Every now and then I come across an article I wish I had written.  This one is The Business of ADHD by Child Psychiatrist Winston Chung, MD.  If I had written it, I would have titled it ADHD Greed.

Three highlights are:

• The American Psychiatric Association is considering lowering the number of symptoms needed for an ADHD diagnosis from 6 to 4.  This is alarming because we already medicate 57% of children who don't meet the current criterion.  Lowering the number of symptoms needed will surely increase the number of children wrongfully receiving unneeded medication.  Woops, I forgot.  It's about profits.

• Researchers promise pharmaceutical companies results that would benefit the drug company -- before they conduct the study!

• Allen Frances, MD, Chair of the Task Force that created the current diagnostic criteria for ADHD (and other disorders) laments that his group "inadvertently contributed to three false 'epidemics' - attention deficit disorder, autism and childhood bipolar disorder. Clearly, our net was cast too wide and captured many 'patients' who might have been far better off never entering the mental health system."

For years I have been critical of these three "epidemics" which I call "diagnosis du jour".

Today, NPR covered neurofeedback for treating ADHD.  Ellison has written a book about living with ADHD called Buzz: A Year of Paying Attention. One chapter of the book is devoted to neurofeedback.  Hear the story and read the article here.

This Guest Column appeared in the Brained Dispatch on 17 September 2010.

The Associated Press circulated an article on 30 August 2010 entitled “Questions loom over drug given to sleepless vets”. The article highlighted the serious side effects, including death, for soldiers taking medicine for post-traumatic stress disorder (PTSD). It is something we all need to know.

It is my opinion that a similar article could be written entitled “Questions loom over drug given to sleepless kids".

The correlation between the vets article and some kids taking medication for Attention-Deficit Hyperactivity Disorder (ADHD) is remarkable. Stimulant medications given to children for ADHD, like the medication given to vets, have “serious side effects” including “sudden heart failure”.

Between 1999 and 2003, 19 children suddenly died and another 26 suffered serious cardiovascular problems after taking drugs to treat ADHD, according to a report by the US Food and Drug Administration (FDA). Stimulant medications now have Black Box Warnings from the FDA that include warnings about increased risk of:

1. Heart-related problems:

   1. sudden death in patients who have heart problems or heart defects

   2. increased blood pressure and heart rate

2. Mental (Psychiatric) problems:

   1. new or worse behavior and thought problems

   2. new or worse aggressive behavior or hostility.

FDA medication guides listing other side effects can be found on the FDA website or at the following: http://www.cedarbrook.us/index.php/medication-guides

Although the serious side effects are rare, even one death is unacceptable considering the following. The Great Smokey Mountain study shows that 57% of children who take medication for ADHD do not meet the criteria for ADHD. Children are routinely prescribed stimulant medication for a disorder that they don't have. Why run the risk of sudden death from medication for a disorder one does not have?

While medication for ADHD has helped many people improve focus, attention, and performance it is obvious that we need to be more critical about diagnosis and treatment.

And what about the correlation of children with the “sleepless vets”? There are over 59 causes of difficulties with focus and attention. One of these causes is sleep deprivation. According to the National Sleep Foundation, children aged 5 to 12 need 10-11 hours of sleep and get only 9.5 hours. That is between one half-hour to 1 ½ hours less sleep than they need per night. Teenagers need between 8.5 and 9.5 hours.

If children and teens do not get enough sleep they can have difficulties with focus and concentration -- but it's not because of ADHD. We need to stop the travesty of prescribing medications with serious side effects for 57% of the children who do not even have the disorder.

The first priority in treating any health concern is to “do no harm”. Proper treatment requires accurate determination of the causes and not mis-attribution of symptoms followed by prescriptions for medications with serious side effects. Our children deserve better attention than this.