Here is our position on the FDA warning regarding stimulant medications:

There is no new information on stimulant risks, although the media is presenting it as such. The FDA has been examining potential risks of ADD medications for the last several years. FDA sub-committees of physicians (cardiologists, psychiatrists, pediatricians) have been meeting to determine what level of labeling should be added to stimulant medications since there have been cases of “sudden death” in patients taking stimulants. Those patients who died were found to have underlying cardiac problems, so the question was did the medication cause the underlying cardiac problem or was the cardiac problem a pre-existing condition? The FDA admits it “does not have good information” indicating whether ADHD drugs caused the cardiovascular events. In fact the risk of sudden death in the general population not taking stimulants is higher than the risk of sudden death in ADD patients taking a stimulant. Therefore the FDA concluded that stimulant medications may or may not have contributed to the cardiovascular problems.

This led to the decision by the FDA not to put a “black box warning” on stimulant medications. A black box warning would have been the most serious type warning on a medication package label. Instead the FDA followed the sub-committee recommendations to add notes within the regular text of stimulant medication package inserts on potential cardiovascular risks, and order distribution of medication guides to patients and their caregivers. The warnings on the drug inserts were added LAST YEAR, but it took the FDA until now to order completion of the medication guides. Drug manufactures now have 30 days to implement this additional step, which is why the media is re-presenting this same information.

Additionally, cardiovascular risk studies at Mass General in adult ADD patients taking stimulant medication failed to show any increase risk of cardiovascular problems with long term stimulant use. Patients were followed for two year. The data is not supporting that the medications are causative.

At ADD Health and Wellness centers, we obtain a comprehensive cardiac history from all of our patients, including a thorough family cardiac history to ensure safe assessment prior to use of the medications. ADD treatment guidelines do not recommend routine EKG’s before administering stimulant medications since the data has not shown EKG changes as a side effect.

People often ask about Amino Acids and how to increase them in our diet. Here are the basics.As far as your body is concerned, there are two different types of amino acids: essential and non-essential. Non-essential amino acids are amino acids that your body can create out of other chemicals found in your body. Essential amino acids cannot be created, and therefore the only way to get them is through food. Protein in our diets comes from both animal and vegetable sources.

Most animal sources (meat, milk, eggs) provide what’s called “complete protein,” meaning that they contain all of the essential amino acids.

Most vegetable sources are usually are low on or missing certain essential amino acids. However, different vegetable sources are deficient in different amino acids, and by combining different foods you can get all of the essential amino acids throughout the course of the day. Some vegetable sources contain quite a bit of protein — things like nuts, beans, soybeans, etc. are all high in protein. Quinoa and chick peas are two of my favorite that are high in protein. Also by combining foods you can get complete coverage of all essential amino acids. The digestive system breaks all proteins down into their amino acids so that they can enter the bloodstream. Cells then use the amino acids as building blocks. Here are the different amino acids:

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ADHD has risks that reach beyond the classroom. Studies have shown that the impulsive and inattentive symptoms of ADHD can be a particular risk behind the wheel. People with ADHD are more likely to have motor vehicle accidents, speeding tickets, traffic citations, and experience loss of license. I often tell clients to remember there are “side effects” to not using ADHD medications such as greater risk of car accidents, a leading cause of death at a young age. Families and clinicians should together be weighing the risks of using medications with the risks of not using medications, and supportive counseling and education should always be a part of the treatment. A college sophmore with ADHD shares her experience on the dangers of driving without medication in this Washington Post article  http://washingtontimes.com/metro/20070219-110613-7319r.htm