unsure if stimulants actually cause these sudden cardiac problems. But in the meantime, doctors generally recommend that children with heart conditions or a family history of sudden death not take stimulant medications.

Dr. Vitiello: And some of these children had some underlying condition of the heart that was not known- was not detected. And there is discussion, even though it is not proven one hundred percent, that if you take medication like Ritalin, for instance, or amphetamines- Adderall– you may stimulate the heart and if the heart is already abnormal for some reason, you're more likely to get that kind of rare but certainly tragic event.

Announcer: So, what symptoms or signals might alert parents to possible problems?

Dr. Vitiello: To be sure that the blood pressure… that the heart rate don't go too high. And if the child complains of feeling dizzy or feeling palpitation...that the heart is beating fast...skipping a beat… that would be a reason for assessment...for doing an electrocardiogram...for doing more in-depth examination.

Announcer: In a far more general sense, parents and caregivers should monitor children to gauge their overall response to ADHD medications.

Dr. Vitiello: If a child for instance becomes withdrawn, his affect may become different- they become flat...some kids react to the stimulants becoming, sort of, unemotional- because it becomes so concentrated. Some parents complain that their child has become sad. Often times it's not really sadness but the expression of emotion is somewhat blunted and reduced.

Announcer: As always, if parents and caregivers have concerns it's best to see a physician or mental health professional.

Announcer: This is NIMH Radio.