Health Experts Warn of Antidepressant Dangers for Children, Teens

CBN News ^ | 02.18.04

[Coleus]

Depressed? Consider Fish Oil

New research has found that people with depression who received a daily dose of 1 gram of an omega-3 fatty acid for 12 weeks experienced a decrease in their symptoms, such as sadness, anxiety and sleeping problems.

The only side effect of the treatment appeared to be mild gastrointestinal problems.
All the patients had already tried medications before enrolling in the study, including selective serotonin reuptake inhibitors (SSRIs) such as Zoloft or Prozac, or medications from an older family of drugs called tricyclic antidepressants. All the aforementioned drugs are considered standard treatments of depression.

Previous researchers have suggested that the balance of omega-3 fatty acids in the brain may become skewed in people with depression, and earlier studies have shown that fish oil supplements can help alleviate the symptoms of schizophrenia and bipolar disorder, or manic depression.

But depression isn't the only disease that may be affected by a person's levels of omega-3 fatty acids. Researchers have found that those who have been diagnosed with cardiovascular disease and other conditions associated with depression, have low levels of omega-3 fatty acids in their blood.

The study included 70 depressed patients who took a daily dose of one to 4 grams of EPA or an inactive drug. The treatment lasted 12 weeks.

The doses were either 1 gram, 2 grams or 4 grams of EPA. Those who took 1 gram experienced improvements akin to those given the inactive drug, in all the measurable aspects of depression, including sadness, anxiety, low sexual drive and suicidal tendencies.

There was a significant improvement of those patients who took 1 gram of EPA daily: 69 percent of the patients achieved a 50 percent reduction in their symptoms, in contrast to those who took the inactive drug, where 25 percent of the patients saw improvement.

The higher-dosage groups saw similar improvements, but no higher improvement than those who took the 1 gram daily dose. The study's authors surmise that this result may have had to do with the fact that a small amount of people took the 2 or 4 grams per day. They advised further trials to determine the efficacy of higher doses of EPA in treatment of depression.

Archives of General Psychiatry October 2002; 59: 913-919

[Coleus]

Rude awakening: Poll finds kids severely lacking sleep

Tuesday, March 30, 2004BY ANGELA STEWART Star-Ledger Staff

America's children are significantly sleep-deprived and most of them wake up frequently at night, much to the dismay of their weary parents, a new poll out today shows.

The National Sleep Foundation's seventh annual Sleep in America poll is the first to focus on children. It shows that two-thirds of all children -- 69 percent -- experience one or more sleep problems at least a few times a week. Among the common problems noted are resisting going to bed, difficulty falling asleep, waking up, snoring and breathing difficulties.

Children in every age group are not meeting even the low end of experts' sleep recommendations, the poll found. And parents aren't as aware of the problem as they should be, the group said.

"It's a widespread problem. This study shows that we really don't think sleep is an important thing or we are not quite sure what to do about it," said Lauren Broch, a spokeswoman for the nonprofit Sleep Foundation in Washington, D.C., and associate director of the sleep center at Good Samaritan Hospital in Suffern, N.Y.

Alan Backman, co-director of the Sleep Diagnostics Laboratory at Deborah Heart and Lung Center in Browns Mills, said he is convinced that many children who have ended up with the diagnosis of Attention Deficit Disorder and Attention Deficit Hyperactivity Disorder are really suffering from sleep deprivation or sleep fragmentation.

"The numbers are frightening. We already have a sleep-deprived population. For kids to suffer like this places them at a severe disadvantage in terms of their academic achievements and otherwise," he said.

The poll, based on a random telephone survey of 1,473 adults with a child 10 or younger in their household, also found that:

• Nearly one-third of children 10 and younger wake up at least once a night needing attention, including 14 percent of school-age children.
• Parents of infants are awakened an average of four nights a week, resulting in the loss of more than 200 hours of sleep during the child's first year.
• About three of every four parents say they would change something about their child's sleep if they could.
• About one-quarter of infants, toddlers and pre-schoolers appear sleepy or overtired during the day, according to their parents.
• Many doctors, 52 percent, don't ask about a child's sleep habits.
• For older children, caffeine consumption and a television in the bedroom were identified as major sleep disrupters.

Broch said lifestyle issues such as children and parents having overly-booked schedules and eating out more often result in later bedtimes than in prior generations.

Even on weekends, children are not catching up on their sleep, the poll found. In fact, about one-quarter of pre-school and school-age children actually sleep less on weekends than on weekdays.

"It's not just on the parents, it's in the community, it's in the after-school activities and play dates. Everything can start piling on top of each other. The process of naturally winding down and going to sleep doesn't happen until much later," she said.

Indeed, many sleep problems in children arise from a failure on the part of parents to establish routines early in life that allow the child to fall asleep at a reasonable hour, said Kendall Sprott, director of community pediatrics at Children's Hospital of New Jersey at Newark Beth Israel Medical Center. Parents also can unknowingly reinforce undesirable behaviors by playing with children or giving them food when they wake up in the middle of the night.

"I have found a lot of parents would rather continue the pattern of having their sleep interrupted than trying to get the child to change their patterns because it might be met with resistance like crying," he said.

Sometimes, children's sleep problems can be so serious that they require the attention of sleep specialists. For 8-year-old Dean Falkinburg of Barnegat, the sleep-walking that started about a year ago was really the first sign of a sleep disorder. When his mother, Vickie, 38, began to pay closer attention, she noticed her son would also stop breathing for what seemed like minutes at a time, ultimately ending up gasping for air, a condition known as sleep apnea. It was often accompanied by heavy snoring.

"I didn't even remember anything about getting up. It's a little scary for me because I would go down the stairs and I could have tripped," said Dean, an articulate second-grader, who is now being treated for his sleep problems at Deborah.

When it comes to most sleep issues in children, however, parents would be amazed to learn how much power they have to affect change themselves, said Ashish Shah. A pediatric pulmonologist, Shah oversees the pediatric sleep laboratory at Morristown Memorial Hospital. When parents bring a sick child into their bed, for instance, the child begins to expect more of the same, even when he or she returns to health, Shah said.

"Common sense is the rule," he said.

Angela Stewart writes about health care. She can be reached at astewart@starledger.com  or (973) 392-4178.

[Coleus]

Check your local listings for airtimes.

(Current show is updated every weekday at 5pm EST.)

DEPRESSION

Five Years Gone: Anti-Depressants May Hold Key to Columbine

By Gailon Totheroh
CBN News Science & Medical Reporter

April 20, 2004

The FDA estimates that sales of anti-depressant drugs in the United States increased from 14 million prescriptions in 1992 to 157 million in 2002.

CBN.com – (CBN News) - Five years ago, two boys plotted and carried out what would become the nation's deadliest school shooting. Today, questions still remain as to why Columbine happened.

Some experts say prescription drugs are a main factor. Anti-depressants that are supposed to help people cope with depression may have played a role in triggering a Columbine killer.

April 20, 1999, is a day Mark Taylor will never forget. That was the day Mark was hit by more than a dozen rounds fired by gunman Eric Harris at Columbine High School. Taylor just barely survived the rampage in which Harris and fellow student Dylan Klebold carried out the nation's deadliest school shooting, killing 12 students and a teacher, before shooting themselves.

Taylor said, "I think of it every single day."

Five years later, questions remain as to why they did it. Taylor's convinced it has to do with anti-depressants called SSRI's, short for the scientific name, Selective Serotonin Reuptake Inhibitors.

Harris was on one of them. Autopsy reports show he had the anti-depressant Luvox in his system at the time of the Columbine shootings. Harris had been taking the drug since early 1998. And just three months before the Columbine killings, his dose was doubled.

Taylor thinks Luvox triggered Harris' attack on Columbine, and is now on a crusade to ban it and others like it.

SSRI anti-depressants hit the headlines in March, when the Food and Drug Administration issued a health advisory on 10 popular types. With more than 150 million prescriptions written in the U.S. alone, the names are quite familiar: Prozac, Paxil, Zoloft, Effexor, Celexa, Remeron, Lexapro, Luvox, Serzone and Wellbutrin.

But the FDA is now concerned about clinical trials, where some patients taking the drugs demonstrated increased hostility and more suicidal thoughts.

Dr. Ann Tracey, the director of the International Coalition for Drug Awareness, says, "I think these drugs are far too deadly to remain on the market." She says the way SSRI's work makes them deadly: they regulate a chemical in the brain called Serotonin, a neurotransmitter that plays a role in mood and behavior.

Infamous crimes have been committed by people on SSRI's. Andrea Yates, convicted of killing her children in Texas, was on Effexor. Nineteen-year-old Corey Baadsgaard had just increased his dose of the SSRI Zoloft when he walked into his high school carrying a loaded rifle.

