Nearly all Attention Deficit Hyperactivity Disorder (ADHD) drugs leave the patient with side effects. In certain situations it has been reported that these side effects are just as bad, and in some cases worse, than the actual symptoms of ADHD in the first place. But does this statement ring true and if so, what are the reasons for it?

To begin to understand this statement we must first try to understand how ADHD symptoms and ADHD drug side effects, differ. First of all, the symptoms of ADHD can include any or all of the following, in no particular order: a lack of attention to detail, hyperactivity, becoming easily bored or fed up and possibly aggressive, not listening carefully and interrupting frequently during a conversation. The symptoms could make a child to seem rude, hyperactive and antagonistic, but these all depend on how severe the condition presents itself as every child reacts in a different manner. A few children only exhibit minor attention difficulties, and yet others are liable to become disruptive and aggressive.

Now, for ADHD drugs side effects, some of the following could be prevalent: weight loss, upset stomach, insomnia, mood changes and headaches. Clearly the one side effect that really stands out is the mood swings as ADHD symptoms in the main include the disposition of a child. There are a few drugs that cause a child to develop more aggressive behaviour than before the drug was taken. This has a lot to do with the effect of the drugs wearing off, and the consequences this has on the body could cause a worse reaction as soon as the drug effect has worn off.

But are the side effects associated with ADHD drugs a problem? Well, at this moment in time, the benefits of ADHD drugs for the most part far outweigh any disadvantages that could occur. In saying this though, it’s entirely feasible for a child on ADHD drugs to suffer severe side effects. As with all ADHD medication, it is highly probable that one side effect at least, will be experienced, but in the main these are mild and do not last for an extended period. Although the side effects could be mild with ways of alleviating the problem, sometimes the side effects can get so bad that they turn out to be intolerable for the child, as well as and parent.

Another worrying side effect can be insomnia and this has the potential of causing a child to be short-tempered and have even more problems with their concentration. Stomach problems and headaches do not help matters either.

It’s fairly obvious that drugs assist in the management of ADHD symptoms to a certain point but they can also be potentially a cause for worse side effects than the actual symptoms of ADHD. It is in cases like these that unconventional ADHD treatments such as behavioural therapy and herbal remedies should be looked at. Be sure to confer with a physician or doctor before discontinuing any ADHD medication to try alternatives.

Studies have shown that a strong relationship between medical conditions/problems and mental health exists. It is estimated that up to one-third of individuals with a serious medical condition experience symptoms of depression. Chronic illness can trigger or exacerbate depressive (feelings of helplessness or despair) or anxiety symptoms (concern about the future), not to mention both the mental and physical stress of coping with a prolonged illness. The limitations of the medical condition significantly alter a person’s life, which could create huge and seemingly overwhelming situations. Self image, independence (or lack of), and social interactions are obstacles that are put to limits. Lastly, emotional problems could slow down or prevent full recovery from medical conditions.

The severity of a medical condition typically varies with each person and that person’s subjective ability in addressing the challenges a chronic or prolonged illness can bring up. Medical challenges are not limited to the aging population, as hearing loss, vision impairment, endocrine disorders, gastric issues, surgery, as well as autoimmune diseases could happen to all age groups. Any one of these could create feelings of loss (loss of mobility, social interaction, resources, finances, and one’s own mortality). The rate for depression occurring with other medical illnesses is quite high:

• Heart attack: 40%-65%
• Coronary artery disease (without heart attack): 18%-20%
• Parkinson’s disease: 40%
• Multiple sclerosis: 40%
• Stroke: 10%-27%
• Cancer: 25%
• Diabetes: 25%

Cleveland Clinic: Copyright 1995-2009, The Cleveland Clinic Foundation

The relationship between medical issues and mental health is a two-way street. Mental health challenges like anxiety, depression, and substance abuse have a strong link to physical ailments. Sleep and fatigue due to mental health problems affect and stress us, and if we are not given enough time to replenish our body we become more susceptible to illness. When we are experiencing symptoms of anxiety and panic attacks our body experience what is referred to as flight or fight syndrome, which is just one clear example of the stress these mental health issues have on our body. This would also make our body more prone to illness and breakdowns.

Another factor to consider in addressing medical conditions and mental health is medication. Some medications have side effects that could amplify emotions such as anxiety or depression. If a person has substance abuse problems, the risk of abusing prescriptions is greatly increased. Energy level or lack thereof, creates less ability to socialize and increase feeling of isolation, and medications can amplify these feelings as well. Also, some medications may have other side effects such as a change in sexual desire, which could affect self confidence and relationship issues.

It is important to understand that medical challenges could have a huge impact on a person’s psyche. Identify emotional issues that may surface or are surfacing, and have a dialogue with your support group to educate them on what you are currently feeling and what you may experience later on. Try to develop regular sleep patterns and resist the urge to isolate. Your doctor can educate you and your loved ones on medications and side effects. Inviting a loved one or significant other in on such a discussion will only serve to educate them better on what you are feeling and how best to cope with it. There are some exercise programs out there such as water aerobics that may be possible for some with doctor approval. Monitoring your diet is another way to stay both physically and mentally healthy. Lastly, seek out a therapist who has experience working with individuals with medical conditions to get the best help for your situation.

