The National Institute of Mental Health estimates that between 5% and 7% of children have ADHD. They speculate that about 2.5 million American children and 1.5 million adults take medication for ADHD to control behavior and increase focus.

Stimulant drugs like Concerta, Adderall, Ritalin, etc. are classified as schedule II drugs –the same category as cocaine. They can increase blood pressure and heart rate which is problematic for children with heart conditions. It could result in vulnerability to sudden cardiac arrest — an erratic heartbeat that causes the heart to stop pumping blood through the body — and other heart problems.

After review of these implications by the FDA, the FDA mandated that these medications carry warnings of possible heart risks in those with heart defects or other heart problems.

The AHA is now recommending children receive a thorough exam, including a family history and an EKG, before children are put on the ADHD drugs to insure that they don’t have any undiagnosed heart issues.

"We don’t want to keep children who have this from being treated. We want to do it as safely as possible." said Dr. Victoria Vetter, a pediatric cardiologist at the University of Pennsylvania School of Medicine and head of the committee making the recommendation.

AHA recommendations: http://www.americanheart.org/presenter.jhtml?identifier=3055953
http://www.americanheart.org/presenter.jhtml?identifier=3055974

Apparently one student had the drugs, gave one to another student who swallowed it and was taken ill. The sick student was then taken to the hospital and released. Other students were involved in the safekeeping of the drugs after they were brought to school.

The student that brought the drugs (Strattera and Concerta for treatment of ADHD) attempted to trade the drugs for alcohol.

The Denver Post says,

Two of the students have been charged with distribution and possession of a schedule II controlled substance and unlawful acts while the third was charged with possession of a controlled substance and unlawful act. Possession and distribution of a schedule II controlled substance is a felony, officials said.

While these students were apprehended, the incidence of ADHD drug sales and use is quite common among students at middle school, high school, and university.

The New York Times (www.nytimes.com) reported in 2005 in an article called The Adderall Advantage that:

At many colleges across the country, the ingredients for academic success now include a steady flow of analeptics, the class of prescription amphetamines that is used to treat attention deficit hyperactivity disorder [ADHD].

Since Ritalin abuse first hit the radar screen several years ago, the reliance on prescription stimulants to enhance performance has risen, becoming almost as commonplace as No-Doz, Red Bull and maybe even caffeine. As many as 20 percent of college students have used Ritalin or Adderall to study, write papers and take exams, according to recent surveys focused on individual campuses. A study released this month by the National Center on Addiction and Substance Abuse at Columbia found that the number of teenagers who admit to abusing prescription medications tripled from 1992 to 2003, while in the general population such abuse had doubled.

Dr. Robert A. Winfield, director of University Health Service at the University of Michigan, Ann Arbor, sees a growing number of students who falsely claim to be A.D.H.D. so they can get a prescription. At least once a week, a jittery, frightened, sleep-deprived student who has taken too many tablets for too many days shows up at his office. "Things have really gotten out of hand in the last four to five years," he said. "Students have become convinced that this will help them achieve academic success."

On campus, the drugs are either sold or given away by people with prescriptions, or they are procured by students who have learned to navigate the psychiatric exams offered by campus health centers, which usually provide the drugs at a discount. Unlike Ritalin, two newer members of the family of analeptics - Adderall and Concerta - come in time-release forms and can keep a patient medicated an entire day.

Louisiana State’s The Daily Reveille (www. media.www.lsureveille.com) reported that a survey documented in the journal Nature cites that one in five students used Adderall & Ritalin for a study booster.

Final exams traditionally have students studying long hours to cram for their final exams. But some students are now using a quick-fix for brain retention.

One in five respondents of adult professionals said they have used drugs to enhance brain power, according to a January survey in Nature journal. The online survey polled 1,400 people in 60 countries.

Ritalin and Adderall were the two drugs participants said they took.

Ritalin and Adderall are commonly used to treat attention-deficit hyperactivity disorder. They are also used to treat symptoms of narcolepsy and chronic fatigue syndrome. The stimulants are supposed to reduce impulsive behavior and facilitate concentration.

But people diagnosed with ADHD are not the only ones who can benefit from the drugs.

