Ritalin Gone Wrong - Childrens ADD Drugs Dont Work Long-Term - NYTimes article

[Bob]

New York Times article

Ritalin Gone Wrong - Childrens ADD Drugs Dont Work Long-Term

http://www.nytimes.com/2012/01/29/opinion/sunday/childrens-add-drugs-dont-work-long-term.html

This isn't directly related to CFS, but for anyone interested in ADD/ADHD, or medical research in general, it's a fascinating read, and explains that so much ADD research has been misleading, because it's been based on only short-term results. It explains that the consensus medical opinion about ADD/ADHD has been mistaken.

It blows apart what I understood about ADD and ADHD.

The article highlights flaws within the medical and research communities, which has led to bad decisions. Just like with CFS, it seems that this condition has been misunderstood, possibly as a result of too much influence by a particular niche vested interest with a lot of resources at its disposal. In this case the vested interest would probably have been the drugs companies (possibly with the assistance of psychiatrists or neurologists), as opposed to just psychiatrists in the case of CFS.

 

[liquid sky]

Interesting article. I have nieces who have been treated with stimulant meds. such as Ritalin. I could never see any real progress for them from using the drugs. I could also see that the upbringing of these girls was chaotic and most likely the cause of their problems. They are grown now and things did not work out well for them.

One point the article made was that by giving the child a pill it does 2 things. It causes the child to believe there is something wrong with them, that they are not normal. It also reinforces the belief that all things in life can be fixed by taking some sort of pill. I saw both of these problems with my nieces also.

 

[Nielk]

I have a major problem with this article. Again, the blame is put on the parents and chaotic family life, There is no correlation between the two. Plenty of children grow up in dysfunctional families and /or go through traumatic events yet, never develop any ADD and ADHD symptoms yet, you find a major amount od children brought up in very stable homes with caring parents who develop ADD or ADHD. This is going back to the dark ages where they blamed autism or retardation on an unloving mother. What a unfair guilt trip to put on parents of these children. Dowes the lack of long term effect of stimulanttdrugs automatically point to adverse experiences of the child? This is setting back science to a couple of decades ago. Besides what scientific basis do they have for their conclusion. I think it's ludicrous!

 

[*GG*]

I have a major problem with this article. Again, the blame is put on the parents and chaotic family life, There is no correlation between the two. Plenty of children grow up in dysfunctional families and /or go through traumatic events yet, never develop any ADD and ADHD symptoms yet, you find a major amount od children brought up in very stable homes with caring parents who develop ADD or ADHD.

This is going back to the dark ages where they blamed autism or retardation on an unloving mother. What a unfair guilt trip to put on parents of these children. Dowes the lack of long term effect of stimulanttdrugs automatically point to adverse experiences of the child? This is setting back science to a couple of decades ago. Besides what scientific basis do they have for their conclusion. I think it's ludicrous!

Yeah, I think the NYT likes to NOT blame people, it's always something else. Our "great society" experiment?

GG

 

[Bob]

I have a major problem with this article. Again, the blame is put on the parents and chaotic family life, There is no correlation between the two. Plenty of children grow up in dysfunctional families and /or go through traumatic events yet, never develop any ADD and ADHD symptoms yet, you find a major amount od children brought up in very stable homes with caring parents who develop ADD or ADHD. This is going back to the dark ages where they blamed autism or retardation on an unloving mother. What a unfair guilt trip to put on parents of these children. Dowes the lack of long term effect of stimulanttdrugs automatically point to adverse experiences of the child? This is setting back science to a couple of decades ago. Besides what scientific basis do they have for their conclusion. I think it's ludicrous!

Yes, well every ME patient in the UK knows what it's like to be blamed for our own illness! So I have much sympathy for your thoughts there Nielk.
I don't know anything about ADHD but I found the article interesting.
At a basic level, I think it means that the medical community still don't have much insight into ADHD, and that the current treatments aren't working.
Like I said, I don't know anything about ADHD, but I would have thought that well-tuned psychological programs might help some children with ADHD to cope better, to have better insight into their condition, and to make the most out of their abilities. That might be a helpful approach, rather than just giving them a pill that plasters over the cracks.

 

[Nielk]

Yes, well every ME patient in the UK knows what it's like to be blamed for our own illness! So I have much sympathy for your thoughts there Nielk.
I don't know anything about ADHD but I found the article interesting.
At a basic level, I think it means that the medical community still don't have much insight into ADHD, and that the current treatments aren't working.
Like I said, I don't know anything about ADHD, but I would have thought that well-tuned psychological programs might help some children with ADHD to cope better, to have better insight into their condition, and to make the most out of their abilities. That might be a helpful approach, rather than just giving them a pill that plasters over the cracks.

Hi Bob,

I have a grandson who is 11 now and was diagnosed with ADHD when he was 5. He is basically highly intelligent, well behaved with no emotional problems.
He just can't focus his attention. In school, he is daydreaming the whole day. He has a very high I.Q.-taught himself to read at age 3 and is now reading at adult level.
His parents have tried putting him on Ritalin type medications but, none of them helped. He actually had very bad adverse effects from them. He knows he has this problem yet, he is fine, happy, normal. He doesn't get anything out of school. All his knowledge comes from his avid reading habit and interest in many subjects. I don't thin that a professional counselor/psychologist.psychiatrist can help him. They can't restore his attention and like I said, he is a wonderful happy kid.