Baadsgaard said, "I was getting pretty low, like rock bottom. You know? Suicide was the constant thought I was having."

In early February, FDA advisors discussed concerns about the unknown effects of the drugs on children and the fear that some antidepressants may increase suicidal tendencies. Advisors told the FDA that the use of antidepressants by children and teenagers is skyrocketing, despite lack of evidence that they alleviate depression and for some, may even make it worse. FDA officials responded by asking manufacturers to place bolder warning labels on the drugs.

Dr. Aradhana Sood is a leading researcher on the effects of SSRI's and other mood-altering medications on children. She is the chairman of Child and Adolescent Psychiatry at Virginia Commonwealth University, and Medical Director for the Virginia Treatment Center for Children in Richmond, Virginia.

Dr. Sood said, "I feel that we have known for at least a decade that SSRI's do cause what is called a hypo-manic disenhibition, meaning in certain children they will produce a heightened sense of impulsiveness."

But unlike Taylor, Dr. Sood says the problem is not the medication, but the physicians prescribing them.

"There is a wide variety of people who are, and I don't want to be patronizing, but who are not trained adequately in child psychiatry," said Dr. Sood, "who are now prescribing anti-depressants a great deal and who do not realize the risk that that carries. They might think that because the child is getting more irritable, the depression is increasing, so they increase the medication, which makes it even worse."

In 2002, the FDA estimates that doctors wrote a record number of anti-depressant prescriptions for children under 18, about 11 million. Nearly three million of those prescriptions were for children 11 and under. Overall, the FDA estimates that sales of anti-depressant drugs in the United States increased from 14 million prescriptions in 1992 to 157 million in 2002.

Dr. Tracey said, "I find more that doctors are actually encouraging and pushing, putting lots of pressure on parents to medicate their children."

The government has been reviewing the safety of antidepressants since last summer. The FDA's counterpart in Britain first sounded the alarm last year, when it banned all SSRI's except Prozac for patients under 18.

Taylor says he hopes the U.S. will eventually do the same. But until then, he will be working toward that goal. "This is a mission that I can't stop," he said. "I want to stop it. I mean, I want to get on with my own life, but it's just too important."

And while Dr. Sood believes the drugs work in helping children overcome major depressive disorders, she does take the decision to place a child on antidepressants seriously.

Sood said, "The decision to be put on medication is a very important one. It's what's going to effect their life for a long period of time, because this isn't an antibiotic."

Until the questions about SSRI's are settled, FDA officials say parents with kids who are taking them need to watch for symptoms of agitation, anxiety and hostility, signs that their children may be heading for trouble.

[Coleus]

Herbs, drugs and severe depression

Depression drugs tied to teen suicide

Moody kids -- normal or not? For some children, bipolar disorder could be the culprit

FDA probed on antidepressants, suicide link

Antidepressant use in children rising More research needed to determine safety, effectiveness

[Coleus]

Study confirms link between antidepressants and suicide

Drugs much riskier for kids than what was once thought, scientists say

Friday, April 23, 2004

BY ED SILVERMAN

Star-Ledger Staff

For the first time, a study has compared previously undisclosed data about four antidepressants with published medical findings, and found the drugs pose a risk to children.

The results are the latest confirmation that several popular medicines used to treat children for depression are riskier than previously known and may lead to suicide. The study appears in the latest edition of The Lancet, the British medical journal.

After reviewing the data, researchers wrote the risk of children taking Paxil, Zoloft, Celexa and Effexor outweighed the benefits.

For instance, an unpublished Effexor study by Wyeth, its manufacturer, revealed 14 suicidal events, compared with just one in a published study. And published data on Zoloft by Pfizer omitted information showing twice as many suicidal events, according to a scientist who helped conduct the Lancet study.

"These drugs appear not to be any better than placebo," said Tim Kendall of the National Collaborating Centre for Mental Health in London, who co-authored the study at the request of U.K. medical authorities. "And there might well be an increased risk of suicide."

A spokesman for Wyeth said Effexor should never be prescribed to children. Spokespeople for Glaxo, which markets Paxil, and Pfizer didn't return calls seeking comment. Forest Labs, which makes Celexa, couldn't be reached.

The study appears amid a widening controversy over antidepressants that has engulfed the Food and Drug Administration, several of the world's biggest drug makers and a growing number of families around the country that want the use of these medicines restricted.

The controversy, however, is not straightforward.

Many doctors and their patients argue antidepressants save lives. And though an increasing number of children are prescribed antidepressants, only Prozac was ever approved for children in the United States. The growth reflects off-label usage, a common practice among doctors to write prescriptions even though regulators have not approved a medicine for a specific use.

Nonetheless, the issue has prompted congressional investigations that are attempting to shine a spotlight on the FDA's internal review procedures. It has opened a debate over access to unpublished clinical-trial data, which may include unflattering information about a drug.

"The story of research into antidepressant use in childhood depression is one of confusion, manipulation and institutional failure," The Lancet wrote in an editorial accompanying the study.

The unpublished clinical trial data was first disclosed last year after U.K. medical authorities demanded the information from drug makers. Consumer advocates say the risks found in that data underscore the need to have access to such information.

"Doctors have been getting false information," said Vera Sherav of the Alliance for Human Research Protection in New York. "And when you have misinformation about the safety and benefits of a medical treatment, you're putting people at risk."

Last month, the FDA asked drug makers to place warnings on labels that the pills may cause suicidal thoughts. But the agency was criticized by politicians and families for failing to follow the lead of British medical authorities, who urged doctors not to prescribe the drugs to children.

The agency has also been accused of muzzling one of its own medical reviewers, who wants to restrict the use of antidepressants in children, but was prevented from making his recommendation at a meeting two months ago. Last week, the FDA, which has asked Columbia University to analyze all clinical trial data, denied the charges.

One New Jersey parent yesterday said the Lancet findings were eye-opening.

"This tells a completely different story and I'm happy this was done," said Laurie Yorke of Clark, whose son twice attempted suicide while on Paxil. "Parents want to be given information they need. If you're not told a risk is there, you're not going to look for it."

Selective serotonin reuptake inhibitors in childhood depression: systematic review of published versus unpublished data

	Selective serotonin reuptake inhibitors in childhood depression: systematic review of published versus unpublished data
	Craig J Whittington, Tim Kendall, Peter Fonagy, David Cottrell, Andrew Cotgrove, Ellen Boddington
		[PDF]
	Volume 363 Issue 9418 Page 1341

[ActionNewsBill]

Yet, marijuana remains illegal.

[Coleus]

Related articles

18.04.2004: Why millions of women are hooked on the happy pills
15.04.2004: Pills 'help most women beat blues'
30.03.2004: Doctors 'forced' to overprescribe antidepressants
24.03.2004: US acts on drug suicide warning
14.03.2004: Drugs watchdog 'ignored dangers'
13.03.2004: Leader: Regulation of drugs
13.03.2004: Drug safety agency accused of cover-up
13.03.2004: The riddle of the drug regulators
03.02.2004: Company 'held back' data on drug for children
26.03.2003: Drug review halted over company links

The Truth Seeker - Pescription Drugs and Murder

Despite the lack of any scientific basis for this alleged psychiatric malady, children are being drugged by the millions with this cocaine-like substance even though Ritalin's manufacturer warns that “...frank psychotic episodes can occur with abusive use” and psychiatry's Diagnostic & Statistical Manual for Mental Disorders (the DSM) states that the major complication of Ritalin withdrawal is suicide!

STUDENTS, PRESCRIPTION DRUGS,& MURDER

1.On May 25, 1997, 18-year-old Jeremy Strohmeyer raped & murdered a 7-year-old African American girl in Las Vegas, Nevada. Strohmeyer had been diagnosed with ADD & prescribed Dexedrine, a Ritalin-like drug, immediately prior to the killing.

2.On October 1st, 1997, in Pearl Mississippi, 16-year-old Luke Woodham stabbed his mother, 50-year-old Mary Woodam, to death & then went to his high school where he shot 9 people - killing 2 teenage girls & wounding 7 others. Published reports say he was on Prozac.

3.Exactly 2 months later on Dec 1, 1997, Michael Carneal, a 14 year-old, opened fire on students at a high school prayer meeting in West Paducah, Kentucky. Three teenagers were killed, five others were wounded, one of whom was paralyzed. Carneal was reportedly on Ritalin.

4.Then in February, 1998 a young man in Huntsville, Alabama, while on Ritalin went psychotic - chopping up his parents with an ax & also killing one sibling & almost murdering another.

