Currently viewing the tag: "Ritalin"

Guinea Pig Alert: Ritalin Could Result in More Severe Inattention

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human_guinea_pigsHow does it feel to be a human medical guinea pig, part of vast research project to determine whether ADHD is a true medical condition or not? And also to determine whether the current prescribed treatment—pharmaceutical speed—is a valuable treatment option for said potential disorder? Forget that the researchers (scientists, doctors, politicians, school officials, teachers, parents) have already made up their minds before the results have come in—that’s today’s medical research, philosophy and practice whether you like it or not. But how does it feel that your children are the ones being indiscriminately tested on? Oh wait…you don’t believe me…ah, I see…well then:

A recent study now suggests that Ritalin and other speed drugs regularly fed to children might cause long-term brain changes. You don’t say? Gosh, I recall some quack with a blog reporting that vociferously over the last few years… Yes, according to the study, users of methylphenidate (most commonly sold as Ritalin) had higher levels of a protein called the dopamine transporter in their brains after one year of treatment compared to before they starting taking the drug. And these increased levels may lead to future drug tolerance, and get this…”could result in more severe inattention”!

Dopamine_TransporterScientists have speculated that people with ADHD naturally have more dopamine transporters in their brains, but according to study researcher Dr. Gene-Jack Wang, of Brookhaven National Laboratory in Upton, N.Y., the new study suggests that the increase comes from the drug treatment itself and is not associated with the so-called condition alone. Prior to the study, none of the participants had ever been treated with ADHD drugs.

Even scarier is that this study only looked at the effects following one year of speed medication therapy. It is unknown what the longer-term effects might be. Do you still feel good about subjecting your kid to an ongoing medical study?

Among study participants, a 24% increase in the number of dopamine transporters was found in some areas of the brain, while there was no increase in dopamine transporters in a group of healthy participants who did not take Ritalin.

doctor worship (Copy)So my question to parents is, “Why?” Why do some of you so unquestioningly trust the authority of a profession that treats with dangerous drugs first, does research later? Isn’t anyone else out there uncomfortable with the notions of, “We believe that possibly…,” “We think it might…,” and other rationalizations of uncertainty when it comes to the health of your children? I would never, ever, ever subject my child to drugs because some arrogant professionals tell me that they “believe it might help.” Sorry but that’s sloppy parenting.

Unfortunately, too many people still consider medical science their ultimate health authority. No doubt, modern medicine does some pretty incredible things, but I am not placing my faith in a practice and industry that often acts before it knows…not when it comes to the health of me and my loved ones. Yes, I am offended by the modern medical approach to what I have so openly called a “non-condition.” ADD is NOT a disorder. We all have it when we are forced to endure something that doesn’t inspire us. Drugging our children because we can’t understand how to tap into their inspiration is not the answer. Hopefully this study is the beginning of the end to this massive public guinea pig project…but I doubt it.

ADD: The Next Wave of Drugging Children Has Begun

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Last post we discussed the dangers of Ritalin and other central nervous system stimulants in treating ADD.  As disturbing as the rise in Ritalin prescriptions over the last twenty years has been, an even more upsetting trend has begun over the last decade–the use of antipsychotic medication to treat ADD.

Antipsychotics, the big guns, for people (children) with “serious” mental health issues–schizophrenia, bipolar disorder, and so forth–are tranquilizing psychiatric meds used to treat psychosis (including delusions or hallucinations, as well as disordered thought).  There are two types of antipsychotics–typical and atypical.  Atypical antipsychotics are newer and have less severe side-effects, but all antipsychotic medication comes with heavy dangers:

Antipsychotics are some of the biggest selling and most profitable drugs, netting $22 billion in 2008.  That might be why we have seen an increase in off-label (not approved by the FDA) prescribing.  Many states have been reporting high amounts of Medicaid reimbursement for doctors’ prescribing these potent meds–Texas and Florida to name two.

