Guest guest Posted October 2, 2003 Report Share Posted October 2, 2003 Thu, 2 Oct 2003 06:40:58 -0500 HSI - Jenny Thompson Behavior Mod Squad Behavior Mod Squad Health Sciences Institute e-Alert October 2, 2003 ************************************************************** Dear Reader, The phrase " Not enough children are getting drugs, " should not be used by radio reporters while I'm driving a car. It could be hazardous to other drivers. Last week I was listening to Morning Edition on National Public Radio (NPR) while driving to work. And when I heard the beginning of a report on the use of medication to treat attention deficit hyperactivity disorder (ADHD), I should have pulled over to the shoulder of the road and turned off the car so that I could talk back (shout back!) to the radio without endangering my fellow motorists. I'm happy to say that I got to work without plowing my car into anyone else. That's the good news. The bad news: Even though hundreds of thousands of children are being given pharmaceuticals to treat ADHD, there are " experts " out there who are convinced that our kids are under-medicated. Now aren't you glad you weren't driving a car when you read that last sentence? ----------------------------- Dreaming up diseases ----------------------------- The NPR report was part of a series on mental illness in children. But does ADHD really qualify as a mental illness? In the most extreme cases, possibly. But I wholeheartedly agree with a Brandeis University medical sociologist named Peter Conrad who told NPR that the American medical establishment has come to regard normal human differences as medical problems - such as judging a child to have a disease because he doesn't pay as close attention as the kid in the next desk. And you know what we do with a disease in this country: We medicate it. In direct counterpoint to Mr. Conrad's clear thinking, the NPR piece also featured Columbia University psychiatrist Peter Jensen who believes that only half the kids with ADHD are being properly medicated. So if Mr. Jensen had his way, the number of U.S. kids taking an ADHD medication would roughly equal the entire population of Ireland. That's well over 3 million. Mr. Jensen is particularly pleased with a National Institutes of Mental Health (NIMH) study that compared the effectiveness of behavior modification to medication in treating ADHD. The behavior modification proved to be useful, but medication was found to be more effective. Case closed, says Mr. Jensen. Time to medicate those 1.5+ million stragglers. But psychologist William Pelham says, not so fast. Both Pelham and Jensen participated in the NIMH study, and Mr. Pelham points out that other studies (ones that didn't simply compare a behavior modification group to a medication group) have found that more than half of ADHD subjects may be successfully treated with behavior modification alone. No doubt, the concept of trying behavior modification before resorting to drugs is going to be a hard sell to the medical establishment. But there's still a critical element missing from both of these treatment options. ----------------------------- Oh behave! ----------------------------- The behavior modification techniques described in the NPR report don't include diet modification. And that's a huge omission. In the e-Alert " How to Dismantle an '89 Ford " (6/3/02), HSI Panelist Allan Spreen, M.D., told us how he had successfully treated hyperactive children with a two-step process: 1) by discovering and removing food allergies, and 2) by enhancing nutrition. The drawback to this process is that it's more difficult to strictly modify a child's diet than it is to have a prescription filled. And dietary changes take time. A pill is a quick fix. But that quick fix comes with possible side effects as well as long-range problems. In the June 2002 e-Alert, Dr. Spreen wrote: " It's amazing how many hyperactive children are chemically sensitive. The trick is finding out what the sensitivity is. Food allergies are chemical sensitivities, and they must be ruled out first. This starts by cutting out the historic offenders - milk (or other dairy), wheat, corn, soy, peanut, and adding to the list anything (ANYTHING) that the child craves (or just insists on eating everyday). " Bear in mind also that sugar is a chemical. It's purified and concentrated to a point w-a-a-a-y beyond what our bodies were genetically designed to comfortably handle, and blood sugar swings resulting from its use can absolutely have an impact on behavior. Improvement can be absolutely amazing, and then maddening to discover that so much control was available from within the refrigerator. " ----------------------------- Add nutrients ----------------------------- Once a child's diet is purged of aggravating factors, there are important nutrients that can help calm hyperactivity. Dr. Spreen recommends vitamin C in high doses (a " great detoxifier " ) as well as alpha lipoic acid; used in conjunction with a good basic multi-vitamin/mineral regimen. Dr. Spreen adds, " Most ADHD kids have deficient diets, and essential fatty acids (important for proper nerve formation and conduction) are often undersupplied. Fish oil supplements, along with extra vitamin E to assist in its metabolism, can be very helpful. Sometimes, magnesium (in doses not high enough to loosen stools) can be a big calmer in the mineral department, and certain amino acid-type supplements like GABA and L-tryptophan can be amazingly effective. However, get educated by starting at the beginning and don't quit until you have the answer. " ----------------------------- Option one ----------------------------- The NPR report quotes a Johns Hopkins psychiatrist named Daniel Safer who notes that over many years of treating children with ADHD he's seen the attitude of parents change. Where parents were once cautious about medicating their children, many are now quite willing to request a prescription for Ritalin. Several factors have contributed to this change in attitude. In 1991, for instance, the U.S. Office of Education officially identified ADHD as a condition qualifying a child for special education. And there's no doubt that the direct advertising of prescription drugs has made our culture much more comfortable with the idea of solving problems with pharmaceuticals. And now there's a new drug that's making the decision to medicate just that much easier. Strattera is a non-stimulant ADHD medication introduced by Eli Lilly less than a year ago. And it's selling like gangbusters. One million prescriptions for Strattera were written between November 2002 and June 2003. The fact that Lilly can back up a new product with a formidable international marketing effort has a lot to do with these huge sales. But an ADHD drug that doesn't mimic amphetamines (as Ritalin does) is probably very attractive to parents. But is it safer? That's hard to answer. Like Ritalin, the long-range effects of Strattera are still a question mark. And Strattera's most common side effects (mood swings, dizziness, nausea, vomiting, decreased appetite, and tiredness) read like the symptoms of a disease. Does that sound like the best way to help kids get focused? Dr. Spreen sums up the ADHD situation with this comment: " Never assume that drugs are the only answer. " And I would add to that: As effective as it may be in treating ADHD, behavior modification isn't complete without modification of the diet as well. ************************************************************** To start receiving your own copy of the HSI e-Alert, visit: http://www.hsibaltimore.com/ealert/freecopy.html Or forward this e-mail to a friend so they can sign-up to receive their own copy of the HSI e-Alert. ************************************************************** ... and another thing You don't really need another reason to increase your vitamin C intake, but here's one anyway. Researchers at the University of Manchester and the Institute of Public Health at Cambridge University examined data from an 8-year population survey of almost 25,000 subjects to analyze the association between rheumatoid arthritis and vitamin C intake through fruit and vegetable consumption. Only 73 subjects developed rheumatoid arthritis, and their diets had one common denominator: low intake of fresh fruits and vegetables. Exactly how these foods protect the body from this debilitating, inflammatory disease will require further research. Without question, a daily orange, apple, carrot, and banana will do most of us quite a bit of good. And munching them may just let us cross rheumatoid arthritis off our list of things to worry about. To Your Good Health, Jenny Thompson Health Sciences Institute ************************************************************** Sources: " Analysis: Increasing Diagnosis and Drug Treatment of Children with ADHD Ignites Controversy Among Professionals " Snigdha Prakash, Morning Edition, National Public Radio, 9/25/03, npr.org " Side Effects - Children and Adolescents " strattera.com " Low Vitamin C Linked to Greater Arthritis Risk " Karen Birchard, The Medical Post, V. 39, Issue 24, 6/17/03, medicalpost.com Copyright ©1997-2003 by www.hsibaltimore.com, L.L.C. 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