Attention Deficit Hyperactivity Disorder (ADHD); the flip side of stimulant medication
As a clinical psychologist, child therapist, integrated learning practitioner and a mother I am persuaded that parents need to be able to make informed decisions when it comes to important matters such as helping our children with learning and functioning in this world.
Unfortunately too often parents are only given biased perspectives and research based on these one-sided perspectives by the “experts”.
Herewith a short summary of recent research contra-indicating the use of Stimulant medication (Ritalin, Concerta, Dexedrine, Adderall, Desoxyn, Cylert, etc.) as the sole treatment of learning difficulties and ADHD. Except for Cylert all of these drugs have nearly identical effects and side effects and are included in Schedule II of the DEA (Drug Enforcement Administration in the USA) for the most highly addictive drugs. Ritalin and the amphetamines can for most purposes be considered one type of drug.
According to C. Hannaford (2005) there are compelling reasons to question the continued practice of treating hyperactivity and attention deficit disorders with Ritalin and other such drugs.
First, ADHD is currently understood primarily as a behavioral label with no proven genetic or pathological background – in other words it is not an inherited illness. The causal agents are most certainly a combination of environmental factors which are headed up by lack of adult (especially parent) attention and non-stimulating learning environments. When faced with an ADHD diagnosis, adults have two divergent choices: transform themselves and then the education system, or suppress the child. Too often drug therapy seems the easier route. Children are naturally curious, active and dependent on parental attention for their learning. When children have something interesting to do, or when they are given a reasonable amount of quality attention, ADHD often disappears.
Second, non-intrusive, child-centered, common sense methods work better in the long run. Some of these will be mentioned later. Suitably applied, these methods will allow children to be in charge of their emotions and physical energy and give them tools to use throughout their lives.
And third, the risks of drug use usually outweigh the benefits. Drugs interact with the brain and the body in intricate, often undesirable ways. Dr. Peter R. Breggin, M.D (2001) states that despite more than thirty years of effort and thousands of studies, advocates admit that they are unable to demonstrate the safety or the efficacy of stimulant drugs beyond a few weeks. Just read the “WARNING” section on the official FDA-approved label for Ritalin, a complete version of this can be found in any Physician’s Desk Reference. Observing standard practice today it is clear that most of these warnings are not heeded. The nations of the Western world face a potentially tragic situation with millions of children being exposed long-term to a drug whose long-term hazards have not been determined. There are also serious questions about Ritalin’s short-term efficacy and safety.
Drugs, such as Ritalin and the amphetamines and sometimes the tricyclic anti-depressants (Tofranil and Norpramine) used in the treatment of hyperactivity, all modify the levels of the natural neurotransmitters in the brain. Simply taking Ritalin for several days damages dopamine-rich cells in the brain area called the caudate and habenula nucleus in the frontal lobes. The habenula maintains the connection to cells that produce serotonin (the feel good brain chemical) and helps regulate dopamine transmission to the brain by slowing its release elsewhere. Ritalin use causes dopamine to go elsewhere and serotonin to decrease – hence the most common side-effect of lowered mood and depression. Thus the body slows down for a time and the person can focus.
This focus is not a natural process but comes about because these drugs bind to the dopamine transporter proteins in the brain and thus affect dopamine action on multiple brain systems. Most affected are the frontal lobes, basal ganglion and corpus striatum – the brain areas responsible for increased motor control, motivation, integrative thought and sense of time. The frontal lobes control our ability to shift from a free association, open state to a detailed, focused state of awareness. This ability to shift from a broader, diffuse state to a sharper, narrow focus is important for human thinking and problem solving. This is the way high level formal reasoning occurs as we easily move back and forth between the big picture and the details. Ritalin, though it allows for attention to repetitive schoolwork, detail and rote memory, inhibits the ability to shift focus between open and focused consciousness.
One of the troubling effects of Ritalin in children is often seen as “improvement” by teachers and adults as it often causes an obsessive over-focusing that can manifest as an Obsessive Compulsion disorder (OCD). These children are sometimes unable to stop performing the tasks that were assigned to them. Drug-induced OCD is a form of severe brain dysfunction. It is an involuntary obsession that the child often cannot stop on his or her own.
Some examples of studies cited by Dr. P.R. Breggin (2001) include actions such as obsessive-compulsive drawing and writing at home; counting puzzle pieces over and over; 36-hour stretch play with Legos with no break to eat or sleep; rewriting work; over-erasing; repetitive checking of work; overly detail oriented; coloring over and over the same area; obsessive-compulsive playing of video games; excessive pressure on pencil; markedly detail oriented in drawings; inability to terminate school and play activities; raking leaves for 7 hours and then as they fell individually, etc.
The motivational drive that makes us creative, unique, happy and curious individuals decreases with stimulant drug use. The same happens with television and video games as they reduce our need to acquire stimulation through our own actions. Ritalin and other stimulants can decrease sensory-seeking behavior that motivates us to actively explore our world and learn. In an American study cited by Hannaford (2005) among school aged children taking Ritalin, 43 % under the age of ten and 50 % between the ages of ten and nineteen are depressed.
