Understanding why drugs are so popular (from PBS)...
It is tempting to view this pattern as suggesting that the ADHD diagnosis provides teachers with a new technique for regaining control of the classroom in a world where many of the traditional methods of control have been eliminated. Drugs have replaced the reprimand.
But it seems to me that the real problem may be that the concept of compulsory, cookie-cutter education needs rethinking. In spite of the rhetoric in schools of education about the importance of taking into account the individual needs of the children in a classroom, the current system of public education is designed to make that nearly impossible. State curriculum guidelines and requirements, coupled with further requirements from the local community, prevent teachers from making any serious effort to tailor materials and assignments to the differing abilities and dispositions of individual children. Nor is there any mechanism, of the sort one would find in a school-choice-based system of education, for parents to seek out schools tailored to the temperaments and capabilities of their children. Instead, it becomes necessary to find ways of making children able to perform in the environment as they find it. And, in late twentieth-century America, when it is difficult or inconvenient to change the environment, we don't think twice about changing the brain of the person who has to live in it. The rise in consumption of Ritalin is only one manifestation of this cultural practice. Consider Prozac or, in previous decades, Valium.
None of this should be taken to suggest that there are no cases of genuine brain damage or dysfunction that require medical intervention. There have always been diseases of the brain, as of any other organ, and they should be treated as such. But difference does not automatically equal disease. Is changing the child's brain chemistry, by prescribing Ritalin-like drugs, really the most appropriate response to the child who doesn't perform well in the modern school environment? Perhaps it's time we asked ourselves whether the fact that so many children can't learn well in our schools is a reflection on the schools, not the children.Read more
In this case, I can't fathom what the reasoning is:
ARTICLE: Nearly 1 million children in the United States are potentially misdiagnosed with attention deficit hyperactivity disorder simply because they are the youngest -- and most immature -- in their kindergarten class, according to new research by a Michigan State University economist.
From Salon: "Anatomy of an Epidemic": The hidden damage of psychiatric drugs...
What about stimulants used to treat ADHD. How effective are they? These stimulants alter behavior in a way that teachers can appreciate. They subdue finger-tapping and disruptive symptoms. But in the 1990s, the National Institute of Mental Health started looking to see if things like Ritalin were benefiting kids with ADHD, and to this day they have no evidence that this drug treatment improves long-term functioning in any domain -- the ADHD symptoms, lower delinquency rates, better performance at school, et cetera. Then the NIMH studied whether these drugs provide a long-term benefit, and they found that after three years, being on medication is actually a marker of deterioration. Some patients’ growth has been stunted, their ADHD symptoms have worsened. William Pelham, from the State University of New York at Buffalo and one of the principal investigators in that study, said, "We need to confess to parents that we’ve found no benefit." None. And we think that with drugs, the benefits should outweigh the risks.What's so risky about Ritalin? For one, a significant percentage -- between 10 and 25 percent -- of kids prescribed medication for ADHD will have a manic episode or psychotic episode and deteriorate in such a way that they’re diagnosed with bipolar disorder. A similar study in 2000 on pediatric bipolar disorder reported that 84 percent of the children treated for bipolar illness -- at the Luci Bini Mood Disorders Clinic in New York -- had been previously exposed to psychiatric medications. The author, Gianni Faeda, wrote, "Strikingly, in fewer than 10 percent of the cases was diagnosis of bipolar disorder considered initially." The reality is that until children were medicated with stimulants and antidepressants, you didn't see juvenile bipolar mania.But if these studies are so groundbreaking, why have they gone unreported in the media? Because the NIMH didn’t announce it. Just as they didn’t announce the 2007 outcome study for schizophrenia patients. In that study, the recovery rate was 40 percent for those off meds, but only 5 percent for those on meds. I checked all the NIMH press releases for 2007, and found no release on this study. I found no announcement of it in any American Psychiatric Association publication or textbook. Not a single newspaper published an account of the study. And that’s because the psychiatric establishment -- the NIMH, the APA, even the National Alliance on Mental Illness, an advocacy organization -- did not put out any press release about it or try to alert the media in any way.Are you suggesting that psychiatrists are beholden to pharmaceutical companies? Not exactly, although most of the leading academic psychiatrists act as consultants, advisors and speakers for them. The problem is that psychiatry, starting in 1980 with the publication of the DSM-III, decided to tell the public that psychiatric disorders were biological ailments, and that its drugs were safe and effective treatments for those ailments. If it suddenly announces to the public that a long-term NIMH-funded study found that the 15-year recovery rate for schizophrenia patients was 40 percent for those off meds and 5 percent for those on meds, then that story begins to fall apart. By not reporting the results, psychiatry maintains the image of its drugs in the public mind, and the value of psychiatrists in today’s therapy marketplace.So do you think psychiatric drugs should be used at all? I think they should be used in a selective, cautious manner. It should be understood that they’re not fixing any chemical imbalances. And honestly, they should be used on a short-term basis. But beyond this, I think we should look at programs that are getting very good results. This is what I love about Keropudas Hospital’s program in Finland. They have 20 years of great results treating newly psychotic patients. They see if patients can get better without the use of meds, and if they can’t, then they try them. It’s a best-use model, not a no-use or anti-med model. It fits with our studies done in the 1970s that found if you use this model, you get better outcomes, and a good number of people get better and go on with their lives.
