Coffee and ADHD?

                        Did anyone catch Good Morning America today?  A mom, who suspects her son has ADHD (there’s been no formal diagnosis, but she stated that her son is very active and has trouble concentrating and finishing tasks. . . .) gives him two, four ounce cups of coffee, each day.  She says it calms him down and helps him to focus.

                        Well, according to GMA, this has the “Mommy Blogs buzzing” with many people questioning this mother’s actions.

                        Really??  You have got to be kidding me.  How can giving a child eight ounces of coffee a day (that’s just one cup) be controversial when giving a child a drug like Ritalin raises few, if any, concerns?

            Understand a couple of things.  First, Ritalin, and drugs like it such as Concerta and Adderall, are STIMULANTS designed to control impulsivity.  Thus, the caffeine in the coffee is most likely just acting in the same manner.  Indeed, the literature talks about many adults “self-medicating” with caffeine.

Second, and far more importantly, amphetamines like Ritalin, can have VERY serious side-effects.  Aside from the fact that Ritalin is in the same drug classification as cocaine (and, you can check this out), Ritalin, and drugs like it, have been associated with stroke, chromosome damage, and even death.  And, let’s not even mention the other psychotropic medications (including antidepressants) that often are prescribed for these kids.

New research points out the benefits of dietary changes and supplementation when it comes to treating disorders like ADHD.  Cut out the artificial sweeteners, the artificial colors, cut back on the sugar, and see what happens.  Look into supplementation, especially with essential fatty acids.  Talk to a nutritionist with experience in this field, and find out what a difference diet can make.  (Not the first time this was discussed:  http://sparkdevelopment.blogspot.com/2011/08/importance-of-nutrition.html).

Kudos to this mom for finding something far safer than heavily controlled, often abused, pharmaceutical concoctions to help her son.

One in Thirty Eight

Anyone catch the article in Newsday today, “Study in South Korea finds higher rate of autism,” by The Associated Press Carla K. Johnson (AP Medical Writer) (http://www.newsday.com/news/health/study-in-south-korea-finds-higher-rate-of-autism-1.2864765)?  Seems that South Korea puts the autism rate at one (1) in thirty eight (38)!  Is autism truly that prevalent?  It seems like it sometimes . . .

Personally, I don’t know what to say about the study.  It was based on an extremely large survey (55,000 students), follow up and some testing, although there is speculation that the population that responded to the survey may have been disproportionately made up of parents with children with issues, and it was indicated that very few of the children actually went through an entire diagnostic procedure.  How accurate was the survey?  And, how can it be so very different from our own CDC’s estimate of one (1) in one hundred (100) (although, I have mentioned it before, that estimate is probably low).

But it makes you think.  How do we define “autism”?  How do we diagnose it?  How accurate can we possibly be when it comes to disorders that are so subjective in nature?

What’s really at issue, though, is once it is diagnosed, what do we do about it?

And, again, sorry to anyone following this blog.  I am still working on my book about my son, and how we helped him “recover” from ADHD, ODD, and PDD.  The first half is done – the part about our story (from a father’s perspective).  The second half, the one with all the relevant research about the methods we used, is taking a while.  Seems there’s a whole lot of stuff that supports what we did.  I’m still trying to glean through the best of it.

MRIs, Autism & ADHD

I may be wrong, but I think we have another “duh” moment. According to “Brain MRI may lead to early autism detection,” reported by Nicole Ostrow of Bloomberg News, researchers studying 60 children, half diagnosed with mild autism and half without autism, were able to identify autism 94% of the time using magnetic resonance imaging. Specifically, the MRI looked at water diffusion along the brain’s nerve fibers.

The article talks of “the disorder’s biological base,” and objective markers, and early detection.

While there is no doubt that early diagnosis and more objectivity are worthy goals, I have to wonder, if autism is a neurological disorder, and even subjectively, differences in behavior, intellect and communication are readily apparent, isn’t it a given that brain processing will be different? Isn’t this just objective confirmation of what we already know? (and why only 94% success?)

Also, this test does nothing to shed light on the cause of autism. When the article discusses “the disorder’s biological base,” is it suggesting that the differences found in the autistic brain are innate, and thus, the cause of the disorder? Or, is it merely finding changes in the brain caused by some external, environmental insult (which, combined with a genetic disposition of susceptibility to such harm, is what we believe to be the true cause of the disorder)? If it’s the latter, are these differences in brain processing really a “biological base”?

And, another thought, this one regarding ADHD. We’ve always maintained that disorders like ADHD are part of the ASD spectrum (and there are researchers out there who apparently believe likewise). That is, that whatever is causing the ASD epidemic also is causing the ADHD epidemic. It’s just a different degree of effect and a different manifestation. I’ll bet if the same MRI studies were done on kids diagnosed with ADHD, the researchers would find that the ADHD brains also process information differently.

