ADHD "Epidemic"

In 1993, California neurologist Fred A. Baughman, Jr., MD, began asking agencies and researchers for research data that supports the assertion that attention-deficit hyperactivity disorder (ADHD) is caused by a neurochemical imbalance. Present diagnosis of ADHD is very subjective. Many of the signs of ADHD can also indicate boredom, frustration, emotional distress, perceptual learning difficulties, or a lack of discipline and structure in the child's environment. Dr. Baughman sought confirmation that ADHD is, indeed, an organic disease, characterized by a "definite, discernible (patient by patient) physical or chemical abnormality/marker" that responds to the stimulant Ritalin. He was referred to James M. Swanson, PhD, Director of the Child Development Center at the University of California-Irvine.

In his article "Attention-Deficit Hyperactivity Disorder (ADHD) As Fraud: Commentary on the Report of the Council on Scientific Affairs of the AMA" (May 11,1998), Baughman writes about his encounter with Swanson at the American Society for Adolescent Psychiatry Meeting in San Diego, California, March 5-8, 1998. As a speaker at this meeting, Swanson referred to MRI brain scan research performed by F.X. Castellanos, et al., and a study by P.A. Filipek, et al. These studies found "brain atrophy in subjects with ADHD, but not in controls."

Speaking from the audience, Baughman pointed out that "93% of the subjects in the Castellanos studies had been on chronic stimulant therapy" [e.g., Ritalin], and inquired as to the stimulant status of those in the Filipek study. Swanson acknowledged that Filipek et al., also utilized ADHD subjects who had been on chronic stimulant therapy. This information was not contained in the Swanson et al. review of the research (published in Lancet, 1998; 351: 429-433), nor in the AMA's Council of Scientific Affairs Report (JAMA, 1998; 279: 110-117). Braughman explains that these studies actually give "strong, replicated evidence that chronic stimulant therapy (methylphenidate, amphetamine) causes brain atrophy - not confirmation of an ADHD phenotype at all, as we were led to believe."

Occupational therapist Sue Parry (Mercer Island, Washington) has also been investigating the validity of the ADHD "epidemic." As part of her investigation, Parry reviewed the information contained in two Drug Enforcement Administration (DEA), Office of Diversion Control, documents: "Conference Report, Stimulant Use in the Treatment of ADHD" (Dec. 1996) and "Methylphenidate: A Background Paper" (Oct. 1995). Parry found wide variations in the amount of methylphenidate (Ritalin) used per 100,000 population from state to state and from year to year. For example, Tennessee ranked 42nd in the nation in 1987 while Maryland ranked 3rd. By 1994, Tennessee had climbed to 7th while Maryland sank to 47th. In December 1996, the DEA reported that when the data is broken down to zip code areas, "there is wide variability in the consumption of methylphenidate from one locality to another within most states." Such variations in Ritalin use indicate a corresponding variation in the diagnoses of ADD. AD D is not a communicable disease. Why does Ritalin use - and by inference the incidence of ADD - vary so greatly from area to area and from year to year in the same area?

Psychiatrist Peter R. Breggin, MD, who wrote Talking Back to Prozac and Talking Back to Ritalin (Common Courage Press, 1998), notes that "[m]ost recommendations for psychostimulants originate from the schools." Many of today's public school teachers face large classes of students with diverse learning styles, abilities, and needs. They are under pressure to maintain order and to drill measurable skills so that students will pass standardized tests, used to evaluate the quality of education. Instead of addressing underlying causes behind a child's disruptive behavior, school personnel often suggest that the child be put on Ritalin. School staff often get their information about ADD and its treatment from CHADD (Children and Adults with Attention Deficit Disorder), a parents group that receives financial backing from Ritalin's manufacturer, Novartis (formerly Ciba-Geigy).

Breggin explains that "Ritalin's sought-after therapeutic effect, 'compliance' in school and the family, is in fact an adverse drug effect. This drug-induced docile behavior is caused by chemically blunting or subduing the child's higher brain function.... The drug effect has nothing to do with any supposed disorder in the child. Psychostimulants will suppress the spontaneous behavior of healthy animals and children alike. Psychostimulants will also suppress emotional expression...by suppressing needs and their expression, psychostimulants encourage conformity."

Ritalin has been shown to decrease blood flow to the brain in a pattern similar to one caused by cocaine use. Cocaine is linked to impaired thinking ability and memory loss, which affects the ability to learn. Ritalin also disrupts pituitary function and growth hormone production, inhibiting physical growth. In some children, the drug causes insomnia, increased agitation, depression, and even psychosis. Ritalin, a Schedule II drug, is also highly addictive; and, Breggin writes, children may experience withdrawal reactions on a daily basis.

The promotion of Ritalin is under fire. On November 11, 1999, the Colorado State Board of Education adopted a resolution that encourages school personnel to stop advocating the use of psychotropic drugs for behavior management (http:/ /home.att.net/~fred-alder). The resolution also asks that school staff work with doctors in making the negative effects of such drugs more widely known. On May 1, 2000, a class action suit was filed in Texas. The suit accuses Novartis, CHADD, and the American Psychiatric Association of "fraud" and "conspiracy" in overpromoting Ritalin (see www.breggin.com).

"Attention-Deficit Hyperactivity Disorder (ADHD) As Fraud: Commentary on the Report of the Council on Scientific Affairs of the AMA" by Fred A. Baughman Jr., MD, May 11. 1998. http://home.att.net/~fred-alder)

"Attention-Deficit Hyperactivity Disorder (ADHD) As Fraud: Commentary on the Report of the Council on Scientific Affairs of the AMA" by Fred A. Baughman Jr., MD, May 11. 1998. http://home.att.net/~fred-alder)

"ADHD: A Market-based Affliction?" by occupational therapist Sue Parry, October 1998. "Upcoming Government Conference on ADHD and Psychostimulants Asks the Wrong Questions" by Peter R. Breggin, MD (www.breggin.com)

"News Release - Psychiatrist Discloses Ritalin's Hidden Dangers to Children" (www.breggin.com)

"Interview with Peter Breggin, MD" Corporate Crime Reporter, April 20, 1998.

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By Jule Klotter

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