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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by ed_uk on January 19, 2005, at 8:28:11
Hello,
Since amphetamines have the potential to be neurotoxic, should we be concerned that Adderall is being prescribed to children?
Ed.
Posted by linkadge on January 19, 2005, at 10:46:09
In reply to Reason to be concerned?, posted by ed_uk on January 19, 2005, at 8:28:11
Do you have any evidence to suggest that it is neurotoxic in the doses prescribed to children ??
Linkadge
Posted by ed_uk on January 19, 2005, at 11:04:53
In reply to Re: Reason to be concerned?, posted by linkadge on January 19, 2005, at 10:46:09
Hi Link,
>Do you have any evidence to suggest that it is neurotoxic in the doses prescribed to children ??
No, but I didn't say that it *was* neurotoxic at the doses prescribed to children, I said that it was *potentially* neurotoxic. The absence of research in this area is hardly reassuring. What do you think? I can honestly say that if I was a parent, I would be very uncomfortable about giving an amphetamine to my child unless they had extremely severe mental health problems.
Regards,
Ed.
Posted by Mistermindmasta on January 19, 2005, at 11:26:05
In reply to Reason to be concerned?, posted by ed_uk on January 19, 2005, at 8:28:11
> Hello,
>
> Since amphetamines have the potential to be neurotoxic, should we be concerned that Adderall is being prescribed to children?
>
> Ed.
>
>In my opinion, which is only based on what I remember from my past readings about amphetamines and neurotox issues, is that in prescribed doses it won't directly cause neurotoxicity. What I'm concerned about is that it might alter a child's brain as it grows. Maybe that is what you actually meant to get at? Anyway, when the brain constantly has exogenous stimulants thrown at it, it might develop in such a way that the child would permanently need stimulants in order to feel normal. This would not happen in adults, since the brain is generally done developing. I believe there was that recent study about how rats had deficits in reward in adulthood when given stimulants as a young pup (is that the right word?) as the brain was developing; I dont think this is neurotoxicity per se, but its similar. And yes, I would be concerned if I were a parent. More research needs to be done.
Posted by mike13 on January 19, 2005, at 14:46:53
In reply to Re: Reason to be concerned?, posted by Mistermindmasta on January 19, 2005, at 11:26:05
In my understanding stimulants such as Adderal have been around for 20 + years.. I think if there was a potential for Nuerotoxicity.. wouldn't we know by now???
Posted by linkadge on January 19, 2005, at 16:21:20
In reply to Re: Reason to be concerned? » linkadge, posted by ed_uk on January 19, 2005, at 11:04:53
Generally the doses of amphetamines given to children are much less than people use to get high. I would assume that the euphoria and the neurotoxicity are closely related.
Lets also just assume that the model of hyperactivity is correct. In this case the post synaptic receptors are not getting enough dopamine. IF this is corrected then generally the post synaptic receptor would not be getting too much dopamine, but hopefully the right ammount.
Excessive amounts would produce the euphoria and probably the neurotoxcity.
Linkadge
Posted by TheOutsider on January 19, 2005, at 17:47:17
In reply to Re: Reason to be concerned?, posted by linkadge on January 19, 2005, at 16:21:20
I have a lot of respect for you Ed but I have to say that I'm very sceptical about the risks of stimulents when used sensibly!
I know children are theoreticly especialy at risk from neuro toxicity.
To reiterate what has already been said amphetamines have been around for a long time, and have been used to treat ADHD for 40 years at least, so its odd that no neurotoxic effects have been discovered!Secondly a point that know one has mentioned here yet, you have to balance the risks of prescribing a drug with the risks of not prescribing it. This is something that doesn't seem to occure to the British medical proffesion!
If your going to leave ADHD kids to stumble through life without help then *I think* they will most likely end up with other mental health problems due to the difficulties that have encounted, in turn they will need to be medicated, or self medicate.
Please Ed, dont become on of 'them'! (a typical British stimulent phobic doctor)
Posted by linkadge on January 19, 2005, at 18:38:26
In reply to Re: Reason to be concerned?, posted by linkadge on January 19, 2005, at 16:21:20
Generally, we do now by now. The brains of heavy amphetamine users (abusers) show marked abnormalities from healthy human brains.
Linkadge
Posted by linkadge on January 19, 2005, at 19:03:08
In reply to Re: Reason to be concerned?, posted by linkadge on January 19, 2005, at 18:38:26
I think that we should be concerned about the liberal prescribing of stimulants to kids who don't even meet the RDI of vitamins and minerals.
Or who have valid social reasons for their inability to concentrate (ie parents recent death/divorce)High doses have been shown to be neurotoxic, but clincial doses to kids who need them is not a problem.
Linkadge
Posted by lars1 on January 19, 2005, at 20:54:16
In reply to Reason to be concerned?, posted by ed_uk on January 19, 2005, at 8:28:11
> Since amphetamines have the potential to be neurotoxic, should we be concerned that Adderall is being prescribed to children?
Hi Ed,
I agree with what TheOutsider said about weighing the risk of using them against the risk of *not* using them. However, I think that non-neurotoxic alternatives (methylphenidate, Wellbutrin) should at least be *tried* first. The published research on amphetamine neurotoxicity is not very reassuring. I wonder if there have been unpublished studies done as part of the regulatory approval process for some of the newer psychostimulant formulations like Adderall XR and Concerta?
Lars
Posted by ed_uk on January 20, 2005, at 12:25:20
In reply to Re: Reason to be concerned? (mild rant), posted by TheOutsider on January 19, 2005, at 17:47:17
Hi TheOutsider,
>I have a lot of respect for you Ed...
I also have much respect for you :-)
>......so its odd that no neurotoxic effects have been discovered!
Not really, considering the absence of any adequate research into the long term effects of stimulant use in childhood.
> you have to balance the risks of prescribing a drug with the risks of not prescribing it.
I agree absolutely :-) It can be very difficult though when the nature and magnitude of the risks are not known.
>Please Ed, dont become on of 'them'! (a typical British stimulent phobic doctor)
I won't :-) I'm not stimulant phobic at all and anyway I'm not going to be a doctor!
Regards,
Ed.
This is the end of the thread.
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