ADHD

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The Draft Australian ADHD Clinical Practice Points are out for public comment until 28 November 2011. (available at http://consultations.nhmrc.gov.au/open_public_consultations/a-d-h-d) Please make the effort to prepare a submission. Common-sense voices concerned about the welfare of children, and not the profit and convenience of adults, need to be heard right now. It is certain the ADHD industry will be very organised and use this opportunity to try and expand their already lucrative markets. They cannot be allowed to dominate this very important process.  My detailed submission follows. Feel free to borrow at will.

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Open letter to Professor Michael Kohn

Dear Professor Michael Kohn,

Despite significant longstanding evidence to the contrary a recent article in the Daily Telegraph stated:

“Westmead Hospital pediatrician Professor Michael Kohn, who has patients under the age of six, said… more evidence had recently come to light which confirmed that children with ADHD had brains that developed slower. Stimulant medication like Ritalin helped brain growth. “Children with ADHD have a lower rate of brain growth and development and they do not reach the same peak of brain growth that children without ADHD do,” Prof Kohn said. “When we give them stimulant medication, scans show a more normal pattern of brain development than would otherwise have occurred.[1]

This letter seeks evidence supporting your claim that giving ‘ADHD’ children stimulants, amphetamines (dexamphetamine) and amphetamine-like drugs (Ritalin, Concerta) aids in ‘brain development’. I am very surprised by this claim as numerous studies have long established that the use of psycho-stimulants by children has regularly resulted in gross malfunctions in the brain, and ‘can cause shrinkage (atrophy) or other permanent physical abnormalities.[2] As this is the opposite of what you are claiming, I would like to have access to any contradictory new evidence and if it is valid help to publicise it. If, however, there is not adequate supporting evidence I would welcome an explanation of why you made this surprising claim.

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by Martin Whitely

In February 2010 a review of information from the Raine Study, a longitudinal study of the health and wellbeing of thousands of Western Australian children, provided the world’s first long term (8 year) data on the safety and efficacy of ADHD stimulants. It provided challenging evidence that amongst children diagnosed with ADHD those ‘medicated’ with stimulants had significantly worse outcomes than those ‘never medicated’. Specifically those ‘ADHD diagnosed and  medicated’ were 10.5 times more likely to be failing school than those ‘ADHD diagnosed and never medicated’. In addition the past use of stimulant medications was associated with permanently raised diastolic blood pressure.

Some of the authors of the ADHD data review (with a history of advocating the use of stimulants) were obviously expecting different results and tried to diminish the significance of its findings and revised their own methodology after results were in. Fortunately a robust committee process lead by a principled chairperson ensured the integrity of the review.

The Raine Study is a unique data source with the potential for further analysis. The ADHD medication review analysed the outcomes for the Raine Study children at age 14. A further six years of data (at ages 17 and  20) has now been collected. Whether this rich data source will be utilised, and who will do the analysis (and can they be trusted), are all questions that are yet to be answered.

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The major theme to emerge from the two day forum was that there is a growing body of evidence that the long term use of ADHD medications by children provides no benefits and poses significant risks to growing minds and bodies. Forum participants were also concerned this evidence is being ignored and that the application of the over-simplified, dumbed down, ‘ADHD’ label denies children appropriate individualised responses to their unique circumstances.

The two top priorities identified by the forum were:

1 – The redevelopment of the draft national guidelines on ADHD by a group of mental health experts without commercial ties to the pharmaceutical industry who will ignore commercially tainted evidence and incorporate the emerging evidence of long term harm into their deliberations. (refer to One Year on From the Release of the National ADHD Guidelines)

2 – Urgent action to address the disproportionate use of psychotropic drugs by children in the care of the state (in either foster or institutional care). There is significant evidence that these often previously abused children are being ‘medicated’ with a range of psychotropic drugs as a substitute for safer, more effective, individualised interventions.

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Martin Whitely MLA – Member for Bassendean

Press Release – Embargoed until Wednesday 17 February 2010

The world’s first long term data review revealed that ADHD diagnosed children who had used stimulants (amphetamine based drugs like dexamphetamine and Ritalin) were 10.5 times more likely to fail to reach an age appropriate educational standard than children diagnosed with ADHD but never medicated.

“This completely destroys the basis of ADHD child drugging. The ADHD industries claim that without medication ADHD children risk academic failure has been shown to be complete BS. It is not just that ADHD drugs don’t improve long term school performance, the evidence is they drag kids down.”

“Parents will be furious they have been conned into giving their children taxpayer subsidised amphetamines. No responsible parent would knowingly increase their child’s chances of academic failure.”

The finding that past stimulant use was associated with sigificantly and permanently increased diastolic blood pressure which increases the risks of future heart attacks and strokes is of even greater concern. “Failing school is bad enough but increasing the risk of an early death from a heart attack or a stroke is something else.”

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Note: all words in italics are direct quotes from the report

Highlights

SignificanceThe longitudinal and comprehensive nature of the Raine study provides a unique opportunity to examine the long-term outcomes associated with the use of stimulant medication during childhood.[1] The 9 year data (ages 5 to 14) available from the Raine study is the only comprehensive educational, social, and health long term data source on the effect of stimulant medication available worldwide.

Permanent cardiovascular damage from medicationThe most noteworthy finding in the study was the association between stimulant medication and diastolic blood pressure. Compared to not receiving medication the consistent use of stimulant medication was associated with a significantly higher diastolic blood pressure (of over 10mmHg) This effect did not appear to be solely attributable to any short-term effects of stimulant medication, as when comparing groups who were currently receiving medication, it was found that those who had consistently received medication at all time points had a significantly higher mean diastolic blood pressure than those who had not consistently received medication in the past (difference of 7mmHg).These findings indicate there may be a lasting longer-term effect of stimulant medication on diastolic blood pressure above and beyond the immediate short-term side-effects.[2]

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In February 2010 Martin Whitely appeared on the 7:30 Report in a report regarding the Raine Study ADHD medication review. To see a full transcript of the debate please see the following link: ADHD medication debate re-ignites.

(The video can be viewed by following the links located on the right hand side of the transcript article)

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