According to one major study, between 1995-2002, nearly 5.8 million childrens’ doctors visits resulted in antipsychotics being prescribed.  Almost one-third of those were doled out by non-mental health practitioners.  53% were given to children for behavioral indications or affective disorders, conditions for which antipsychotics have not been carefully studied in children.  The overall frequency of antipsychotic prescribing increased from 8.6 per 1000 US children in 1995-1996 to 39.4 per 1000 US children in 2001-2002.

Can anyone think of a reason besides the obvious financial incentive to prescribe antipsychotic medication to children labeled ADD?  Try this: Perhaps the stimulant drug solution to treat ADD, so prevalent over the last two decades, isn’t providing the results that we’d hoped for.  One study has shown that long-term benefits are non-existent in those taking Ritalin.  Why, then, perhaps stronger drugs will do the trick.  I’m just waiting for the chemotherapy solution for ADD.  You think I’m joking…

Watch the video below for more info on the dangers of antipsychotic use in children.

ADD Rx: Turning Kids Into Speed Freaks

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So what’s the big deal about ADD anyway?  Why do I care about this “disorder” at all?  Why care about a diagnosis that has become so common that the number of children labeled with it has nearly tripled since the 1970s…why?  I care because the primary treatment for children branded with ADD is dangerous stimulant drugs.Ritalin, or methylphenidate, was first synthesized in the 1940s and identified as a stimulant the following decade.  In the 1960s, doctors first started prescribing Ritalin for hyperactivity, or minimal brain damage, as ADD/ADHD was called then.  The 1990s saw an explosion of Ritalin prescriptions, as ADD became the widely diagnosed condition it is today.

Ritalin is produced and consumed primarily in the United State, with 85% of all prescriptions going to American kids.  Strange that the consuming public has yet to catch on to this anomaly.  Hmmm…ADD said to affect 3-5% of kids worldwide, but why is the U.S. the highest consumer of doctor prescribed speed for this disorder???  A newer, time-released version of Ritalin has been on the market for the last decade; it’s called Concerta.

Ritalin and Concerta work by increasing dopamine levels in the brain.  Dopamine is the neurotransmitter responsible for feelings of pleasure and the reward system.  The compound methylphenidate is very similar to amphetamines, including methamphetamine (meth, crystal, crank), as they all belong to a family of chemicals called phenethylamines.  The all act as central nervous system stimulants.  The methylphenidates, however, actually resemble cocaine more in their structure; yet all three substances–cocaine, amphetamines, and Ritalin–all basically do the same thing; they just do it a bit differently, pharmacologically that is.

Like all the other stimulants just noted, Ritalin has a high potential for tolerance and dependency.  As tolerance increases, so does the need for greater doses to achieve the same desired effect.  The U.S. Drug Enforcement Agency (DEA) knows this, as they pointed out at their 2000 Congressional Testimony before the Committee on Education and the Workforce: Subcommittee on Early childhood, Youth and Families.  In response to a 1995 petition by Children and Adults With Attention Deficit Disorder (CH.A.D.D.) and the American Academy of Neurology to lower the regulatory controls on methylphenidate, the DEA conducted an extensive review of the use, abuse liability, actual abuse, diversion, and trafficking of methylphenidate, the DEA said:

The CH.A.D.D. petition characterized methylphenidate as a mild stimulant with little abuse potential – this is not what our review found (emphasis mine) and the petitioners subsequently withdrew their petition. In December 1996, the DEA held a conference on “Stimulant Use in the Treatment of ADHD”. We gathered experts in the fields of ADHD research and treatment, psychiatry, social work, ethics and law enforcement who offered their expertise and unique perspectives to the many controversial topics related to ADHD and its treatment. In addition, the DEA participated in the 1998 National Institutes of Health (NIH) Consensus Conference. In 1998 and 1999, the DEA was invited to the Council of Europe to participate in joint meetings with the Pompidou Group and the International Narcotics Control Board (INCB) to discuss the control of stimulants in Europe and the diagnosis and treatment of ADHD with stimulants. Today, I will present a summary of the data we have gathered about the use of Ritalin and like drugs. These data show:

    • The number of children diagnosed as having ADHD is unknown.

