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Recently the Minneapolis Star Tribune summarized
part of the controversy over Ritalin currently raging in academe, the halls of congress
and the local classroom. The Strib chose to focus on ritalin as a gateway drug for
cocaine. That is, a child first medicated with ritalin is much more likely to try cocaine
at some point in his/her life than a ritalin-free child.
While that is true, it is not the only controversial aspect of the
current debate. Even the diagnosis, Attention Deficit Hyperactivity Disorder (ADHD) for
which ritalin is most commonly prescribed, is under fire. One group of psychiatrists claim
that ADHD is a neurodevelopmental disorder and that it has an hereditary basis. This means
that it’s a brain disorder with symptoms that change as the patient matures, and that
one or both parents may have had it as a child. This segment of practitioners also cite
studies that show decreased blood flow in the frontal lobe. That’s believed to be the
part of the brain responsible for concentration and attention.
“There is no evidence for a brain disorder — no biological
basis whatsoever for the diagnosis,” according to Peter Breggin, MD, a psychiatrist
and noted expert on the side effects of all psychotropic medications. “It’s
really a bogus diagnosis, created by the drug companies to sell their product.” And
that's the reason for the class action suits recently filed in California, New Jersey and
Texas. They charge that there has been a conspiracy between Novartis, maker of the drug,
the American Psychiatric Association, (APA) and Children and Adults with ADD (CHADD), to
develop and expand a market for the drug. Last year there were almost nine million
prescriptions written for ritalin, 90% of which were sold in the United States. Just as
the internal documents of the tobacco companies were made public, all secret dealings
between the three defendants in this case will be revealed. By doing this, it is hoped
that children and adults now taking the drug will learn whether the risks they are taking
are realistic.
Although ritalin has been marketed as a very safe medication, questions
about its many side effects are being raised. “If parent’s knew how dangerous
this drug really is, they would never allow their children to take it for any
reason,” said Breggin. “It works by suppressing normal neurological
function.”
One might think that great care would be taken before prescribing a
synthetic amphetamine (speed or meth), to anyone, especially children. It carries such a
high addiction rate that the FDA classifies it with cocaine and morphine. Yet almost 20%
of the children in our national school system have been prescribed this medicaton at some
time during their school years. Check out ABC.com key word “ritalin” for
information about the growing use of ritalin amongst addicts and college students who
often use it to cram for exams. It is the drug most often stolen from medicine cabinets
and schools to be resold on the streets. The website claims the going rate in big cities
across the nation is $5 per pill. I have found independent sources who claim to have sold
it for as much as $20 on Twin Cities streets. When sold on the black market, the pills are
sometimes crushed, cooked and injected, or washed down whole with alcohol.
Even if one can excuse ritalin’s potential for addiction, it has
other alarming side effects. The two most common are loss of appetite and sleep
disturbance. Most parents are told this much about the medication, and given advice on how
to cope with appetite problems or sleep problems. But the appetite loss can become so
extreme that anorexia develops. That’s what happened to a recent high school graduate
from a small northern Minnesota school. Mary Ellen was first medicated for ADHD at age 14.
Ritalin was only the first of many psychiatric drugs given her. At one point, her parents
were advised to institutionalize her. It only took two years to develop anorexia, and she
only discovered that it was a medication side effect when her parents’ insurance
company would no longer cover her “illness.” Since they could not afford to pay
for her treatment independently, she stopped taking the drug. Slowly, she started eating
— and living— again.
Is there a legitimate use for ritalin, dexadrine and aderall? Experts
strongly disagree on that subject. Aggie Smolecki, RN, Child and Adolescent Psychiatry at
Hennepin County Medical Center (HCMC) states that “modern medical imaging such as
Positron Emitting Tomagraphy (PET) scans indicate a ‘hypofunction’ of frontal
lobe brain metabolism in children with ADHD. That is, reduced activity in the part of the
brain thought to control concentration and attention. Stimulants have proven to restore
this metabolism to near normal, consequently allowing for improved concentration and
reduced hyperactivity in children.”
However, both the National Institutes of Health, and the Center for
Disease Control and the American Academy of Pediatrics (2000) report have confirmed that
there is no biological basis for the diagnosis. Additionally, Karen Effram, retired
pediatrician and education advocate from Minnetonka points to the critical lack of
long-term studies that would delineate the medication's positive and negative effects on
major organs of the body. That's an important consideration because most children
medicated in pre-school will remain on the medication until they graduate from high
school. Until such longitudinal studies are done, “it is impossible to know whether
the drug's immediate capacity to make the child more compliant in the classroom is worth
the risks being taken.”
Ritalin was first introduced almost 50 years ago, and to date there
have been more than 170 studies on its effectiveness. But no group of children have been
followed from the time they were first medicated until twenty years later. Only that would
tell if the drug has lasting effects on the body.
