ritalin

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   Parents throughout the country are being pressured and compelled by schools to give
psychiatric drugs to their children.  Teachers, school psychologists, and administrators
commonly make dire threats about their inability to teach children without medicating
them.  They sometimes suggest that only medication can stave off a bleak future of
delinquency and occupational failure.  They even call child protective services to
investigate parents for child neglect and they sometimes testify against parents in court.  
Often the schools recommend particular physicians who favor the use of stimulant drugs
to control behavior.  These stimulant drugs include methylphenidate (Ritalin, Concerta,
and Metadate) or forms of amphetamine (Dexedrine and Adderall).
     My purpose today is to provide to this class the scientific basis for rejecting the use of
stimulants for the treatment of attention deficit hyperactivity disorder or for the control of
behavior in the classroom or home.
I. Escalating Rates of Stimulant Prescription
    Stimulant drugs, including methylphenidate and amphetamine, were first approved for
the control of behavior in children during the mid-1950s.  Since then, there have been
periodic attempts to promote their usage, and periodic public reactions against the
practice.  In fact, the first Congressional hearings critical of stimulant medication were
held in the early 1970s when an estimated 100,000-200,000 children were receiving these
drugs.
    Since the early 1990s, North America has turned to psychoactive drugs in
unprecedented numbers for the control of children. In November 1999, the U.S. Drug
Enforcement Administration (DEA) warned about a record six-fold increase in Ritalin
production between 1990 and 1995.  In 1995, the International Narcotics Control Board
(INCB), a agency of the World Health Organization, deplored that 10 to 12 percent of
all boys between the ages 6 and 14 in the United States have been diagnosed as having
ADD and are being treated with methylphenidate [Ritalin]. In March 1997, the board
declared, "The therapeutic use of methylphenidate is now under scrutiny by the American
medical community; the INCB welcomes this."  The United States uses approximately
90% of the world's Ritalin.
    The number of children on these drugs has continued to escalate. A recent study in
Virginia indicated that up to 20% of white boys in the fifth grade were receiving
stimulant drugs during the day from school officials.  Another study from North Carolina
showed that 10% of children were receiving stimulant drugs at home or in school.  The
rates for boys were not disclosed but probably exceeded 15%.  With 53 million children
enrolled in school, probably more than 5 million are taking stimulant drugs.
    A recent report in the Journal of the American Medical Association by Zito and her
colleagues has demonstrated a three-fold increase in the prescription of stimulants to 2-4
year old toddlers.
II.  The Dangers of Stimulant Medication
    Until recently, no studies have systematically examined the rate of psychotic
symptoms caused by routine treatment with stimulant drugs such as methylphenidate
(Ritalin) and amphetamine (Dexedrine, Adderall).  Doctors who prescribe stimulant
drugs often seem forgetful to the fact that they can cause psychoses, including manic-like
and schizophrenic-like disorders.  Without providing a scientific basis, the literature often
cities rates of 1% or less for stimulant-induced psychoses.  
    The rate of psychotic symptoms that appear during stimulant treatment has recently
been investigated in a 5-year retrospectives study of children diagnosed with Attention
Deficit Hyperactivity Disorder (ADH).  Among 192 children diagnosed with ADHD at
the Canadian clinic, 98 had been placed on stimulant drugs, mostly methylphenidate.  
Psychotic symptoms developed in more than 9% of the children treated with
methylphenidate.  The psychotic symptoms caused by methylphenidate included
hallucinations and paranoia.
    When children developed depression, delusions, hallucinations, paranoid fears and
other drug-induced reactions while taking stimulants, their physicians mistakenly
concluded that the children suffered from clinical depression, schizophrenia or
bipolar disorder that has been unmasked by the medications.  Instead of removing the
child from the stimulants, these doctors mistakenly prescribed additional drugs, such as
antidepressants, mood stabilizers, and neroleptics.  Children who were put on stimulants
for inattention or hyperactivity ended up taking multiple adult psychiatric drugs that
caused severe adverse effects, including psychoses and tardive dyskinesia.
    It is time to recognize that the supposedly increasing rates of schizophrenia,
depression, and bipolar disorder in children in North America are often the direct
result of