 

  • Psychostimulants are effective in treating the symptoms of ADHD. Long-term studies looking at the effects of using these drugs are very limited.

 

 

  • The medical use of stimulants in the treatment of ADHD in children continues to escalate.

 

 

  • The expansive use of these drugs for childhood behavioral disorder in the United States differs significantly from medical practices in the rest of the world (United Nations data)

 

 

  • The NIH Expert Panel (1998 Consensus Conference) concluded that the variability in physician diagnosis of ADHD as evidenced by areas of extremely high and low distribution and prescribing rates of stimulants is suggestive of both over and under-diagnosis (Expert Panel, NIH Consensus Conference).

 

 

  • Poison control data, emergency room data and high school surveys all indicate that the abuse of methylphenidate has increased significantly since 1990. !!!!

 

 

  • A number of questionable practices have contributed to the diversion and abuse of stimulant medication including improper diagnosis, lack of adequate information to youth, parents, and schools regarding the abuse potential of these drugs and lax handling of medication (Consensus statement, 1996 DEA Conference).

 

And in 1997 the United Nation’s International Narcotics Control Board (INCB) has also expressed similar concerns:

  • the International Narcotics Control Board (INCB) has observed that world-wide use of methylphenidate has risen from less than 3 tonnes in 1990 to more than 8.5 tonnes in 1994, and continued to rise in 1995.
  • The United States accounts for approximately 90 per cent of total world manufacture and consumption of the substance. The unprecedented sharp increase is due to its controversially extensive use in the treatment of ‘attention deficit disorder (ADD)’ in children. Some other countries have also reported more moderate increases in the use of methylphenidate for this purpose.
  • The INCB shares the concern of the United States Drug Enforcement Agency (DEA) about the increased use of methylphenidate, most commonly marketed in that country under the brand name Ritalin. The latest data indicates that 10 to 12 per cent of all boys between the ages 6 and 14 in the United States have been diagnosed as having ADD and are being treated with methylphenidate. Treatment is more prevalent in middle class communities and is expected to rise in 1996.
  • ADD might be diagnosed too often overlooking other causes for attention and behavior problems and that doctors may be overprescribing methylphenidate. United States investigators found divergent prescribing practices among physicians, only 1 per cent of whom were responsible for the majority of all methylphenidate prescriptions issued. This also has impact on regional variations in the use of methylphenidate.
  • The Board is also concerned that, contrary to labeling, some doctors prescribe stimulants to children under the age of six and, in many cases, other recommended forms of treatment are not applied. The duration of treatment with methylphenidate, which in many countries is restricted to three years, tends to be much longer in the United States and many children remain on it into adolescence and even adulthood. No information on possible side-effects of such long-term treatment with methylphenidate is currently available. 
  • ***The INCB is also concerned that the use of Ritalin is being actively promoted by an influential parent association, which has received significant financial contributions from the preparation’s leading United States manufacturer. The same parent association has petitioned the DEA to ease the control of this substance, a move which would make methylphenidate even more easily available. Among the changes sought is dropping the requirement that the patient be re-examined by a doctor before a prescription for methylphenidate can be refilled.
  • At present, the unprecedented high level of ADD diagnosis in children, the very widespread prescription of Ritalin and the growing abuse and black market appear to be limited to the United States. But, the INCB foresees the likelihood that this trend will soon take hold in other countries. Some of the parent groups promoting methylphenidate in the United States have announced their intention to extend their activities outside the country. The Board is therefore requesting all Governments to exercise utmost vigilance to prevent the overdiagnosing of ADD and any medically-unjustified treatment with methylphenidate and other stimulants. It has also requested the World Health Organization (WHO) to investigate this matter and to provide expertise to national public health authorities.

Anybody need more convincing?  Ritalin and the other stimulant drugs used to “treat” ADD (Adderall, Concerta, Desoxyn) are habit forming and dangerous (more on this in next post)–the DEA knows it, and so does the United Nations.  But today American doctors prescribe these dangerous drugs freely, to treat a  condition with such wide parameters and potential for subjectivity (despite what the American Medical Association claims), one that has expanded in its definition steadily since its inception–that’s what really concerns me.

