Archive for the ‘Children and Medication’ Category

Doctors Create a New Normal by Over-Prescribing Drugs

June 10, 2012

Some doctors seem to relish the opportunity to prescribe psychiatric drugs. After all, from the perspective of a passive observer, prescriptions of such medication are becoming all too frequent. I wonder if it will get to the stage when those not on drugs will feel left out and marginalised because of it:

PRESCRIPTIONS of antipsychotic drugs given to children have doubled in only five years, data obtained under freedom of information laws shows.

Antidepressant prescriptions have also risen, bucking international trends to reduce the use of the drugs after they were linked to children developing suicidal thoughts.

A psychiatry professor at the University of Adelaide, Jon Jureidini, said he was concerned antidepressant medication use was increasing despite warnings about suicide risks.

He said antidepressants should almost never be used in children.

After the US drug regulator issued a warning about the risk of suicide in children and teenagers taking antidepressants, there was a 58 per cent drop in the use of the drugs.

Yet between 2007 and 2011 in Australia antidepressant prescriptions increased from nearly 22 prescriptions per 1000 children aged below 16 to nearly 27, data provided to the Herald by the Department of Human Services under freedom of information laws shows.

Last year there were about 14 antipsychotic prescriptions for every 1000 children, compared with seven in 2007.

Professor Jureidini said it was likely the increase in the prescription of antipsychotics could be explained by doctors prescribing the drugs for behavioural problems, or by conditions such as personality disorder being reclassified as bipolar disorder and then treated with antipsychotics.

”There has been a very significant increase in the prescription of antipsychotic drugs and we can be pretty confident there has not been an increase in psychosis,” he said.

Antipsychotics are recommended for the treatment of children with conditions such as bipolar disorder, in some cases. National Health and Medical Research Council guidelines say doctors can consider prescribing an antidepressant for childhood depression in the short term, where psychological therapy has not been effective or has been refused.

Professor Jureidini said more monitoring of the drugs and their side effects was needed, along with training for GPs on non-pharmacological treatments.

A clinical adviser to the National Prescribing Service, Philippa Binns, said those who were prescribing antipsychotics and antidepressants to children should be specialists in children’s psychiatric problems.

I plead to doctors worldwide to please resist from writing a prescription for drugs unless you have tried all  other options which have turned out to be unsuccessful.

ADHD Diagnosis a “Convenient Out For Lazy Teachers”: Dunham

May 1, 2012

I commend for her courageous piece on the rising rates of ADD and ADHD diagnosis. Ms, Durham refuses to pull punches, raising a view I have been quite vocal about – the dubious role of teachers in the diagnosis process. Deborah suggests that teachers may be taking the lazy approach instead of the responsible one. She also raises strong arguments about the lack of research about the long-term ramifications of taking Ritalin, the contribution of diet to a child’s mental state and the lack of engagement and stimulation in school.

I’m starting to wonder if it’s possible for doctors, teachers and parents to diagnose kids with anything other than  Attention Deficit Disorder? According to a new study, the rate that kids are diagnosed continues to increase by 5.5% each year, but are there really that many more kids with ADD and ADHD? It seems like this has become a convenient “out” for many lazy teachers, doctors and parents who don’t know what to do with kids who don’t fit the “mold”.

The rates of ADHD diagnosis in the developed world increased annually by an average of 3% from 1997 to 2006 and 5.5% from 2003 to 2007 in the U.S. But researchers wanted to know–as did we–how accurate these diagnoses really are.

Led by a team of researchers at the University of Basel’s Katrin Bruchmueller, 473 child and adolescent psychotherapists and psychiatrists across Germany were surveyed on how they diagnose people with ADD or ADHD. In three out of the four cases, the described symptoms and circumstances did not fulfill ADHD diagnostic criteria. In fact, many mental health practitioners were found to base their decisions on unclear standards.

For example, male patients were more readily diagnosed when they displayed symptoms such as impulsiveness, motoric restlessness and lack of concentration–all things that can be perfectly normal when growing up. Boys were more likely to be diagnosed than girls, and on the same note, male doctors tended to diagnose ADHD more frequently than their female counterparts.

In short, what the researchers found what that ADHD is over-diagnosed because doctors rely too much on their intuition and not on a defined set of criteria.

All of this is troubling because it means that kids are the ones who are suffering as a result. Instead of taking the time to accurately diagnose them (if there is even anything at all wrong besides just being a “kid”), they are put on brain-altering drugs which is risky for anyone, especially someone who is still young and developing.