"It does work [for anyone]. We know that from lab studies," said Martha Farah, director of the Center for Cognitive Neuroscience at the University of Pennsylvania, according to CNN.com

This is an international phenomenon. The reason is that low-dose stimulant medication is not a targeted approach to fixing ADHD. Instead, low-dose stimulant medication works the same for non-ADHD students. Here’s an example: if we have 50 ADHD students and 50 high functioning non-ADHD students, give them both a boring task, the both will perform better on that task.

Students know this and it helps the cram for exams. Will it help to prosecute all these students under felony charges? Not likely.

In response to the AHA’s recommendation, the Pediatric Cardiology Division at the University of Virginia Children’s Hospital will begin offering electrocardiograms (ECG or EKG) for ADHD children taking stimulant medications for the disorder.

According to Dr. George McDaniel, director of the Pediatric Electrophysiology Program at UVA Children’s Hospital, this exam is important because not all children show obvious signs of a heart condition or abnormality.

The AHA also recommends that ADHD children receive a thorough family history and an EKG by their healthcare providers to screen for problems before they may arise.

Experts at UVA Children’s Hospital say the recommendations are conservative but the information is worth knowing.

Families should be reassured that there is no real urgency for a patient who is not having any difficulties,” said Dr. Paul Matherne, director of the Division of Pediatric Cardiology at UVA Children’s Hospital. “According to the guidelines parents should not stop their child’s medication and can have this screening done by their medical care provider at their next appointment."

The study was performed by researchers from Brainclinics Diagnostics and the Radboud University department of Biological Psychology both from Nijmegen (the Netherlands), the Institute of Psychiatry (London) and the Brain Resource Company (Sydney, Australia).

The researchers based their findings on data from 300 people. This group was segmented into 100 ‘frequent mobile phone users,’ 100 ‘non-mobile phone users,’ and a control group of 100 people. Differences in brain activity on tests of attention, memory, and executive function were measured using QEEG or quantitative EEG. QEEG is more art than science and is a relatively nascent technology.

Curiously, the researchers concluded that frequent mobile phone users demonstrated slowed brain function, but the users also showed better focused attention. The researchers attribute better focused attention as a ‘learning effect’ related to cell phone users filtering out distractions when making phone calls in distractive surroundings.

Wisely, the researchers note that these data are preliminary and need to be replicated. Furthermore, it is difficult to determine whether the healthy or unhealthy.

"The frequent mobile phone user group used their mobile phone - at the time of data collection - only 2.4 years on average which can currently be considered as a short time. Therefore, it is to be expected that the observed effects in this study can be more severe with prolonged mobile phone use" according to Martijn Arns, co-author of the study.

The Food Standards Agency (“FSA”) recommended ministers call for manufacturers to remove six artificial colors by the end of 2009. The FSA also urged a European Union-wide ban. This reversed the FSA’s decision last month when it dismissed calls for action on the additives.

According to The Independent, “The FSA’s advice to parents will be strengthened to warn them about the dangers of the E-numbers tartrazine (E102), quinoline yellow (E104), sunset yellow (E110), carmoisine (E122), ponceau 4R (E124) and allura red (E129).”

The Independent further reports that, “These colors and the preservative sodium benzoate (E211) were linked to hyperactivity in a £750,000 study by Southampton University, which found they made primary school children become distracted and fail a computer attention test.

The researchers estimated that 30 per cent of cases of attention deficit hyperactivity disorder (ADHD) would be prevented if companies removed the colors used in the £13bn-a-year global additives industry.

If the ministers elect to have the dyes and additives banned, the UK’s biggest producers of confections, soft drinks, ice cream, and others will have to reformulate their products.

The Independent:

The Southampton researchers had warned the seven additives were as harmful as lead in petrol, which was banned after it proved to lower children’s IQ by five points. Their research, in The Lancet in September, was the evidence that artificial additives worsened the behavior of normal children as well as those diagnosed with ADHD.

Dame Deirdre Hutton, who chairs the Food Standards Agency, said: "It is the agency’s duty to put consumers first. These additives give color to foods but nothing else. It would therefore be sensible, in the light of the… study, to remove them."

The board decided to take no action on sodium benzoate because it was "a preservative" rather than a color. E211, which is linked with other potential health problems, is found in many soft drinks including Diet Coke, Irn-Bru, Lucozade and Fanta, and its removal would pose a significant technological and financial challenge to drinks companies.