ADD matters to me precisely for these reasons…because if I can help even one family, one child, from getting put on these dangerous drugs, to be treated for something that makes them “different” from the norm (the masses), for something that their teachers can’t figure out or deal with, then I’ll have accomplished something; something I’ll be satisfied with.  That’s why I care.

No Dumb Kids

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Last post I described a phone conversation between me and a fifteen-year-old boy that called asking about ADD drugs.  When I explained to him how drugs like Ritalin and Concerta are essentially speed he asked what he could take as an alternative.  I said it depends on what the person you are asking believes about the label “ADHD.”

“What do you mean?” he asked.

“Well, for instance, some people, myself included, don’t really believe that ADHD, as it’s defined, is a disorder.  The inability to concentrate, being disruptive in class, or any of those other things that irritate teachers are characteristics we all have when we aren’t inspired by something.  It just tells me that the kid labeled as ADHD isn’t inspired in school.  That says a lot more about teachers than children in my book.”

“Well, I’m just bored in school.”

“Exactly.  But I’ll bet there are things you do that you have no problems concentrating on.  What do you like to do?  What do you love?”

“Sports.”

“What do you play.”

“Football…and baseball.”

“What’s your position in football?”

“Defensive end.”

“So when the ball is snapped, and you’re going after that quarterback, ready to crush his skull…are you thinking about something else?”

“Ha ha…no.”

“So you don’t have ADD when you’re playing sports.”

“No, I guess not.”

“Everybody has ADD when they are forced to do something they are uninspired by.  When you are in school, you are likely uninspired.  Unfortunately for you, you’ve got to go to school until you are eighteen–that’s the law.  In the meantime, find what you love and do it.  And when you are old enough to make your own life decisions, do what you love, and do it well.  You’ll be more fulfilled that way.”

He got it.  I don’t believe there are any dumb children.  But I do believe that there are plenty uninspiring teachers out there.  Maybe they’d be better labeled babysitters, because if they are not inspiring every one of their students, then they are failing as teachers.  In my opinion, teaching is finding what the student loves and showing them how the subject matter relates to what they love.  Give me a room full of football players and I will teach them every math concept under the sun.  All it takes is teacher creativity.  But we all know that’s lacking in our schools…we’ve all been there.

That wasn’t my experience in college, however.  I was so lucky to have outstanding and highly creative professors.  My college algebra teacher was a comedian and a genius.  Nobody finished that class without a basic understanding of math and a hell of a lot of laughs.

Just watch the movie, Stand and Deliver, to understand what I’m talking about.  Teacher Jaime Escalante, “is able to win over the attention of the students by implementing innovative teaching techniques, using props and humor to illustrate abstract concepts of math and convey the necessity of math in everyday lives.” ~ from Wikipedia

No, I’m not buying into ADHD one iota.  Find what inspires a kid, nurture it, and use that to teach them academic concepts, and that kid will thrive.  Giving them doctor-prescribed speed drugs is a cop out.

Doctor Prescribed Speed for Kids

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Got an interesting call this evening from a fifteen-year-old boy who asked, “Why is taking ADD drugs bad?”

I asked why he wanted to know this, and if he was on one of these drugs.  He said he was, and his parents wanted him to wean off.  Hmmm….

I asked the lad why he had chosen to call me, and how he found me in the first place.  Expecting him to say, “From your informative blog, sir,” I was somewhat surprised when he said he found me in the Yellow Pages.  Doh!

Tucking my chest back in, I informed him that I am not a medical doctor, I am a chiropractor, so I can’t give him medical advice; but I certainly know enough about various drugs, ADHD meds included, to give him some general, if not pertinent information.

So I asked him which drug he was on, and why his parents wanted him off it.  He said he was taking Concerta (a lighter version of Ritalin).  His parents were concerned because it made him tired all the time and non-functional when he wasn’t on it.  Basically, he said he was sleeping more than usual when not on the drug.