 

[Bob]

Hi Bob,

I have a grandson who is 11 now and was diagnosed with ADHD when he was 5. He is basically highly intelligent, well behaved with no emotional problems.
He just can't focus his attention. In school, he is daydreaming the whole day. He has a very high I.Q.-taught himself to read at age 3 and is now reading at adult level.
His parents have tried putting him on Ritalin type medications but, none of them helped. He actually had very bad adverse effects from them. He knows he has this problem yet, he is fine, happy, normal. He doesn't get anything out of school. All his knowledge comes from his avid reading habit and interest in many subjects. I don't thin that a professional counselor/psychologist.psychiatrist can help him. They can't restore his attention and like I said, he is a wonderful happy kid.

Thanks Nielk, for sharing that interesting insight into ADHD.

I didn't learn anything useful in school. I think they are horrible places that don't allow people to develop. I'm not surprised that a highly intelligent child learns better by himself than at school. Schools are so restrictive in the types of learning that they allow. So many children learn better by actually 'doing' things (i.e. getting involved in things) than learning by wrote. I have a family member who left school thinking they were stupid, but they are one of the most creative, insightful and intelligent people I know. They just couldn't get on at school, because they couldn't learn from text books or instructions.

 

[Glynis Steele]

There was a study in the Netherlands about diet and ADHD, although in the study they were looking at food allergy. They said that an elimination diet was a valuable instrument to assess whether ADHD was induced by food, but that the prescription of diets on the basis of IgG blood tests should be discouraged I think they are on the right lines, regarding foods causing a problem, but I wonder whether it could be a gut bacterial problem.

Effects of a restricted elimination diet on the behaviour of children with attention-deficit hyperactivity disorder (INCA study): a randomised controlled trial

Dr Lidy M Pelsser MSc a , Klaas Frankena PhD b, Jan Toorman MD c, Prof Huub F Savelkoul PhD b, Prof Anthony E Dubois MD d, Rob Rodrigues Pereira MD e, Ton A Haagen MD f, Nanda N Rommelse PhD g, Prof Jan K Buitelaar MD

Background

The effects of a restricted elimination diet in children with attention-deficit hyperactivity disorder (ADHD) have mainly been investigated in selected subgroups of patients. We aimed to investigate whether there is a connection between diet and behaviour in an unselected group of children.

Methods

The Impact of Nutrition on Children with ADHD (INCA) study was a randomised controlled trial that consisted of an open-label phase with masked measurements followed by a double-blind crossover phase. Patients in the Netherlands and Belgium were enrolled via announcements in medical health centres and through media announcements. Randomisation in both phases was individually done by random sampling. In the open-label phase (first phase), children aged 48 years who were diagnosed with ADHD were randomly assigned to 5 weeks of a restricted elimination diet (diet group) or to instructions for a healthy diet (control group). Thereafter, the clinical responders (those with an improvement of at least 40% on the ADHD rating scale [ARS]) from the diet group proceeded with a 4-week double-blind crossover food challenge phase (second phase), in which high-IgG or low-IgG foods (classified on the basis of every child's individual IgG blood test results) were added to the diet. During the first phase, only the assessing paediatrician was masked to group allocation. During the second phase (challenge phase), all persons involved were masked to challenge allocation. Primary endpoints were the change in ARS score between baseline and the end of the first phase (masked paediatrician) and between the end of the first phase and the second phase (double-blind), and the abbreviated Conners' scale (ACS) score (unmasked) between the same timepoints. Secondary endpoints included food-specific IgG levels at baseline related to the behaviour of the diet group responders after IgG-based food challenges. The primary analyses were intention to treat for the first phase and per protocol for the second phase. INCA is registered as an International Standard Randomised Controlled Trial, number ISRCTN 76063113.

Findings

Between Nov 4, 2008, and Sept 29, 2009, 100 children were enrolled and randomly assigned to the control group (n=50) or the diet group (n=50). Between baseline and the end of the first phase, the difference between the diet group and the control group in the mean ARS total score was 237 (95% CI 186288; p<00001) according to the masked ratings. The difference between groups in the mean ACS score between the same timepoints was 118 (95% CI 92145; p<00001). The ARS total score increased in clinical responders after the challenge by 208 (95% CI 143273; p<00001) and the ACS score increased by 116 (77154; p<00001). In the challenge phase, after challenges with either high-IgG or low-IgG foods, relapse of ADHD symptoms occurred in 19 of 30 (63%) children, independent of the IgG blood levels. There were no harms or adverse events reported in both phases.

Interpretation

A strictly supervised restricted elimination diet is a valuable instrument to assess whether ADHD is induced by food. The prescription of diets on the basis of IgG blood tests should be discouraged.

 

[Ocean]

Hi Bob,

I have a grandson who is 11 now and was diagnosed with ADHD when he was 5. He is basically highly intelligent, well behaved with no emotional problems.
He just can't focus his attention. In school, he is daydreaming the whole day. He has a very high I.Q.-taught himself to read at age 3 and is now reading at adult level.
His parents have tried putting him on Ritalin type medications but, none of them helped. He actually had very bad adverse effects from them. He knows he has this problem yet, he is fine, happy, normal. He doesn't get anything out of school. All his knowledge comes from his avid reading habit and interest in many subjects. I don't thin that a professional counselor/psychologist.psychiatrist can help him. They can't restore his attention and like I said, he is a wonderful happy kid.

I have ADHD and it can make life as an adult very difficult. Problems with executive functioning become big obstacles when you have to manage your own life as an adult. It can also affect your thinking, actions, and choices in a way that serve up lifelong consequences. I did just fine in school as far as grades and behavior, but ADHD absolutely affects my life and does add an extra obstacle, and not a small one. And it definitely affects learning, sometimes a different type of teaching is required to best fit someone with a different learning style.