The FSA stressed that its decision "does not mean there is an immediate ban".

Campaigners welcomed the first decisive move in the UK against additives, whose effect on hyperactive children were first identified in 1975. Richard Watts, of the Children’s Food Campaign, said: "This decision is good news for children and parents, who have known for many years that these additives affect children’s behavior." Anna Glayzer, an Action on Additives campaigner, said the FSA had put the consumer first. "We will be keeping a close eye on the industry to see what effect the voluntary ban has."

The Food and Drink Federation said the recommendation was "bizarre", as manufacturers were already removing the additives. "[Most] products don’t contain these colors," a statement said.

The six colorings facing a ban:

Tartrazine (E102)
Description: Synthetic yellow dye found in sweets, biscuits, mushy peas
Products: Disney Winnie the Pooh Cake Kit, Lidl orange jelly, Bacardi Breezer tropical lime, Asda mushy peas
Health effects: causes hyperactivity, linked to allergic reactions and migraine.

Quinoline Yellow (E104)
Description: Synthetic dye in sweets, pickles, smoked fish
Products: Aero orange, Galaxy Minstrels, M&Ms, Bassett’s Sherbet Lemons
Health effects: Causes hyperactivity and is linked to rashes. Banned in US.

Sunset Yellow (E110)
Description: synthetic yellow dye found in sweets, ice cream, fizzy drinks
Products: Cadbury Creme Egg, Haribo Jelly Beans, Irn-Bru
Health effects: causes hyperactivity and linked to stomach upsets and swelling of skin.

Carmoisine (E122)
Description: Synthetic red dye found in ready meals, sweets
Products: Love Hearts, Galaxy Minstrels, Cadbury Mini Eggs, various lollipops
Health effects: causes hyperactivity and is alleged to cause water retention in those allergic to aspirin. Banned in US.

Ponceau 4R (E124)
Description: synthetic red dye found in sweets, biscuits, drinks
Products: Bassett’s Pear Drops, Halls Blackcurrant Soothers, Supercook Alphabet Icing
Health effects: causes hyperactivity and is believed to cause problems for asthmatics. Banned in US.

Allura red (E129)
Description: synthetic red dye found in sweets, soft drinks, Turkish delight
Products: Fry’s Turkish Delight, Cadbury Mini Eggs, Maynards Wine Gums
Health effects: causes hyperactivity and may bring on allergic reactions.

In an article reported in the Journal of Clinical Psychiatry, February 2008, author of the University of Utah in Salt Lake City and his colleagues find that the roles are reversed in adults; females seem to be more impacted than men.

"We found that adult women with ADHD frequently have high levels of emotional symptoms as well as the cognitive problems found in ADHD," Dr. Frederick W. Reimherr told Reuters Health.

Reimherr’s conclusions were drawn from analysis of data from two clinical trials of Strattera. Strattera is a non-stimulant medication for ADHD produced by Eli Lilly, a pharmaceutical giant.

ADHD symptom data were collected ADHD on 515 individuals. Approximately one third of this population were women. Seventy-five percent of the women in this population had a combined-type ADHD as opposed to only 62% of the male population represented in this study.

Women also presented more problems with sleep than did males in the study. Women had higher scores measuring both anxiety and depression than did their male counterparts.

Women presented poor temper control, mood volatility, and emotional over-reactivity than did their male counterparts (37 % in women as opposed to 29 % of males).

In an interview with Reuter’s Health correspondents, Reimherr cites that, "these symptoms – depression, temper control problems, feelings of tension, and over-reacting to life stresses – might cause a doctor to miss the diagnosis of ADHD … We feel that this will lead to problems in treatment for such women."

Such studies are limited to the initial data collected by the original researchers at Lilly. Therefore, one is not able to draw positive conclusions regarding the origins of the differences cited by Reimherr. For example, do hormones, age differences, economic statuses, education, or marital statuses, affect the data? We cannot know due to the limitations of the data in this study.

The authors conclude that minority parents, on average, have less educational attainment than non-minority parents. Education is a factor that influences awareness of healthcare. In light of this, minority children with ADHD often do not receive proper medical intervention. The authors cite that, “Educated majority parents, on the other hand, have less tolerance for ADHD symptoms, have greater access to medical services.”

