| How should one look upon Attention Deficit | | | | children and that 32% of the children involved in the |
| Hyperactivity Disorder (ADHD) and what is the | | | | study were already receiving one or more medications |
| effective way to aid those who are given this | | | | prior to the onset of the study. Of those in the study |
| diagnosis? There has been considerable debate as to | | | | who were the medication management group, they |
| whether or not ADHD is a genuine disorder. | | | | numbered only 144 of which Breggin finds to be |
| Psychiatrist and professor Robert Hedaya (1996, pg. | | | | enormously small.Breggin states that in the ratings of |
| 140) mentions that an examination by Hartmann in 1993 | | | | the children themselves that they noted increased |
| felt that ADHD is actually normal variant of human | | | | anxiety and depression however this was not found to |
| behavior that doesn't fit into cultural norms.In addition, | | | | be a significant factor by the investigators. Breggin also |
| there is no objective test for this disorder. Hedaya | | | | believes that the study was flawed in that drug |
| (1996, pg. 140) mentions that a commonly used test is | | | | treatment continued for 14 months whereas behavioral |
| the TOVA (test of variables of attention), a test | | | | management was utilized for a much shorter duration. |
| where the client must use a computer and hit a target | | | | Breggin argues that the behavioral management |
| at various points. This test is designed to measure the | | | | strategies, which involved mainly a token economy |
| person's response time and distractibility. However, | | | | system, were ineffective as well and did not take into |
| Hedaya (1996, pg. 140) notes, this tool cannot be relied | | | | consideration family dynamics but regardless, the study |
| upon to make or exclude the diagnosis in and of itself. | | | | still showed that there was no difference between the |
| Hedaya (1996, pg. 268) notes that there has been | | | | populations treated with drugs versus those |
| controversy in the use of stimulants for the treatment | | | | undergoing behavioral management solely. Breggin |
| of ADHD, he states, medications alone do not provide | | | | notes that many of the children receiving medications |
| adequate or full treatment in this disorder.Hedaya (1996, | | | | had adverse drug reactions, which consisted of |
| pg. 269) notes that the most serious risk in the use of | | | | depression, irritability, and anxiety. 11.4% reported |
| methylphenidate (Ritalin) for ADHD is that about 1% of | | | | moderate reactions and 2.9% had severe reactions. |
| these children will develop tics and or Tourette's | | | | However, Breggin also states that those reporting the |
| Syndrome. Hedaya asks the question,"One might | | | | adverse drug reactions were not properly trained, but |
| wonder-, why use methylphenidate at all?" Hedaya | | | | were rather only teachers and/or parents.The study, |
| argues that the side effects involved in the use of | | | | as Breggin concludes, showed no improvement in the |
| methylphenidate are mild. However, he notes that side | | | | children treated with medications in the areas of |
| effects include nervousness, increased vulnerability to | | | | academic performance or social skill development. |
| seizures, insomnia, loss of appetite, headache, | | | | Breggin feels that the study was improper in that all of |
| stomachache, and irritability. Hedaya (1996, pg. 271) | | | | the investigators were known to be pro-medication |
| argues that the causation of ADHD lies in problems in | | | | advocates prior to and after the study. Breggin states |
| dopamine regulation in the brain and states that | | | | that Ritalin and other amphetamines have almost |
| stimulants work by stimulating dopamine in the brain | | | | identical adverse reactions and have the potential for |
| and thus the symptoms of ADHD are | | | | creating behavioral issues as well as psychosis and |
| lessened.However, previously Hedaya states that | | | | mania in some individuals. Breggin argues that these |
| Zametkin (1995) noted that stimulants have the same | | | | medications often cause the very behaviors they are |
| effect in both those diagnosed as ADHD and those | | | | intended to treat. He notes that children treated with |
| who are not (Hedaya, 1996, pg. 139). Dr. William Carey | | | | these medications often become robotic and lethargic |
| of the Children's Hospital of Philadelphia commented at | | | | and that permanent neurological tics can result.In his |
| the National Institutes of Mental Health Consensus | | | | textbook, Attention Deficit Hyperactivity Disorder, |
| Conference in 1998 that the behaviors exhibited by | | | | Russell Barkley, an advocate for the use of |
| those considered ADHD were normal behavioral | | | | methylphenidate in the treatment of ADHD, notes that |
| variations. A Multimodal Treatment Study was | | | | there is little improvement in academic performance |
| conducted by the National Institutes of Mental Health in | | | | with the short-term use of psychostimulant medication. |
| 1999 in regards to ADHD. Psychiatrist Peter Breggin | | | | Barkley also acknowledges that the stimulant |
| and the members of the International Center for the | | | | medications can affect growth hormone but at |
| Study of Psychiatry and Psychology challenged the | | | | present there is not any knowledge of the long-term |
| outcomes of this study because it was not a placebo | | | | effects on the hypothalamic-pituitary growth hormones. |
| controlled double blind study. Breggin also argues that | | | | Barkley (1995, pg. 122) also states, at present there are |
| that the analysis conducted of behaviors in the | | | | no lab tests or measures that are of value in making a |
| classroom of those children studied showed no | | | | diagnosis of ADHD.Dr. Sidney Walker, III, (1998, pg. 25) a |
| significant differences between those children receiving | | | | late board-certified neuropsychiatrist comments that a |
| stimulant medications versus those who only were | | | | large number of children do not respond to Ritalin |
| utilizing a behavioral management program (MTA | | | | treatment, or they respond by becoming sick, |
| Cooperative Group, 1999a, pg. 1074). Breggin notes that | | | | depressed, or worse. |
| there was no control group in the study of untreated | | | | |