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3 New Things About ADHD
Mark L. Fuerst
Who’s filling ADHD prescriptions now?
What’s new in ADHD? The following slides highlight key findings of 3 new studies. The first shows that a growing number of reproductive-aged women are filling prescriptions for ADHD medicine. A second found that toxic pollutants and economic disadvantages combine to increase risk for ADHD behaviors in low-income, urban children. A third suggests that specialized video games may be a potential new option to treat children with ADHD without medication.
CDC researchers, led by Kayla N. Anderson, PhD, used the Truven Health MarketScan Commercial Database to estimate the percentage of women aged 15–44 years with private employer-sponsored insurance who filled prescriptions for ADHD medications each year. The percentage of reproductive-aged women who filled at least one ADHD medication prescription increased 344% from 2003 (0.9% of women) to 2015 (4.0% of women).
Clinical Implications for Study 1: Prescribing ADHD medications to reproductive-aged women is increasingly common. Additional research on ADHD medication safety during pregnancy is warranted to inform women and their healthcare providers about any potential risks associated with ADHD medication exposure before and during pregnancy.
Source: Anderson KN, et. al. Attention-Deficit/Hyperactivity Disorder Medication Prescription Claims Among Privately Insured Women Aged 15–44 Years - United States, 2003–2015. MMWR January 19, 2018/67(2);66–70.
Previously, a prospective cohort study in New York City found a significant association between prenatal PAH exposure and ADHD behavior problems at age 9. A new study of 351 children evaluated the joint effects of prenatal exposure to PAH and prenatal/childhood material hardship on ADHD behavior problems.
Clinical Implications for Study 2: “There is no single trigger for ADHD. Air pollution and economic hardship are part of a mix of genetic, environmental, and social factors contributing to childhood behavioral problems, including ADHD,” said lead author Frederica P. Perera, Professor of Environmental Health Sciences at Columbia University’s Mailman School of Public Health. “Children would be best served by a multifaceted response that combines economic assistance for women with policy interventions to reduce air pollution exposure in urban areas, especially in low-income communities of color.”
Source: Perera FP, et. al. Combined effects of prenatal exposure to polycyclic aromatic hydrocarbons and material hardship on child ADHD behavior problems. Environmental Research Volume 160, January 2018, Pages 506-513.
The goal of an upcoming trial is to see whether “exercising” those areas of the brain that help guide behavior and control impulses results in long-term benefits for children with ADHD. The treatment, called Central Executive Training, uses computerized brain-training games.
Clinical Implications for Study 3: “We want a treatment that keeps working after children finish it, so the idea is to essentially 'train them up' to get benefits that last well beyond the end of treatment,” said principle investigator Michael Kofler, PhD, Assistant Professor of Psychology at Florida State University. “This new grant will allow us to test how long the beneficial effects remain after training ends.”
Source: Kofler, M. Central Executive Training for ADHD (CET) Clinicaltrials.gov