Ped Med: ADHD Treatments Raise Questions

http://www.upi.com/ConsumerHealthDai...4-063453-8729r

Note from Jan: Some have claimed they have seen no evidence of kids as
young as two being given ADHD meds. There has been evidence and here is
more.
Ped Med: ADHD treatments raise questions
By LIDIA WASOWICZ
UPI Senior Science Writer

SAN FRANCISCO, March 24 (UPI) -- While no causative connection has been
proven, reports of a small number of children medicated for
attention-deficit/hyperactivity disorder seeing snakes or suffering strokes
have prompted two federal advisory panels to recommend that parents and
physicians be alerted to the potential risks.

In the latest non-binding move, a Food and Drug Administration pediatric
committee Wednesday urged a beefed-up warning on the drugs' labels, though
not the direst type referred to as a "black box." That's the kind an
FDA-commissioned group of experts focusing on safety had favored in February
after reviewing cases of sudden death, heart attacks, strokes and other
cardiac problems experienced by a tiny fraction of ADHD patients who were
taking the medicines and who apparently had underlying cardiac
irregularities.

The specialists meeting Wednesday took the softer approach in part because
of testimony by psychiatrists and mental health officials concerned about
frightening families away from needed treatment. They said stimulant drugs
like Ritalin, Adderall and Concerta are effective against hyperactivity,
lack of focus and impulsivity that form the hallmarks of ADHD. However,
others have raised red flags about overuse of the drugs -- which rack up
close to $3 billion in annual sales.

Both panels agreed patients, parents and physicians should receive clearer
information about potential side effects, including heart problems,
psychotic symptoms like hallucinations of snakes, worms, spiders, roaches,
bugs, jellyfish and other creepy crawlies, manic episodes or aggressive
behavior -- effects the drug companies say are no more prevalent among
medicated patients than among the general population.

The FDA is now free to follow the prescription of either or neither of the
panels.

In discussing ADHD treatments, consider some straight talk about the
disorder:

-- Diagnosis is in the eyes of the beholder, there being no biological
diagnostic test.

-- There are compelling clues but no patented proofs of the basis for the
disorder.

-- There is no cure.

-- Treatment can control behavior, but there is little evidence it can
increase knowledge or improve academic skills or achievement.

-- The condition is chronic, likely to last years, perhaps decades, with the
majority of children affected to some degree into adolescence and even
adulthood.

-- Most children improve with age, showing fewer symptoms and problems by
their early 20s, whether or not they receive treatment.

-- There is a dearth of sound scientific evidence of the effects of
psychotropic drugs on growing brains and bodies over the long haul.

-- Every chemical treatment, even when properly prescribed, can have
unwanted and oftentimes unforeseen effects.

-- Inappropriate administration of medication, either for the wrong child or
at the wrong dose, can have additional, devastating, even deadly,
consequences.

-- All treatments come with caveats.

-- Most psychiatric drugs are not approved by the Food and Drug
Administration for younger age groups, and, like the majority of medicines
for minors, are used "off-label," or at the doctor's discretion.

"Medication will help reduce some symptoms, but taking medication over time
won't eliminate them," said pediatric neurologist Donna Palumbo of the
University of Rochester in New York. "We can't say if you take this drug for
five years, (the problem) will go away. We can't predict what will happen."

In a change of medical mind, increasing numbers of youngsters are taking the
drugs for prolonged periods.

"Part of the reason for (the) overall increase in prescriptions is that kids
are now being treated throughout the day and during adolescence, unlike the
former pattern of stopping with puberty," said Stephen Hinshaw, professor
and chair of psychology at the University of California, Berkeley, and
author of "The Years of Silence are Past: My Father's Life with Bipolar
Disorder" (Cambridge University Press, 2002).

"If ADHD is validly diagnosed and is present in about 5 percent of children,
current rates are more understandable, despite the concerned reactions of
some critics."

Those concerns arise in part from some spectacular spikes in the growth
charts of pharmaceutical sales in recent years.

