ADHD drugs: New report advises caution on diagnosis and adult use

FOR IMMEDIATE RELEASE
Monday September 26, 2005
ADHD Drugs: Effective and Generally Safe for Kids and Teens,
But New Report Advises Caution on Diagnosis and Adult Use
Consumer Reports Best Buy Drugs project analyzes attention deficit medications
(Washington, D.C.) – Between 60 percent and 80 percent of children and teens who take so-called stimulant drugs to treat Attention Deficit Hyperactivity Disorder (ADHD) are helped by the medications, becoming better able to focus and less hyperactive, impulsive and disruptive, according to a new report from Consumer Reports Best Buy Drugs.
But the report strongly cautions that an ADHD diagnosis is difficult and that many children and teens taking stimulants today either do not have ADHD or have only mild symptoms that may not warrant drug treatment. Parents should get a careful diagnosis of their child and a second opinion if they have doubts, the report advises.
The report, available free to the public at www.CRBestBuyDrugs.org, also recommends adults be equally cautious before taking stimulants for ADHD since medical evidence is lacking on whether the drugs indeed help adults.
“These medicines are effective when used appropriately, but they should be prescribed only for people who really need them.” says Marvin M. Lipman, MD, medical editor of Consumer Reports magazine. “The jury is out so far on whether adults really benefit from treatment with them.”
The new report is based on an independent, scientific review of available medical evidence by the Drug Effectiveness Review Project, a 14-state initiative based at the Oregon Health & Science University. The initiative compares drugs on effectiveness and safety for state Medicaid programs.
Consumer Reports Best Buy Drugs combines those reviews with available medical and pricing information to identify Best Buys in each category. The Web site features free, easy-to-understand reports that discuss safety, side effects, effectiveness and price. Every drug report also is peer-reviewed by medical experts in the particular category.
“In recent years we have seen a surge in the use of attention deficit drugs, so parents and patients are sorely in need of independent information about their effectiveness,” Lipman says.
Among people aged 20 to 64, prescriptions for ADHD drugs have doubled between 2000 and 2004, according to a recent study by Medco Health Solutions of those enrolled in its pharmacy benefit programs. The study found that 1 percent of adults with health insurance were taking such drugs, up from 0.5 percent in 2000.
A separate study by Centers for Disease Control and Prevention (CDC) found that 8 percent of children aged 4 to17 have been diagnosed with ADHD in 2003; about half were taking medicines for the disorder.
The new report took effectiveness, safety, cost, dosing convenience, and duration of action into account when identifying Best Buy Drugs for ADHD:
• Methylphenidate tablets – 5mg, 10mg and 20mg
• Methylphenidate sustained release tablets or capsules (Metadate ER, Metadate CD, and Methylin ER) – 10mg, 20mg, 30mg
• Dextroamphetamine tablets – 5mg, 10mg
• Dextroamphetamine sustained release or long-acting tablets – 5mg, 10mg and 15mg
These medicines have been tested by time, and are available in low- or moderate-cost generic or “branded” generic forms. Their monthly cost ranges from $10 to $86. Many of the brand name drugs for ADHD cost $100 a month and up, and are no more effective.
Stimulant drugs, including the Best Buys, come in short- and long-acting formulations. That’s especially important with the ADHD drugs because dosing convenience (one pill a day instead of two, three or more) and the period of time a stimulant pill is active in the body are critical elements of ADHD treatment.
Duration of action in the body is also a selling point of many of the newer and more expensive brand-name ADHD drugs, some of which have been heavily advertised to consumers.
The report concludes that other types of drugs sometimes used to treat ADHD, such as antidepressants and antipsychotics, lack proof of effectiveness in treating it and should be used with caution.
Parents of older teens and college students are urged to be alert to their children’s use of stimulants without a prescription. The medicines are increasingly being taken by students who do not have ADHD, to increase mental alertness and help them stay awake at night to study. Such use can be habit-forming.
Since December, Consumer Reports Best Buy Drugs has released reports on eight widely-used categories of prescription drugs to date, with a new report each month. The project is designed to help patients, with their doctors, find effective, safe, and affordable medicines, and is supported by the Engelberg Foundation, a private philanthropy, and the National Library of Medicine.
CRBestBuyDrugs.org has just been revised. The free Web site now contains downloadable summary versions of drug reports in Spanish and English as well as other materials prepared originally in print for the project’s outreach campaign. In addition, the revised site offers initial guidance to Medicare beneficiaries who will soon be faced with choosing a drug benefit.