ICPA - ADHD and Other "Psychological Disorders"

ADHD and Other
"Psychological Disorders"

ADHD Linked to Watching TV
www.whitedot.org/issue/iss_story.asp?slug=ADHD+Toddlers

Chiropractic for Children in the News

The following television interview on Health Watch shows the benefits of chiropractic care in children with ADHD symptoms. Dr. Marty Rosen, ICPA Certification instructor for SOT. View the news clip here: http://wbztv.com/video/?id=30936@wbz.dayport.com

FDA Changes Label Rules on ADHD Stimulants

On June 29, 2005 the Wall Street Journal Online published a remarkable article by Jennifer Corbett Dooren titled "FDA Wants Label Changes For Some ADHD Drugs." The URL for the entire article is http://online.wsj.com/article/0,,SB111998399463271852,00.html?mod=home_whats_news_us.

In the article, Dooren notes that the FDA is requiring new labeling changes for stimulant drugs used to treat ADHD. Most, it appears, are variations on methylphenidate (Ritalin, Concerta, etc.). The drugs have produced side-effects including, according to the FDA, events "such as visual hallucinations, suicidal ideation, psychotic behavior, as well as aggression or violent behavior."

The article adds: "Meanwhile, the FDA is seeking the panel's advice on what information it should provide to the public about the ADHD drugs that are widely used in children while it's collecting information on the number of types of psychiatric events possibly associated with ADHD drugs along with possible cardiovascular risks.

"The agency is concerned with possible cardiovascular events in people using the drugs. Earlier this year Health Canada ordered Adderall off the market after reports of sudden death in 20 patients, including 12 reports of stroke."

While these drugs clearly help some severely afflicted individuals, they also are increasingly being found to have adverse effects. At the same time some are being implicated as possible causes for liver cancer, scientists report that incidents of liver cancer in children have roughly doubled over the past two decades.

The Rise and Fall of ADD/ADHD

This very interesting article by Fred A Baughman Jr, MD lays out the invention and evolution of ADD as a disease affecting our children. Well written and referenced, this testimony may be an eye opener to parents who are led to believe in this diagnosis for their children.

Our Nov-Dec 2002 Membership Newsletter had a great article by Peter Breggin, MD on the multi-side effects associated with ADD treatment.
View the references here

ADD: The Catch-All Diagnosis

ADD/ADHD has become the catch all diagnosis. It is conservatively estimated that between 5 and 7 million have been diagnosed with ADHD!

"There is a myriad of disorders that can mimic ADHD. Often parents or teachers, through their own investigation, will determine the diagnosis for their child's school problems as ADHD, when in fact, the difficulties are unrelated to ADHD." View the abstract

The following website, ADHD Parents Support Website offers 50 different conditions that mimic the symptoms of ADD/ADHD leading to some of the over diagnosis. Although there is acknowledgment of the necessity for improved diagnosis, this type of extensive assessment is not frequently employed:

"There is no diagnostically definitive test for ADHD. Therefore, assessments for ADHD need to be comprehensive and should involve multiple domains, informants, methods, and settings. The comprehensive assessment needs to determine whether the subject has ADHD or another disorder. Thus, evaluation of various organic conditions, functional disorders, developmental status, situational, environmental, and family problems should all be explored. The clinical interview of the child and family is one of the cornerstones of the assessment process. A comprehensive medical history and examination, psychoeducational tests, and school-related evaluation, as well as a view of the child's social and emotional functioning, are also crucial. A wide array of rating scales, tests, and measures have been developed to aid in the systematic standardized assessment of the various deficits associated with ADHD. None of these tests is definitive, however." View complete abstract.

What results then is protocol inadequacies combined with practitioner, parental and school official frustration with a child's behavior. This leads to the extensive administration of a wide array of psycotropic drugs we see in our society today. The following site lists the drugs used.Pharmacological and Psychostimulants Used for ADHD.

The most commonly prescribed drug is Ritalin. Billed as a successful treatment whose side effects are minimal. Here is the package insert for Ritalin. Let the parents decide for themselves...Ritalin Side Effects.

And our final link on ADD is one which brings to light the relationship between some ADD support groups and self interested pharmeceutical companies. This statement on their website summarizes it quite well: "Trust not in “ADD” labels and organizations but rather in the belief that all children have the potential to live well-adjusted lives."

ADD/ADHD will continue to be used as a catch all diagnosis unless parents become informed. We as Doctors of Chiropractic remain the best patient advocates and educators in any health field today. Our enthusiasm and commitment in providing information for parents to make informed health choices for their families is unprecedented. Keep up your awesome work--it does matter!

Obstacles to the Diagnosis and Treatment of ADHD Identified Across Europe

Unfortunately, Europe is now publishing concerns stating there is substantial barriers to the diagnosis and effective management of ADHD states an article by Lilly (a Pharmeceutical Co. which produces drugs for depression, schizophrenia, diabetes, cancer, osteoporosis and many other diseases) Whereas the U.S. has held the number one place for diagnosis and prescribing for ADHD, Europe may soon become a close runner up. One news article in the U.K.., “ Parents may face jail over compulsory drug orders,” reveals a new fear tactic underway.

