ADHD Experts Re-evaluate Zeal for Drugs
January 16, 2014
By Dr. Mercola
Attention deficit hyperactivity disorder (ADHD) now impacts 1 in 10 American children—a 22 percent increase from 2003.1 About two-thirds of these children are on some form of prescription medication, which has become the go-to treatment for this increasingly common condition.
ADHD makes it hard for children to pay attention and control impulsive behavior, and stimulant drugs like Ritalin and Adderall often work quickly to improve focus and impulse control (at a significant price, since side effects are steep).
The use of such drugs in children is one of the most controversial topics in medicine, and it's set to become even more hotly debated as one of the key study's used to support medication's use is being called into question.
Most Influential Study on ADHD Drugs May Have Been Oversold
In 1999, an $11-million study funded by the National Institute of Mental Health came to the conclusion that medication was superior to behavioral therapy for treating ADHD.2 The study even went a step further to say that combining the two therapies was of little use and provided virtually no additional benefit over drugs alone.
Not only do pharmaceutical companies use this study to promote their medications, but insurance companies and school systems also use the data to avoid using more expensive behavioral therapies for kids with ADHD.
Now, critics and even some of the study's original authors are concerned that the research did more harm than good, discrediting behavioral therapy that could be extremely beneficial for kids with ADHD.
Not only that, but more recent research has suggested that medication's benefits may not last as long as those from behavioral therapy, which teach children new skills and behaviors that they can use for a lifetime. As reported by the New York Times:3
"…in retrospect, even some authors of the study — widely considered the most influential study ever on A.D.H.D. — worry that the results oversold the benefits of drugs, discouraging important home- and school-focused therapy and ultimately distorting the debate over the most effective (and cost-effective) treatments.
The study was structured to emphasize the reduction of impulsivity and inattention symptoms, for which medication is designed to deliver quick results, several of the researchers said in recent interviews.
Less emphasis was placed on improving children's longer-term academic and social skills, which behavioral therapy addresses by teaching children, parents and teachers to create less distracting and more organized learning environments."
More Recent Research Shows the Value of Therapy Over Medication
One of the major flaws of the 1999 study was that it measured symptoms such as forgetfulness and fidgeting instead of longer term goals like academic achievement and peer interactions. This put therapy at a disadvantage right from the start, since it is therapy, not drugs, that would be useful for helping children achieve such improvements.
A follow-up study by one of the original study's co-authors revealed, in fact, that when one all-inclusive measurement was used (to look at treating a child as a whole), combination therapy was significantly better than medication alone, and behavioral therapy also proved to be a viable alternative to drugs. His paper received little attention, according to the New York Times.4
Adding even more confusion to the 1999 study, after the children were followed into young adulthood, some of their original conclusions are being further challenged. It appears that the medications' effects may be wearing off or not lasting for the long run (some have also speculated that the children may have stopped taking the drugs, which is quite possible given their side effects).
Side Effects from ADHD Drugs May Be Worse Than ADHD
The side effects from ADHD medications are often far worse than the condition itself. These drugs actually rival illegal street drugs in terms of their dangerous risks to health, which include:
Permanent brain damage ||Cardio toxicity and liver damage ||Cancer
|Changes in personality, depression, and/or hallucinations ||Heart attack and stroke ||Sudden death and suicide
In children, the long-term effects of drugs are typically largely unknown, and in the short term, the drugs are leading to potentially deadly medical emergencies. According to data released by the Substance Abuse and Mental Health Services Administration (SAMHSA), ADHD drugs such as Ritalin, Vyvanse, Strattera, and Adderall (and their generic equivalents) were responsible for nearly 23,000 emergency room visits in 2011.5
This is a more than 400 percent increase in ER visits due to adverse reactions to such drugs in a mere six years! Drugs prescribed for ADHD are not "mild" by any means.
These are hard-core, "class 2" narcotics, regulated by the Drug Enforcement Agency as a controlled substance because they can lead to dependence. The majority of kids diagnosed with ADHD will be prescribed these potentially dangerous drugs, the most common being Ritalin. By definition, Ritalin stimulates your central nervous system and may certainly interfere with the delicate and complex workings of your brain and personality. Side effects include:
Sudden death in people who have heart problems or heart defects ||Stroke and heart attack ||Increased blood pressure
|New or worse behavior and thought problems ||New or worse bipolar illness ||New or worse aggressive behavior or hostility
|New psychotic symptoms (such as hearing voices, believing things that are not true, are suspicious) ||New manic symptoms ||Increased heart rate
|Slowing of growth (height and weight) in children ||Seizures ||Eyesight changes or blurred vision
An ADHD Diagnosis Is Subjective
Diagnosing ADHD really comes down to a matter of opinion, as there is no physical test, like a brain scan, that can pinpoint the condition. At present, diagnosis is dependent on subjective evaluation and observations by parents, teachers, health care providers and the child, and once a diagnosis is given, it is considered a life-long condition. Dr. Jerome Groopman, a professor of medicine at Harvard Medical School, told the New York Times:6
"There's a tremendous push where if the kid's behavior is thought to be quote-unquote abnormal — if they're not sitting quietly at their desk — that's pathological, instead of just childhood."
Only children who struggle with inattention and hyperactive or impulsive behaviors around the clock are deemed to have ADHD—or at least they should be. But according to a 2010 study,7 an estimated 20 percent of children are misdiagnosed with ADHD. According to some, the disorder may not even be a "real" disorder at all. Psychiatrist Leon Eisenberg, hailed as the "scientific father of ADHD," actually went on record saying that ADHD is " a prime example of a fictitious disease." He made this stunning confession in a 2012 interview with the German paper Der Spiegel, just seven months prior to his death8 at the age of 87.
