ADHD
and Other
"Psychological Disorders"
FDA Changes Label Rules on ADHD Stimulants
On June 29, 2005 the Wall Street Journal Online
published a remarkable article by Jennifer Corbett Dooren
titled "FDA Wants Label Changes For Some ADHD
Drugs." The URL for the entire article is http://online.wsj.com/article/0,,SB111998399463271852,00.html?mod=home_whats_news_us.
In
the article, Dooren notes that the FDA is requiring new labeling changes
for stimulant drugs used to treat ADHD. Most, it appears, are variations
on methylphenidate (Ritalin, Concerta, etc.). The drugs have produced side-effects
including, according to the FDA, events "such as visual hallucinations,
suicidal ideation, psychotic behavior, as well as aggression
or violent behavior."
The article adds: "Meanwhile, the FDA
is seeking the panel's advice on what information it should
provide to the public about the ADHD drugs that are widely
used in children while it's collecting information on the number
of types of psychiatric events possibly associated with ADHD
drugs along with possible cardiovascular risks.
"The agency
is concerned with possible cardiovascular events in people
using the drugs. Earlier this year Health Canada ordered Adderall
off the market after reports of sudden death in 20 patients,
including 12 reports of stroke."
While these drugs clearly help
some severely afflicted individuals, they also are increasingly
being found to have adverse effects. At the same time some
are being implicated as possible causes for liver cancer, scientists
report that incidents of liver cancer in children have roughly
doubled over the past two decades.
The Rise and Fall of ADD/ADHD
This very interesting article
by Fred A Baughman Jr, MD lays out the invention and
evolution of ADD as a disease affecting our children. Well
written and referenced, this testimony may be an eye opener
to parents who are led to believe in this diagnosis for
their children.
Our Nov-Dec 2002 Membership Newsletter had
a great article by Peter Breggin, MD on the multi-side effects
associated with ADD treatment.
View
the references here
ADD: The Catch-All Diagnosis
ADD/ADHD has become the catch all diagnosis.
It is conservatively estimated that between 5 and 7 million have been diagnosed
with ADHD!
"There is a myriad of disorders that can mimic ADHD.
Often parents or teachers, through their own investigation,
will determine the diagnosis for their child's school problems
as ADHD, when in fact, the difficulties are unrelated to
ADHD." View
the abstract
The following website, ADHD
Parents Support Website offers 50 different conditions
that mimic the symptoms of ADD/ADHD leading to some of
the over diagnosis. Although there is acknowledgment of
the necessity for improved diagnosis, this type of extensive
assessment is not frequently employed:
"There is no diagnostically
definitive test for ADHD. Therefore, assessments for ADHD need
to be comprehensive and should involve multiple domains, informants,
methods, and settings. The comprehensive assessment needs to
determine whether the subject has ADHD or another disorder.
Thus, evaluation of various organic conditions, functional
disorders, developmental status, situational, environmental,
and family problems should all be explored. The clinical interview
of the child and family is one of the cornerstones of the assessment
process. A comprehensive medical history and examination, psychoeducational
tests, and school-related evaluation, as well as a view of
the child's social and emotional functioning, are also crucial.
A wide array of rating scales, tests, and measures have been
developed to aid in the systematic standardized assessment
of the various deficits associated with ADHD. None of these
tests is definitive, however." View
complete abstract.
What results then is protocol inadequacies combined with
practitioner, parental and school official frustration with
a child's behavior. This leads to the extensive administration
of a wide array of psycotropic drugs we see in our society
today. The following site lists the drugs used. Pharmacological
and Psychostimulants Used for ADHD .
The most commonly prescribed
drug is Ritalin. Billed as a successful treatment whose side
effects are minimal. Here is the package insert for Ritalin.
Let the parents decide for themselves... Ritalin
Side Effects.
And our final link
on ADD is one which brings to light the relationship
between some ADD support groups and self interested pharmeceutical
companies. This statement on their website summarizes it
quite well: "Trust not in "ADD" labels and organizations
but rather in the belief that all children have the potential
to live well-adjusted lives."
ADD/ADHD will continue to
be used as a catch all diagnosis unless parents become
informed. We as Doctors of Chiropractic remain the best
patient advocates and educators in any health field today.
Our enthusiasm and commitment in providing information
for parents to make informed health choices for their families
is unprecedented. Keep up your awesome work--it does matter!
Obstacles to the Diagnosis and Treatment of ADHD
Identified Across Europe
Unfortunately, Europe is now
publishing concerns stating there is substantial barriers to
the diagnosis and effective management of ADHD states an article
by Lilly (a Pharmeceutical Co. which produces drugs for depression,
schizophrenia, diabetes, cancer, osteoporosis and many other
diseases) Whereas the U.S. has held the number one place
for diagnosis and prescribing for ADHD, Europe may soon become
a close runner up. One news article in the U.K.., " Parents
may face jail over compulsory drug orders," reveals a new
fear tactic underway.
Republican Dan Burton (Ind) Blasts
CHADD -- A Leading Public Support Group for ADD
There has been sugnificant evidence about the
relationship between CHADD and pharmaceutical companies (Ciba-Geigy,
the makers of Ritalin. This was originall broought to light
in a documentary: ADD: A Dubious Diagnosis. The Merrow Report.
The following article reviews how one member of congress
is exposing this conflict of interest to Congress.
Read the
complete article here
Early Use of ADHD Drug Alters Brain
Ritalin use in preteen
children may lead to depression later in life. Ritalin and
cocaine have different effects on humans. But their effects
on the brain are very similar. When given to preteen rats,
both drugs cause long-term changes in behavior.
One of the changes
seems good. Early exposure to Ritalin makes rats less responsive
to the rewarding effects of cocaine. But that's not all good.