Furthermore, the authors cite a study indicating that, “African American and Hispanic children have 2 to 4 times more chronic physical and mental conditions than does the general public. There are not only higher levels of physical illnesses, such as diabetes mellitus, hypertension, and asthma, but also many neuropsychiatric conditions (Bazargan et al.,2005; Levitt Katz et al., 2005).”

According to Dr. Hervey-Jumper, “A child of any race can be deeply affected by attention difficulties not only during school years but for a lifetime. It is tragic that many minority children are not provided with culturally sensitive assessments when we have effective treatments that can start these children on a track of progress. Untreated attention disorders can cause devastating results and we believe there are solutions for children of all ethnic backgrounds.”

Much of this study was a compilation of previous data. The authors do cite that all children should be treated and assessed individually to account for cultural differences. They also recognize the paucity of clinicians capable of performing in this capacity.

Research suggests that ADHD drivers have a greater likelihood of having or causing an accident. Obviously, hallmarks of the ‘disorder’ are inattention, distractibility, and sometimes hyperactivity. So, when their cell phone rings and they answer, bad things tend to happen.

According to Daniel Cox, Ph.D., professor of psychiatry and neurosciences at the University of Virginia Health System, as a group young ADHD drivers are two to four times more likely to have a car accident than non-ADHD drivers. Cox’ research will examine the effects of methylphenidate (MPH), a controlled-release stimulant worn as a patch, on young ADHD drivers facing real-life distractions.

This is rather clever marketing as the research is funded by Shire Pharmaceuticals, the pharmaceutical mega-giant who makes Adderall and the MPH patch. As I’ve stated before, it’s always questionable when a pharmaceutical giant funds a university study on its own medications. In this instance, it will make great marketing if the good Dr. Cox finds that young adults drive better while on meds! But, heck, since stimulant medication has the same effect on non-ADHD people, shouldn’t we all take it prior to driving? Regardless of that fact, if young ADHD people can wear a patch and drive better, that’ll sell millions of dollars worth of medicine!

The study would likely be significantly more impressive if Dr. Cox used unmedicated non-ADHD young adults and medicated non-ADHD young adults as control groups. I’d be more than eager to see those results.

Or maybe, just maybe, ADHD or not, we should put our cell phones away, put out our cigarettes, not eat in the car, put our pet in a pet carrier, and focus on driving. Shouldn’t we demand that of our ADHD teens before placing a stimulant patch on their arms? 

This study directly contradicts previous studies which indicate stimulant treatment could increase substance abuse risk.  The authors of the current study (Biederman, et al) maintain that previous studies produced conflicting results because they had several limitations; some only looked at adolescents, although young adults are at the highest risk of substance abuse. The authors argue that other studies did not control for conditions such as conduct disorder that are known to be associated with substance abuse. This is commonly referred to as co-morbidity and is truly the norm for ADHD as ADHD virtually never presents by itself. It is commonly associated with conduct disorder, learning disabilities, dyslexia, etc. The authors also maintain that other studies may have examined the impact on use of only a particular substance.

Biederman, like Russell Barkley, seems to get substantial funding from the pharmaceutical industry. That being disclosed, Biederman’s previous research tended to promote the use of stimulant medication [from www.Sciencedaily.com]:

“Earlier studies under the MGH Psychopharmacology group had suggested that stimulant treatment might actually reduce the risk of substance abuse in ADHD patients, who are at elevated risk to begin with…”

Imagine that! Taking stimulant medication in the same class as cocaine or speed in my early years would prevent me from desiring to use addictive drugs in my later years! Now that’s impressive, Joe. Obviously that was an untenable position, but Joe got the next best result with his try-again research methodology; it may not prevent substance abuse later on, but at least, Dr. Joe maintains, it doesn’t cause it.

"Because stimulants are controlled drugs, there has been a concern that using them to treat children would promote future drug-seeking behavior," says Dr. Joe, the study’s lead author.

The MTA (Multimodal Treatment of ADHD) found that after three years of drug taking, they couldn’t find any difference in children medicated and children who had done nothing at all. The study’s authors said they witnessed no overall global academic improvement, behavioral improvement, or social improvement. They also found that children in their study had lower overall weight. Height was also less than peers.

