The topic of Attention Deficit Hyperactivity Disorder is a controversial one. Some believe it's a made-up diagnosis, foisted on active children by drug manufacturers. Others, who have seen a child's behavior and ability to sit and learn improve with medications, believe it's real.

ADHD affects more than 8 percent of children in the United States. Children with ADHD have trouble paying attention, are easily distracted, tend to have trouble sitting still and they often act impulsively, without thinking about the consequences of their actions. These behaviors make it hard for children to make friends and to do well in school. These symptoms can persist into the teen years, and for some, even into adulthood.

ADHD is difficult to diagnose before age 6. Younger children often show some of the traits associated with ADHD in some situations, but this is normal. At age 6 or older, children who are persistently inattentive, hyperactive and impulsive for six months or longer should be evaluated, especially if they are having trouble at school or in social situations.

Two recent research studies have found measurable differences in the brains of people diagnosed with ADHD, giving strength to the argument that it is truly a disorder.

One study found that those who have a variant of a certain gene are much more likely to be diagnosed with ADHD. This dopamine D4 receptor gene influences parts of the brain that help a person pay attention. The study confirms the findings of other studies, which found that ADHD is an inherited disorder that affects brain chemistry.

The second study found that Ritalin - a common drug used to treat ADHD - works by increasing levels of a chemical in the brain called dopamine. This suggests that low levels of dopamine in the brain are associated with ADHD, and it also helps explain why people with ADHD are more likely to abuse drugs. (Drugs such as methamphetamine, cocaine, nicotine and caffeine increase dopamine levels in the brain, which makes people with low levels of dopamine feel better and function better.)

The most common medication used to treat ADHD is methylphenidate (Ritalin, Metadate and Concerta). Amphetamine (Adderall) and dextroamphetamine (Dexedrine, Dextrostat) are others. All these drugs are stimulants - but they work in people with ADHD by increasing dopamine levels, which help the brain function more normally.

These drugs do have possible side effects: insomnia, decreased appetite, headaches and stomachaches are the most common. Sometimes a lowered dose or different drug may be better tolerated.

For many children, the improvement in their ability to learn in school and to relate to other children is so significant that minor side effects are worth it.

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Kathryn B. Brown worked as a registered nurse and a family nurse practitioner before coming to work for the East Oregonian. Her column appears here every other week. She can be reached at kbbrown@eastoregonian.com.

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