Miscellaneous Information on the Side Effects of Ritalin...
U.S. DEPT. OF JUSTICE: “Of particular concern is that ADHD literature prepared for public consumption does not address the potential or actual abuse of methylphenidate. Instead, methylphenidate is routinely portrayed as a benign, mild substance that is not associated with abuse or serious side effects. In reality, however, the scientific literature indicates that methylphenidate [Ritalin] shares the same abuse potential as other Schedule II stimulants. Further, case reports document that methylphenidate abuse can lead to tolerance and severe psychological dependence.” Ritalin (methylphenidate) is an amphetamine-like prescription stimulant commonly used to treat Attention Deficit Hyperactivity Disorder (ADHD) in children and adults. Many think Ritalin (methylphenidate) is safe, or mild, because so many children use it. However, the government classifies the psychoactive drug with cocaine and morphine because it is highly addictive. Long-Term Effects of Ritalin: Changes in Brain Development Ongoing research shows early-life use of Ritalin (methylphenidate) has complex effects that endure later into life. A study published in Biological Psychiatry suggests that exposure of Ritalin in youth may later disrupt development of brain cells in the hippocampus, region of the brain critical to memory, spatial navigation, and behaviorial inhibition. Damage can lead to memory problems, disorientation and depression in adulthood. Ritalin is a Schedule II Substance, which means Ritalin has a "high potential for abuse" that "may lead to severe psychological or physical dependence," and the federal government sets limits on the amount of these amphetamine drugs that may be manufactured each year. A review of 20-years of scientific literature on using stimulant medications, including Ritalin, to treat children with ADD and ADHD found a consensus: there is no documented long-term benefit (academic achievement or pro-social behavior) in using psychoactive drugs.Abrupt cessation of stimulant drugs such as Ritalin can cause extreme fatigue and severe, even suicidal, depression in adult patients. The question of whether methylphenidate (Ritalin) impairs creativity in children; Ritalin may have subtle impacts on cognitive and intellectual processes. Both parents and researchers have noticed that children taking Ritalin sometimes answer questions in ways that seem overly compliant or narrow, suggesting the drug might restrict creative thinking. One study found hyperactive children taking Ritalin offered less varied answers to open-ended questions. How much do the “neuro-enhancing” drugs really help? And there's the question of what we mean by “smarter.” The psycho-stimulants help students bear down on their work, but with odd effects. One college student says he spends “too much time researching a paper rather than actually writing it.” Another student looked back at papers he'd written while on Adderall and found them verbose: “I'd produce two pages on something that could be said in a couple of sentences.” Could enhancing one kind of thinking exact a toll on others? All these questions need proper scientific answers, but for now much of the discussion is taking place furtively, among an increasing number of Americans who are performing daily experiments on their own brains (or their children's brains)A few links and videos that seal the case for, abolishing psychiatric drugs being administered to children...
How drug companies' PR tactics skew the presentation of medical research When doctors are deciding which drug to prescribe a patient, the idea behind evidence-based medicine is that they inform their thinking by consulting scientific literature. To a great extent, this means relying on medical journals. The trouble is that pharmaceutical companies, who stand to win or lose large amounts of money depending on the content of journal articles, have taken a firm grip on what gets written about their drugs. That grip was strong way back in 2004, when The Lancet's chief editor Richard Horton lamented that "journals have devolved into information laundering operations for the pharmaceutical industry." It may be even tighter now. Drug companies exert this hold on knowledge through publication planning agencies, an obscure subsection of the pharmaceutical industry that has ballooned in size in recent years, and is now a key lever in the commercial machinery that gets drugs sold. The planning companies are paid to implement high-impact publication strategies for specific drugs. They target the most influential academics to act as authors, draft the articles, and ensure that these include clearly-defined branding messages and appear in the most prestigious journals. Over the past few months I've tried to find out as much about these companies as possible. I wanted to know how big this industry is, exactly how it operates, and how people in the business think about their work. It's a nervous, opaque industry, but I did find answers to some of my questions. There are now at least 250 different companies engaged in the business of planning clinical publications for the pharmaceutical industry, according to the International Society for Medical Publication Professionals, which said it has over 1000 individual members. Many firms are based in the UK and the east coast of the United States in traditional "pharma" centres like Pennsylvania and New Jersey.
How flimsy research gets inferior drugs to market Some of the biggest problems in medicine don't get written about, because they don't concern eye-catching things such as one patient's valiant struggle: they're protected from public scrutiny by a wall of tediousness. Here is one problem that affects millions of people. What if we had rubbish evidence on whether hundreds of common treatments really work, simply because nobody asked the right research question? A paper published this week looks at how much evidence there was for every one of the new drugs approved by the FDA between 2000 and 2010, at the time they were approved. You might think drugs only get on the market if they've been shown to be useful. But "useful" can mean many different things: for FDA approval, for example, you only need trials to show your drug is better than a placebo. That's nice, but with most medical problems, we've already got some kind of treatment. We're not interested in whether your drug is better than nothing. We're interested in whether it's better than the best currently available option. So it turns out that, out of all the 197 new drugs approved in the past decade, only 70% had data to show they were better than other treatments (and that's after you ignore drugs for conditions where there was no current treatment).
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