It might mean that the drug short-circuits the brain's reward
system. That would make it difficult to experience pleasure
-- a "hallmark symptom of depression," Carlezon
and colleagues note.
The other change seems all bad. Early exposure
to Ritalin increases rats' depressive-like responses in a stress
test. "These
experiments suggest that preadolescent exposure to [Ritalin]
in rats causes numerous complex behavioral adaptations, each
of which endures into adulthood," Carlezon and colleagues
conclude. "This work highlights the importance of a more
thorough understanding of the enduring neurobiological effects
of juvenile exposure to psychotropic drugs."
http://my.webmd.com/content/article/78/95700.htm?lastselectedguid={5FE84E90-BC77-4056-A91C-9531713CA348}
Antidepressant use on the rise among
US children
Prescriptions for antidepressant medications
for children and teenagers rose substantially during the
1990s, US researchers have found. In 1994, 13 to 19 out of
every 1,000 children were prescribed an antidepressant. Prescriptions
were most common among boys aged 10 to 14 and girls aged
15 to 19.
Whether a child was treated by a primary
care physician or a psychiatrist seemed to affect prescription
choices, the authors add. ADHD was the most common diagnoses
in children who were prescribed an antidepressant by a primary
care physician. In contrast, the primary medical diagnosis
in children treated by a psychiatrist was most likely to
be depression.
Dr. Julie Magno Zito, of the University
of Maryland in Baltimore, and colleagues report. "The expanded
utilization of antidepressants for the management of behavioral
and emotional disorders of youth in the 1990s was prominent," they
advise that more research is needed to strengthen the evidence
that the medications are appropriate for children and teens.
SOURCE: Pediatrics
2002 (May); 109 (5): 721-727
1.6 million elementary school children
have been diagnosed with ADHD
About 1.6 million cases of attention deficit
hyperactivity disorder (ADHD) have been diagnosed in American
elementary school children, according to the Centers for
Disease Control and Prevention.
The standard medical treatment
is drug treatment.
SOURCE: British
Medical Journal 2002 (June 1): 324 (7349): 1296
ADHD: Management Beyond Medication
This letter to the editor of American Family
Physicians addresses the need to evaluate school environments
for children diagnosed with ADD/ADHD in order to meet the
individual child's needs.
Read
the "ADHD: Management Beyond Medication" letter
Consider Fish Oil Over Ritalin
Children with attention-deficit
hyperactivity disorder (ADHD) have problems paying attention,
listening to instructions, and completing tasks; they also
fidget and squirm, are hyperactive, blurt out answers, and
interrupt others.
It is conservatively estimated that 3-5% of
the school-age population has ADHD. Although drugs, such as
Ritalin, are frequently used to treat ADHD, they are fraught
with complications. Disadvantages include possible side effects,
including decreased appetite and growth, insomnia, increased
irritability, and rebound hyperactivity when the drug wears
off.
One would not expect to find that a single cause or even
a handful of factors could explain why ADHD appears to be
so rampant in our society. Because it is accepted that both
genetic and environmental factors play a role in ADHD, many
other factors-both intrinsic and extrinsic-could influence
an individual's fatty acid status.
Inefficient Conversion
of ALA (Flax Oil) To EPA And DHA
A possible cause for the low
fish oil status of the ADHD children may be impaired conversion
of the fatty acid precursors LA and ALA to their longer and
more highly unsaturated products, such as EPA and DHA (fish
oil fats).
It appears that children with ADHD just are not able
to chemically convert the plant omega-3, ALA to fish oil very
well. The problem is further worsened when omega-6 fats are
consumed and the ideal omega-6:3 ratio of 1:1, progresses
to the typical standard American ratio of 15:1. Many of these
children have ratios which are even worse and can be as high
as 50:1.
This study provides the research evidence supporting
the use of the omega-3 fats found in fish oils to effectively
address the underlying deficiency that is present in most
of these children and appears to be contributing to the ADHD.
Nutritional
Considerations for ADHD
Two books worth having for your lending
libraries:
Smart Fats: How Dietary Fats and Oils Affect Mental,
Physical and Emotional Intelligence
by Michael A. Schmidt and Omega 3 Connection by Dr. Stolle
Kids with ADHD May Need Iron
Results of a small study in France suggest that
children with attention-deficit/hyperactivity disorder (ADHD) may
be low on iron. An iron deficiency could be a contributing
factor to ADHD because it leads to abnormal functioning of
the brain neurotransmitter dopamine. A French research team
tested 53 youngsters with ADHD and a comparison group of
27 children. They found that 84 percent of the kids with
ADHD had low iron levels compared with only 18 percent of
the children in the control group; 32 percent of the ADHD
kids had extremely low iron levels compared to only one of
the youngsters in the matched group. The researchers found
that the lower the iron levels, the more severe a child's
ADHD symptoms. They suggested that iron supplements might
improve dopamine activity in kids with ADHD and reduce the
need for the drugs often prescribed to treat the disorder.
While growing children need iron, supplements can lead to
toxicity, and children should not take iron except upon the
advice of a physician. Results of the French study were published
in the December 2004 issue of the Archives of Pediatric and
Adolescent Medicine.
Source: Archives of Pediatric and Adolescent
Medicine, December 2004
Read more about ADD/ADHD:
ICPA
Page on Ritalin
The
ADD/ADHD Page @ Chiro.Org
Fight for Kids. com
Learn
more about Methylphenidate (Ritalin) and ADHD
And
even more on the side effects of psycotropic drugs for
children.
Drug Companies fail
to warn parents
Doctor
visits by youngsters with ADHD up 90%
The
Hyperactive Child and Chiropractic
Find
a Doctor of Chiropractic for Your Child
Source: http://www.icpa4kids.org