What interests me greatly is the fact that when the authors of these studies have close ties to the pharmaceutical industry, their data tends to be skewed in favor of medicine. When there isn’t a close tie, we tend to get contradictory data, which is what one would expect.

I’m not an advocate of medicine, but I’m not an opponent either. It has its place and can help some children in the short-term. It must be supported with cognitive and behavioral interventions to maximize the opportunity for change. 

As far a research goes, all I want is the truth. Nothing skewed. No hidden agendas.

Florida’s health insurance program for the poor, created with the assistance of big pharmaceuticals, has nearly doubled over the last seven years costing Florida taxpayers $30 million in 2006. That cost has risen yearly from $9 million in 1999.

Florida remains undecided regarding joining a suit launched by several states including Pennsylvania, South Carolina, and Texas. The real bone of contention between the states and drug makers is the rising costs associated with new drugs the pharmaceutical companies touted to have fewer side effects. The states maintain the drugs were untested and do not demonstrate increased efficacy.

"The situation is out of control," said David Cohen, a professor at Florida International University who has been studying the use of antipsychotics since 1983. While no long-term studies have been done on the effects the drugs have on children, there is evidence children on the drugs face greater risks of diabetes, hyperglycemia and extreme weight gain, Cohen said.

The Daytona Beach Journal says, “According to a study that looked at three years of data, about 40 percent of the antipsychotics prescribed to Florida Medicaid children were given to children diagnosed with ADHD – a use not approved by the Food and Drug Administration.”

Texas has similar projects to the Florida that are now in litigation. Suits allege that Janssen Pharmaceutica and several other Johnson & Johnson subsidiaries treatment guidelines – "improperly influenced" and paid for by the drug companies –increased sales of the antipsychotic Risperdal.

An official with Janssen said the company will defend its actions.

But steroids aren’t the only drug of choice for professional baseball players, so are stimulant medications like Ritalin, or Adderall. However, Major League Baseball (MLB) has a strict policy regarding doping. Mandatory drug testing began in 2004. At that time, a positive test for steroids resulted only in a referral to treatment — not a suspension. After considerable negotiation between MLB and the player’s union, current first-time offenses result in a mandatory 50-game suspension. Second offenses result in a 100 game suspension. Third strike and you’re out for a lifetime ban. These harsh anti-doping measures were settled in November 2005. To see that they were followed, MLB also created the independent system administrator. They hired physician Bryan Smith.

According to USA today, “Congress took issue with the increased rate at which Smith was approving therapeutic-use exemptions for players with ADHD. Smith approved 103 therapeutic-use exemptions for ADHD drugs in 2007, 75 more than the previous season. The suggestion from Tierney [Rep. John Tierney, D-Mass] was that players were using drugs such as Ritalin and Adderall after amphetamines were added to baseball’s list of banned substances.”

Given the use of steroids among baseball players to increase performance in a very highly competitive field has raised considerable suspicion among members of congress and the public in general.

Newsweek reports:

According to records MLB officials turned over to congressional investigators as part of George Mitchell’s probe into steroid use in baseball, the number of players getting "therapeutic use exemptions" from baseball’s amphetamines ban jumped in one year from 28 to 103—which means that, suddenly, 7.6 percent of the 1,354 players on major-league rosters had been diagnosed with ADD.

One possible reason for this increase: in 2005 baseball banned the use of "greenies," amphetamines that help players remained focused and energetic through the rigors of a 162-game season. Amphetamines were once as common as deli spreads in big-league clubhouses—in some, greenies were used to spike the coffee. Players are now seeking doctors’ prescriptions for ADD medications, usually Ritalin and Adderall, apparently to replace the now-illegal energy boosting drugs. (Ritalin is the trade name for the drug methylphenidate, and Adderall is an amphetamine-dextroamphetamine; they are both considered stimulants.)

Only the players know why they need stimulants. Perhaps some of the players do have ADHD. It’s difficult to say. We do know that for many years players have used stimulant drugs to increase their performances in a highly competitive field where their livelihoods depend on performance. When amphetamines were banned, exemptions for stimulant medication went up. It does draw suspicion. It also depicts the incredible lengths we go to when money is involved.

Co-author, Professor William Pelham, of the University at Buffalo, says: "The children had a substantial decrease in their rate of growth so they weren’t growing as much as other kids both in terms of their height and in terms of their weight. And the second was that there were no beneficial effects – none."