More than three million kids in the U.S. take drugs for their supposed difficulty focusing. In 30 years there has been a twentyfold increase in the consumption of these. And while medications like Ritalin may help increase concentration in the short term, not enough is known about the long-term health consequences–although some say drugs like this can stunt a child’s growth, other speculate that they can cause heart problems and even sudden death.

But is it really possible that three million kids in our country really suffer from ADD or ADHD, or has this just become a catch-all diagnosis by lazy doctors, parents and teachers?

We know that an unhealthy diet, sugar, processed foods, stress and a lack of sleep and exercise can all contribute to someone’s mental state. So, it’s entirely possible that our society has become so unhealthy that we are the ones creating these problems in our kids. And it’s not always synthetic drugs that are the answer.

The other issue that could be a major factor here is that kids are not engaged and stimulated in school enough. Taking millions of kids who all have different learning styles and trying to force them to comply and fit into one method of learning does not work. No one can possibly be expected to sit at a tiny, uncomfortable desk for eight hours a day in a classroom with florescent lights and the blinds drawn on the windows. Yet, when a child doesn’t conform, they are thought to have ADD.

Perhaps instead of jumping to conclusions and forcing our kids to swallow mind-altering drugs in order to fit our ideals of how they should behave, all of us–parents, teachers and doctors–should take more time to fully evaluate the unique learning style and personality that each child has and then alter how we interact with them accordingly. That’s not to say that everyone is lazy (because they aren’t) and there aren’t some legitimate cases of ADD (because there certainly are), but research like this points to the fact that we need to take more time and better understand how to consistently diagnose this disorder.

101 Ways to Misdiagnose ADHD

March 20, 2012

I am not sure if ADHD exists or not. Since I am not a doctor or medical professional, I will decide to err on the side of caution and give ADHD the benefit of the doubt. But whether or not it exists doesn’t seem to be the pressing issue. The issue seems more to do with the poor children misdiagnosed with ADHD in what seems to be a completely haphazard fashion:

A STUDY of almost a million Canadian children has found those born in December, the last month of the school year intake, are more likely to be diagnosed with ADHD and medicated for it than those born in January.

Relative immaturity may result in the inappropriate diagnosis of ADHD, the University of British Columbia researchers suggest.

They raise “concerns about the potential harms of overdiagnosis and overprescribing” for the condition. Children given medication for ADHD may suffer adverse effects on sleep, appetite and growth and face increased risk of cardiovascular events, the paper says.

Inappropriate diagnosis may lead teachers and parents to treat the child differently and change self-perceptions.

The study in this month’s Canadian Medical Association Journal, found boys born in December were 30 per cent more likely to receive a diagnosis of ADHD than boys born in January and 41 per cent more likely to be given medication for ADHD.

The medical fraternity has let themselves down with ADHD. It seems from this untrained eye that too many kids are being diagnosed with this condition and therefore, too many kids are needlessly medicated. What this does is bunch real sufferers of ADHD with kids who have come down with a bout of, for example, immaturity.

Children are Misdiagnosed with ADHD: What’s the Surprise?

March 6, 2012

Whilst I am not medically trained, and my opinion is based on experience rather than any medical credentials, I can’t help but wonder if ADHD even exists. If it does, then surely the seemingly rampant overdiagnosing of ADHD together with the overprescribing of Ritalin-type drugs, isn’t doing the legitimacy of the condition any favours.

I have written extensively about this issue and recounted my frustrations watching students prescribed drugs for conditions I was positive they didn’t suffer from. It seems that there are a multitude of factors that don’t get enough attention before the drugs are administered such as: diet, home life, self-esteem and social life.

Should I really be surprised when I read that some children are misdiagnosed?

Children who were born late in the school year and so are almost 12 months younger than their oldest classmates are more likely to be diagnosed and given medication like Ritalin for attention deficit hyperactivity disorder, it was found.

They are being ‘inappropriately labelled and treated’ the authors said.

Greater caution should be given to making the diagnosis in order to prevent children from being given potentially harmful medicines without justification, they said.

There are thought to be around 1.7m people with attention deficit problems in Britain with between three and seven per cent of school age children affected.

There is no data collected on how many children in Britain are on drugs for the problem but in 2010 there were over 850,000 prescriptions dispensed for medicines to treat the condition in England and Wales at a cost of almost £44m.