This starts a vicious cycle as these youngsters are then subsequently “treated” for depression by adding another drug (an anti-depressant). This new drug interacts with the stimulant and new problems arise – such as sleep disorders, for which yet another drug is prescribed – commonly a tranquilizer. This creates havoc in the developing brain and nervous system and can lead to deadly consequences.
This cocktail of psychiatric drugs or even just the stimulants can make children psychotic. They become suspicious and distrustful, imagine things that are unreal, and even hallucinate small insects or objects. They can become artificially energized into a state of mania, a condition characterized by grandiose plans, bizarre notions of invulnerability, poor judgment and sometimes paranoia and violence. Dr. Breggin documented in reclaiming our children (2000) that several of the school shooters in the tragic incidents of Columbine and Heritage High School in Georgia, USA were taking Ritalin.
Ritalin acts on the brain just like “speed” – neuro-pharmacologically it has the same effects, side effects and risks as cocaine and amphetamines. Research also shows that there is no evidence that Ritalin improves learning, long-term academic achievement, psychological well-being or social behavior. A study has found brain shrinkage in labeled ADHD adults who have been taking Ritalin for years. Ritalin use also leads to a persistent reduction in the density of dopamine transporters in the brain, even after Ritalin use is discontinues. Since Parkinson’s disease is related to low dopamine production, children who are medicated for hyperactivity may be more prone to Parkinson’s disease in later life (cited in Hannaford, 2005). Overall this is not a great record for stimulant drugs.
Some of the precautions and adverse reactions stated for Ritalin include: loss of appetite, abdominal pain, weight loss, insomnia, irregular heart beat, nervousness and possibly hypersensitivity, anorexia, nausea, dizziness, palpitations, headache, dyskinesia and drowsiness. Regarding stress, there is a very specific statement in the Physician’s Desk Reference: “Ritalin is usually not indicated for symptoms associated with acute stress reactions.” This in itself is already in most cases an contra-indication for stimulant medication as most kids who are being treated for ADHD is already in acute stress – or their neurological system is, as they are not coping with the demands placed on them by conventional schooling and functioning.
Ethically, we are asking our children to “just say No to drugs” and yet we are giving them the message that they are only OK if they are on this drug. Tucker Janes, a special education teacher cited in Hannaford (2005) stated it very clearly: “the use of drugs far exceeds our understanding of those drugs, and our motivation in this treatment is disgracefully oriented more towards control than education.”
When the research so strongly shows that integrated movement, supportive touch, music and play grow brain areas necessary for increased focus and learning for a lifetime, without detrimental effects, why do we use potentially harmful drugs as a first resort?
With research showing that rough and tumble play, especially during early adolescence, reduces hyperactivity and the symptoms of ADHD, and that playing with autistic children just 15 hours a week greatly reduces the symptoms of autism, we might consider play, nurturing touch and movement as a first choice in treatment, and revert to drugs only after that has failed. Hannaford (2005) continues to say that in a short period of time “hyperactive” children and adults she has worked with using movement, have been able to slow and coordinate their movements, shift easily between details and the broad picture and not only focus but have fun with learning.
For more information on movement therapy and the research it is established upon please visit these websites:
The HANDLE approach (based in the USA) (www.handle.org)
Neurophysiological Psychology (based in the UK) (www.inpp.org.uk)
Move to Learn (based in Australia) (www.movetolearn.com.au)
Integrated Learning Therapy (based in South-Africa) (www.ilt.co.za)
I can be contacted via e mail: Annamarie.devilliers@gmail.com.
Sources for this article:
Breggin, P.R. (2001). Talking Back to Ritalin: What Doctors Aren't Telling You About Stimulants and ADHD. Revised. Cambridge: Perseus Books.
Breggin, P.R. (2000). Reclaiming Our Children: A Healing Solution for a Nation in Crisis. Cambridge MA: Perseus Books.
Hannaford, C. (2005). Smart moves: Why learning is not all in your head. Salt Lake City, Utah; Great River Books.
Suggested viewing:
The Drugging of our Children (Gary Null) (SSRI drug dangers)(Columbine shooting)
1:43:04 - 5 years ago
In the absence of any objective medical tests to determine who has ADD or ADHD, doctors rely in part on standardized assessments and the impressions of teachers and guardians while the they administer leave little room for other causes or aggravating factors, such as diet, or environment. Hence, diagnosing a child or adolescent with ADD or ADHD is often the outcome, although no organic basis for either disease has yet to be clinically proven. Psychiatrists may then prescribe psychotropic drugs for the children without first without making it clear to parents that these medications can have severe side-effects including insomnia, loss of appetite, headaches, psychotic symptoms and even potentially fatal adverse reactions, such as cardiac arrhythmia. And yet, despite these dangers, many school systems actually work with government agencies to force parents to drug their children, threatening those who refuse with the prospect of having their children taken from the home unless they cooperate.
