Wednesday, September 15, 2010

ADHD: Nutrition versus Meds

Came across an interesting little snippet on an ADHD forum to which I belong. In an attempt to avoid medicating her child, suspected by doctors of having ADHD, a Mom tried to help her son through a nutrition intervention. It is unclear whether she had consulted with anyone about her approach, but what was clear is that the child had an immediate reaction to the intervention – apparently a very bad one which prompted this Mom’s call for help on the forum. Specifically, she indicated that it was as if the child was going through “withdrawal” and after two weeks, she only saw his behavior getting worse.

Tina responded privately to her offering advice and insight into the situation. Among other things, she noted that, as we always tell the parents here at the center, while the “withdrawal” like symptoms may be upsetting, the fact that her child had a definitive response to a new intervention is usually a very positive sign. At a minimum, it shows a clear sensitivity related toward that intervention (in this case, what the child was eating), and that usually means you’re looking in the right direction. The trick now is to figure out the proper approach.

Moreover, as we always tell parents, whenever trying a new intervention, many times things tend to get worse before they get better – especially behaviors. The child literally feels very different, the body is physically affected, and the child’s mind and body must adapt. This can be rough, and lead, at least in the beginning, to worse behaviors.

Finally, like anything else, it takes time to adjust to new interventions. Unlike medication, nutrition intervention takes time. This is especially so if the gut is affected or you are addressing a deficiency. Simply put, it takes time for the body to heal.

Another gentleman on the forum (we’ll call him “Biff”) had a different response. Posted on the forum: give up the diet and give him meds.

Guess who had the right approach?

It turns out that not long after Biff’s post, Mom gave us an update. It took a couple of weeks, but she stuck with the dietary intervention and was now seeing very positive results. In particular, she noted that her son was “calmer,” “focus[ing] longer,” and experiencing “less sensory break downs.”

Tina 1: Biff O

Saturday, September 4, 2010

ADHD, Adderall and Lindsay Lohan

So, heard the latest? I am not making this up.

Adderall May Have Unhinged Lindsay Lohan (8/20/2010 12:30 AM PDT by TMZ Staff)
Lindsay Lohan's Adderall dependence -- the result of a medical misdiagnosis -- may have been the reason she went off the rails.

[T]he docs at the UCLA rehab facility believe Lindsay was misdiagnosed with Attention Deficit Hyperactivity Disorder ... and then prescribed Adderall to treat the phantom affliction.

Dr. Joe Haraszti -- a prominent L.A. addiction specialist [states that] people who take Adderall when they don't need it can experience similar effects as people who use cocaine or methamphetamine.

Dr. Haraszti tells us ... people who unnecessarily take Adderall can display manic symptoms ... "and often do things like 'driving around until all hours of the morning ... smoking heavily ... tweeting ... and texting all night long." The doc adds, "They can become very impulsive."

"The doc also notes that people in that situation "might then complain of insomnia and then take Ambien or other sleep aids to help fall asleep ... it's a vicious cycle."

Dr. Marc Kern -- another addiction expert -- tells us alcohol abuse is also very common among patients who take Adderall.

Dr. Kern tells us, 'The Adderall counteracts the sedative side effects of alcohol use … making these people often drink more than someone who does not take the drug."


That is, pretty much, word for word, the article about Ms. Lohan, ADHD and Adderall. Now, let’s play a game. How many things are terribly wrong about the information contained in this article?

Here are my top three:

1. How is someone like Lindsay Lohan “misdiagnosed?” One would assume that she has access to the best medical practitioners around, right? So, are her doctors so inept that they could not diagnose a “disorder” that affects anywhere from 8% to 15% (or more, depending upon your information source) of the population?

Or, is it more likely, that the “disorder” is so vaguely defined, subjectively diagnosed, and misunderstood, both in its manifestation and causes, that it too difficult to diagnose correctly?
In either event, if Ms. Lohan is truly misdiagnosed, either through her doctors’ lack of skill or the inherent vagueness of this “disorder,” how do we know that our kids are not also being misdiagnosed?

2. “[P]eople who take Adderall when they don't need it can experience similar effects as people who use cocaine or methamphetamine.”

Ah, this one’s a bit trickier. Yes, people who take Adderall “can experience similar effects as people who use cocaine or methamphetamine.” No issue there. That’s because Adderall, Ritalin, and the like ARE IN THE SAME CHEMICAL FAMILY AS COCAINE AND METHAMPHETAMINE!! (in fact, Ritalin’s real name is “methyiphenidate”). And, like cocaine, they are all Schedule II controlled substances! (see http://www.justice.gov/dea/pubs/scheduling.html).

Thus, “like cocaine, Ritalin is a powerful stimulant that increases alertness and productivity. Ritalin and cocaine also look and act the same. Both have a similar chemical structure.” http://learn.genetics.utah.edu/content/addiction/issues/ritalin.html

So, what’s terribly wrong with this statement? First, Adderall affects EVERYONE the same way, whether you have ADHD or not! That’s why you can’t use the drug’s so-called effectiveness as a diagnostic tool. So, when you give your “ADHD” kid Adderall, he/she may “experience similar effects as people who use cocaine or methamphetamine,” including as
“Dr. Haraszti tells us … manic symptoms ... and impulsiv[ity]."

And lets not forget what Dr. Kern has to say: “alcohol abuse is also very common among patients who take Adderall.”

3. Just a headcount – how many of you parents out there were told either that (a) ADHD was very difficult to properly diagnose; or (b) that drugs like Ritalin and Adderall are class II controlled substances, just like cocaine, with a similar chemical structure as cocaine, that can cause “manic symptoms, impulsivity, and/or alcohol abuse”?

I’ll bet you were told, like me, these drugs were perfectly safe, with few if any side-effects. And, if your son/daughter had diabetes, you’d give him/her insulin, wouldn’t you?