Nutrition: The Often-Overlooked Factor to ADHD Treatment
Behavioral problems clearly do exist, and do appear to be more prevalent than in decades past, with or without the ADHD label. The question on everyone's mind is what's causing it? The cause of ADHD remains elusive, although there are many contending culprits, including poor nutrition and environmental toxins ranging from food and vaccine additives to agricultural chemicals. Behavioral therapy is certainly a preferable treatment to side effect-ridden drugs, but even that may not address basic nutrition, which I believe is a key factor.
We know that the food choices of most children and adults today are incredibly poor, and how can you possibly expect a child to have normal behavior if he is fed refined grains, sugars, and processed foods loaded with chemicals and largely devoid of natural nutrients? If your child struggles with behavioral difficulties, whether he or she has been diagnosed with ADHD or not, I strongly recommend addressing the following five factors:
- Too much sugar. High sugar content and starchy carbohydrates lead to excessive insulin release, which can lead to falling blood sugar levels, or hypoglycemia. Hypoglycemia, in turn, causes your brain to secrete glutamate in levels that can cause agitation, depression, anger, anxiety, and panic attacks. Besides that, sugar promotes chronic inflammation in your body, and many studies have demonstrated the connection between a high-sugar diet and worsened mental health.
- Gluten sensitivity. The evidence suggesting that gluten sensitivity may be at the root of a number of neurological and psychiatric conditions, including ADHD, is quite compelling. According to a 2011 study,9 celiac disease is "markedly overrepresented among patients presenting with ADHD," and a gluten-free diet has been shown to significantly improve behavior in kids. The study went so far as to suggest celiac disease should be added to the ADHD symptom checklist.
- Too few beneficial bacteria. As explained by Dr. Natasha Campbell-McBride, a medical doctor with a postgraduate degree in neurology, toxicity in your gut can flow throughout your body and into your brain, where it can cause symptoms of autism, ADHD, dyslexia, dyspraxia, depression, schizophrenia, and other mental disorders. Reducing gut inflammation is imperative when addressing mental health issues,10 so optimizing your child's gut flora is a critical step. To learn more, please see my previous article, "Are Probiotics the New Prozac?"
- Animal-sourced omega-3 deficiency. Research has shown that kids low in omega-3 fats are significantly more likely to be hyperactive, struggle with learning disorders, and display behavioral problems. Omega-3 deficiencies have also been tied to dyslexia, violence, and depression. A clinical study published in 2007 examined the effects of krill oil on adults diagnosed with ADHD.11
In that study, patients improved their ability to concentrate by an average of over 60 percent after taking a daily 500mg dose of krill oil for six months. They also reported a 50 percent improvement in planning skills, and close to 49 percent improvement in social skills.
- Food additives and GMO ingredients. A number of food additives are thought to worsen ADHD, and many have subsequently been banned in Europe. Potential culprits to avoid include Blue #1 and #2 food coloring; Green #3; Orange B; Red #3 and #40; Yellow #5 and #6; and sodium benzoate, a preservative.
Recent research also shows that glyphosate, the active ingredient in Monsanto's Roundup herbicide, used in large quantities on genetically engineered Roundup Ready crops, limits your body's ability to detoxify foreign chemical compounds. As a result, the damaging effects of those chemicals and environmental toxins are magnified, and may result in a wide variety of diseases, including brain disorders that can affect behavior.
- EMF. Limit exposure to radiofrequency microwave radiation, cell and portable phones, and electro-pollution. This is especially true for the sleeping environment where rest and repair occurs. It should be as electrically neutral as possible.
- Other Toxic Exposures. Avoid all known toxins, like MSG and artificial sweeteners, including aspartame, mercury from "silver" amalgam fillings, fluoride in the water supply, and any others you can think of.
There's Typically No 'Quick-Fix' for ADHD
Those who value drugs for ADHD do so primarily because they change behavior quickly (and, if you have health insurance, for little cost). But while their behavior may be changed, the children are learning that they are "sick" and in need of medication to act "normal."
Many come to depend on the drugs and, should they ever discontinue them, will lack the knowledge of how to effectively manage their challenging behaviors. Ultimately, this is a process that involves lifestyle changes combined with therapy for learning new skills and behavior. The original drug-focused study ultimately did children a major disservice by promoting drugs as a life-long solution, which they clearly are not. The fact that the study's own authors are expressing remorse is quite telling. Co-author Dr. Lily Hechtman of McGill University in Montreal told the New York Times:
"I hope it didn't do irreparable damage. The people who pay the price in the end is the kids. That's the biggest tragedy in all of this."
Besides addressing your child's nutrition, as described above, I also recommend implementing the following strategies to improve ADHD or other behavioral issues:
- Clear your house of dangerous pesticides and other commercial chemicals.
- Avoid commercial washing detergents and cleaning products used on clothes, and replace them with naturally derived cleaning products free of added perfumes, softeners, etc.
- Spend more time in nature. Researchers have found that exposing ADHD children to nature is an affordable, healthy way of controlling symptoms.
- Investigate sensory therapy and emotional wellness tools. Instead of looking for a quick fix, encourage ADHD sufferers to talk, and find out what emotions are causing issues. You may also want to consider energy psychology tools such as the Emotional Freedom Technique (EFT) to improve emotional coping and healing.