5.On March 24, 1998 in Jonesboro, Arkansas, 11-year-old Andrew Golden & 14-year-old Mitchell Johnson shot 15 people killing four students, one teacher, & wounding 10 others. According to one report, the boys were believed to be on Ritalin.

6.2 months later another grisly school massacre occurred. On May 21, 1998 15-year-old Kip Kinkel of Springfield, Oregon murdered his parents & proceeded to his high school where he went on a rampage killing two students & wounding 22 others. Kinkel had been prescribed both Prozac & Ritalin.

7.On April 16th, 1999, 15-year-old Shawn Cooper of Notus, Idaho took a 12-guage shot gun to school & started firing, injuring one student & holding the school hostage for about 20 minutes. Terrified students ran for their lives, some barricading themselves in classrooms. Cooper had been taking Ritalin when he fired the shotgun's rounds.

8.The incident in Idaho did not make the national press (no one, thank G-d, was killed). But all that changed four days later when 18-year-old Eric Harris killed 12 students & a teacher at Columbine High School before killing himself. Harris was on one of the SSRI anti-depressants called Luvox.

9.One month later to the day, on May 20th of this year TJ Solomon, a 15-year-old high school student in Conyers, Georgia, while on Ritalin opened fire on & wounded 6 of his classmates. Thankfully, none were killed.

10.Then there's 14-year-old Rod Mathews who had been prescribed Ritalin since the 3rd grade & beat a classmate to death with a bat. And 19-year-old James Wilson who had been on psychiatric drugs for 5 years & took a .22 caliber revolver into an elementary school in Greenwood, South Carolina killing 2 young girls, & wounding 7 other children & 2 teachers!

Testimony of Bruce Wiseman  Why Did They Do It?  The Perils of Prozac - Part II

Dr. Mary Ann Block, DO Medical Director of The Block Center

Expert Opinion Regarding SSRIs and Violence

[Coleus]

Drug Companies “Fudge” Data Concerning Antidepressants And Children

By Greg Arnold, February 24, 2004, Abstracted from “Antidepressant Makers Withhold Data on Children” in the Washington Post, January 29, 2004.

Starting in 1984, the Journal of the American Medical Association was the first journal to require authors of original research articles to disclose any financial ties with companies that make products discussed in papers submitted.¹ Although it was not thought to be a serious issue, the ubiquitous infiltration of the drug companies into the medical community have raised questions about tainted results in studies funded by drug companies.

Finding editors with no financial ties to companies, in order to provide an objective view of the article, has become so problematic that prominent journals are starting to have difficulty in getting objective reviews for papers.^(1,2) Frequently, drug companies will allow researchers to publish only data that is favorable toward the product in question. Makers of popular antidepressants such as Paxil, Zoloft and Effexor have refused to disclose the details of most clinical trials involving children taking these drugs.

With an estimated one percent of children in the United States suffering from depression each year, 57 percent are on antidepressants. Researchers have found that the unpublished studies hide the fact that most antidepressant drugs have little to no affect on the children who take them. Most of the studies’ outcomes have turned out with negative results and these are the ones that doctors and parents do not have access to.

For example, GlaxoSmithKine, makers of the antidepressant Paxil, conducted three trials on children taking the drug. Although each of the three studies showed negative results, only one was published. Pfizer, makers of Zoloft, sponsored two trials in children. Although one trial had a negative result, Pfizer pooled the negative results with a positive study and only published the combined result, which was positive.

Scientists believe the only way to ensure that science is conducted in the public interest is for it to be funded with public dollars, as opposed to pharmaceutical industry dollars.

References:

¹ Angell M. Academic Medicine For Sale? The New England Journal of Medicine 2000; 342: 1516-1518

² Scott J. Treatment of chronic depression. New England Journal of Medicine 2000; 342: 1518-1520

[Coleus]

We Are Drugging Our Youth Twice as Much

According to a U.S. study, spending on stimulants and other psychiatric medications being used to treat young people with hyperactivity and depression have increased significantly.

Characteristics of the study include:

• In a group of children studied between the years of 2000 and 2003, there was a 77 percent increase on the spending of behavioral medications.
• Prescription information was reviewed for 300,000 U.S. youth aged 19 and younger
• Spending on behavioral medications jumped to $6.4 million in 2003--up from $3.6 million in 2000.
• Around 5 percent of the participants in the study took at least one type of behavioral drug.
• The study also found that since 2000 there has been a 142 percent increase in the treatment of autism and other so-called “behavior disorders.”

Supporters of these psychiatric medications believed the increase was due to better access to health care and therefore a higher number of diagnoses. Critics, on the other hand, disagreed and claimed that society had become too dependent on finding a quick fix and overmedicating youth was not the solution.

Research has revealed that the biggest increase was in the amount of money spent on medications to treat attention deficit hyperactivity disorder, or ADHD, particularly among very young children. It was also discovered that hyperactivity drug spending for all children and teenagers has increased by 183 percent, and 369 percent in children ages 4 and younger.

Yahoo! News May 17, 2004

Spending Grows to Treat Youth Behavior

Mon May 17,12:06 AM ET

Add Health - Reuters to My Yahoo!

WASHINGTON (Reuters) - Spending on stimulants and other psychiatric drugs to treat young people with conditions ranging from hyperactivity to depression is increasing strongly, a new U.S. study issued on Monday showed.

There was a 77 percent increase in spending on behavioral medications between 2000 and 2003 in a group of children studied by pharmacy benefits manager Medco Health Solutions.

Medco, which helps companies and other groups provide drug coverage, reviewed prescription information for 300,000 U.S. youths aged 19 and younger to compile its report.

For the study group, spending on behavioral medications rose to $6.4 million in 2003 from $3.6 million in 2000.

The use of psychiatric medication in children is a controversial but growing trend.

While some advocates say the increase results from better access to health care and more diagnoses, critics say children and teens are being overmedicated in a society too reliant on a quick fix.

About 5 percent of children in Medco's study took one or more behavioral drugs, Medco Chief Medical Officer Robert Epstein said.

While it was good for children to seek treatment, "you always have to wonder, does every child need to be treated with a prescription medication," Epstein said in an interview.

Money spent on attention deficit hyperactivity disorder, or ADHD, medicine saw the biggest increase over the three years -- especially among very young children.

While hyperactivity drug spending for all children and teen-agers rose 183 percent, it nearly quadrupled -- rising 369 percent -- in those 4 and younger, the Medco study said.

Most ADHD drugs are approved by the Food and Drug Administration (news - web sites) for use in patients 6 and older. A few are approved for those 3 and older.

Both more expensive new treatments and increased use are driving up costs, Epstein added. "It was a mixture of both," he said.

The Medco study also found 142 percent more was spent since 2000 to treat autism and so-called "conduct disorders."

Antidepressant spending also grew but not as much, up 25 percent. Epstein said new generic versions of popular antidepressants like Eli Lilly's Prozac helped lower costs.

[Coleus]

Now They Want to Give Antipsychotic Drugs to "Disruptive" Kids

Researchers have reported that the antipsychotic drug Risperdal (risperidone) seemed to be a safe and effective long-term solution for decreasing disruptive behaviors of “below-average children.” A study was conducted to determine if risperidone was an effective long-term treatment of children who possessed lower IQs and displayed severe disruptive behavior problems.

The study involved the evaluation of 107 children, aged 5 to 12 years old, with severe disruptive behaviors and lower IQs. Each of the children was given 0.02 to 0.06mg of risperidone a day.

Some of the most common side effects from the drug included mild to moderate sleepiness, headache, runny nose and weight gain.

Results of the study showed significant improvement of disruptive behavior problems after the first few weeks of the study and then continued improvement for the remainder of the study. Restlessness, muscle spasms and changes in cognitive function were not found to be common symptoms in the study.

Based on these findings, researchers recommended further studies to assess the effectiveness and safety of risperidone for more than a one-year period.

American Journal of Psychiatry April 2004;161(4):677-84

[Coleus]

How Could Drug Companies be so Evil?

According to the first comprehensive scientific review to include all available studies, including negative data that have long been withheld from public scrutiny by the pharmaceutical industry, four popular antidepressants being used to treat thousands of depressed American children are unsafe, ineffective or both. Those antidepressants are:

• Paxil
• Zoloft
• Effexor
• Celexa

This is damning evidence of the drug companies' patent disregard for the safety of humans and focus on profits. GlaxoSmithKline was found to be concealing evidence that shows that these drugs do not benefit children in any way and only increase their risk of killing themselves. This was confirmed in an article in the Canadian Medical Journal.