Drug Enforcement Agency records show between 1991 and 2000, annual
production of methylphenidate -- a central nervous system stimulant like
Ritalin or Concerta -- shot up by 847 percent, to 14,957 kilograms, or more
than 16 tons. Domestic sales for the period ballooned by nearly 500 percent.

During the same nine years, the annual production quota for the other half
of the stimulant treatment equation, amphetamines -- the active ingredient
in the anti-ADHD drugs Adderall and Dexedrine -- rocketed more than 2,000
percent, to 9,007 kilograms, or nearly 10 tons.

Against this backdrop, the annual number of prescriptions written for ADHD
over the nine years mushroomed by a factor of 5, capping at 11 million for
methylphenidate and 6 million and counting for amphetamines.

An estimated 80 percent of the total, or some 14 million, were for children,
with 40 percent of these for youngsters 3 to 9. In addition, doctors made
out 4,000 orders for stimulants for tykes 2 and under.

Critical of such trends, the DEA has made a point of noting most of these
drugs are not approved for use in children under 6 and none for toddlers
under 3 because their safety and effectiveness have not been established in
those age groups.

In line with the DEA figures, an analysis by Medco Health Solutions, a
prescription management company, found drug spending for behavioral
conditions ran up 77 percent between 2000 and 2003, due to hikes in both
costs and use.

Medications prescribed primarily to treat ADHD were a standout during the
period. Spending jumped 183 percent for children overall and 369 percent for
tots under 5, nearly one in 10 of whom was taking one or more of the drugs,
noted the report, aptly dubbed, "Managing Generation Rx."

Central nervous system pediatric medicines, which encompass those for
behavioral and neurological conditions, outran even cardiovascular
medications to reach the top spot in spending for all prescription drugs for
all ages in 2003.

"This analysis provides a striking commentary on the state of pediatric
treatment in this country, as well as the costs shouldered by parents whose
children live with these conditions," Dr. Robert Epstein, Medco's chief
medical officer, said in a statement accompanying the release of the
analysis of prescription data for 300,000 minors under 20.

"It goes without saying that early detection and appropriate treatment of
these conditions is extremely important, but the emphasis is on
'appropriate' with an eye on cost-effective therapy, as well."

With Americans producing, and popping, 80 percent to 85 percent of the
world's supply of the pills, it is little wonder the U.S. ADHD market --
which brought in more than $2.5 billion in revenues, or 97 percent of the
total, in 2004 -- dwarfs all others, according to a report from Datamonitor,
a London-based independent market analyst.

It is, however, more than slightly startling to note the estimated 2.5
million medicated American children ages 4 to 17 -- or some 56 percent of
those diagnosed with ADHD -- comprise but a tiny fraction of the more than
20 million youngsters identified with the disorder worldwide.

"There is definitely both a higher willingness to prescribe drugs and
acceptance by families to have their children on drugs in the U.S., whereas
parents in the EU (European Union) generally prefer to try other non-drug
interventions first," said Alistair Sinclair, Datamonitor central nervous
system analyst.

Even more than the Europeans, the Japanese -- whose national insurance does
not cover such medications -- lag behind the Americans in their awareness
and drug treatment of ADHD.

As other Asian countries, Japan leans toward a conservative corner of
culture where conditions like ADHD often come with stigma attached and where
parents and patients tend either not to be aware of a problem or prefer to
manage it on their own, without outside medical assistance, the report
observes.

It does not address the question of why Japanese and, for the most part,
European children consistently outscore their American counterparts on
standardized measures of academic achievement.

In one recent international comparison, for example, U.S. fourth graders
came in 12th in math scores, behind Singapore, Korea, Japan, Hong Kong,
Netherlands, Czech Republic, Austria, Slovenia, Ireland, Hungary, and
Australia.

They came in third in science, following Korea and Japan. By the eighth
grade, the American students slipped to the 28th and 17th slots, out of 41
countries, respectively. By 12th grade, they were close to the bottom,
besting only Cyprus and South Africa in math and coming in 16th out of 21
nations in science.

The preponderance of mainstream research suggests psychiatric drugs, if
properly administered and monitored, are safe, at least in the short term,
and effective, at least for clamping down on the core symptoms of ADHD, but
there is little hard-core evidence they upgrade a child's scholastic skills.

