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Use of Stimulants to Treat ADHD: Interdisciplinary Research at the HDC

Use of Stimulants to Treat ADHD: Interdisciplinary Research at the HDC. Bill Frankenberger These studies represent collaborations with students and faculty at UW-Eau Claire. Significance of the Topic Growth of ADHD in the 90’s. 700% increase in Ritalin production 1990 -1997

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Use of Stimulants to Treat ADHD: Interdisciplinary Research at the HDC

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  1. Use of Stimulants to Treat ADHD:Interdisciplinary Research at the HDC Bill Frankenberger These studies represent collaborations with students and faculty at UW-Eau Claire

  2. Significance of the TopicGrowth of ADHD in the 90’s • 700% increase in Ritalin production 1990 -1997 • 3754% increase in Amphetamine production 1993 - 1999 (Dexedrine and Adderall), 65% increase 1998 - 1999 • One half million children, aged 3 to 6, were treated (1995) • Increasing use of multiple medications • Increasing abuse in schools

  3. Amphetamine Production Quotes

  4. Ritalin 1990 1999 81% 62% Dexedrine & Adderall 1990 1999 19% 38% Changes in types of stimulants produced from 1990 to 1999DEA Quotas

  5. Target effects of stimulant medication • Better attention in class • Better behavior in class • Better seat work • Better grades • Better relationship with teachers • Better relationship with parents

  6. Side effects of stimulants • Insomnia (¯ REM sleep) • State dependent effects • Decreased appetite • Slowed rate of growth • Tic development • Increased heart rate & blood pressure • Rebound effect

  7. Fourteen years of research on ADHD at the Human Development Center Changes in types of stimulants being used Incidence for general and special education Long-term effects on achievement Student’s self-reports of effects Professionals’ knowledge and attitudes

  8. General ed 1.5% ED 8% LD 5% General ed 5% ED 40% LD 16% Incidence of stimulant useElementary level (Frankenberger et al., 1990; Runnheim et al., 1996; Snider et al., 2000) Before 1990 Mid to late 1990s

  9. Interaction Plot for ITBS Complete Composite Scores (Frankenberger & Cannon, 1999)

  10. Doherty, Frankenberger, Fuhrer & Snider (2000) 925 students, WI, MN 86 receiving Meds for ADHD Moline & Frankenberger (in press) 651 students, WI, MN 50 receiving Meds for ADHD Student Self-Reported Effects of Stimulant Medication

  11. Mean Cluster Ratings (Moline & Frankenberger, in press)

  12. Student reported side effects (Moline & Frankenberger, in press) • 64% of students reported side effects at least sometimes (2 or higher) • 30% reported side effects almost always or always • 55% felt sleepy after taking medication • 53% reported some difficulty sleeping • 43% reported headaches • 54% reported not feeling like eating lunch • 40% reported tics not present before meds

  13. Student reported side effects (Doherty et al., 2000) • 58% did not feel like themselves • 43% did not feel like eating lunch • 35% had difficulty sleeping • 36% reported tics • Not feeling like themselves was related to wanting to discontinue use of medication

  14. Non-ADHD Student reports of Medication Abuse (Moline & Frankenberger, in press) • 53% of students reported seeing some students give away or sell their medication at least some of the time • 28% of students reported that students give away or sell their medication almost always or always

  15. ADHD Student reports of Medication Abuse(Moline & Frankenberger, in press) • 34% of students reported being approached to give away or sell their medication at least some of the time • 11% of students reported being approached to give away or sell their medication almost always or always

  16. Other Findings: Positive Correlations (Moline & Frankenberger, in press) • Doctor visits related to increased dosage • Dosage related to increased side effects • Dosage related to giving away or selling

  17. If it were up to you, would you continue taking your medication? (Doherty et al., 2000; Moline & Frankenberger, in press) Stop Now Continue

  18. Do you need meds to pay attention to activities that you find interesting?(Moline & Frankenberger, in press) Never Always

  19. Type of Medication used to Treat Children with ADHD (Frankenberger et al., 1990)

  20. Type of Medication used to Treat Children with ADHD (Moline & Frankenberger, in press)

  21. School Psychologist • Return Rate (n=414) • national 47%, state 53% • Majority female 61% Comparison of Professionals’Knowledge, Attitudes, & Experience (Frankenberger et al., submitted)

  22. Comparison of Professionals In your experience, who most frequently recommends students for AD/HD assessment? Teachers 77% Parents 15% School Psychologists 3% Physicians 1%

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