Fortunately, the British medical journals are far more responsive than the American ones. The Lancet’s editorial states:

• Research on SSRIs in children is marked by confusion, manipulation, and institutional failure.
• In a global medical culture where evidence-based practice is seen as the gold standard for care, these failings are a disaster.
• How confident is society that similar failings will not occur on a larger scale in the future?
• Changes are required at every level of the global health-care infrastructure
• Despite these findings, the FDA continues to support these worthless antidepressants by claiming the failed trials don’t necessarily mean the drugs are ineffective. Data has also confirmed that taking SSRIs weren’t any better for you than taking a placebo.

Folks, if this doesn't make you fighting mad, what will?

Just sit down and think about it for a moment. Drug companies do the research and learn that the drugs don't work, yet are willing to sell and market them to children even when it is clear that they are causing many children to commit suicide.

Unpublished studies of venlafaxine suggested the drug increased suicide-related events such as suicidal thoughts or attempts by 14 times compared with placebo. This is reprehensible and despicable behavior equivalent to any third-world dictator.

How can anyone possibly support this approach?

Rather than risking the potentially deadly side effects of these drugs, I recommend the following three steps.

• Omega-3 oils, specifically fish oil, is probably the single most important nutrient for a child with depression to take.

• Next they should only drink water as their beverage, taking care to avoid fruit juices, soda and milk.

• Restrict sugars and grains, which cause insulin levels to be elevated.

Popping pills is rarely the answer to helping children suffering from depression; it is only a temporary Band-Aid. In order to truly help these children, we need to focus on finding the underlying cause of the problem, then search for ways to treat it.

[Coleus]

I've noticed many children born in the iron curtain have that disorder, mainly those in orphanages in Romainia and Russia.

[Coleus]

Parents hope diet might help kids' behavior

May. 28, 2004 07:30 PM

CHICAGO - Madalyn Berner of Wheaton, Ill., once routinely described her son Richie as "hyper, impulsive and distracted." By age 6, he had developed a tic and had begun hitting himself, screaming at high pitches and compulsively washing his hands.

Doctors diagnosed the troubled boy with attention deficit and hyperactivity disorder and prescribed medication. When Richie began to hear voices, Berner abruptly changed course.

Instead of switching drugs, Berner dropped them altogether and revamped her son's diet, eliminating wheat and dairy products. Without wheat, she said, his hyperactivity vanished. Without dairy, he could suddenly read. His rashes and constipation also disappeared.

Nutritional interventions offer threads of hope for some parents with children battling neurological development disorders such as autism, Asperger's syndrome and related problems - called autism spectrum disorders, which some physicians now say can include ADHD.

There is no known cause for these behaviors, which are often characterized by abnormal language, ritualistic or compulsive actions and an inability to develop normal social relationships. There is no cure. Autism rates, meanwhile, appear to be skyrocketing, though current U.S. statistics aren't available from the Centers for Disease Control and Prevention. In the-mid-1980s, two studies found autism in 1 to 3 per 10,000 U.S. children. Studies abroad suggest it's actually 1 per 1,000 children or higher.

Dietary changes are far from a cure and eyed skeptically by the mainstream medical community because the scientific evidence is still shaky. Often, removing certain foods has absolutely no effect on children.

But if there's any chance it can make a difference, there's no harm in trying. Meanwhile, parents who have witnessed changes in their children tell powerful, intoxicating success stories.

"You won't see it espoused in main pediatric journals," said Dr. Sandy Newmark, director of the Pediatric Center for Integrative Medicine in Tucson, which specializes in ADHD and autism. "But there is a whole community out there looking at diet."

This underground community assembled recently in Chicago for the Autism One Conference, one-stop shopping for parents and professionals in search of medical, legal and alternative information on autism spectrum disorders. The conference (www.autismone.org) featured several presentations that focused on diet sensitivities and environmental factors such as chemicals and metals in a child's system.

Laura Cellini of Springfield, Ill., talked about what helped her 5-year-old son, Jonathan, who developed normally his first year but lost his language skills and became severely autistic. When wheat, dairy, soy, corn, caffeine and foods with artificial colors were eliminated, Jonathan's symptoms improved. Whenever he does eat a forbidden food, he regresses almost immediately, Cellini said.

"I won't deny it's difficult and expensive," said Cellini, part of a diet sensitivity panel led by Dr. Alan Bain, director of the Center for Integrative Health Care in Chicago and Deerfield. "But we wouldn't be doing this if it didn't work. Of all the things we've done, (dietary changes) have been the most beneficial."

Conventional medicine considers autism a neuro-developmental disease. Treatment methods include speech, physical and occupational therapy, and anti-psychotic drugs.

The alternative viewpoint also believes autism might have a genetic predisposition but also can be triggered by environmental influences, including toxins, infectious agents and immunizations. The symptoms are a result of metabolic imbalances, gastrointestinal abnormalities, autoimmune and allergic problems as well as nutritional deficiencies.

Cleaning up the gut and removing allergens are key alternative treatment methods. Doctors might also use heavy doses of vitamin supplementation, probiotics to balance the internal flora and Omega 3 fatty acids.

In Berner's case, the treatments - cobbled together from three health practitioners, including a chiropractor - dramatically changed her son's life. Today, Richie Berner, 8, not only is functioning in a normal classroom setting, but also is one of the best rebounders on his YMCA basketball team, a team sport he previously couldn't play.

Barb Valentin, his Sunday school teacher at St. Michael School in Wheaton, was astonished to learn he'd once had behavioral problems and called him "bright, alert and involved in class."

[Coleus]

Depression pills: Do they kill or cure?

Sunday, June 20, 2004

BY ED SILVERMAN

Star-Ledger Staff

Only hours before Stephanie Fritz hanged herself last November, she was sitting at the dinner table with her family in Tinton Falls, excitedly discussing an upcoming vacation and a concert at the Stone Pony in Asbury Park. The 15-year-old high school sophomore, a member of the swim and tennis teams at Red Bank Catholic, had been taking Zoloft, a widely used antidepressant, for four months. On this day, her last, she seemed upbeat.

Stephanie's father, Scott, blames the medication for his daughter's fatal mood swing. "The drug companies say kids get depressed and that suicide is a byproduct of the illness," he said. "But no one knows how these drugs work. And I think there's a definite connection."

Fritz's suspicions are at the heart of a growing controversy over a popular group of medicines that also includes Prozac, Effexor and Paxil. Researchers, who do not fully understand the effect of antidepressants on the brain, have thus far failed to prove a link between the drugs and suicidal behavior.

Going forward, the effort to establish any such link may be hampered as much by ethical dilemmas as by scientific quandaries. Researchers have access to data on suicide (30,622 deaths in the United States in 2001, with 1,611 victims between ages 15 and 19), and to rough estimates of antidepressant use (up 9.2 percent each year from 1998 to 2002, according to the pharmacy benefit manager Express Scripts Inc.). But, ethically speaking, should anyone run a study designed specifically to determine if a drug might kill a kid?

"I'm not sure these questions really can be answered. We can only look at associations," said Aidan Stokes, a psychiatrist and member of the Canadian government advisory panel that has warned against prescribing the drugs to children and adults. "But I think the apprehension has to be addressed."

The issue has engulfed regulators, doctors and lawmakers, and has turned a light on the often-ignored world of unpublished clinical trials. Drug companies argue strenuously that their trials -- published or unpublished -- have not produced any suicides. But last week, the American Medical Association called for the creation of a public registry for all trials, out of concern that negative data is suppressed by drug makers.

"Studies with positive findings are more likely to be published than studies with negative or null results," says Joseph Heyman, an AMA trustee. "We are concerned that this pattern of publication distorts the medical literature."

The debate over antidepressants and suicidal behavior, which surfaced a decade ago after Prozac was approved by regulators, resurfaced last year when medical authorities in Britain issued warnings about prescribing the drugs, especially to anyone under 18. In the United States, only Prozac is approved for use in patients under 18, but other antidepressants are commonly prescribed -- and some experts have voiced concern that children are especially susceptible to the effects of the drugs.

Under growing pressure, the Food and Drug Administration held a meeting earlier this year to explore the issue. Fritz and many other parents whose children attempted or committed suicide while on an antidepressant testified that the drugs should be restricted or banned.

The agency, which is being investigated by a congressional committee for allegedly muzzling one of its own medical reviewers at that meeting, did not reach a conclusion. Two months later, however, the FDA did tell drug makers to strengthen warnings on product labels.

Meanwhile, the FDA commissioned Columbia University researchers to review reports on side effects and clinical trial data from drug companies. The results are due this summer, but there are no guarantees this undertaking will yield anything conclusive. And even if it does find links to suicide, the FDA appears unlikely to withdraw any of the antidepressants.