The study was conducted on children in British Columbia in Canada where the school year coincides with the calender year.

It was found that children born in December, so the youngest in their school year, were 40 per cent more likely to be diagnosed and almost 50 per cent more likely to be treated for ADHD than children born in January, the start of the school year.

It;s time doctors were open to more scrutiny about their ADHD diagnosis.

Healthy Eating May Help ADHD Kids: Don’t Tell the Doctors

January 10, 2012

I find the ADHD trends highly frustrating. I am not a doctor or medical professional of any kind so it’s not for me to speculate whether or not ADHD exists. What bothers me, is the rapid increases in children being diagnosed (and more importantly, medicated) with the syndrome. To me Ritalin and other types of ADHD medication must be the last resort. It’s side-effects are often quite pronounced and sometimes quite sad to experience. Kids with larger than life personalities and great bursts of creativity can often be left following their own shadows (I have personally witnessed this!)

When I first entered into the profession I was given medical forms to fill out about a particular student. A previous teacher must have recommended that this student be assessed due to the belief that she may have some ADHD symptoms. In my view she was just a child with poor self-esteem who lacked concentration. In my assessment of her I made it clear that I felt that beyond her concentration being poor there was no other reason to suspect that she may have ADHD.

It didn’t help. Unfortunately, within weeks of being presented with this patient, the doctor prescribed her with Ritalin. No suggestions of a change of diet, no therapy to examine if there is any cause for her low self-esteem and no evidence that she was sent to have her language skills tested. Just the “go to” method, the “one pill fits all” strategy – the blasted pill!

I am proud to say that this child is now off the medication. Her parents decided it was not something they wanted her to be on permanently so they eased her off it. Doctors would be shaking their heads right now and accusing the parents of being irresponsible. But the parents were right. She is now a happy, focussed, non-medicated young teenager.

Doctors can be far too quick to diagnose and prescribe. In my view, they do this out of self-interest. If they were more considerate they would seriously look at diet before prescribing Ritalin.

SIMPLY eating healthier may improve the behaviour of children with attention deficit hyperactivity disorder (ADHD) if therapy and medication fail, says a study published in the journal Pediatrics.

Nutritional interventions should therefore be considered an alternative or secondary approach to treating ADHD, not a first-line attack, said the review by doctors at Northwestern University Medical School in Chicago, published on Monday.

What they mean by that is first pop the pills and then consider your sugar intake. This is ridiculous. What is the big deal about investigating diet and other possible causes before, as a last resort, prescribing the medication?

Click on the link to read Who Needs Quality Teaching or Parenting When You Have Medications?

Click on the link to read Get Your Kids on Ritalin Before Their Grades Suffer

Click on the link to read It is Doctors Not Teachers Who Are Helping Children Get Good Grades

Experts: Medicate Your ADHD Kid or We’ll Report You To The Authorities

November 21, 2011

I suppose it was only a matter of time.  The writing was on the wall earlier this year when experts were outraged when a mother, Christie Haskel, claimed that coffee had cured her son of ADHD.  The medical experts came out in force against Ms Haskel.  How can this woman treat her child with something other than a drug with pharmacological effects that resemble closely those of cocaine and amphetamines?  And coffee? That could damage the poor child’s health!

Now it seems they have taken their pro-drug, anti-choice platform a further step into the ultra-extreme. Now they are threatening parents – take the drugs or you’ll be reported:

EXPERTS have warned that parents who don’t medicate children with ADHD could be referred to child protection authorities under controversial draft guidelines being considered by the National Health and Medical Research Council.

The practice points, to guide doctors who treat the disorder, were drawn up by an NHMRC expert working group to address community concern over the use of stimulant medication to treat attention deficit hyperactivity disorder. They state: “Consideration should be given to the ability of the child/adolescent and their caregivers to implement strategies. As with any medical intervention, the inability of parents to implement strategies may raise child protection concerns.”

Child psychiatrist and Monash University lecturer George Halasz says the situation should not be seen as unique to ADHD and parents who fail to manage serious conditions such as their child’s asthma or diabetes could also be considered to be failing their duty as a parent.

Dr Halasz said the new guidelines were a step in the right direction because they asked doctors to first try to find other explanations for a child’s behaviour before they diagnosed ADHD.

Firstly there is a gulf of difference between a parent’s decision not to administer ADHD drugs and a decision not to treat a child for asthma and diabetes. Secondly, this move does not promote trying alternate methods but reinforces what many suspect; that Ritalin and it’s type have become a one-stop fix for a condition yet to be fully proven.

