Top 40 misleading, dangerous or just plain stupid claims made about ADHD

Join the search for the Top 40 misleading, dangerous or just plain stupid things ever said or written about ADHD.  If you think you know of any statements likely to qualify make a comment below or email [email protected]

The catalyst for this search was my blog on 21 June 2011 (http://speedupsitstill.com/evidence-support-adhd-expert-prof-kohns-claim-amphetamines-aid-brain-development). In that blog I invited Sydney paediatrician Professor Michael Kohn to justify his claim that ‘stimulant medication, like Ritalin, helped brain growth’ in ADHD children. Unfortunately Professor Kohn never took up my invitation to provide evidence to support his astonishing claim.

Subsequently readers asked me in light of the longstanding evidence that drugs like dexamphetamine and Ritalin impair brain development, was Prof Kohn’s claim is among the most misleading and dangerous assertions about ADHD I have heard? Currently I rank Professor Kohn’s statement at number 5 although his comment at number 10 is also a doosey.

To date the most misleading, dangerous or just plain stupid things I have heard or read include;

1- “This [dexamphetamine] is not addictive stuff. In fact, I wish it was a little more addictive so that my younger patients would remember to take it rather than having to be reminded by their long-suffering parents.” – Perth psychiatrist Dr Roger Paterson[1. Dr Roger Paterson interviewed on Face the Facts, video recording taken from Channel 31 Perth, 27 January 2003]  Unlike Doctor Patterson the manufacturers of dexamphetamine acknowledge the drugs addictive properties. Refer to http://speedupsitstill.com/adhd-amphetamine-addiction-and-abuse

2- “Fidgeting and foot movements (known in our research setting as ‘Wender’s sign’) are very common signs of hyperactivity in adult ADHD patients – so much so that such patients can usually be diagnosed in the waiting room by a knowledgeable receptionist.”– Distinguished Professor of Psychiatry at the University of Utah School of Medicine, Paul Wender.[2. Paul H. Wender, Attention-Deficit Hyperactivity Disorder in Adults, Oxford University Press, New York, 1995, p. 20.]  

3- “A lot of people discovered they had ADHD by accident. For example, truckies who needed uppers to keep them awake while they were driving across the Nullarbor suddenly found that they were driving a whole lot better…when they were taking dexies.” [3. Toner was presumably unaware that driving with non-prescription dexamphetamine is illegal and carries penalties including disqualification from driving, fines and/or imprisonment. Research has found that rather than ‘driving a whole lot better’ people who use dexamphetamine illicitly or for ADHD make more mistakes while driving, probably because the drug causes tunnel vision which stops them seeing peripheral information like red lights. Beata Silber, Katherine Papafotiou et al., ‘The effects of dexamphetamine on simulated driving performance’, Psychopharmacology, 179, 2005, pp. 541–42.] – Michelle Toner then Executive Officer of the pharmaceutical company ADHD support group the Learning and Attentional Disorders Society of WA (LADS).[4. Michelle Toner interviewed on, Face the Facts, video recording taken from Channel 31 Perth, 27 January 2003.]

And another cracker from Michelle Toner in the same TV interview

4- “In order to get a high equivalent to what people are taking [as] street speed, you would have to take close to 200 tablets [of dexamphetamine]. Children take 1 or 6 tablets a day and it is not addictive at all.’’ [5. 200 standard 5mg tablets is a dose of one gram (1,000 mg). GlaxoSmithKline’s Prescribing Information for Dexedrine (a brand of dexamphetamine) states ‘While toxic symptoms occasionally occur as an idiosyncrasy at doses as low as 2mg, they are rare with doses of less than 15mg; 30mg can produce severe reactions, yet doses of 400 to 500mg are not necessarily fatal.’ Available at http://us.gsk.com/products/assets/us_dexedrine.pdf]

5-“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.  When we give them stimulant medication, scans show a more normal pattern of brain development than would otherwise have occurred.” [6. Janet Fife-Yeomans, ‘Rising rate of ADHD drugs for kids like Ritalin’, The Daily Telegraph, 13 June 2011.  Available at http://www.dailytelegraph.com.au/news/rising-rate-of-adhd-drugs-for-kids-like-ritalin/story-e6freuy9-1226073934249]  Westmead Hospital Sydney Paediatrician Professor Michael Kohn who is unfortunately a member of the reference group tasked with developing Australian Clinical Practice Points (clinical guidelines) for the diagnosis and treatment of ADHD. For further details see http://speedupsitstill.com/evidence-support-adhd-expert-prof-kohns-claim-amphetamines-aid-brain-development  

6- “Now we can say with confidence that ADHD is a genetic disease.” Cardiff University Professor of Psychiatry Anita Thapar September 2010.[7. ‘Study finds genetic link to ADHD’ ABC Online News, 30 September 2010 <http://www.abc.net.au/news/stories/2010/09/30/3026236.htm>] [8. Professor Thapar’s statement about her own research was just plain wrong. Her flawed research was given undeserved credibility because it was published in The Lancet. Consequently her inaccurate pronouncements were repeated uncritically around the globe, giving the diagnosis of ADHD undue credence. (for full details see http://speedupsitstill.com/genetic-basis-adhd )] (added 30 June 2011) More detail available at http://speedupsitstill.com/genetic-basis-adhd

7- “Long Term Use – The effectiveness of ADDERALL XR for long-term use, i.e., for more than 3 weeks in children and 4 weeks in adolescents and adults, has not been systematically evaluated in controlled trials.” Quote from Shire Pharmaceuticals  website —  http://pi.shirecontent.com/PI/PDFs/AdderallXR_USA_ENG.PDF (added 30 June 2011)

Comment- This statement is true but obviously extremely worrying given that children are regularly prescribed ADDERALL XR, a long acting form of dexamphetamine, for years on end.