"I don't want to rule out any possibility, but it's very difficult to imagine these drugs would be withdrawn. They've all been very effective in adults," said Russell Katz, who heads the FDA's division of neuropharmacologic drug products. "But is it possible we won't have a definitive decision? Yes, that's absolutely possible."

One reason is that each drug company's clinical trials describe suicidal behavior differently. A key challenge for the Columbia researchers is to scour the data and distinguish between patients who made a serious attempt at suicide and patients who harmed themselves only minimally.

Given the difficulties of this analysis, "it's more likely that they can demonstrate an association" between antidepressants and suicide, but not a definitive scientific link, said David Fassler, a psychiatry professor at the University of Vermont and a trustee of the American Psychiatric Association.

To some experts, an association may be enough of a red light.

"Causal links are rarely possible with 100 percent certainty," said Jane Garland, a psychiatry professor at the University of British Columbia in Vancouver and a member of the Canadian advisory panel. "But patterns of association can be seen," she said, and these patterns can "build a reasonably strong case."

As an example, she cited studies conducted by GlaxoSmithKline, which sells Paxil, that showed some mildly depressed adolescents needed to be hospitalized for suicidal ideas or worsening depression after receiving the medicine. But no one taking a placebo was hospitalized.

"That is hard to dismiss," she said. "If these drugs are treating depression, you would expect the opposite -- a lower rate, not a higher rate, in those receiving the drug."

David Healy, a professor at the University of Wales and author of "Let Them Eat Prozac," noted that as more clinical trial data becomes available -- Glaxo last week published summaries on it Web site, for instance -- regulators and physicians will gain new insights.

The drug makers have studies "where they had made what are still confidential judgments that their drugs caused agitation/ suicidality in people," said Healy, who has been critical of the pharmaceutical industry.

Even if the Columbia University analysis suggests a link between antidepressants and suicide, Canada's Stokes believes that further study will be needed. But, he added, it's unlikely that the pharmaceutical industry would be willing to conduct the research.

"It's unlikely that there will be a smoking gun," said Steven Simring, a psychiatry professor at the University of Medicine & Dentistry in New Jersey. "It's really a statistical story. And the best they can come up with is a strong link. But I don't think it will be the final word anyway, because no matter what they say, someone will be unhappy."Ed Silverman covers the pharmaceutical industry for The Star-Ledger.

[cyborg]

I don't agree with Gary Null on every issue but he had a pretty good study going about psychiatric drugs inducing violence in military personnel.

[Coleus]

What is ADHD?

• Diagnosis
• Behavioral Signs
• Physical Markers

If you or your child has just been diagnosed with attention deficit hyperactivity disorder (ADHD), don't despair. While in the past, a frightening regimen of powerful pharmaceuticals was used for this disorder, newer findings in nutrition and wellness are providing less invasive options for treating and preventing ADHD. ADHD is a condition marked by an inability to pay attention, concentrate, or complete tasks, sometimes accompanied by hyperactivity that occurs in both adults and children. Previously it was called simply attention deficit disorder (ADD), but clinicians now refer to this disorder as ADHD and differentiate three types: inattentive, hyperactive-compulsive, and combined. In the past, ADHD has been called hyperkinetic syndrome and even minimal brain syndrome, reflecting our poor understanding of this condition (Sangare 2000). Whatever the name, the prevalence of ADHD is soaring. According to the American Psychiatric Association's Diagnostic & Statistical Manual-IV-TR (DSM-IV), 3-7% of children currently have ADHD, with boys outnumbering girls 3 to 1. In addition, a study finds that 1-6% of adults meet formal diagnostic criteria for ADHD (Wender et al. 2001).

Obtaining a Diagnosis
The first step in deciding whether you or your child has ADHD is seeing a health professional qualified to make a diagnosis. Unfortunately, this can be a tricky process. ADHD has been called a "fad" and the condition "du jour" because so many people are suddenly "discovering" they have it due to the over-diagnosis of this disorder. One reason is that few health professionals can agree on just what ADHD is and fewer still follow the diagnostic criteria already established for it. Often diagnoses are made by a single health professional without adequate training in behavioral science. Since clear biochemical, genetic, and anatomical markers of ADHD are not yet available, diagnosing ADHD requires a detailed medical history along with observations and is best accomplished using a team approach.

According to the DSM-IV, a person needs to have first experienced ADHD in a persistent and disabling manner for 6 months before age 7 in order to qualify as having this condition. However, many people are diagnosed with ADHD without any early history of the ailment.

In addition, many other conditions can cause symptoms that mimic ADHD. Many children who have been sexually abused show symptoms that can often be confused with ADHD. For example, one study found that physical or sexual maltreatment and post-traumatic stress disorder (PTSD) (hyperarousal/hypervigilance) symptoms overlapped with those of ADHD (Ford et al. 2000). ADHD is also frequently confused with bipolar disorder but differs substantially in that bipolar children suffer from hypersexuality and parental conflicts that do not occur in ADHD (Geller et al. 2000).


Behavioral Signs
Despite the many difficulties in obtaining an accurate diagnosis, there are increasingly clear behavioral criteria for ADHD. Behavioral tests used to measure ADHD include assessments of how well patients can concentrate and process information because many ADHD children cannot think abstractly or isolate pieces of information and combine them into whole ideas, instead thinking in whole pictures. Here are some current signs to watch out for in both children and adults:

• Motor Problems: Visual attention loss, hyperactivity, altered facial expression (such as oversized and sustained smile), abnormal motor skills, excessive fidgeting, and constant hand and leg movements (Kuhle et al. 2001)
• Attention Problems: Procrastination, impulsive talking, difficulty starting or finishing tasks, reading disorders, low educational level, dependency on a rigid schedule to function, and extreme disorganization (Rasmussen et al. 2000)
• Mood Disorders: Bursts of anger, frequent interrupting, inappropriate behavior in social situations, anxiety, depression, feelings of hopelessness, and low self-esteem
• Addictions and Alienation: Drug addictions, alcohol abuse, criminal offenses, and difficulty maintaining a career or relationships (Mannuzza et al. 2000)

Physical Markers
Some exciting recent research is beginning to uncover the biochemical and genetic changes found in ADHD:

• Low Neurotransmitters: According to a fascinating theory from evolutionary medicine called the "reward deficiency syndrome," due to genetic defects some people do not produce sufficient neurotransmitters, particularly dopamine, in response to pleasure drives for eating, love, and reproduction. As a result they seek dopamine release and sensations of pleasure via junk foods and drugs, such as sugar, alcohol, cocaine, methamphetamine, heroin, nicotine, marijuana, and by compulsive activities, such as gambling, eating, sex, and risk-taking behaviors (Comings et al. 2000). Other researchers support this theory, noting low levels of serotonin are linked to ADHD and are associated with increased aggression in humans and other animals (Mitsis et al. 2000). As we'll see below, nutritional and wellness strategies to increase these neurotransmitter levels naturally offer attractive treatment options for ADHD.
• Genetic Defects: Following the rewards deficiency syndrome theory and the fact that stimulant medications act primarily by altering levels of dopamine, numerous genetic studies of ADHD have looked at defects in genes that control dopamine receptors. One allele of the dopamine D2 receptor gene is associated with alcoholism, drug abuse, smoking, obesity, compulsive gambling, and several personality traits (Comings et al. 2000). Other researchers support these findings, suggesting that defects in dopamine receptors genes are implicated in ADHD (Sunohara et al. 2000).

Conventional TreatmeNTS

• Drug Addictions

• Nonstimulant Drugs

When you or your child are first diagnosed with ADHD your primary care health professional will most likely suggest stimulant medications such as Ritalin (methylphenidate), Dexedrine (dextroamphetamine), Desoxyn (methamphetamine), Cylert (pemoline), or Adderall. Adderall is a mixture of four different amphetamine salts and is considered the current drug of choice because it remains in the body longer than Ritalin and causes fewer ups and downs. Unfortunately, Adderall has the same side effects as other stimulant drugs used for ADHD, including drug interactions, insomnia, dizziness, headache, loss of appetite, growth impairment, tics, stomach aches, and zombie-like behavior (PDR 2002).

Stimulants for ADHD work by suppressing all spontaneous behavior. Chimps cease any self-generated behavior, while in humans, play, socializing, and exploration all decline (Breggin 1999). Stimulant medications are used for ADHD because people with this disorder have slower brainwaves in frontal and polar regions of the brain than people without it (Chabot et al. 2001). These drugs show short-term effectiveness for control of overactivity, impulsivity, inattention, aggressiveness, and low academic productivity but no long-term control. Long-term studies since the 1960s, using markers such as finishing high school, finding a job, and avoiding drugs, alcohol, or arrest, have found that children who took stimulants for ADHD did no better later in life than those who did not (Mannuzza et al. 2000).