Where the United States does have an unshakable lead is in the global ADHD
drug market, which is forecast to swell from $2.7 billion in 2005 to an
anticipated $3.3 billion by 2015.

Next: Taking a backward glance at ADHD treatments

(Editors' Note: This series on ADHD is based on a review of hundreds of
reports and a survey of more than 200 specialists.)

My son's eczema completely cleared up once he started on methylphenidate. I
had always told the consultant that it was stress related and she laughed at
me, he was 6/7 at the time. Yet it flared up at the beginning of each and
every school term!
I know someone is going to say that kids grow out of it, I am aware of that,
but his stopped immediately he went on medication.

Thats one for Jan Drew ??????????

"Twittering One" wrote in message
oups.com...
ADD meds (the ones that do not irritate, chemically)
help my inflammatory skin disorders.

They also reduce the pain and over-sensitivity
associated with increased permeability
associated with inflammatory skins disorders, eg,
stinging due to absorption of irritants.

That's not news.
Ask a Neuro-Dermatologist; drugs that impact
norep regulation have been used for many years, eg,
TCAs.

But those are not as safe as Dexedrine,
and Dex has fewer AEs.

"tracey3121" wrote in message
...
My son's eczema completely cleared up once he started on methylphenidate.
I had always told the consultant that it was stress related and she
laughed at me, he was 6/7 at the time. Yet it flared up at the beginning
of each and every school term!
I know someone is going to say that kids grow out of it, I am aware of
that, but his stopped immediately he went on medication.

Thats one for Jan Drew ??????????

Glad it worked for eczema.....

Anyone wish to discuss it being given to two year old children?

The fact the kids in the US scored LOWER..academically?

The fact the US has MORE kids of these drugs and WHY?

Very, very strange...silence from Mark Probert.

http://www.upi.com/ConsumerHealthDai...=20060324-0634...

Note from Jan: Some have claimed they have seen no evidence of kids as
young as two being given ADHD meds. There has been evidence and here is
more.
Ped Med: ADHD treatments raise questions
By LIDIA WASOWICZ
UPI Senior Science Writer


SAN FRANCISCO, March 24 (UPI) -- While no causative connection has been
proven, reports of a small number of children medicated for
attention-deficit/hyperactivity disorder seeing snakes or suffering strokes
have prompted two federal advisory panels to recommend that parents and
physicians be alerted to the potential risks.


In the latest non-binding move, a Food and Drug Administration pediatric
committee Wednesday urged a beefed-up warning on the drugs' labels, though
not the direst type referred to as a "black box." That's the kind an
FDA-commissioned group of experts focusing on safety had favored in February
after reviewing cases of sudden death, heart attacks, strokes and other
cardiac problems experienced by a tiny fraction of ADHD patients who were
taking the medicines and who apparently had underlying cardiac
irregularities.


The specialists meeting Wednesday took the softer approach in part because
of testimony by psychiatrists and mental health officials concerned about
frightening families away from needed treatment. They said stimulant drugs
like Ritalin, Adderall and Concerta are effective against hyperactivity,
lack of focus and impulsivity that form the hallmarks of ADHD. However,
others have raised red flags about overuse of the drugs -- which rack up
close to $3 billion in annual sales.


Both panels agreed patients, parents and physicians should receive clearer
information about potential side effects, including heart problems,
psychotic symptoms like hallucinations of snakes, worms, spiders, roaches,
bugs, jellyfish and other creepy crawlies, manic episodes or aggressive
behavior -- effects the drug companies say are no more prevalent among
medicated patients than among the general population.


The FDA is now free to follow the prescription of either or neither of the
panels.


In discussing ADHD treatments, consider some straight talk about the
disorder:


-- Diagnosis is in the eyes of the beholder, there being no biological
diagnostic test.


-- There are compelling clues but no patented proofs of the basis for the
disorder.


-- There is no cure.


-- Treatment can control behavior, but there is little evidence it can
increase knowledge or improve academic skills or achievement.


-- The condition is chronic, likely to last years, perhaps decades, with the
majority of children affected to some degree into adolescence and even
adulthood.