Republican Dan Burton (Ind) Blasts CHADD --
A Leading Public Support Group for ADD

There has been sugnificant evidence about the relationship between CHADD and pharmaceutical companies (Ciba-Geigy, the makers of Ritalin. This was originall broought to light in a documentary: ADD: A Dubious Diagnosis. The Merrow Report. The following article reviews how one member of congress is exposing this conflict of interest to Congress.
Read the complete article here

Early Use of ADHD Drug Alters Brain

Ritalin use in preteen children may lead to depression later in life. Ritalin and cocaine have different effects on humans. But their effects on the brain are very similar. When given to preteen rats, both drugs cause long-term changes in behavior.

One of the changes seems good. Early exposure to Ritalin makes rats less responsive to the rewarding effects of cocaine. But that's not all good. It might mean that the drug short-circuits the brain's reward system. That would make it difficult to experience pleasure -- a "hallmark symptom of depression," Carlezon and colleagues note.

The other change seems all bad. Early exposure to Ritalin increases rats' depressive-like responses in a stress test. "These experiments suggest that preadolescent exposure to [Ritalin] in rats causes numerous complex behavioral adaptations, each of which endures into adulthood," Carlezon and colleagues conclude. "This work highlights the importance of a more thorough understanding of the enduring neurobiological effects of juvenile exposure to psychotropic drugs."

http://my.webmd.com/content/article/78/95700.htm?lastselectedguid={5FE84E90-BC77-4056-A91C-9531713CA348}

Antidepressant use on the rise among US children

Prescriptions for antidepressant medications for children and teenagers rose substantially during the 1990s, US researchers have found. In 1994, 13 to 19 out of every 1,000 children were prescribed an antidepressant. Prescriptions were most common among boys aged 10 to 14 and girls aged 15 to 19.

Whether a child was treated by a primary care physician or a psychiatrist seemed to affect prescription choices, the authors add. ADHD was the most common diagnoses in children who were prescribed an antidepressant by a primary care physician. In contrast, the primary medical diagnosis in children treated by a psychiatrist was most likely to be depression.

Dr. Julie Magno Zito, of the University of Maryland in Baltimore, and colleagues report. "The expanded utilization of antidepressants for the management of behavioral and emotional disorders of youth in the 1990s was prominent," they advise that more research is needed to strengthen the evidence that the medications are appropriate for children and teens.

SOURCE: Pediatrics 2002 (May); 109 (5): 721-727

1.6 million elementary school children have been diagnosed with ADHD

About 1.6 million cases of attention deficit hyperactivity disorder (ADHD) have been diagnosed in American elementary school children, according to the Centers for Disease Control and Prevention.

The standard medical treatment is drug treatment.

SOURCE: British Medical Journal 2002 (June 1): 324 (7349): 1296

ADHD: Management Beyond Medication

This letter to the editor of American Family Physicians addresses the need to evaluate school environments for children diagnosed with ADD/ADHD in order to meet the individual child's needs.

Read the "ADHD: Management Beyond Medication" letter

Consider Fish Oil Over Ritalin

Children with attention-deficit hyperactivity disorder (ADHD) have problems paying attention, listening to instructions, and completing tasks; they also fidget and squirm, are hyperactive, blurt out answers, and interrupt others.

It is conservatively estimated that 3-5% of the school-age population has ADHD. Although drugs, such as Ritalin, are frequently used to treat ADHD, they are fraught with complications. Disadvantages include possible side effects, including decreased appetite and growth, insomnia, increased irritability, and rebound hyperactivity when the drug wears off.

One would not expect to find that a single cause or even a handful of factors could explain why ADHD appears to be so rampant in our society. Because it is accepted that both genetic and environmental factors play a role in ADHD, many other factors-both intrinsic and extrinsic-could influence an individual's fatty acid status.

Inefficient Conversion of ALA (Flax Oil) To EPA And DHA

A possible cause for the low fish oil status of the ADHD children may be impaired conversion of the fatty acid precursors LA and ALA to their longer and more highly unsaturated products, such as EPA and DHA (fish oil fats).

It appears that children with ADHD just are not able to chemically convert the plant omega-3, ALA to fish oil very well. The problem is further worsened when omega-6 fats are consumed and the ideal omega-6:3 ratio of 1:1, progresses to the typical standard American ratio of 15:1. Many of these children have ratios which are even worse and can be as high as 50:1.

This study provides the research evidence supporting the use of the omega-3 fats found in fish oils to effectively address the underlying deficiency that is present in most of these children and appears to be contributing to the ADHD.

Nutritional Considerations for ADHD

Two books worth having for your lending libraries:

Smart Fats: How Dietary Fats and Oils Affect Mental, Physical and Emotional Intelligence
by Michael A. Schmidt
and
Omega 3 Connection by Dr. Stolle

Kids with ADHD May Need Iron

Results of a small study in France suggest that children with attention-deficit/hyperactivity disorder (ADHD) may be low on iron. An iron deficiency could be a contributing factor to ADHD because it leads to abnormal functioning of the brain neurotransmitter dopamine. A French research team tested 53 youngsters with ADHD and a comparison group of 27 children. They found that 84 percent of the kids with ADHD had low iron levels compared with only 18 percent of the children in the control group; 32 percent of the ADHD kids had extremely low iron levels compared to only one of the youngsters in the matched group. The researchers found that the lower the iron levels, the more severe a child's ADHD symptoms. They suggested that iron supplements might improve dopamine activity in kids with ADHD and reduce the need for the drugs often prescribed to treat the disorder. While growing children need iron, supplements can lead to toxicity, and children should not take iron except upon the advice of a physician. Results of the French study were published in the December 2004 issue of the Archives of Pediatric and Adolescent Medicine.

Source: Archives of Pediatric and Adolescent Medicine, December 2004