The British Psychological Society said in a 1997 report that physicians and psychiatrists should not follow the American example of applying medical labels to such a wide variety of attention-related disorders: “The idea that children who don’t attend or who don’t sit still in school have a mental disorder is not entertained by most British clinicians.”

Another problem I have, is how can you even consider reporting parents for not giving their children a drug that has the following possible side-effects:

How about we report lazy doctor to the authorities who prescribe this drug without due process? How about we report bullying tactics by so-called experts? How about we let parents decide for themselves what is in the best interests of their children?

How about you think about the consequences of drugging such a large proportion of our young?

Prescribing ADHD Drugs to 4-Year Olds Seems Irresponsible

October 17, 2011

I am not a doctor, so I do not have the expertise to comment on the ADHD diagnosis becoming a regular feature of classrooms across the globe.  But I can’t help but get agitated as kids younger and younger are being given these drugs.  The cynic in me suspects that this has more to do with pharmaceutical profits and less to do with responsible medicine.

Children as young as 4 years old may now be treated with medications such as Novartis AG (NOVN)’s Ritalin for attention deficit hyperactivity disorder, under new guidelines from the American Academy of Pediatrics.

The recommendations, the first in a decade, expand the age range of kids who may be prescribed the drugs from preschoolers through 18-year-olds. Earlier guidelines included children ages 6 to 12. ADHD affects about 8 percent of children and youth and is the most common neurobehavioral disorder in kids, according to the American Academy of Pediatrics.

Expanding the age range will help ensure more children get the appropriate therapy, according to the guidelines. Treating preschoolers may increase their chances of succeeding in school and targeting teens recognizes that ADHD is a long-term condition that may even extend into adulthood.

“Because of greater awareness about ADHD and better ways of diagnosing and treating this disorder, more children are being helped,” said Mark Wolraich, lead author of the report and a professor of pediatrics at the University of Oklahoma College of Medicine in Oklahoma City, in a statement.

For preschoolers with the disorder, it’s recommended that parents and teachers first try to manage children with behavior therapy that uses a system of rewards and consequences. If that doesn’t work, then doctors can prescribe medications, according to the recommendations being presented today at the American Academy of Pediatrics National Conference and Exhibition in Boston.

I have three major issues with the last paragraph in particular.

1.  I don’t believe you can determine such a disorder at such a young age with such confidence as to justify prescribing a Ritalin-like drug to them.

2. The idea that some “behaviour therapy” is all that is tried before a child gets a prescription is just shocking.  There should be many steps before a child warrants a prescription.  Prescribing drugs to a child should be the last resort.  And who checks whether the behaviour therapy was properly administered?  How many teachers say they have tried everything, when you know they haven’t even come close?

3.  This leads me to my third point.  Teachers should not have such a big say in the decision to prescribe drugs to a child.  Teachers are often too easily motivated by the need to teach a civil and restrained class.  Their need to see students calm and manageable often gets in the way of a more considered approach when it comes to the question of ADHD drugs.

Four year olds on ADHD drugs!  Do we really want this to become the norm?

Mum Gives Her Son Coffee to Treat His ADHD

September 8, 2011

Whilst I don’t for a second advocate giving coffee to a child, I applaud Christie Haskel for trying to find an alternative to the drugs doctors prescribe.  As I was watching the abc report on this mother I felt like the reporter was trying to manipulate me into thinking that this woman acted irresponsibly and recklessly by treating her child without consulting a doctor.

But I didn’t fall for the manipulation.  Good on her for resisting Ritalin.  She has every right to find an alternative to a drug many parents are weary of.  Below are some issues I had with the reporting of this story.

1.  The story quotes that “experts say there is no proof it works.”

Well actually I am of the opinion that if it works for some people, as it has worked for this mother it “can” work.  No more proof required.

2.  The piece lists the “potentially dangerous side-effects of caffeine.”

What about the potential side-effects of Ritalin?