-- Most children improve with age, showing fewer symptoms and problems by
their early 20s, whether or not they receive treatment.


-- There is a dearth of sound scientific evidence of the effects of
psychotropic drugs on growing brains and bodies over the long haul.


-- Every chemical treatment, even when properly prescribed, can have
unwanted and oftentimes unforeseen effects.


-- Inappropriate administration of medication, either for the wrong child or
at the wrong dose, can have additional, devastating, even deadly,
consequences.


-- All treatments come with caveats.


-- Most psychiatric drugs are not approved by the Food and Drug
Administration for younger age groups, and, like the majority of medicines
for minors, are used "off-label," or at the doctor's discretion.


"Medication will help reduce some symptoms, but taking medication over time
won't eliminate them," said pediatric neurologist Donna Palumbo of the
University of Rochester in New York. "We can't say if you take this drug for
five years, (the problem) will go away. We can't predict what will happen."


In a change of medical mind, increasing numbers of youngsters are taking the
drugs for prolonged periods.


"Part of the reason for (the) overall increase in prescriptions is that kids
are now being treated throughout the day and during adolescence, unlike the
former pattern of stopping with puberty," said Stephen Hinshaw, professor
and chair of psychology at the University of California, Berkeley, and
author of "The Years of Silence are Past: My Father's Life with Bipolar
Disorder" (Cambridge University Press, 2002).


"If ADHD is validly diagnosed and is present in about 5 percent of children,
current rates are more understandable, despite the concerned reactions of
some critics."


Those concerns arise in part from some spectacular spikes in the growth
charts of pharmaceutical sales in recent years.


Drug Enforcement Agency records show between 1991 and 2000, annual
production of methylphenidate -- a central nervous system stimulant like
Ritalin or Concerta -- shot up by 847 percent, to 14,957 kilograms, or more
than 16 tons. Domestic sales for the period ballooned by nearly 500 percent.


During the same nine years, the annual production quota for the other half
of the stimulant treatment equation, amphetamines -- the active ingredient
in the anti-ADHD drugs Adderall and Dexedrine -- rocketed more than 2,000
percent, to 9,007 kilograms, or nearly 10 tons.


Against this backdrop, the annual number of prescriptions written for ADHD
over the nine years mushroomed by a factor of 5, capping at 11 million for
methylphenidate and 6 million and counting for amphetamines.


An estimated 80 percent of the total, or some 14 million, were for children,
with 40 percent of these for youngsters 3 to 9. In addition, doctors made
out 4,000 orders for stimulants for tykes 2 and under.


Critical of such trends, the DEA has made a point of noting most of these
drugs are not approved for use in children under 6 and none for toddlers
under 3 because their safety and effectiveness have not been established in
those age groups.


In line with the DEA figures, an analysis by Medco Health Solutions, a
prescription management company, found drug spending for behavioral
conditions ran up 77 percent between 2000 and 2003, due to hikes in both
costs and use.


Medications prescribed primarily to treat ADHD were a standout during the
period. Spending jumped 183 percent for children overall and 369 percent for
tots under 5, nearly one in 10 of whom was taking one or more of the drugs,
noted the report, aptly dubbed, "Managing Generation Rx."


Central nervous system pediatric medicines, which encompass those for
behavioral and neurological conditions, outran even cardiovascular
medications to reach the top spot in spending for all prescription drugs for
all ages in 2003.


"This analysis provides a striking commentary on the state of pediatric
treatment in this country, as well as the costs shouldered by parents whose
children live with these conditions," Dr. Robert Epstein, Medco's chief
medical officer, said in a statement accompanying the release of the
analysis of prescription data for 300,000 minors under 20.


"It goes without saying that early detection and appropriate treatment of
these conditions is extremely important, but the emphasis is on
'appropriate' with an eye on cost-effective therapy, as well."


With Americans producing, and popping, 80 percent to 85 percent of the
world's supply of the pills, it is little wonder the U.S. ADHD market --
which brought in more than $2.5 billion in revenues, or 97 percent of the
total, in 2004 -- dwarfs all others, according to a report from Datamonitor,
a London-based independent market analyst.