Pelham adds, "In the short run [medication] will help the child behave better, in the long run it won’t. And that information should be made very clear to parents."

Here’s the most telling observation of the study: "I think that we exaggerated the beneficial impact of medication in the first study. We had thought that children medicated longer would have better outcomes. That didn’t happen to be the case. There’s no indication that medication’s better than nothing in the long run."

It’s obvious that this information was not good for the pharmaceutical industry. As is now common practice, a study will be launched to counter this kind of negative press. So, it was no surprise that the respected Mayo Clinic released a study two months later that “…reveals that compared to children without AD/HD, children with ADHD are at risk for poor long-term school outcomes such as low achievement in reading, absenteeism, repeating a grade, and dropping out of school. Both studies appear in the current edition of the Journal of Development & Behavioral Pediatrics, (http://www.jrnldbp.com).”

“In this study, treatment with stimulant medication during childhood was associated with more favorable long-term school outcomes,” explains William Barbaresi, M.D., Mayo Clinic pediatrician and lead author of the reports.

The MTA study focused on real families in real-time. The researchers were able to observe family dynamics, environment, pharmacological interventions and their relationships to academic and behavioral outcomes. This, of course, takes a significant amount of time and field researchers.

According to the Mayo Clinic Press Release, “The two Mayo Clinic studies are the first population-based, long-term studies to investigate links between ADHD, school performance and factors that modify long-term school performance of children with ADHD."

Here’s how research like this works: researchers are given access to school files and medical records. They select and review data from files to draw their conclusions. This is becoming more popular than live research because it is less expensive, doesn’t require a significant number of field researchers, and can be done in less time. Unlike real-time research like the MTA, the Mayo study’s limitations are significant; it doesn’t allow real-time access to families or teachers to gain information regarding environment, family issues, etc; to interpret information; or to clarify written information. So the researchers are fairly limited to test scores and medical records. While this makes it easy to prepare and select data, it falls far short the information gather by a real-time study.

The Mayo study press release summarizes the research:

Dr. Barbaresi believes that both studies provide the first solid evidence of the long-term negative academic performance associated with untreated ADHD – as well as evidence for the best way to manage this problem. Dr. Barbaresi says, “The finding that treatment with stimulant medications is associated with long-term improvement in school outcomes is significant. Previously, there was evidence that treatment with stimulant medications improved short-term academic performance, but there was no good evidence that long-term outcomes are better with stimulant treatment. Our data can guide clinicians in their efforts to help children with ADHD succeed in school.”

Note that no mention is made of height and weight loss of children in the Mayo Clinic study as was found by the MTA. Furthermore it also directly contradicts information released by the MTA. Here’s the rub, funding for the Mayo study was contributed by grants from the U.S. Public Health Service; National Institutes of Health; Mayo Clinic Foundation for Biomedical Research; and McNeil Consumer and Specialty Pharmaceuticals.

Obviously the one extraordinary contributor was McNeil Consumer and Specialty Pharmaceuticals. McNeil is the producer of Concerta, a stimulant medication for ADHD. Is it likely that McNeil would contribute to a study that would indicate weight loss and stunted growth from use of its product? Not likely.

Would McNeil contribute to a study whose researchers said, “I think that we exaggerated the beneficial impact of medication in the first study. We had thought that children medicated longer would have better outcomes. That didn’t happen to be the case. There’s no indication that medication’s better than nothing in the long run." Not likely.

It is a direct conflict of interest for a pharmaceutical company to participate in research with universities, hospitals, or other entities. I’ve never seen negative information released from a study performed by a pharmaceutical company on their own drug. Strange, isn’t it?

The Daytona Beach Journal reports that several states are suing big pharmaceutical companies over rising costs of psychotropic drugs used to treat disorders like ADHD, schizophrenia, and depression.

Florida’s health insurance program for the poor, created with the assistance of big pharmaceuticals, has nearly doubled over the last seven years costing Florida taxpayers $30 million in 2006. That cost has risen yearly from $9 million in 1999.

Florida remains undecided regarding joining a suit launched by several states including Pennsylvania, South Carolina, and Texas. The real bone of contention between the states and drug makers is the rising costs associated with new drugs the pharmaceutical companies touted to have fewer side effects. The states maintain the drugs were untested and do not demonstrate increased efficacy.