However, Ritalin can cause changes in heart rate and rhythm, and there
have been cases of sudden heart attack because of the use of the medication. In one such
case the child died swiftly, the autopsy revealed some lasting damage connected with long
term use of the drug. The coroner for the city of Detroit found that the child had
suffered “cortical atrophy.” Since the cortex is the seat of higher learning in
the brain, this case has raised a lot of concern among practitioners. One case is not
sufficient to change the use of the medication at this time, but Effram points out that,
“we seldom actually get to see what happens to the brain of the ritalin user.”
Rather than assisting the learning process, the drug seems to reduce the area available to
process and retain information.
To child advocates like Breggin, there's enough evidence about the
drug’s effect upon the nervous system to warrant an across the board reduction in its
use. “Because ritalin is a synthetic amphetamine, the child can experience euphoria
and then crash to a suicidal depression,” according to Breggin. Is the psychiatrist
likely to intervene and stop the ritalin at this point? — it all depends.
“At HCMC, we immediately assess for the level of suicidality
— whether there is an actual plan and hospitalize the child if he/she is unable to
keep him/herself safe. Euphoria can indicate bi-polar disorder, and suicidal ideation can
indicate major depression.” So the child, at minimum, comes away with a new set of
psychiatric labels, and a new set of medications with additional side effects, when the
extreme mood swings may have only been a side effect of the ritalin.
At this point, sometimes the ritalin dosage is reduced and
antidepressants are also prescribed. Perfectly safe medications, right? These days
everyone takes them when there’s a death in the family, or some other tragedy.
Nothing to worry about is there? On the contrary, the most common side effect of
antidepressants is an intensification of depression, according to Breggin. This much every
psychiatrist knows, in fact they usually prescribe additional meds to counteract that
possibility. Every single one of the children from Jonesboro, Arkansas to Colombine high
school were taking an anti-depressant from the Prozac family, according to Bruce Wiseman,
in a speech before the Pennsylvania House Democratic Policy Committee in 1999. Mr. Wiseman
is the President of the Citizen's Commission on Human Rights and a former Chairman of the
Department of History of John F. Kennedy University. Psychiatrist's don't usually tell
their patients that they are risking a more severe and even psychotic depression when they
place anyone on an anti-depressant. But the violent psychosis is such a common side-effect
of Prozac, that Germany, after reviewing the literature in various medical journals,
refused to license it. In several murder cases where Prozac users blamed the drug for
their sudden descent into violence, Lilly (maker of that drug) attempted to bribe the
prosecutors. For many patients, whether adult or child, anti-depressants make a big
difference in the quality of their lives. But the fact is that 28,000 complaints have been
filed against this medication.
With respect to ritalin, Smolecki states that “when children are
intially prescribed stimulants, psychiatrists and the clinic nurse will review indications
for prescribing the drug and describe the side-effects with the parents or foster
parents.” The suit alleges otherwise. It claims that parents are not given adequate
information. They do not know about its many effects on the heart, kidneys, and nervous
system. Bedwetting can develop with the medication. Anxiety and panic attacks are common,
and there’s potential for seizures and psychosis.
But its ritalin's known effects on growth that are a major concern for
Effram. “It interferes with the production of growth hormone from the pituitary
gland. In children treated from age two there is evidence that the growth of their brains
are affected.” Smolecki states that “the psychiatrists in our clinic have never
prescribed stimulants to children as young as two.” But the suit charges that this is
not an uncommon practice at all.
Is your child or grandchild one of the thousands of children in the
Twin Cities being medicated with Ritalin, Prozac or any of a dozen other psychiatric
medications? It’s impossible to get accurate information from the school system at
this tims. “We just don't have the technology for such a project,” according to
Liz Zeno of Health Related Services of Minneapolis Public Schools. However, that will
change if Barbara Sykora’s bill requiring such a tally is passed this year. It was
proposed during the previous legislative session but failed to pass. A little support from
interested persons throughout the state of Minnesota would make a difference this time
around.
Everyone knows that mental health and related treatment in the state of
Minnesota is a major industry. It brings in about $6 billion annually. Last year the state
received over $137 million for children's services from federal and state funding sources.
See below for graphs depicting funding for all children’s mental
health services in the State of Minnesota. Specific information regarding ritalin was not
available.
If you think you or your child might be experincing side effects from
ritalin or any other psychotropic medication, contact Brenda Glanzman at The
Citizen’s Commission on Human Rights (612)338-5111.
But you don’t need side effects to join the Texas suit. If you
have used ritalin in the last four years, or purchased it for a child, you are eligible.
For the full details of the case check their website www.ritalinfraud.com
or call (800)725-3555.
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