It is, however, more than slightly startling to note the estimated 2.5
million medicated American children ages 4 to 17 -- or some 56 percent of
those diagnosed with ADHD -- comprise but a tiny fraction of the more than
20 million youngsters identified with the disorder worldwide.


"There is definitely both a higher willingness to prescribe drugs and
acceptance by families to have their children on drugs in the U.S., whereas
parents in the EU (European Union) generally prefer to try other non-drug
interventions first," said Alistair Sinclair, Datamonitor central nervous
system analyst.


Even more than the Europeans, the Japanese -- whose national insurance does
not cover such medications -- lag behind the Americans in their awareness
and drug treatment of ADHD.


As other Asian countries, Japan leans toward a conservative corner of
culture where conditions like ADHD often come with stigma attached and where
parents and patients tend either not to be aware of a problem or prefer to
manage it on their own, without outside medical assistance, the report
observes.


It does not address the question of why Japanese and, for the most part,
European children consistently outscore their American counterparts on
standardized measures of academic achievement.


In one recent international comparison, for example, U.S. fourth graders
came in 12th in math scores, behind Singapore, Korea, Japan, Hong Kong,
Netherlands, Czech Republic, Austria, Slovenia, Ireland, Hungary, and
Australia.


They came in third in science, following Korea and Japan. By the eighth
grade, the American students slipped to the 28th and 17th slots, out of 41
countries, respectively. By 12th grade, they were close to the bottom,
besting only Cyprus and South Africa in math and coming in 16th out of 21
nations in science.


The preponderance of mainstream research suggests psychiatric drugs, if
properly administered and monitored, are safe, at least in the short term,
and effective, at least for clamping down on the core symptoms of ADHD, but
there is little hard-core evidence they upgrade a child's scholastic skills.


Where the United States does have an unshakable lead is in the global ADHD
drug market, which is forecast to swell from $2.7 billion in 2005 to an
anticipated $3.3 billion by 2015.


Next: Taking a backward glance at ADHD treatments


(Editors' Note: This series on ADHD is based on a review of hundreds of ...

"Twittering One" wrote in message
oups.com...
ADD meds (the ones that do not irritate, chemically)
help my inflammatory skin disorders.

They also reduce the pain and over-sensitivity
associated with increased permeability
associated with inflammatory skins disorders, eg,
stinging due to absorption of irritants.

That's not news.
Ask a Neuro-Dermatologist; drugs that impact
norep regulation have been used for many years, eg,
TCAs.

But those are not as safe as Dexedrine,
and Dex has fewer AEs.

It wasn't a dark and stormy night when tracey3121 wrote:

My son's eczema completely cleared up once he started on
methylphenidate. I had always told the consultant that it was stress
related and she laughed at me, he was 6/7 at the time. Yet it flared
up at the beginning of each and every school term!

Hope you fired that consultant! Stress *can* excerbate eczema, just ask
anyone who has it. As a child my GP asked if I was worried about
anything when my ezcema first presented, so I'm guessing he saw a
connection in his patients at least.

I know someone is going to say that kids grow out of it, I am aware of
that, but his stopped immediately he went on medication.

I still get bouts occasionally so I've decided to keep up the
preventative measures for myself and son: double rinsing the laundry,
using a "soapless" soap, no hot showers etc.


Vashti

tracey3121 wrote:
My son's eczema completely cleared up once he started on methylphenidate. I
had always told the consultant that it was stress related and she laughed at
me, he was 6/7 at the time. Yet it flared up at the beginning of each and
every school term!
I know someone is going to say that kids grow out of it, I am aware of that,
but his stopped immediately he went on medication.

Eczema is well known to be stress related and removal of stressors is
one of the treatment modalities.

OS had the same problem when he was in middle school, but meds did not
help. The SOB who was his stressor moved to North Carolina, and OS was
cured.

Thats one for Jan Drew ??????????

"Twittering One" wrote in message
oups.com...
ADD meds (the ones that do not irritate, chemically)
help my inflammatory skin disorders.

They also reduce the pain and over-sensitivity
associated with increased permeability
associated with inflammatory skins disorders, eg,
stinging due to absorption of irritants.

