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Is Long Term Use of ADD/ADHD Medication Safe?

  • June 18, 2014
  • RPh on the Go

adhd-medication-guidelinesIn a society where as many as 5-7% percent of elementary school aged children are diagnosed with Attention Deficit Hyperactivity Disorder, or ADHD, we should take a look at what these treatments may do to children in the long run. The condition is known to cause issues with attentiveness, overactivity, and impulsive activity. Children are typically treated with the use of psychostimulant drugs. Doctors and scientists know plenty about how these treatments work and their effectiveness, but information about the long term is still debatable.

In 2012, a study from Wake Forest Baptist Medical Center in North Carolina showed that long-term use of ADHD medications does not appear to have any adverse effects on the brain. The study looked at non-human primate juveniles between the equivalent ages of 6 and 10 years old. After one year of medication, there were no long-lasting effects on brain chemistry, changes in brain development, or an increased propensity for drug abuse with substances such as cocaine.

New research from 2013, however, indicates that there is a major side effect as a result of long term use of stimulant based ADD and ADHD medications. A study from Brookhaven National Laboratory looked at the dopamine density levels in patients who were diagnosed with ADHD, but never used a stimulant drug to treat the condition, as compared to ADHD patients who had used stimulant treatments for one year.

Though it is difficult to find adults with ADHD who have never been treated using stimulant medication, the study managed to find 18 participants. Each of them were given doses of Ritalin personalized to their own needs. Before and after the treatment period, researchers used a positron emission tomography (PET) scan to study levels of dopamine in their brains.

His findings were shocking: After one year of treatment, dopamine transmitter density rose by 24%, shooting down the theory that abnormal dopamine transmitter levels are a biomarker for ADHD. Compared to 11 healthy people, there was no difference in transporter levels before treatment. After treatment, though, was a different story.

How ADHD Medication Works

Medications like Ritalin work through preventing dopamine transfer that would normally leave the brain, which causes the increased density. Few studies have been done on the long term effects of dopamine transmission after a patient stops using the stimulant treatment.


Dopamine is a critical brain chemical. People who have low levels typically have high levels of novelty-seeking behavior, such as drug abuse and participation in high risk sports. Many believe people who suffer from ADHD have a higher concentration dopamine transporters, and therefore they have lower levels of dopamine neurotransmitters.

Still, we don’t know much about the long term safety. All we do know is the levels of dopamine transporters in the brain are no longer a valid biomarker of the condition, and that other options will need to be explored for diagnosis. Further research may provide additional insight into how and why common treatments lose efficacy over time, leading people to seek higher dosages. By keeping on top of research developments over time, pharmacists will be better-armed to answer patient and parent questions about the safety and efficacy of ADHD medications.

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