8– “Signs of the disorder may be minimal or absent when the person is receiving frequent rewards for appropriate behaviour, is under close supervision, is in a novel setting, is engaged in especially interesting activities, or is in a one-to-one situation (e.g., the clinician’s office).”  American Psychiatric Association in DSMIV [8. American Psychiatric Association, Diagnostic and Statistical  Manual of Mental Disorders. Fourth Edition, Text Revised (DSM-IV), (American Psychiatric Association: Washington, D.C., 2000): pp86-87] (added 30 June 2011)

Comment- When I was a teacher and doing my job badly every child in the class displayed ADHD behaviours, when I was teaching well none did.

9- “To publish stories that ADHD is a fictitious disorder or merely a conflict between today’s Huckleberry Finns and their caregivers is tantamount to declaring the earth flat, the laws of gravity debatable, and the periodic table in chemistry a fraud.” Professor Russell Barkley and 82 other signatories to the grandiosely titled ‘International Consensus Statement on ADHD’. 2002. [9. Russell A. Barkley, et al., ‘International Consensus Statement on ADHD’, Clinical Child and Family Psychology Review, Vol 5, No. 2, June 2002, p. 89.] (added 30 June 2011)

Comment- “Not only is it completely counter to the spirit and practice of science to cease questioning the validity of ADHD as proposed by the consensus statement, there is an ethical and moral responsibility to do so”. Professor Sami Timimi 2004[10. Sami Timimi, et al., ‘A Critique of the International Consensus Statement on ADHD’, Clinical Child and Family Psychology Review, Vol. 7, No. 1, 2004, p. 59.]

10- “This is the latest in a series of articles BLASPHEMING the use of Ritalin in the treatment of behavioural disturbance in children.” [10. Medicating our children, Reportage Online, 22 December 2009 http://www.reportageonline.com/2009/12/medicating-our-children/ accessed 29 June 2011] Professor Michael Kohn in response to an article in Sydney’s Daily Telegraph detailing extreme reactions to ADHD medications reported to the TGA, such as psychotic episodes and suicidal ideation. [11. We’re turning our children psychotic with ADHD medication, Kate Sikora, The Daily Telegraph October 13, 2009. http://www.dailytelegraph.com.au/lifestyle/body-soul/were-turning-our-children-psychotic/story-e6frf01r-1225786025127] (added 3 July 2011)

11- ‘28.3 % of 10-12 years old Ukranian boys screened had ADHD behaviors.’  This total figure comprised the 3 ADHD subtypes, with ‘9.7% classified as ‘inattentive’, 12.4% as ‘hyperactive-impulsive type’, and 6.2% as ‘combined type.’[14. Kenneth D. Gaddow (et al), ‘Comparison of Attention-Deficit/Hyperactivity Disorder Symptom Subtypes in Ukrainian Schoolchildren’, Journal of the American Academy of Child & Adolescent Psychiatry, 39:12 (December 2000): p.1522]   – A study conducted by a number of researchers including prominent US psychiatrist and recipient of funding from numerous pharmaceutical companies Gabrielle Carlson.[15. Dr Gabrielle Carlson is a paid consultant to Bristol-Myers Squibb, Eli Lilly, Otsuka America Pharmaceutical and Validus Pharmaceuticals.  She has received travel expenses and honorariums from Ortho-McNeil-Janssen Pharmaceuticals and Shire Pharmaceuticals.  Dr Carlson has also received research funding from Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, and Otsuka America Pharmaceutical. American Academy of Child & Adolescent Psychiatry, ‘2010 Psychopharmacology Update Institute’, Disclosures, (2010).  Available at http://www.aacap.org/cs/2010_psychopharmacology_update_institute/disclosures (accessed 20 July 2011)] (added 21 July 2011)

Comment- The research paper stated ‘It is possible that hyperactive-impulsive behaviors are more evident (and problematic) in crowded Ukrainian apartment buildings’. However, rather than finding that the boys needed better social conditions, bigger flats and more space to play the authors concluded that ‘this study provides additional evidence supporting DSM-IV ADHD subtypes as distinct clinical entities’.[16. Kenneth D. Gaddow (et al), ‘Comparison of Attention-Deficit/Hyperactivity Disorder Symptom Subtypes in Ukrainian Schoolchildren’, Journal of the American Academy of Child & Adolescent Psychiatry, 39:12 (December 2000): p.1520]

The statments above are just the tip of the iceberg. There are many even more outrageous statements out there (including the American Psychiatric Association 18 diagnostic criteria for ADHD see http://speedupsitstill.com/dodgy-diagnosis).

Please join the on-going search for the Top 40, most incorrect, inaccurate, misleading, dishonest, dangerous or just plain stupid things every said or written about ADHD. Send details of statements you nominate to [email protected] Please include as much detail as necessary to verify the authenticity of the statement. Your name will not be made public.