A common concern among caring parents is that treatment for ADHD with stimulant medication such as methylphenidate (Ritalin, Concerta) or dextroamphetamine (Adderall) will lead to addiction and substance abuse in the teen years. http://www.currentpsychiatry.com/home/article/do-stimulants-for-adhd-increase-the-risk-of-substance-use-disorders/aeff7b1bc2f03475bfdad4cd7e0fd91d.html
While this is a valid question, the evidence based answer clearly is “no”, stimulants do NOT lead to substance abuse. Multiple studies over the years continue to demonstrate the stimulants substantially lower the risk for substance abuse. http://www.ncbi.nlm.nih.gov/pubmed/14529324. http://www.jaacap.com/article/S0890-8567(16)30099-5/abstract.
In fact, UNTREATED ADHD children have higher risk for substance abuse than peers in the same age group; treatment with stimulants reduces the risk for kids with ADHD back to the rate seen in the general population.
Bottom line, if you and your doctor decide to treat ADHD with stimulant meds, you do not need to worry you are putting them at risk for later substance abuse or addiction.
Sometimes the simpler things ARE best!
A new study in JAMA shows that half strength apple juice (diluted apple juice) was MORE effective than special (more expensive) electrolyte replacement mixes.
Children studied were aged 6 to 60 months with gastroenteritis (nausea and vomiting) and minimal dehydration. Fewer kids with apple juice required IV fluid therapy – 2.5% vs 9.0% with expensive electrolyte solutions. The goal was to receive 5mL (1 tsp) every 2-5 mins, with a total volume of 2 liters consumed.
Colace, aka Docusate, has been used for decades to help with constipation.
Too bad it does not work…
One in six US adults have constipation and many use over the counter products, such as colace. When studied in clinical trials however, colace is no better than placebo (fake) pills. https://goo.gl/3WhrBH.
Miralex (PEG) is a laxative that is safer for long term use when needed and can be added to any drink. It is preferred to stimulants like Milk of Magnesia for chronic help.
Much hype can be found on the internet re: the potential risks of the HPV vaccine. On the balance of evidence, it clear that the HPV vaccine does FAR more good than harm. Most especially, it reduces the risk of cervical cancer. http://goo.gl/TXdycp
Every major guideline on the topic SUPPORTS giving your child HPV vaccination. My own children received them. The CDC strongly supports their use. http://goo.gl/oZihOX The American College of OB/GYN also recommends routine use for BOTH boys and girls. http://goo.gl/6UTbzL The American Cancer Society promotes standard use of the HPV vaccine as well. http://goo.gl/C87txg
Good sleep is under appreciated, until you don’t have it.
While many medicines may help (ambien, trazodone, restoril, doxepin, rozerem, etc…), the smart approach is to maximize the easy things.
Use the bed only for sleep and sexual activities. Don’t associate TV, computers or other activities with being in bed. Also keep the room quiet, cool and dark. http://goo.gl/PdHoz6
Other points from the Brief Behavioral Treatment of Insomnia tool reviewed recently by Dr Charles Reynolds (http://goo.gl/0zHwh9) include:
• Reduce time in bed. This doesn’t mean decreasing the amount of sleep per se, but rather the amount of wakefulness that can occur during a night.
• Get up at the same time every day of the week. This practice provides a kind of circadian anchor to the brain’s sleep wave rhythms. Even if you’ve slept poorly, getting up at the same time helps you to sleep better the next night.
• Don’t go to bed unless sleepy. This strategy helps to increase sleep drive by keeping you awake longer. Going to bed when you’re not sleepy can lead to frustration and gives your brain the wrong message.
• Don’t stay in bed unless asleep. Learn to associate lying in bed with sleeping, and not with worrying or other activities that may lead to frustration.
Did you know that half of adults and older teens with mild traumatic brain injury (TBI) have symptoms 1 year later? They will experience 4+ post-concussion symptoms at one year, and almost 10% will have very low levels of cognitive function.
What is mild TBI? Defined as loss of consciousness < 30 minutes and disorientation < 24 hrs, it is often described as having your “bell rung”. It is often NOT a benign event. Persisting symptoms can interfere with daily function and include headaches, dizziness, nausea/vomiting, noise sensitivity, fatigue, irritability, memory problems, decreased job performance, poor sleep and even trouble balancing your checkbook!
Theadom A, Parag V, Dowell T, et al, for the BIONIC Research Group. Persistent problems 1 year after mild traumatic brain injury: a longitudinal population study in New Zealand. Br J Gen Pract 2016;66(642):e16-e2
Please take a moment to contact your state legislator and voice SUPPORT for providing coverage to our 78,000 fellow citizens in the Medicaid coverage gap.
The Legislature is considering an alternative plan THIS week.
Nice to see more public education on DIRECT PRIMARY CARE, where patients can pay the doctor directly, without the added cost of insurance middlemen.
@TVFamMed – we offer a low-cost monthly retainer option to provide comprehensive primary care, similar to paying a set fee and using your cell phone as much, or as little as needed.