ADHD drugs become a family matter

9/27/2006

By Marilyn Elias, USA TODAY

Attention-deficit hyperactivity disorder is becoming a condition that family members are treated for together: Parents of children taking ADHD medication are about nine times more likely to also use the drugs than parents of children who aren't on these drugs, according to a prescription analysis out today.

The study of more than 107,000 privately insured children was done by Medco Health Solutions Inc., which manages pharmacy benefits. It is believed to be the largest analysis so far on family use of ADHD drugs. It tracked prescriptions in 2005 for the parents, siblings and twins of children who took medication for attention-deficit disorder.

The growth in adult use of drugs for ADHD, such as Ritalin and Concerta, outpaced the increases in childhood prescriptions since 2000, Medco data show. The disorder is known to be genetic. The new study suggests that many adults start taking ADHD medicine after they see the effects on their children, or they get prescriptions for children after trying the medications themselves.

When parent and child both began ADHD medicine in 2005, the parent started first in 41% of cases, the child in 59%.

"Some parents tell us they want to give it a try before their child uses it," says Andrea Chronis, a psychologist at the University of Maryland and director of an ADHD treatment program.

Mothers with untreated attention-deficit disorder are less involved with their kids and offer less positive support to them than do mothers without ADHD, Chronis' research finds.

"We encourage parents whose kids have the disorder to consider getting evaluated themselves," she says.

In Chronis' study using ADHD medication with mothers, symptoms of the disorder improved, but there was only a modest benefit for their parenting.

"They still need skills training in how to parent. Taking a pill isn't going to teach them how to parent better," Chronis says. Her study was financed by McNeil Pediatrics, maker of the drug Concerta.

In the Medco analysis, 58% of the parents taking drugs along with their children were mothers; 42% were fathers.

The recognition that family members may share attention-deficit symptoms "is all to the good," says psychiatrist David Goodman, a specialist in adult ADHD at Johns Hopkins University School of Medicine in Baltimore. "How can parents help a child with the disorder if they can't manage their own life?"

The upsurge in adults seeking treatment is partly a result of consumer advertising by drug companies, says behavioral pediatrician Lawrence Diller of Walnut Creek, Calif.

He says genetics alone doesn't explain the overlap between parents and children taking ADHD drugs; environment can play a key role. Disorganized parents may find it more difficult to manage children with attention problems by using behavioral techniques, Diller says. So these parents may be more likely to choose medication for their children.

The tilt toward more mothers than fathers opting for drugs doesn't surprise him. In childhood, boys outnumber girls 3-to-1 in ADHD and medication use because they're more likely than girls to act up in class and get noticed, Diller says. When girls grow up, their multiple roles can be a strain, especially for those who are disorganized.

That doesn't necessarily mean they have ADHD, he says.

"No wonder these women feel distracted and overwhelmed," Diller says. "I'm not sure if the Ritalin is treating their ADHD or allowing them to act as superwomen in our demanding culture."

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