That's not news.
Ask a Neuro-Dermatologist; drugs that impact
norep regulation have been used for many years, eg,
TCAs.

But those are not as safe as Dexedrine,
and Dex has fewer AEs.

Jan Drew wrote:
"tracey3121" wrote in message
...
My son's eczema completely cleared up once he started on methylphenidate.
I had always told the consultant that it was stress related and she
laughed at me, he was 6/7 at the time. Yet it flared up at the beginning
of each and every school term!
I know someone is going to say that kids grow out of it, I am aware of
that, but his stopped immediately he went on medication.

Thats one for Jan Drew ??????????

Glad it worked for eczema.....

Sure you are. Years ago (?) I posted about it being tested for treating
the depression that can accompany chemotherapy and you had a negative
comment.

Do not bother to ask me to prove it. Look it up. It is in the archives.

Anyone wish to discuss it being given to two year old children?

According to the article, a few thousand kids are being prescribed
medication WITH A DIAGNOSIS. It does not sound like it is an automatic
2nd birthday present.

The fact the kids in the US scored LOWER..academically?

Well, there are MANY reasons for that. Have you noticed how BOOKS have
become so unpopular among kids? I have.

The fact the US has MORE kids of these drugs and WHY?

Several reasons, as discussed years ago in asad. Look them up. They are
in the archives.

Very, very strange...silence from Mark Probert.

Nah...like I told you in another thread, MARCH MADNESS! Pre-season
baseball, and, I have some serious work to do on my boat. That is all in
addition to a heavy workload.

Jan Drew wrote:
"Mark Probert" wrote in message
...
Jan Drew wrote:
"tracey3121" wrote in message
...
My son's eczema completely cleared up once he started on
methylphenidate. I had always told the consultant that it was stress
related and she laughed at me, he was 6/7 at the time. Yet it flared up
at the beginning of each and every school term!
I know someone is going to say that kids grow out of it, I am aware of
that, but his stopped immediately he went on medication.

Thats one for Jan Drew ??????????
Glad it worked for eczema.....
Sure you are. Years ago (?) I posted about it being tested for treating
the depression that can accompany chemotherapy and you had a negative
comment.

Do not bother to ask me to prove it. Look it up. It is in the archives.

Do not try to use your tricks of laziness....You made the claim, YOU look it
up!

Jan, I am merely mimicking you. Like when I asked you about whether you
ever contacted anyone outside of usenet about Mark Lowry...you said to
look up your answer...which Google lost.

Anyone wish to discuss it being given to two year old children?
According to the article, a few thousand kids are being prescribed
medication WITH A DIAGNOSIS. It does not sound like it is an automatic 2nd
birthday present.

Let this be even more proof that Mark can not go a single day without lying.

What the article said:

An estimated 80 percent of the total, or some 14 million, were for children,
with 40 percent of these for youngsters 3 to 9. In addition, doctors made
out 4,000 orders for stimulants for tykes 2 and under.

Like I said, a few thousand (surely 4000 is a "few")....

The fact the kids in the US scored LOWER..academically?
Well, there are MANY reasons for that. Have you noticed how BOOKS have
become so unpopular among kids? I have.

Why is that?

Computers. Video Games. DVD Players. Movies. Etc.

The fact the US has MORE kids of these drugs and WHY?
Several reasons, as discussed years ago in asad. Look them up. They are in
the archives.

Not YEARS AGO.....NOW!

They are old news to the regulars in ASAD. Look them up.

Care to addresss...THAT?

Check the archives. (That is what you say, see above for reference).

Very, very strange...silence from Mark Probert.
Nah...like I told you in another thread, MARCH MADNESS! Pre-season
baseball, and, I have some serious work to do on my boat. That is all in
addition to a heavy workload.

Uh huh.

Glad you agree.

And YOU have replied the EVERY article posted about ADHD....In MARCH.....

EXCEPT....this one.....?

Redundancy.

Trying to rip it apart... as is your habit, be in MARCH or any MONTH,
regardless....

Restoring what Mark can not handle...

Chose not to handle. Others did a nice job.