Health Secretary Robert F. Kennedy Jr. has often criticized prescription stimulants, such as Aidirall, who are mainly used to treat the hyperactivity attention deficit disorder.
“We damaged the entire generation,” he said last year during a podcast, referring to the number of children taking psychiatric drugs. “We poisoned them.”
In February, the “Make America Healthy Again” commission, led by Mr. Kennedy has announced its intention to evaluate the “threat” represented by drugs such as prescription stimulants.
But are they a threat? And if so, to whom?
Like many drugs, prescription stimulants have potential side effects and there are people who abuse them. However, these drugs are also considered some of the most effective and well -studied treatments that psychiatry has to offer, said dr. Jeffrey H. Newcorn, director of the ADHD division and learning disorders at the Iicahn School of Medicine in Mount Sinai in New York.
Here are some answers to common questions and concerns about stimulants.
What are prescription stimulants?
The prescription stimulants are drugs that help change the way the brain works by increasing communication between neurons.
They are divided into two classes: Metilfenidati (such as Ritalin, Focalin and Concerta) and amphetamines (such as Vyvanse and Aidirall).
Drugs are often prescribed to treat ADHD, but are also used for conditions such as narcolepsy or a eating disorder. Sometimes off-label are also used, for depression resistant to treatment or catatonia, a syndrome that can make a patient move in unusual ways, become immobile or stop talking.
The drugs work by amplifying the activity of dopamine and norepinephrine neurotransmitters in brain nerve cells. Dopamine plays a role in creating the desire for something and motivation to obtain it, while norepinephrine can increase supervision and make concentration easier.
People with ADHD can have a deficit of both of these chemicals, so when they use stimulants, it essentially helps “them”, said dr. Anthony L. Rostain, president of the Department of Psychiatry and Behavioral Health at the Cooper University Health Care, which is based in Camden, NJ
For some users, the effects are profound. “They are like glasses for a poor vision,” said dr. Rostain.
Are the stimulants always used to treat the ADHD?
NO.
Not all those who have been diagnosed with ADHD take stimulants. There are also non -stimulating drugs, such as Strattera (Atomoxetine). And some people don’t require any drugs.
Other interventions, such as behavioral therapy, parents training, school supports and lifestyle changes to regulate sleep and exercise, are important, regardless of whether someone needs drugs or not.
How many people are taking them?
The use of prescription stimulants has been increasing since 2012, in particular among adults, and has significantly increased between women and patients aged between 20 and 39 years in recent years.
In 2023, about 6 % of adults had a current diagnosis of ADHD and about a third of those patients reported having taken drugs for prescribed stimulants, according to an analysis of the centers for the control and prevention of diseases.
In children and adolescents, however, the number of stimulating requirements has been more stable in recent decades.
Overall, it is estimated that about 5 percent of children in the United States is currently prescribed for the ADHD (not 15 percent, the number declared by Mr. Kennedy during his confirmation hearing in January.)
A study published in February discovered that the prescriptions actually decreased among the children after the start of the pandemic.
How many times are the prescription stimulants used?
The investigations on the use of government drugs show that in 2022, among people aged 12 or over 12 years, 1.5 percent reported abusing prescription stimulants in the last year – taking drugs without a doctor who tells them to do it, or not in the way they have been prescribed. Sometimes people aspire to be more productive or to remain awake, but also drugs are used and can produce a high swallow, smoking or snorting the drug or injecting it into the bloodstream.
Young adults aged 18 to 25 were the highest improper use rates: 3.7 percent.
Among the teenagers from 12 to 17, the percentage of improper use was much smaller: 0.9 percent.
This number can vary depending on where they live: in some US schools, up to 1 out of 4 high school students report to abuse prescription stimulants, often motivated by their desire to perform better at school. Some schools do not report any problem with stimulating abuse.
What are the potential side effects?
The intake of stimulants can cause high blood pressure and heart rate, a reduced appetite, difficulty in sleeping and restlessness or agitation.
Other common side effects include headache, an increase in body temperature and abdominal pain.
Less frequently, it is known that the stimulants temporarily slow down the growth of a child, said dr. Rostain, which is why they should have their height and weight monitored by a doctor while taking drugs.
There is also a small risk of developing psychosis that can be linked to dosage. And when stimulants are used improperly, they can addendia.
Patients and their doctors should evaluate the benefits of taking stimulants against these risks. The ADHD, in particular if not treated, is associated with reckless behaviors as a negligent guide, unsafe sex, abuse of substances and aggression. A recent study has shown that people with diagnosis are, on average, dying before their peers – about seven years earlier for men and about nine for women.
How long should stimulants be used?
Depends.
Studies have shown that the symptoms of ADHD can change over time, improving and then worsening again or vice versa. “It is not consistent,” said dr. Rostain. “Cerano and fall for many people.”
As a result, he added, people can end up using ADHD drugs intermittently.
However, some people take these long -term drugs, said dr. Lenard A. Adler, Director of the Adhd program for adults of the Nyu Langone Health.
“Having said that, it is always appropriate when someone is stable on psychostimulants try to lower the dose,” added dr. Adler.
If a patient continues to do well, he said, then it is worth exploring if the drug is still necessary.
Is there still a deficiency of drugs?
YES.
The stimulating shortage started in 2022 continues. According to the Food and Drug Administration, in March, the tablets and the extended release patches of Metilfenida hydrochloride, as well as other types of amphetamine tablets, are not available or short -term.
The availability of specific drugs and formulations may vary according to the Region, said dr. Rostain.
“It leads to a lot of uncertainty, unpredictability and a lot of anxiety on the part of the patients,” he added.