Further, as already noted, stimulant drugs come with some severe side effects. For example, neurological side effects including insomnia, anxiety, social withdrawal, fatigue, passivity, emotional flatness, depression, and sadness due to neurotransmitter disturbances can all occur from using stimulant medications. Also, headaches, facial tics, stereotypical behavior (meaningless, compulsive activities), and obsessive-compulsive behavior (endless repetition of activities) can occur (Kooij et al 2001). A vicious cycle of medication occurs in conventional ADHD treatment in which antidepressants, sedatives, and mood stabilizers are prescribed to control emotional disturbances caused by initial stimulant medication.

Eventually, children as young as 10 years old can develop bipolar disorder due to the medications themselves. For example, one study found that bipolar adolescents with a history of stimulant exposure prior to the onset of bipolar disorder had an earlier age at onset than those without prior stimulant exposure. The study also found that bipolar adolescents treated with at least two stimulant medications were of a younger age at onset compared with those who were treated with one stimulant (DelBello et al. 2001). Other major possible side effects from stimulants include growth impairment due to decreased appetite, cardiovascular problems such as increased blood pressure, and liver damage.

When stimulants are not effective, tricyclic antidepressants such as Tofranil may be given. This class of drugs is usually prescribed to treat major depression. Tricyclic antidepressants work by increasing levels of the brain chemicals serotonin and norepinephrine that affect mood, emotions, and mental state.

Drug Addictions
Among the most troubling side effects of stimulant medications and possible cofactors in ADHD is an increased risk of drug addictions. The explosion of ADHD diagnoses and abuse of powerful stimulant drugs among children has the Drug Enforcement Agency (DEA) and National Institute of Mental Health (NIMH) concerned (Zito et al. 2000). Here are some of the major drug addictions that can occur with ADHD and stimulant medications:

• Alcoholism. One study notes that indicators of ADHD are found among alcoholics, which may indicate high rates of ADHD in their earlier years of life. The study also points to the strong association between addiction and ADHD. Both disorders share clinical aspects and relevant biological markers, and for both, alterations in the same cerebral systems occur (Ponce Alfaro et al. 2000).
• Smoking. A study by Kent et al. (2001) notes that nicotine addiction is more likely in people with ADHD since nicotine promotes the release of dopamine and has been shown to improve attention in adults with ADHD. Another study notes that ADHD is linked to cigarette smoking in children, and mothers who smoke are more likely to have children with ADHD (Levin et al. 2001).
• Cocaine. Mothers who use cocaine are more likely to give birth to children with ADHD. A study of urban African-American children (Bandstra et al. 2001) suggests prenatal cocaine exposure can lead to long-lasting disruption of the brain systems regulating arousal and attention.
• Ritalin Abuse. The DEA classifies methylphenidate and amphetamine as Schedule II drugs (those with the very highest potential for addiction and abuse), a category that also includes methamphetamine, cocaine, and the most potent opiates and barbiturates. Methylphenidate is derived from the same family as cocaine and gives a similar, brief 4-hour high (Vastag 2001), making it an increasingly popular recreational drug. The number of students who abuse Ritalin has exploded. In one survey at a public liberal arts college in Massachusetts, more than 16% of the students reported they had tried methylphenidate recreationally, and 12.7% reported they had taken the drug intranasally, about the same figures found for cocaine and amphetamine use (Babcock et al. 2000). Ritalin tablets are often taken crushed and snorted like cocaine for a quick burst of energy. Emergency room admissions due to Ritalin abuse have also climbed rapidly, and severe side effects such as hyperthermia, hypertension, strokes, seizures, and death are often observed.

Nonstimulant Drugs
To help reduce the harsh side effects of conventional treatments for ADHD, some alternative nonstimulant drugs are being developed. Be sure to check with your primary care health professional to see if some of these drugs might be right for you:

• Atomoxetine is an investigational, nonstimulant drug that is thought to act by blocking norepinephrine transport in the brain and appears to be safe and well tolerated (Michelson et al. 2001).
• Gabapentin is an anticonvulsant drug released in the United States in 1993 for use as adjunctive therapy in refractory partial epilepsy and is sometimes used for bipolar adults. The drug appears to have a good safety profile (Hamrin et al. 2001).
• Bupropion appears to be effective and well tolerated in adolescents with ADHD and depression (Daviss et al. 2001).
• Modafinil is a wake-promoting yet nonstimulant drug that is helpful in adults with ADHD (Taylor et al. 2000).
• Tomoxetine is a novel noradrenergic-specific (stimulated or released by norepinephrine) antidepressant; Aricept (donepezil), cholinergic (acetylcholine releasing) cognitive enhancing anticholinesterase inhibitors; and ABT-418, a novel nicotinic analogue, also look promising (Biederman et al. 2000).

Complementary StrategiES

• Exercise
• Environmental Health
• Sugar
• Allergenic Foods
• Nutrition
• Supplements
• Nutrition

Given the perils of conventional approaches to ADHD and the frightening problems that can arise if untreated, it is fortunate that a wide variety of less invasive, safer, and effective approaches to ADHD are currently available. These include mind-body approaches, environmental strategies, exercise, dietary changes, and supplements.

• Behavioral Medicine
  A good first step in addressing ADHD nonpharmaceutically is using a few key behavioral techniques:
• Establish Routines: Setting routines is an important component of treatment for people with ADHD and should include set times for bed, play, bathing, TV, dinner, school, and homework.
• Maintain Eye Contact: People with ADHD should be encouraged to look people in the eyes when spoken to and acknowledge what was said.
• Practice Meditation: Techniques to enhance focus and attention such as meditation are useful. One therapy called the interactive metronome improves attention, motor control, and selected academic skills in boys with ADHD. An interactive metronome works by combining a computer with a metronome to help the user match his or her timing during tapping exercises to that of a reference tone (Shaffer et al. 2001).
• Avoid Information Overload: Information technologies are creating attention disorders among business executives who have to handle vast amounts of information (Davenport et al. 2000). Because people with ADHD have slow brain processing speeds, they perceive time as moving more quickly and have difficulty processing the glut of new information all around us (Goddard 2000).
• Try Biofeedback: Biofeedback electroencephalograph (EEG) training works to teach children with ADHD to enter a calm, alpha brainwave state and use different neurological pathways, which improves impulse control, increases attention, and allows more efficient processing of information. Biofeedback may be particularly effective for ADHD because people with this disorder have slower brainwaves in frontal and polar regions of the brain than people without it, which explains the use of stimulant medications (Chabot 2001). Biofeedback has also been used to treat alcoholism and appears to work so well that many children with ADHD can stop their drug therapies using this technique. Typically 20-40 sessions are required.

Exercise
The next strategy to try is using an exercise routine. Exercise is a rather obvious but overlooked way to help control the symptoms of ADHD. One study looked at the rate of spontaneous eye blinks, the acoustic startle eye blink response (ASER), and motor activity in children with ADHD. Researchers subjected subjects to a treadmill exercise bout at 65-75% VO2 max (the maximum oxygen uptake by the lungs). The results suggest vigorous exercise can improve symptoms of ADHD via dopamine release (Tantillo et al. 2002). A current position paper on exercise and children by the American Heart Association ( www.americanheart.org/presenter.jhtml?identifier=4596 ) recommends 30 minutes of moderate intensity activity on most days of the week and a minimum of 30 minutes of vigorous activity 3-4 days a week. This level of activity is shown to help prevent a wide variety of behavioral and physical disorders in children.

Environmental Health
While a bit more difficult to perform than mind-body or exercise protocols, a thorough evaluation and clean-up of environmental toxins should be made immediately upon diagnosis with ADHD. Very current research suggests that environmental chemicals, molds, fungi, and neurodevelopmental toxins such as heavy metals and organohalide pollutants are possibly linked to ADHD. Changes in thyroid function may be one reason environmental toxins can affect ADHD (Kidd 2000). One review notes parallels between the features of ADHD and the behavior of monkeys exposed developmentally to lead or polychlorinated biphenyls (PCBs) (Rice 2000).

Finally, according to an article in Life Extension Magazine (O'Brien 2001), mercury vapor from dental amalgam fillings can cause many of the symptoms of ADHD. Mercury toxicity in mothers can cause learning disabilities, autism, and ADHD in unborn children by fast placental transfer and could explain the explosion in learning and behavioral problems since World War II when mercury was first used in dentistry. Symptoms of mercury toxicity include irritability, anxiety, restlessness, memory and attention problems, confusion, and loss of coordination.

