For Many Kids on ADHD Pills, It’s the Start of a Drug Cascade
Episode
23 min
Read time
2 min
Topics
Investing, Leadership, Psychology & Behavior
AI-Generated Summary
Key Takeaways
- ✓Polypharmacy correlation data: Analysis of 166,000 Medicaid children from 2019-2023 shows kids on ADHD medication are more than five times as likely to be on additional psychiatric drugs four years later compared to non-medicated peers. This correlation is most pronounced when children start ADHD medications very young, with differences persisting across sex, race, and foster care status variations.
- ✓Side effect treatment spiral: ADHD stimulants commonly cause mood crashes and agitation as they wear off. Doctors often prescribe additional medications like Prozac to treat these side effects rather than recognizing them as drug-induced reactions. Each new medication creates its own side effects, leading to further prescriptions in what becomes an escalating cycle of polypharmacy throughout childhood development.
- ✓Research gap on drug combinations: Very little scientific research exists on how cocktails of multiple psychiatric medications affect developing brains in children. Psychiatrists openly acknowledge using trial and error approaches, adjusting doses and combinations based on fifteen-minute appointments rather than evidence-based protocols. One psychiatrist describes preschoolers on multiple medications as loose canons in their reactions.
- ✓Behavioral therapy access barriers: For children six and under, parent-child interaction therapy is recommended before medication, but parents report difficulty finding providers and taking time off work for appointments. This therapy requires six to nine months of intensive work. Stanford University study shows 42 percent of children aged three to five receive medication within thirty days of ADHD diagnosis, bypassing behavioral interventions.
- ✓Withdrawal severity and duration: Coming off layered psychiatric medications can take months or years, with each drug affecting the nervous system differently. Danielle reduces her antidepressant by one-tenth of a milligram at a time through a compound pharmacy because larger reductions cause unbearable symptoms including pain, shaking, vision loss, and cognitive dysfunction. She may never fully discontinue medications her brain developed on.
What It Covers
Wall Street Journal investigation reveals children prescribed ADHD medication at young ages are five times more likely to take additional psychiatric drugs four years later. Danielle Ganske's story illustrates this cascade: starting stimulants at age seven led to a two-page list of medications including antidepressants and anti-anxiety drugs, with severe withdrawal symptoms lasting years.
Key Questions Answered
- •Polypharmacy correlation data: Analysis of 166,000 Medicaid children from 2019-2023 shows kids on ADHD medication are more than five times as likely to be on additional psychiatric drugs four years later compared to non-medicated peers. This correlation is most pronounced when children start ADHD medications very young, with differences persisting across sex, race, and foster care status variations.
- •Side effect treatment spiral: ADHD stimulants commonly cause mood crashes and agitation as they wear off. Doctors often prescribe additional medications like Prozac to treat these side effects rather than recognizing them as drug-induced reactions. Each new medication creates its own side effects, leading to further prescriptions in what becomes an escalating cycle of polypharmacy throughout childhood development.
- •Research gap on drug combinations: Very little scientific research exists on how cocktails of multiple psychiatric medications affect developing brains in children. Psychiatrists openly acknowledge using trial and error approaches, adjusting doses and combinations based on fifteen-minute appointments rather than evidence-based protocols. One psychiatrist describes preschoolers on multiple medications as loose canons in their reactions.
- •Behavioral therapy access barriers: For children six and under, parent-child interaction therapy is recommended before medication, but parents report difficulty finding providers and taking time off work for appointments. This therapy requires six to nine months of intensive work. Stanford University study shows 42 percent of children aged three to five receive medication within thirty days of ADHD diagnosis, bypassing behavioral interventions.
- •Withdrawal severity and duration: Coming off layered psychiatric medications can take months or years, with each drug affecting the nervous system differently. Danielle reduces her antidepressant by one-tenth of a milligram at a time through a compound pharmacy because larger reductions cause unbearable symptoms including pain, shaking, vision loss, and cognitive dysfunction. She may never fully discontinue medications her brain developed on.
Notable Moment
After years on multiple medications, Danielle took the antipsychotic Zyprexa for withdrawal symptoms her doctor attributed to an underlying mood disorder. The first dose caused what she describes as a chemical lobotomy where she could not think or speak and felt trapped inside her body, experiencing a complete loss of cognitive function that terrified her.
Episode Transcript
Do you wanna just start by introducing yourselves? My name is Danielle Ganske. I'm 29 years old. My name is Nancy Ganske, and I am Danielle's mother. You can do the math on my age. But A little over twenty years ago, Nancy got a phone call about her daughter, Danielle, that many parents might be familiar with. The head of the lower school called me in and wanted to talk to me about Danielle and getting her tested, maybe for some ADHD or ADD or some learning issues because Danny was not sitting still in class, and they weren't sure if the school was quite the fit for her anymore. And I remember coming home and telling my husband and just crying and saying, what is happening? It was just really confusing and mind boggling, to tell you the truth. Was ADHD, something that was on your radar at that point? Never. I didn't even that was the first time I heard of it. Danielle was diagnosed with ADHD at seven years old and started taking a stimulant. She tried out different ones, like Ritalin and Adderall. On their own, ADHD medications like these have been shown to be safe and effective in clinical trials. And many say taking the drugs has made a huge difference. But for Danielle, what began with ADHD started her down a cascade of medications. Soon, she was taking a daily cocktail of powerful pills. So this document is my list of psychiatric medications that I've been on over my whole lifetime. It's two pages. Looks like a long list. Actually, I think that's whittled down. There's actually more. That was just the highlights for this call, but I think it's a little longer. So at age seven, so it's Prozac, Ritalin, Daytona, Concerta, Adderall. And then ages eight to 10, we have Prozac, Concerta, Adderall. Ages 11, Prozac, Wellbutrin, Intuit, Intuit, Tuniv Concerta. So age 12, Prozac Concerta. 2009 The list goes on. And over time, Danielle went from taking ADHD medications to also taking antidepressants like Prozac, and then anti anxiety drugs like Lorazepam and Xanax. Danielle is not alone. A Wall Street Journal investigation found that a portion of kids that start on ADHD medication at a a young age are more likely to wind up taking additional psychiatric drugs, which, as Danielle and her mother discovered, can have serious side effects and be very difficult to get off of. Nancy, what do you feel when you hear Danielle's list of medications? It's just you hear it, and it's like, she was a child, seven, eight, nine, 10 years old to be put on pharmaceuticals like this. I mean, I wish I could go back in time, but it just breaks my heart that she had to go through this. And it's it's hard to listen to. It's hard to see, to be honest with you. Welcome to The Journal, our show about money, business, and power. I'm Ryan Knudson. It's …
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by Wall Street Journal
“Wall Street Journal investigation reveals children prescribed ADHD medication at young ages are five times more likely to take additional psychiatric drugs four years later.”
by Stanford University
“Stanford University study shows 42 percent of children aged three to five receive medication within thirty days of ADHD diagnosis, bypassing behavioral interventions.”
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