I asked him what it was like when he was actually on the drug, and he said it made him lose his appetite and his stomach hurt.  I told him what he was describing was very much like what people who take methamphetamine experience.  In fact, I said, ADD and ADHD drugs are essentially speed; his parents and he were observing the side effects that come along with a speed trip.  The sleeping all the time is called “the crash,” and his loss of appetite (upset stomach) was his body’s reaction to taking a speed-like drug.

I told him that the rationale behind giving speed to a child labeled ADHD was to help the child focus, and indeed, one of the effects of any stimulant–meth and coke included–is a heightened concentration when taken at low to moderate levels.  The problem, I explained, is that these effects are relatively short-lived, and ultimately, tolerance and withdrawals set in.

Further, I told him, the body has to neutralize the drug, which it does through the liver; and it also needs to filter out and remove the drug from the body, which is carried out by the kidneys.  So when taken over a long period or in high quantities, any drug (even those prescribed by a doctor) can cause stress internally, leading to illness and disease.

This is why his parents were concerned, I explained.  But more importantly, why was he still on the drug if his parents didn’t want him to be?  Where was his doctor in all of this?  He said that he just saw his doctor today, and the doctor wanted to give him his Med Card.

“What’s that?” I asked, naively.

“For medical marijuana.”

“Your doctor wants you to have that…why?”

“Because I have high blood pressure.”

“Where did you find this doctor?  And do your parents know about this?”

“I just moved here and I went into this place, and there was a medical doctor there.”

“OK, listen; you need to go see a real doctor, not just one that’s out to make money.  I know that no responsible doctor is going to give a fifteen-year-old kid a prescription for medical marijuana.  You need to go to a real doctor, with your parents in tow, tell him/her about your high blood pressure, your Concerta meds, your parents concerns, and go from there.”  I also let him know that I was not telling him to get off the doctor prescribed speed; that wasn’t my place.  But, I said, your parents know what’s best for you, so listen to them.  OK kid, I’ve got a patient waiting…call me anytime.

“You should be a real doctor,” he said.

Thanks kid, I’ll think about it.

Part 2 tomorrow.

Driving Under the Influence

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Driving under the influence is a crime, but some researchers think we should make an exception…for the ADHD driver. Doh! According to research recently present to the American Psychiatric Association, adults with ADHD are more prone to auto accidents. So to combat this phenomenon, researcher recommend ADHD drivers to be cranked out on speed. Nice.

The study showed that adult ADHD drivers had significantly more auto collisions than the general public and received more citations. ADHD teens and adults have also been shown to be nearly twice as likely to having their licenses suspended. According to UC Berkeley psychologist Nadine Lambert, Ph.D., “People with ADHD have serious difficulties planning ahead, following through, and staying on task—things you need to do to drive safely.”

Apparently ADHD drivers are more likely to be convicted of speeding, not obeying signs and signals, following too closely, improper passing, and not following road markings. Additionally they’re somewhat more likely than non-ADHDers to participate in reckless driving, drunk driving, and poor lane placement.

So what’s the solution? Give ’em speed. Now that’s responsibility in the psychiatric research profession–recommend drugging our drivers, yeah! I’m never for the drugging solution, especially when it comes to mental health. Instead of encouraging our unfocused fellow citizens to develop good driving skills, we resort to the simple solution—drugs. I’m not anti-drug, but giving legalized speed, and that’s essentially what these ADHD drugs like Ritalin are, is foolish. It’s not going to make one a more attentive driver. Why don’t we just put a kilo of coke in their trunk—that’ll make them pay attention–guaranteed. But no one would seriously suggest that because it’s nonsensical. And so is drugging our drivers.

I deal with a lot of auto accident victims in my Los Angeles, Beverly Hills and West Hollywood chiropractic office. Accidents caused by people under the influence are some of the worst I see. If the general public is considered impaired even under the influence of cold medications, why recommend speed for ADHDers? The use of drugs to treat mental “disorders” will remain somewhat controversial for years to come; but let’s hope cranking out our ADHD drivers won’t cause more problems than they fix.

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