ADHD Symptoms Revisited

In an earlier article here on the EzineArticles website, I discussed a piece by L. Alan Sroufe that had appeared in the New York Times, seriously questioning the effectiveness of Ritalin, Adderall and other stimulants used to treat children with ADHD symptoms. My article largely supported Sroufe’s view, but I’ve since come to believe that the issue deserves another look.

Shortly after Sroufe’s article appeared, Harold S. Koplewicz MD, President of the Child Mind Institute, wrote a point-by-point rebuttal of it; if you’re interested in this issue, the article by Koplewicz bears buy adderall online  reading and can be found online. I won’t bother to summarize the whole piece, but suffice it to say that he brings some fairly persuasive evidence in support of the effectiveness of stimulants to treat ADHD symptoms in children and raises important questions about the validity of the studies cited by Dr. Sroufe and the conclusions drawn from them.

I still have major objections to the current ways we think about and treat ADHD symptoms, however, and I’m not ready to write off Dr. Sroufe, as Koplewicz does. First of all, any discussion that asks the question ‘What is ADHD?’ misses the point; ADHD is not a disease condition, as the label would have us believe. Instead, as defined by the APA in its Diagnostic and Statistical Manual, it’s a set of behavioral markers that many people believe indicate a disease state, but can actually be produced by any number of different conditions, including brain abnormalities, early physical insults, emotional trauma, etc.

The disease model of the current DSM, along with marketing strategies employed by the pharmaceutical industry, contribute to the common misconception that an actual “disease state” has been identified not only for ADHD, but also for depression and other psychological conditions. By and large, the effects of the most common psychiatric medications in use today were actually discovered by accident; once their neuro-chemical effects were better (though not entirely) understood, an underlying disease state was then hypothesized but never proven. As I continually state on in my articles here on eZine, there is no evidence whatsoever to support the theory that depression symptoms are caused by insufficient serotonin in the neural synapses.

Even if we accept that ADHD symptoms result from different conditions, isn’t it possible that the stimulants currently prescribed remedy these symptoms, whatever their origin? Evidence from a great many scientific studies suggests that indeed they do. But I’m more skeptical about this kind of evidence than most people; whenever someone insists that a drug’s effectiveness has been “proven”, I want to ask exactly what that means. For the purposes of FDA approval, a drug’s effectiveness must be demonstrated via clinical trials designed in scientifically acceptable ways and there must be a statistically significant difference between results for groups receiving placebo vs. the actual drug; that doesn’t necessarily say a lot about the degree of the drug’s effectiveness, however.

For instance, new cancer drugs that extend the life of a terminal patient by only three months often receive FDA approval because that’s a statistically significant difference in outcomes, but such drugs certainly don’t cure or eliminate the illness. Koplewicz does make it clear that there is no cure for ADHD, but in my view, he doesn’t look hard enough at what these stimulants actually do and do not do for ADHD symptoms. How much do they help? Which symptoms do they remedy and which are unaffected? What are the side effects and do they outweigh the benefits?

Yes, these stimulants help you focus attention and perform repetitive mental work more easily — and for many, that alone is almost miraculous. They can also help enormously with problem behavior in the classroom. Over the past week, I’ve spent quite a bit of time visiting online forums where people discuss their reactions to Adderall, Ritalin and other stimulants. This may be anecdotal, unscientific evidence but there’s no question in my mind that these drugs have dramatically changed the lives of many, many people. I’ve also read a large number of accounts from people who felt dull, apathetic or zombie-like while taking these medications; many of them underwent disturbing personality changes and some had psychotic episodes.