Asked by S. Carter, North Carolina
My 5-year-old old son has recently had a diagnosis of ADHD and ODD. The nurse put him on Adderall and Risperdal, which do calm him down, help him focus and cut out some of his "behaviors." However, some of my family members think I am wrong for putting him on meds. Are there natural supplements that can give the same results as the prescribed meds? If so, can you get them from a pharmacy so that I can have his insurance pay for it? And lastly, can one ever grow out of these diseases, or will he have to take meds for the rest of his life?
Mental Health Expert
Dr. Charles Raison
Emory University Medical School
These are all great questions, and although it doesn't help your particular situation, you are far from alone in your struggles. I have distant family members who clash about the same issue. Every school year, the mother puts her teenage daughter on a stimulant like Adderall; and every summer, when the father gets custody, he takes her off the medication.
So let's start with the family members who disapprove of what you are doing. I don't need to tell you that feelings run very hot on both sides of the issue of medicating children. Many years' data demonstrate that drugs like Adderall can make a huge difference in the lives of children such as your son who are hyperactive, inattentive and have behavioral problems. (For our readers, ODD stands for oppositional defiant disorder, and ADHD stands for attention deficit hyperactivity disorder.) Just as important, studies now show that drugs like Adderall can reduce bad adult outcomes associated with ADHD such as criminal behavior. Although all medications have risks, drugs like Adderall are overall extremely safe.
We know less about the use of atypical antipsychotics in children, and right now the country is in a backlash against this practice. Many people -- including children -- take these medications without incident, but they can have serious side effects. However, as one who has prescribed psychiatric medications for years, I can tell you why these medications have become so widely used despite their risks: They are often near-miracle cures for people for a wide range of problems ranging from psychosis and mania to depression and behavioral problems.
I have a bias, and it is this: Any medication that significantly improves a person's emotions, functioning or behavior is a blessing and should be continued if the benefits are not outweighed by side effects. If Adderall and Risperdal help your son avoid behaving in ways that will scar him for life and increase his risk for substance abuse, criminality and general misery (all of which are greatly increased in adults who had ADHD and ODD as children), then you are doing him a huge favor by your present course of action. If you agree with this, you should probably reconcile yourself to the fact that you may always have to tolerate the disapproval of certain family members.
The short answer to your question about supplements is no, there are none that have been shown in studies to be as effective as medications like Adderall. This is not to say that strategies including supplements and diet might not benefit individual kids, only that they don't have the overall power of medications. That is, studies suggest that if you put 100 kids on things like supplements and 100 kids on a sugar pill, you don't tend to see much difference overall in the averages of the groups. However, if you find something along these lines that helps and doesn't cause more trouble than it's worth, it makes a lot of sense to add it to the medication regimen. Unfortunately, most insurance plans will not cover supplements, primarily because the scientific support for their use is just not there.
Finally, studies suggest that perhaps 40 percent of children with ADHD will still have symptoms as adults. I don't know of any studies that show how to predict what the odds are that any given child will grow out of the condition. In your case, the thing I would watch most closely is the ODD symptoms. You really want to do everything in your power to get your son's behavior on track. Children who pass through adolescence with ODD have a fairly high risk of ending up with long-term substance abuse and legal problems, both of which usually devastate adulthood. While life offers no guarantees in this regard, having your son on medications that are helping him is a significant step in the right direction.
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