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The Great Medications Scare - Page 2

© John McManamy

hear from the Surgeon General of the United States, the director of the National Institutes of Health (NIH), director of the National Institute of Mental Health (NIMH), nor any other leading researcher."

Had the Surgeon General been called, he might have quoted parts of his landmark Report on Mental Health, published last year, which cited studies pointing to genetic causes of ADHD, and noted that psychostimulatants such as Ritalin are effective for 75 to 90 percent of children with ADHD. The Report also concluded that the diagnostic criteria for ADHD are "clear and validated by research."

But the House subcommittee was not interested in all that. Instead, Chairman Hoekstra felt emboldened to declare: "There is no professional consensus between professionals about the origin and nature of ADHD and that our nation is over-prescribing drugs to treat whatever ADHD is."

The hearing virtually coincided with the announcement of a class-action lawsuit against Novartis Pharmaceutical Corp, makers of Ritalin, charging that Novartis made false claims about the product, but what really got the media's attention was the allegation that the company conspired with the American Psychiatric Association and a nonprofit organization to create a "novel medical disorder" to fuel demand for Ritalin.

The charge is not a new one. It had been made before by the same Fred Baughman MD who testified before the House (and before an earlier House hearing in 1996). His claim that the APA invented the disorder in 1980 is echoed in the lawsuit and cited with approval in a Scientology booklet.

Actually, the timeline widely straddles 1980. In 1968, the APA published the DSM-II of 1968, which alluded to "hyperkinetic reaction to childhood." It wasn't until the DSM-III-R published in 1987 that the APA bestowed on ADHD the name by which it is now known.

News of the suit outraged Patricia Dalton, a clinical psychologist who works with children. Writing in the Washington Post, she noted: "By conservative estimates, three to five percent of school-age children are affected by ADHD and 2.5 percent by mood disorder; only 1.2 percent of these children are treated for ADHD and .3 percent for mood disorder."

She acknowledges that there have been cases where children have been overprescribed, but that the larger problem lies with those in the underprescribed population.

The Surgeon General's Report made the same point, noting that many kids who are medicated do not fully meet the diagnostic criteria for the disorder, but "fewer children ... are being treated for ADHD than suffer from it."

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