  • Abdominal pain
  • Akathisia
  • Alopecia
  • Angina
  • Appetite loss
  • Anxiety
  • Blood pressure and pulse changes (both up and down)
  • Cardiac arrhythmia
  • Diaphoresis (sweating)
  • Dizziness
  • Dyskinesia
  • Dysphoria or Euphoria
  • Formication
  • Headaches
  • Hypersensitivity (including skin rash, urticaria, fever, arthralgia, exfoliative dermatitis, erythema multiforme, necrotizing vasculitis, and thrombocytopenic purpura)
  • Lethargy
  • Libido increased or decreased
  • Nausea
  • Palpitations
  • Pupil dilation[45]
  • Psychosis
  • Short-term weight loss
  • Somnolence
  • Stunted growth
  • Tachycardia
  • Xerostomia (dry mouth aka cotton mouth)

3.  A Psychiatrist is presented warning parents not to become deluded into thinking coffee can cure ADHD:

Can drugs cure ADHD?

A meta analysis of the literature concluded that methylphenidate quickly and effectively reduces the signs and symptoms of ADHD in children under the age of 18 in the short term but found that this conclusion may be biased due to the high number of low quality clinical trials in the literature. There have been no placebo controlled trials investigating the long term effectiveness of methylphenidate beyond 4 weeks thus the long term effectiveness of methylphenidate has not been scientifically demonstrated. Serious concerns of publication bias regarding the use of methylphenidate for ADHD has also been noted. A diagnosis of ADHD must be confirmed and the benefits and risks and proper use of stimulants as well as alternative treatments should be discussed with the parent before stimulants are prescribed.

4.  The question is asked how does the mother know that by solving this one problem she isn’t creating several new ones:

I ask the same question about traditianal ADHD medication:

It was documented in 2000, by Zito “that at least 1.5% of children between the ages of two and four are medicated with stimulants, anti-depressants and anti-psychotic drugs, despite the paucity of controlled scientific trials confirming safety and long-term effects with preschool children.”

It is ludicrous to attack a mother for trying to find alternatives to a drug that comes with known side-effects, has stark similarities to cocaine and amphetamines and hasn’t convincingly proven the case against dependency or long-term side-effects.

Coffee isn’t something you’d want to be giving a child but neither is Ritalin.  I know which one I would rather give my child.

 

Introducing -The Truacy Drug!

August 2, 2011

Sooner or later there will be a drug for everything.  No problem self-made or genetic will be without its own medication.

And we will all be worse for it.

I have a very cynical view of the pharmaceutical industry.  I don’t believe what they are telling us about how they are giving children with poor concentration a quality of life they wouldn’t ordinarily have.  Maybe I should buy in to it, but I don’t.  Instead, I believe that they are replacing one problem with the threat of a much bigger problem.  The effect of drugs on a child isn’t fully known yet.  I fear that when we do have comprehensive data on the effects of drugs such as Ritalin on young children, we won’t like what we see.

The latest drug to concocted is a truancy drug.  That’s right, a drug for not wanting to go to school!  It is recommended that no child under 18 take it, but whoops, that rules out school aged children!  Not much point making a truancy drug for adults.

So  they scrap the idea, right?  Nope.  They find a way to trial the drug on kids aged as young as 11:

SCHOOL truants as young as 11 are being given a powerful ADHD and antidepressant drug in a controversial trial.

The drug, Lovan, is not recommended for anyone under the age of 18 but is being prescribed for children as part of a School Refusal Program being led by Professor Bruce Tonge.

Prof Tonge is chairman of a federal government committee setting new guidelines for the treatment of attention deficit hyperactivity disorder.

But the side-effects are minimal, right?  Nope.

Prof Tonge said the children on the trial and their parents had been warned of potential side-effects of Lovan, including suicidal tendencies.

The question I am bursting to ask is, why do we need a drug for something which is a product of  factors likely to be unrelated to the child’s mental state.

But asking that questions will show me up as a pharmaceutical non-believer.  Because logic isn’t important here.  What is important is that every problem must have its own approved drug.

I’d love to write more on this issue but I’ve got to take my pills now.  I’m trialling a new drug for people who don’t enjoy paying bank fees.

Parents Overdosing Their Kids on Paracetamol

June 7, 2011

It’s crucial for preserving the health of your child’s liver that you take care when administering painkillers with paracetamol:

Regulators are updating the information displayed on the labels of the medicines in order to make them clearer and better tailored to babies and young children.

The new guidance follows research published last month that showed one in four young patients is given too much of the pain reliever, putting them at risk of liver damage.

The study also found that parents often give their children Calpol or similar medicines containing paracetamol at home before going to the GP who then prescribes yet another painkiller.

At the moment, there is one age band for those aged six to 12 years-old, but this will now be split into three bands.

The guidance currently says children aged six to 12 should have 5ml to 10ml of medicine, up to four times in 24 hours.


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