"The situation is out of control," said David Cohen, a professor at Florida International University who has been studying the use of antipsychotics since 1983. While no long-term studies have been done on the effects the drugs have on children, there is evidence children on the drugs face greater risks of diabetes, hyperglycemia and extreme weight gain, Cohen said.

The Daytona Beach Journal says, “According to a study that looked at three years of data, about 40 percent of the antipsychotics prescribed to Florida Medicaid children were given to children diagnosed with ADHD – a use not approved by the Food and Drug Administration.”

Texas has similar projects to the Florida that are now in litigation. Suits allege that Janssen Pharmaceutica and several other Johnson & Johnson subsidiaries treatment guidelines – "improperly influenced" and paid for by the drug companies –increased sales of the antipsychotic Risperdal.

An official with Janssen said the company will defend its actions.

Data from the study were used to evaluate whether stimulant medication effects physical growth in children. The data collected over three years indicates that both height and weight are decreased in children using stimulant medication.

Co-author, Professor William Pelham, of the University at Buffalo, says: "The children had a substantial decrease in their rate of growth so they weren’t growing as much as other kids both in terms of their height and in terms of their weight. And the second was that there were no beneficial effects – none."

Pelham adds, "In the short run [medication] will help the child behave better, in the long run it won’t. And that information should be made very clear to parents."

Here’s the most telling observation of the study: "I think that we exaggerated the beneficial impact of medication in the first study. We had thought that children medicated longer would have better outcomes. That didn’t happen to be the case. There’s no indication that medication’s better than nothing in the long run."

Our good professor, Dr. Russell Barkley just spoke at a national conference citing that medication is by far the best and most trusted method. Unfortunately dinosaurs like Barkley do exist, are respected, and yet completely propagate information that has no substance in current research. Barkley is also a critic of neurofeedback.

On another front -

ADHD Drugs To Be Examined

“Two federal agencies will collaborate in the broadest study ever of prescription drugs for the treatment of attention deficit hyperactivity disorder (ADHD) and the potential for cardiovascular problems.

Over the next two years, the Agency for Healthcare Research and Quality and the Food and Drug Administration (FDA) will examine clinical data of some 500,000 adults and children who have taken such medications to determine whether they increase the risk of heart attack or stroke, the U.S. Department of Health and Human Services announced.

The FDA’s Gerald Del Pan, MD, said case reports describe “adverse cardiovascular events in adults and pediatric patients with certain underlying risk factors who receive drug treatment for ADHD, but it is unknown whether … these events are causally related to treatment.”

The study of all ADHD drugs by class will be coordinated by Vanderbilt University, with analysis by its researchers, Kaiser Permanente of California, the HMO Research Network and i3 Drug Safety, plus the FDA and AHRQ, the government said.”

Curiously, this study has already been done with results published by the University of Oregon. I’ve published the results of this study before, but it was not at all favorable for ADHD drugs. Real data on long term effects, safety, comparative analysis, and general efficacy are lacking. Let’s hope the new study treats the subject with the objectivity and professionalism of the University of Oregon.

As I’ve said in past entries, I’m not a proponent of clinical neurofeedback, and I find there are limitations to some of its research, much of the research, especially research performed over the last few years, demonstrates the possibility that the brain can and will make changes provided it is given the right stimulation. Unfortunately, clinical neurofeedback training doesn’t address other core issues like organization, memory, discriminatory processing, auditory processing, time on-task, and other cognitive skills. That’s exactly why I created Play Attention. It addresses far more than clinical neurofeedback.

Probably most importantly, neither neurofeedback or Play Attention cause any stunted growth, weight loss, tics, or any side effects like medication. From our follow-up with our clients over the last eleven years, positive training effects last as well. Far unlike medication which "In the short run will help the child behave better, in the long run it won’t. And that information should be made very clear to parents."

The following press release from the University of British Columbia maintains that a research study has demonstrated that cognitive training can improve attentional control, impulse control, and other executive functions.

Furthermore, the study’s authors cite that practice of cognitive skills in early development years may decrease incidence of ADHD. I have insisted that this was possible for nearly a decade.