Mark Myers received his Master of Social Work Degree from Loyola University in 1987. He has been practicing in the helping profession since 1981. He is an Illinois Licensed Clinical Social Worker since 1990. Also, since 1988, he is a Certified Alcohol and Other Drug Counselor. Mr. Myers provides counseling to individuals, couples, children and adolescents for a variety of areas including: drug and alcohol abuse, parenting issues, marital issues, depression, anxiety, and anger issues. He presents workshops and consultations to mental health professionals and the community from the mental health and addictions fields.

The drug that is most commonly used for treatment of obesity is sibutramine.

DRUG CLASS AND MECHANISM
It is the drug of class appetite suppressants, also called serotonin-nor epinephrine reuptake inhibitors, that works by acting on control centers in the brain that controls the appetite. The drug decreases appetite by blocking the reuptake of neurotransmitters that is dopamine, nor epinephrine and serotonin. This alters their balance within the nerve cells thereby affecting the nerve function and interaction.

AVAILABLE DOSAGE FORMS
Capsules, 5mg (blue and yellow), 10mg (blue and white), 15mg (white and yellow). BRAND NAMEs, Reductil, Meridia, Sibutrex. STORAGE CONDITIONS, Capsules should be stored at 25°C (77°F), A tight, light-resistant container should be used for their storage. The capsules should be protected from heat and moisture.

INDICATED USE. This drug is used for losing weight along with a well balanced and low caloric diet. It is indicated for people with an initial body mass index of more than 30 kg/m2 or if they also have other risk factors such as diabetes mellitus, high cholesterol or hypertension than it is 27 mg/m2.

DOSING: Sibutramine is taken once daily, generally in the morning. Initially the therapy is started with one 10mg tablet per day. The dose may be increased to achieve the desired effect upto 15mg by the physician after several weeks. Sibutramine may be taken with or without food.

DRUG INTERACTIONS:

In the liver Sibutramine is converted to its active form.
This conversion is inhibited by, Ketoconazole (Nizoral), Cimetidine (Tagamet), Erythromycin (Erytab, Eryc, Ilosone), clarithromycin (Biaxin), danazol (Danocrine), diltiazem (Cardizem, Tiazac, Dilacor), fluconazole (Diflucan), fluoxetine (Prozac), itraconazole (Sporanox), propoxyphene (Darvon), troleandomycin (Tao) verapamil (Verelan, Covera, Calan, Isoptin).

A decreased conversion and effectiveness of sibutramine can result if these are used with sibutramine.
Serotonin syndrome may appear in people who take sibutramine along with a) Selective serotonin reuptake inhibitors (SSRIs) such as, fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft)b) monoamine oxidase inhibitor drugs (MAO inhibitors) such as, Selegiline (Deprenyl, Eldepryl, Emsam), Hydralazine (Apresoline)Isoniazid (Laniazid, Nydrazid)

The serotonin syndrome may include these symptoms anxiety, dizziness, confusion, excessive sweating, shivering, fast heart rate, tremor, disorientation, vomiting, excitement, fever, loss of coordination, loss of consciousness, and weakness. Serotonin syndrome can also be caused if sibutramine is used with medications used for migraines such as sumatriptan (Imitrex), zolmitriptan (Zomig) and dihydroergotamine (DHE), dextromethorphan in many cough medications such as Robitussin-DM, meperidine (Demerol), pentazocine (Talwin) and fentanyl (Duragesic), or lithium (Eskalith).

These drugs should not be used with sibutramine as they can cause life threatening problems. So it is better not to use sibutramine and drugs from any of these classes of drugs. If required the minimum interval between takings the drugs from either class or sibutramine should be at least 2 weeks.

PREGNANCY AND NURSING MOTHERS:

As there is no evidence that sibutramine can cause any harm to the fetus, thus the use is not recommended. Women should use contraception if there is any chance of becoming pregnant.
It is not known whether sibutramine or its active products accumulate in breast milk. Sibutramine, therefore, is also not recommended for nursing mothers.

SIDE EFFECTS:

Sibutramine is well-tolerated but it can cause some unwanted effects. Blood pressure and pulse may be measured and laboratory tests performed to monitor side effects. The most common side effects have been constipation, insomnia, headache, and dry mouth. Other less common side effects include abdominal pain, acne, rash, chest pain, anxiety, joint pain, back pain, excitation, depression, sweating, dizziness, drowsiness, changes in taste, irregular or painful menstrual periods, flu-like syndrome, increased cough, muscle pain, nausea, vomiting, and neck pain, nervousness, tingling of the extremities, sore throat, and sinus congestion.

Abnormal liver tests have also been reported.
Depression, psychosis, mania, suicidal thoughts and suicide have been rarely reported during treatment however, sibutramine as the cause has not been established. Sibutramine probably should be discontinued in case of any of these events occur during treatment.

OVERDOSE OR MISSED DOSE:
Symptoms of overdose may include fast heartbeat. If it is suspected contact your local poison control center or emergency room immediately. In case of a missed dose, the dose should be taken as soon as you remember. But if it is near the second dose skip the missed dose and take the regular dosing schedule. Remember that it is not a good choice to double the dose if dose is missed.