Medical Moment: The efficacy of ADHD medication in education

Published: Sep. 22, 2022 at 5:36 PM EDT
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(WNDU) - About six million kids in the U.S. are diagnosed with attention deficit hyperactivity disorder, or ADHD. Of those diagnosed, 90 percent are prescribed stimulant medications to help with their academic performance.

Medications used to treat ADHD have both advantages and disadvantages.

By reducing symptoms of hyperactivity, impulsivity, and inattention, medication can help patients to do better at school and work. They can also improve interactions with family members and friends. Treatment with ADHD medication is shown to improve motor vehicle driving skills and lessens the risk of accidents based on results from large medical registry studies of stimulant medications. Consistent use of medication reduces delinquency, substance abuse, criminality, and suicidality.

There are two known disadvantages with ADHD medications.

One is that they can cause unwanted side effects like insomnia, appetite loss, or nausea. However, these side effects can be controlled by reducing the dose or changing medications. The second disadvantage pertains to stimulant medications, which are addictive substances. Being misused in a way that is not prescribed by a doctor can lead to addiction. They can also be diverted to others for either substance abuse or performance enhancement which is especially problematic for immediate release stimulants.

But a new study reveals some surprising findings bout these drugs’ effectiveness.

Adderall
Adderall(WBAY Staff)

Trouble focusing, unable to sit still, problems with paying attention. The symptoms of ADHD can affect a child’s ability to learn in the classroom.

Medication has long been thought by some experts to help children with ADHD and their academic performance, but not everyone agrees.

“Medication is not the silver bullet or is it ineffective,” said Sabrina Schuck, an executive director of child development at University of California, Irvine.

New research from Florida International University shows that they may be right. In a study on kids with ADHD between the ages of seven and 12, researchers found the students learned the same amount of content whether they were taking medication or a placebo.

They also found medication slightly improved test scores if it taken the day of the test, but not enough to boost grades. This research suggests that there may be cheaper and more effective methods to try first, such as behavioral therapy or even focusing on improving sleep.

Poison control centers report increase of children exposed to ADHD drugs
Poison control centers report increase of children exposed to ADHD drugs

“Teens with ADHD have two to three times more difficulties with sleep problems,” said Stephen Becker, a clinical psychologist with the Cincinnati Children’s Hospital Medical Center.

And poor sleep is linked to poor school performance.

“You’re probably going to do less well in school the next day,” Dr. Becker explained. “You’re going to retain less information. You might struggle more during a test.”

Experts say it may be beneficial for kids with ADHD to create a bedtime routine such as brushing teeth, putting white noise, and keeping phones out of the bedroom.

It is important to note that in the study, researchers found that the medication helped students with ADHD complete more seatwork and improved their classroom behavior.

More recently, the FDA has approved two devices for ADHD treatment in children.

The first device is the Monarch external Trigeminal Nerve Stimulation (eTNS) System, a trigeminal nerve stimulator. Whereas the vagal nerve stimulator is used to control epileptic seizures, this therapy does not require surgical insertion. The trigeminal nerve stimulator sits on the face. A small-scale study using data from the device manufacturer suggests that about half of pediatric ADHD patients responded to use of this device.

The FDA also approved a digital therapeutic treatment that uses a video game called EndeavorRx to treat ADHD. The sensory stimulus and motor challenges of the game target the neural pathways that control focus and attention. Studies sponsored by the device’s manufacturer suggest that the prescribed use of the game improves attention and has few adverse effects. Both devices may prove to be valuable additions to medication and behavior management, however more evidence of effectiveness is needed in guiding clinical decisions.