Odds Are

One might assume that since up to 10% of U.S. children now carry a diagnosis of ADHD, and since those children start medications as young as age 4 and continue to use them for many years, the safety studies that got these drugs approved would have been especially rigorous. Yeah, no. Only 5 of 32 preapproval trials focused on safety, these trials enrolled an average of 75 patients (as opposed to the recommended 1,500), and few lasted as long as 12 months, with approval sometimes granted after only 8 weeks of study and some older drugs being “grandfathered” in with essentially no safety data whatsoever.

I see one bright spot in this desert of data. Whenever I prescribe a stimulant for ADHD, I’ll understand that I’m taking a gamble, and I’ll fondly remember our family trip to Las Vegas.

David L. Hill, M.D., FAAP, is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and  adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.