Complicating this matter is the No Child Left Behind act (“NCLB”). It is my belief that the NCLB has added to the ADHD problem due in part to the program’s rigid adherence to test scores based on a watered down curriculum that forces teachers to teach the test. Subjects are taught quickly requiring rote memorization rather than significant reasoning or logical application. Additionally, teachers seldom have time to individualize curriculum or nurture students with learning disabilities like ADHD. Thus, rather than encouraging cognitive skills and the development of attention, NCLB has helped promote diffused attention while simultaneously discouraging the development of cognitive skills.

NCLB has also decreased recess time, children’s access to the arts like music and drama, and even physical education. Research has clearly demonstrated increased abilities in mathematics and other academic subjects when students are involved in music and the arts.

The press release:

Program Promises Improvement in Academic Achievement for Children of Poor Families

An innovative curriculum for preschoolers may improve academic performance, reduce diagnoses of attention deficient hyperactivity disorder (ADHD), and close the achievement gap between children from poor families and those from wealthier homes, according to research led by a Vancouver neuroscientist who is an expert on the development of the cognitive functions that depend on the prefrontal cortex area of the brain, called executive functions (EFs).

University of British Columbia Psychiatry Prof. Adele Diamond, who is Canada Research Chair in Developmental Cognitive Neuroscience, led the first evaluation of a curriculum called Tools of the Mind (Tools) that focuses on EFs. These functions include resisting distraction, giving a more considered response instead of your first impulse, working with information you are holding in mind, and the mental flexibility to think “outside the box.”

The program was developed over the last 12 years by educational psychologists Deborah Leong and Elena Bodrova and has been used in several U.S. states. Its value in improving EFs has not been determined until now.

The study is published in this week’s issue of Science.

"EFs are critical for success in school and life. These skills are rarely taught, but can be, even to preschoolers. It could make a huge difference, especially for disadvantaged children," says Diamond, who is a member of the Brain Research Centre at UBC Hospital; the Child and Adolescent Psychiatry Dept. at BC Children’s Hospital; the Child & Family Research Institute (CFRI); and the Human Early Learning Partnership (HELP). Her work is also supported by Vancouver Coastal Health Research Institute and BC Mental Health and Addiction Services.

"The recent explosion in diagnoses of ADHD may be partly due to some children never learning to exercise attentional control and self-discipline," says Diamond.

"Although some children are strongly biologically predisposed to hyperactivity and wouldn’t benefit from training, others may be misdiagnosed because what they actually need are skills in self-regulation."

Previous research has shown that EFs are stronger predictors of academic performance than IQ, she adds. Children from lower-income families enter school with disproportionately poor EF skills and fall progressively farther behind in school each year – facts which Diamond says are related and correctible.

"Helping at-risk children improve EF skills early might be critical to closing the achievement gap and reducing societal inequalities. We showed EFs can be improved in preschoolers without fancy equipment and by regular teachers in regular public school classrooms."

Most interventions target consequences of poor self-control rather than seeking prevention at an early age, as does Tools. "Early intervention – heading off problems before they develop – costs far less and achieves far better results than trying to correct problems once they have developed," Diamond says.

"If throughout the school-day EFs are supported and progressively challenged, benefits generalize and transfer to new activities. Daily EF ‘exercise’ appears to enhance and accelerate brain development much as physical exercise improves our bodies," she adds.

The research team, which includes investigators from the National Institute for Early Education Research at Rutgers University in New Jersey, evaluated 147 five-year-olds in a low-income, urban U.S. school district. Researchers compared Tools with a balanced literacy curriculum (dBL) that covered the same academic content as Tools but without a focus on EF.

Both programs were new, instituted at the same time and used identical resources. Children and teachers in Tools and dBL were randomly assigned and teachers had equivalent levels of education and teaching experience. The children in both curricula were from the same neighborhood and ethnic group, and from families with very similar levels of income and parental education. Children received either Tools or dBL for one to two years.

Evaluation involved two computerized tests that measured EF. These tasks were different from anything any of the children had done before. Better performance by children in Tools shows that they were able to generalize and transfer their EF skills to new situations.

Tools encourages out-loud self-instruction and dramatic play. "Preschool teachers are under pressure to limit play and spend more time on instruction but social pretend play may be more critical to academic success," says Diamond.