A Response to a Post on Dr. Rory F. Stern's Website

I came across a post entitled "How Do ADD/ADHD Medications Really Work" by Dr. Rory F. Stern. He asked for comments. You all know this subject has been addressed here many times. Here's what I wrote to Dr. Stern.


Wow.

I must admit I was a little upset when I saw the title of this post: “How Do ADD/ADHD Medications Really Work,” because NO ONE really knows how any of these medications work. We’ve all been told about the medical theory underlying ADHD, i.e., that ADHD is the result of a chemical imbalance in the brain involving certain neurotransmitters and that the medications help regulate such neurotransmitters.

However, this is only a THEORY. No one really knows what causes ADHD, and NO ONE really knows how any of these medications actually work. As most of you certainly know, ADHD is a symptom driven diagnosis – if you check off enough behaviors on the Conners sheet in enough environments, you will be diagnosed with ADHD regardless of what is actually causing the behaviors.

If you do the research, you’ll find studies that “prove” inattentiveness and impulsivity can be traced back to many different “causes” -- overexposure to media (including television and video games), poor diets and food allergies, nutrition deficiencies (including essential fatty acids), sensory integrations problems, sleep problems or emotional issues, to name but a few. I noticed that some of the previous posts mention such issues.

But, to Dr. Stern’s credit, he did not try to explain exactly how these medications work, nor did he take a stand on their use. The subject of medication is near and dear to me, and I have blogged about it extensively in the past. While I am certainly not a proponent of medication, I do realize that for some people it is a life changer. I only urge that you try other therapies and approaches, and use medications as a last resort.

Without getting into the gory details, our son was diagnosed with ADHD, borderline ODD, and PDD by the age of 7. We reluctantly tried medications, and unfortunately for our son, he got hit with nearly every side-effect you could get, from wild mood swings, to hyper anxiety, to facial tics. One med led to another, and to another, as his doctors tried to medicate his side-effects away and get his behavior under control.

He was a mess, and the cocktail of ever changing meds was only making him worse. When we mentioned trying alternatives ranging from dietary changes to homeopathy to sensory integration work, we were told by every professional that meds were the only proven therapy and the rest was a waste of time and money. However, our son’s downward spiral on the meds, the doctors’ insistence on more meds, and our desperation drove us to explore the alternatives.

We did, and we have never looked back. It took time and a lot of effort, but by the time our son entered sixth grade, he was completely off all medications and you would never have known there was ever an issue with this child.

Over that time, we learned a great deal about meds that the doctors never shared with us. First, nearly all studies show that over the long run, these meds lose their effectiveness. Second, these meds almost always have side-effects (although some may argue that the benefits outweigh the side-effects). Third, while rare, there are some serious issues with these medications that have led some to be banned in other countries. Fourth, the effectiveness of such meds is greatly over sold. You see, it depends on your definition of “effectiveness.” If you define “effectiveness” as having some “effect,” then these meds are very effective. If you define “effectiveness” as satisfactorily alleviating the issues for which the medication is given, you’ll find that these meds aren’t nearly as effective as promised.

In fact, during a Special Education PTA seminar, less than 30% of the parents who tried medications to regulate their children’s behavior thought the meds did what they were supposed to do, and 100%(!!) experienced side-effects. This number was interesting since a psychologist writing on the subject of the effectiveness of psychotropic meds, made a similar distinction, and stated with authority, that such meds had an “effect” 70% of the time, but only really worked about 30% of the time!

So, I was truly shocked to see how many people responded that their children were helped by meds. I was even more shocked by the apparent lack of those who had awful experiences with medications, like we did. I can only say to those who responded by saying that meds were life savers, I am truly glad that you were able to help your children, and be aware how lucky you are!