Attention Deficit Hyperactivity Disorder

Diet
Specific dietary tactics including avoiding allergenic foods, reducing sugar intake, and increasing consumption of foods rich in vitamins and minerals have been shown to help control ADHD in children and adults.

Allergenic Foods
Food allergies are a common, though controversial area of concern for people with ADHD. Oligoantigenic (few-foods) diets for ADHD have convincing double-blind evidence of efficacy (Egger et al. 1985); however, they appear to be most effective in children, not adults (Arnold 2001). In brief, a nonallergenic diet involves eliminating many foods considered allergenic. The theory that certain foods are allergenic and cause health problems such as ADHD is based on the premise from evolutionary medicine that foods which are the most genetically altered from wild foods on which we evolved are the most likely to cause allergies.

The most widely known proponent of the allergenic theory of ADHD is Benjamin Feingold, M.D., who suggested that food additives in particular are to blame, including artificial colors, flavor enhancers, thickeners, bleaching and anticaking agents, and preservatives. Research has indeed shown that food dyes can cause irritability, restlessness, and sleep disturbances (Rowe et al. 1994) while other food additives can cause similar symptoms (Boris et al. 1994). Other commonly allergenic foods and food products, such as wheat, oranges, soy, milk, corn, and eggs, are also often eliminated. An elimination diet involves systematically eliminating one possible food allergen at a time to see whether a specific food is causing ADHD.

Sugar
Sugar is certainly the single most damaging food linked to ADHD and a variety of other disorders. The sudden release of insulin and drop in blood glucose caused by refined sugar intake (reactive hypoglycemia) rapidly raises adrenaline, causing a fight or flight response and the aggressive behavior, hyperactivity, and attention problems found in ADHD (Wender et al. 1991). Children with ADHD also experience abnormal rhythms in regard to the stress hormone cortisol, which often occurs in people who have problems metabolizing carbohydrates (Kaneko et al. 1993; Wolraich et al. 1994). Girardi et al. (1995) found that, upon sugar feeding, people with ADHD release only half the catecholamines (adrenal hormones such as norepinephrine and epinephrine that counterbalance a rapid drop in glucose due to high insulin) as controls. Girardi et al. (1995) also noted that PET scans of children with ADHD showed much less brain activity due to insufficient glucose and tests indicated worse cognitive performance.

In addition, many of the children with ADHD became more hyperactive following the glucose intake in an effort to trigger their adrenal glands to produce more catecholamines. Finally, the most recent studies also show that ADHD is linked to catecholamine dysfunction and energy disorders in brain neurons because it is improved by medications that enhance catecholamine function (Todd et al. 2001). The results of this and other studies on sugar and ADHD emphasize the importance of well-balanced meals rich in protein and complex carbohydrates, which raise catecholamine levels and control fluctuations in glucose.

Poor Nutrition
Optimal levels of certain nutrients, which are often hard to obtain in a normal diet, are crucial in preventing and treating ADHD. In addition, deficiencies of certain nutrients during the critical period of brain formation can lead to permanent damage that may be linked to ADHD in later life. Since 90% of total brain growth takes place during the first 3 years of life, it is essential to provide high-quality building blocks, through diet or supplementation, during this period. Poor nutrition affects the development of the brain during this period and can have damaging effects that may lead to ADHD (Scrimshaw et al. 1968). Early studies show that children who lack optimal amounts of essential nutrients experience reduced attention span and intellectual ability (Crook 1980). Unfortunately, a U.S. Department of Agriculture (USDA) dietary survey of 3300 U.S. children and adolescents showed that less than 1% meet the recommended daily requirements for the five food groups and 16% do not meet any of the requirements (Munoz et al. 1997).

Nutritional Supplements

• Essential Fatty Acids
• Phosphatidylserine
• Choline
• DMAE
• Amino Acids
• Vitamins
• Minerals
• Herbs
• Hormone Imbalances

Numerous studies suggest that people with ADHD may be deficient in specific nutrients and that in some cases, supplementation may improve some of the symptoms of the disorder.

Essential Fatty Acids
Essential fatty acids (EFAs) are the most important nutrients to consider in the battle against ADHD. For example, one study found that a deficiency of long-chain polyunsaturated fatty acids is linked to ADHD (Richardson et al. 2000a; 2000b). Another study found that deficiencies in highly unsaturated fatty acids (HUFAs) cause the symptoms of ADHD. After 12 weeks of supplementation with HUFAs, researchers found major improvements in ADHD-related symptoms in children with specific learning difficulties such as dyslexia (Richardson et al. 2002).

Some ADHD diagnoses might be EFA deficiencies in disguise. One study found that ADHD patients reporting symptoms indicative of EFA deficiency had significantly lower levels of plasma arachidonic acid (AA) and docosahexaenoic acid (DHA) than did ADHD patients without these symptoms or controls. In this study patients with low omega-3 fatty acid levels had more temper tantrums and learning, health, and sleep problems than those with high levels of these fatty acids (Burgess et al. 2000). DHA supplementation has proven helpful in people with ADHD (Voigt et al. 2001). DHA can be found in deep-sea, cold-water fatty fish, such as salmon, herring, and tuna; sea vegetables (which is where fish obtain DHA); and micro-algae. Supplements are derived from these sources. Linoleic and linolenic acids found in products such as flax and hempseed oil are precursors of DHA and AA, but their manufacture in the body can be blocked by saturated and trans fats.

Phosphatidylserine
Phosphatidylserine (PS) is a natural extract of lecithin and a phospholipid that is vital to brain cell structure and function. Phospholipids are molecules with an amino acid component and a fatty acid component which are found in every cell membrane in our bodies. ADHD, dyslexia, dyspraxia, and autism are now considered "phospholipid disorders" because phospholipids are so important in the natural history, symptoms, and prevalence of these conditions which aggregate within families (Richardson et al. 2000a; 2000b). PS plays an important role in neurotransmitter systems, brain metabolism levels, and maintaining nerve connections in the brain. PS helps lower cortisol levels that are increased in chronically stressed individuals and improves brain cell membrane fluidity, which helps with dementia and depression. While there is little experimental data available using PS for ADHD as yet, its many cognitive benefits suggest it should prove extremely helpful (Jorisse et al. 2001).

Choline
Choline, a precursor for acetylcholine, is another important supplement for ADHD. One study found that the genetic and structural indicators of poor memory in the brain (called developmental instability) correlated with lower concentrations of creatine-phosphocreatine (Cre) and choline-containing compounds, whereas Cre and N-acetyl-aspartate correlated with good memory. This finding may be due to differences in frontal lobe energy metabolism (Yeo et al. 2000).

DMAE
Dimethylaminoethanol (DMAE) is naturally present in the brain and found in such "brain foods" as anchovies and sardines. DMAE accelerates the brain's synthesis of acetylcholine. As a supplement for ADHD, it has been used effectively to treat such symptoms as shortened attention span, hyperactivity, learning and behavior problems, reading and speech difficulties, and impaired motor coordination (Dean et al. 1990).

Amino Acids
Adequate protein intake is essential for manufacture of neurotransmitters in the brain from amino acids, which is crucial for reducing ADHD symptoms. Children with ADHD are often deficient in L-glutamine, a precursor for gamma-aminobutyric acid (GABA), a neurotransmitter that calms the mind and may play a role in hyperactivity. One study suggests that ADHD is caused by a deficiency of glutamate, with prefrontal brain regions being especially affected, while obsessive-compulsive disorder is caused by too much glutamate (Carlsson 2000). Another review found that amino acid supplementation for ADHD is most effective in the short term (2-3 months), but long-term benefits and ideal dosages have yet to be determined (Arnold et al. 2000).

Vitamins
Vitamins may help prevent and treat ADHD by protecting the nervous system from free radical attack and supporting the body in making neurotransmitters. Sociologists Schoenthaler et al. (2000) found that multivitamin supplementation of school-age children (ages 6-12) with behavioral problems such as ADHD helps control antisocial behaviors such as swearing, vandalism, assault, and refusal to work. Previous studies by these researchers have shown similar findings among prisoners, ages 13-26. Of all the vitamins, B vitamins are particularly important for fighting ADHD because they assist brain enzymes in using carbohydrates for energy, help synthesize neurotransmitters such as serotonin, dopamine, and GABA, and form myelin, which shields connections between neurons. A deficiency of B1 (thiamin) causes nervousness, irritability, and increased sensitivity to noise. B6 deficiency causes low levels of neurotransmitters such as serotonin, which are found in hyperactive children (Bhagavan et al. 1975). Vitamin C is also important for making neurotransmitters.