If that’s the case, then you have to wonder. We were always told by Robert’s doctors that ADHD was caused by a brain chemistry imbalance with respect to certain neurotransmitters, and that drugs were the only way to address his issues.

If the ADHD brain, like the autistic brain, processes information differently, is that really the result of a “neurotransmitter imbalance?” And, more to the point, how can messing with those neurotransmitters, as the ADHD meds are theorized to do, really fix the problem?

Just a thought.

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?

ADHD, Lead Exposure & Smoking -- "Shocking New Findings?"

My sister directed this AOL article to me: "Smoking, Lead Exposure Increase ADHD Risk," by Stephanie Booth.

In it, is the not surprising conclusion that children, exposed in utero, to tobacco smoke and/or lead, had a statistically higher risk of being diagnosed with ADHD. Specifically, "children exposed prenatally to tobacco smoke had a 2.4-fold increased likelihood of ADHD diagnosis. Those whose blood showed what researchers categorized as high lead levels were 2.3 times more likely to have ADHD. Exposure to both lead and prenatal tobacco triggered what head researcher Tanya Froehlich, M.D., a developmental and behavioral pediatric specialist and assistant professor of pediatrics at Cincinnati Children's Hospital Medical Center,called an alarming 'synergistic effect.' Children in this category had eight times the risk of being diagnosed with ADHD."

I say these "findings" are "not surprising" because, as I've been saying for many years, everything from a ADD (and even speech and language delays that eventually lead to further diagnoses) to full blown autism are probably caused by the same thing ? a genetic predisposition to harm and an exposure to one or more environmental insults. The only thing that varies is the severity and manifestation of harm.

Throw in societal "insults," e.g., over exposure to television, video games, computers (both in terms of content, format & presentation, and the devices themselves), and poor eating and nutrition, and you have a perfect recipe for brain and nervous system development problems.

I think it interesting that science can find links to ADHD and ASD etc., but they can't find "the cause." Why? Well, if you want my humble opinion, no one will ever find "the cause" because there probably is no single cause. The combination of factors ? exposure to environmental insults, the timing of that exposure, the extent of that exposure, the nutrition/eating habits of the mother and child (before, during and after pregnancy (if breast feeding), breast feeding habits, vaccination issues (timing, content, number), exposure to smoking, lead, mercury, airplane fuel, electromagnetic radiation, etc., childrearing practices, and media exposure. The list goes on and on.

Who could possibly device a test for all these things and the infinite combinations possible? And, note, the combinations are worse than the sum of the parts.

Worse, and I hate to say it, who really wants the truth? I mean, what happens if someone definitively proves that vaccines really do cause harm? Or overprescription of antibiotics? Or exposure to cell phones, microwaves, Wi-Fi? Or too many video games? Or that fast food, convenience foods, genetically engineered foods, baby formula, is actually harmful?

Can we, as a society, deal with the economic impact of such findings? Are you ready to give up your cell phone?

So, instead of pouring resources into the Sisyphean Task of finding "the cause," why not focus on prevention and treatment. Admit that there is potential danger out there. Take steps to minimize the risks these children face. And, figure out a way to reverse the damage.

How NOT to diagnose ADD

Got a call from a mom the other day. Concerned that her son might have ADD, she brought him to the family pediatrician. However, the doctor said he could not diagnose ADD with certainty. Instead, Mom told me the doctor said, "he would prescribe the ADD medication, and if it worked [?], then they would know for sure her son had ADD."

My jaw dropped into my lap. This is so wrong, that in my humble opinion, it borders on malpractice.

First, how on Earth can you prescribe a powerful, psychotropic drug to a child without having at least a reasonable certainty that the child suffers from the disorder which that drug is supposed to treat? These are serious drugs with serious known side-effects we're talking about!

Imagine fearing you had cancer, and you seek a diagnosis from your doctor. Your doctor says he can't tell for sure whether you have cancer, but, he'll start you on chemotherapy. If it works -- whatever that means -- then you'll know you had cancer.

Sound right to you?

Second, using drugs to diagnose ADD was rejected as an approach over a decade ago! The fact of the matter is, when given in prescription appropriate doses, these drugs have the SAME effect on "normal" folks as they do on those with ADD. Thus, the drugs "work" no matter to whom they are given.

Finally, has this mom's doctor not read anything about these drugs being abused on college campuses by students seeking an edge? If these students are using these drugs to enhance their attention and studying skills, how can you possibly use them as a diagnostic tool?

When did the prescription of these drugs become so commonplace, so automatic, so nonchalant, that we forget that there are dangers attached to the practice? That it is not "normal" to need these drugs? That we are doing no more than putting these poor children into a drug-induced state?

Again, I understand the use of medications. When you've tried everything else, and nothing is working, and you are desperate for your child to have a happy, successful life. I get it. I've been there. I've done that.

But, it is a last resort! One taken after very careful consideration. You would think a doctor would know that.