Minerals
Select minerals are especially effective in preventing and controlling ADHD. Zinc is an important cofactor for production of neurotransmitters, prostaglandins, and melatonin and for metabolism of dopamine and fatty acids, all of which are involved in ADHD. One study showed that zinc and fatty acids were decreased in children with ADHD (Bekaroglu et al. 1996). A more recent study examined zinc, D-amphetamine, and Efamol (evening primrose oil, rich in gamma-linolenic acid) in subjects with and without ADHD, using hair, red cell, and urine measurements to assess zinc levels. Efamol supplementation was beneficial only in those with borderline zinc levels. This suggests that Efamol works by improving zinc deficiency. Zinc deficiency in people with ADHD may also be the reason for poor responses to stimulant therapy (Arnold et al. 2000). Magnesium levels appear to be low in patients with ADHD, and supplementation has reduced hyperactivity (Starobrat-Hermelin et al. 1997). A dosage of 200 mg daily has been used in most studies. Finally, iron deficiency has been implicated in ADHD and is a fairly common problem in children.

Herbs
Numerous herbs are shown to help prevent and control ADHD by improving blood flow to the brain and nervous system, reducing stress, and removing toxins from the body.

Hypercoagulation is a disorder in which excess coagulation of the blood leads to hypoxia, or low oxygen, and death in tissues. In newer studies, hypercoagulation has been linked to immune system function and numerous seemingly unrelated diseases such as cancer, heart disease, and cognitive disorders such as ADHD. To help control hypercoagulation, an array of hypocoagulant supplements including curcumin (turmeric extract), ginger, and ginkgo should be used (Liao 2000). In ADHD, hypercoagulation is more of a concern in adults than children.

A study of a combination herbal product containing American ginseng extract, Panax quinquefolium (200 mg), and Ginkgo biloba extract (50 mg) was tested for its ability to improve the symptoms of ADHD. Between 31-74% of patients taking the medication experienced improvements in various indicators including anxiety, shyness, social problems, hyperactivity, and impulsiveness (Lyon et al. 2001). Fish oil, enzymes such as bromelain and Wobenzym, and massage have also been shown to lower blood viscosity.

Interestingly, methylphenidate (Ritalin) appears to work like ginkgo and other herbs by increasing regional cerebral blood flow (Kim et al. 2001). Structural studies show that in children with ADHD there is decreased blood flow and energy use in the prefrontal cortex and striatum. One possible result is a decrease in volume of certain brain areas in people with ADHD. The brain regions responsible for attention, including the anterior corpus callosum, right anterior white matter, and cerebellar areas, are actually smaller in people with ADHD (Paule et al. 2000). Another study indicates there are left hemispheric white matter deficits due to dysmyelination and gray matter deficits in the right hemisphere in ADHD patients (Overmeyer et al. 2001).

Stress-reducing herbs, such as passion flower, valerian, or lemon balm, are recommended because stress contributes to ADHD (Berdonces 2001). Finally, detoxifying herbs and algae, such as spirulina, have also been suggested for ADHD. Spirulina may help ADHD by removing aluminum, carbon tetrachloride, and other toxins from the body (Torres-Duran et al. 1998; Vadiraja et al. 1998). Sevulla et al. (1995) found an 81% improvement in academic scores when children took 1 gram of spirulina every day for 6 months.

Hormone Imbalances
In adults, certain prohormone supplements such as dehydroepiandrosterone (DHEA) may help control or prevent ADHD. ADHD is associated with low blood levels of neurosteroids such as DHEA, its principal precursor pregnenolone, and its principal metabolite dehydroepiandrosterone-sulfate (DHEA-S). Conversely, higher blood levels of these neuro-steroids are associated with fewer symptoms of ADHD (Strous et al. 2001). Prohormone supplements are not safe for children. However, hormone-controlling drugs may sometimes help in cases of child ADHD. For example, some research suggests that children ages two to seven with ADHD and learning disabilities have high levels of thyroid hormone and thus thyroid hormone lowering drugs, such as neomercazole, may be effective. Thyroid treatment is effective in the presence of documented thyroid abnormality only (Arnold 2001).

SUMMARY

Conventional treatments for ADHD have included psychostimulants such as Ritalin, Dexedrine, and Desoxyn that suppress spontaneous behavior. Research has shown that the use of these drugs provides very few if any positive long-term benefits. In addition, serious physical and emotional side effects are seen in children while taking these powerful medications. New nonstimulant drugs with fewer harsh side effects are currently being introduced as a safer alternative. Allergies from genetically altered food and additives may also trigger symptoms of ADHD and hyperactivity. An elimination diet that will pinpoint possible food allergens is recommended. Hormone imbalances such as an overactive thyroid should be checked in both adults and children with ADHD.

Complementary strategies such as behavior modification, physical exercise, and avoidance of environmental toxins can be a safe and effective approach in managing ADHD. Poor nutrition early in life can have long-term effects on brain development and functioning. Many adults and children with ADHD are lacking in vital nutrients. Research has shown that proper supplementation can significantly reduce the severity of their symptoms. Nutritional supplements and appropriate dosages for children should be physician-supervised based on total medical treatment, age, and body size.

1. Essential fatty acids: DHA from fish oil is the most important essential fatty acid for the brain. The recommended daily dose of DHA is 1000-2000 mg daily for adults and 500-1000 mg daily for children. For those who cannot afford DHA fish oil, flax oil may work because it usually converts in the body to DHA (and EPA). Flax oil liquid may also be easier for children to take than DHA capsules.
2. Vitamins and minerals: Life Extension Mix and Children's Formula Life Extension Mix are ideal sources of many vitamins and minerals such as vitamins B and C, zinc, and magnesium, vital in maintaining the health of neurotransmitters. Follow dosing recommendations on the product label.
3. Choline helps to restore low levels of acetylcholine in the brain. A suggested dose is 1000-6000 mg daily to boost memory and concentration. However, it is difficult to obtain enough choline in dietary supplements. Adults can obtain high potencies of choline and other nutrients for the brain in a product called Cognitex. Children may have to rely on choline powders with an unpleasant taste. DMAE is a more convenient way for some children to obtain acetylcholine precursors.
4. DMAE helps accelerate synthesis of acetylcholine. Adults: Begin at a low dose of 100 mg in the morning and 100 mg in the evening on an empty stomach, gradually building up to 500 mg twice daily. Some individuals do well remaining at a low dose because side effects such as headaches, muscle tenseness, and insomnia may occur at higher doses. Children: half the recommendation for adults.
5. Phosphatidylserine is a phospholipid that is vital to neuronal functioning and brain metabolism. Adults: 100-400 mg daily for people with neuronal dysfunction. Children: 100 mg daily.
6. Amino acids: Be sure to eat well-balanced meals with complete protein. Adults: glutamine, 1 or more grams daily; and GABA, 1/8-1/4 tsp daily. Children: glutamine, 250-500 mg daily; and GABA, 1/8 tsp daily.
7. Herbs such as ginkgo and ginseng will improve blood flow to the brain and help remove toxins from the body. Life Extension Herbal Mix enables one to obtain high potencies of brain-boosting herbal extracts along with some acetylcholine precursors. The advantage of Life Extension Herbal Mix is that it comes in a powder form that some children will find palatable. Adults: 1 tbsp daily. Children: 1 tsp daily.
8. Theanine helps calm the nervous system without sedation. Adults: 300-400 mg daily. Children: 100-200 mg daily.
9. DHEA: Low levels of the neurosteroid DHEA are associated with ADHD. Blood testing is highly recommended first to eliminate the possibility of hormone-related cancers and to establish a baseline for supplementation. DHEA supplementation is not appropriate for children.
10. Mind-body techniques: Try massage, biofeedback, meditation, and routine setting. Avoid information overload.
11. Exercise: The American Heart Association recommends 30 minutes of moderate intensity activity on most days of the week and a minimum of 30 minutes of vigorous activity 3-4 days a week. This level of activity is shown to help prevent a wide variety of behavioral and physical disorders in children.
12. Environmental health: Avoid pollutants including PCBs and heavy metals (often found in fish). Buy organic foods whenever possible and use air and water filters.
13. Diet: Try allergy testing and a Feingold-type elimination diet. Avoid sugar.

Related Links

• Pay Attention
• Obsessive-Compulsive Disorder protocol
• Childhood Nutrition: The Road to Lifelong Health
• Mercury Amalgam Toxicity

For more informatiON

Contact Children and Adults with Attention Deficit Disorder (CHADD), (800) 233-4050.