Monday, December 16th, 2013
The rising number of diagnoses with attention deficit hyperactivity disorder (ADHD), particularly among kids, has been paired, logically, with a sharp rise in the number of prescription drugs distributed to treat the condition. But some medical experts, even longtime advocates for better diagnostic tools and more aggressive treatment, are questioning whether drug companies have played fair with their marketing tactics. More from NBC News:
The rise of A.D.H.D. diagnoses and prescriptions for stimulants over the years coincided with a remarkably successful two-decade campaign by pharmaceutical companies to publicize the syndrome and promote the pills to doctors, educators and parents. With the children’s market booming, the industry is now employing similar marketing techniques as it focuses on adult A.D.H.D., which could become even more profitable.
Few dispute that classic A.D.H.D., historically estimated to affect 5 percent of children, is a legitimate disability that impedes success at school, work and personal life. Medication often assuages the severe impulsiveness and inability to concentrate, allowing a person’s underlying drive and intelligence to emerge.
But even some of the field’s longtime advocates say the zeal to find and treat every A.D.H.D. child has led to too many people with scant symptoms receiving the diagnosis and medication. The disorder is now the second most frequent long-term diagnosis made in children, narrowly trailing asthma, according to a New York Times analysis of C.D.C. data.
Behind that growth has been drug company marketing that has stretched the image of classic A.D.H.D. to include relatively normal behavior like carelessness and impatience, and has often overstated the pills’ benefits. Advertising on television and in popular magazines like People and Good Housekeeping has cast common childhood forgetfulness and poor grades as grounds for medication that, among other benefits, can result in “schoolwork that matches his intelligence” and ease family tension.
A 2002 ad for Adderall showed a mother playing with her son and saying, “Thanks for taking out the garbage.”
The Food and Drug Administration has cited every major A.D.H.D. drug — stimulants like Adderall, Concerta, Focalin and Vyvanse, and nonstimulants like Intuniv and Strattera — for false and misleading advertising since 2000, some multiple times.
Sources of information that would seem neutral also delivered messages from the pharmaceutical industry. Doctors paid by drug companies have published research and delivered presentations that encourage physicians to make diagnoses more often that discredit growing concerns about overdiagnosis.
Many doctors have portrayed the medications as benign — “safer than aspirin,” some say — even though they can have significant side effects and are regulated in the same class as morphine and oxycodone because of their potential for abuse and addiction. Patient advocacy groups tried to get the government to loosen regulation of stimulants while having sizable portions of their operating budgets covered by pharmaceutical interests.
Image: Prescription pills, via Shutterstock
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Tuesday, November 26th, 2013
New research by the Centers for Disease Control and prevention reports that attention deficit hyperactivity disorder (ADHD) affects 11 percent of American children, spiking a staggering 43 percent since 2003 and growing by 2 million children since 2007. Researchers, far from being alarmed, are saying the finding shows that public awareness efforts and better diagnostic tools are helping families and doctors make an accurate number of diagnoses. More from CNN.com:
Today, 6.4 million children between the ages of 4 and 17 – 11% of kids in this age group – have received an ADHD diagnosis, according to the study, which is based on a survey of parents. That’s 2 million more children than in 2007.
The number of children using medications to treat ADHD is also rising. Since the last survey taken in 2007, there has been a 28% increase in children taking drugs to manage the disorder. More than 3.5 million children in the 4 to 17 age group, or 6%, are taking ADHD medications, the survey found.
These data are part of the CDC’s National Survey of Children’s Health, a national cross-sectional, randomized telephone survey. The survey is conducted every four years, and questions about ADHD diagnosis have been included since 2003. The latest data are from interviews conducted via telephone from February 2011 and June 2012, with 95,677 interviews completed and an overall response rate of 23%.
But while rising rates of ADHD diagnosis may be an alarming headline, Dr. John Walkup, director of child and adolescent psychiatry at Weill Cornell Medical College and New York-Presbyterian Hospital, found some positive news when looking at rates of prevalence and treatment. In his view, the data suggest that the increasing diagnosis rate of ADHD is getting closer to the true prevalence of ADHD, which is even higher.
“We’ve been working so hard for so long to improve treatment,” Walkup said. “If the prevalence rate is 9 to 11% and we’re getting 8% currently diagnosed, it suggests that the public advocacy for treatment is paying off.”
Image: ADHD buttons, via Shutterstock
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Thursday, November 7th, 2013
A new, broader definition of attention deficit hyperactivity disorder (ADHD) is leading to over-diagnosis and unnecessary medication of many children, a new report published in the British Medical Journal says. The rise also amounts to a $500 million bump in health care costs associated with ADHD in the U.S. alone. More from Reuters:
Less restrictive diagnostic criteria have contributed to a steep rise in diagnoses for the behavioral brain condition -particularly among children – the researchers said, and in the use of stimulant drugs to manage it.
The broader definition also “devalues the diagnosis in those with serious problems”, said Rae Thomas, a senior researcher at Australia’s Bond University who led an analysis of the problem and has published it in the British Medical Journal.
“The broadening of the diagnostic criteria is likely to increase what is already a significant concern about overdiagnosis,” he said. “It risks resulting in a diagnosis of ADHD being regarded with skepticism, to the harm of those with severe problems who unquestionably need sensitive, skilled specialist help and support.”
People with the ADHD are excessively restless, impulsive and easily distracted, and children with the condition often have trouble in school. It is most often diagnosed in children, mainly boys, but it is also known to persist into adulthood.
There is no cure, but the symptoms can be kept in check by a combination of behavioral therapy and medications such as Ritalin or a newer drug called Vyvanse.
Image: Hyper boy, via Shutterstock
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Tuesday, October 1st, 2013
The number of children who are being prescribed medications for mental health conditions including attention deficit hyperactivity disorder (ADHD) and anxiety is stabilizing, even as the number of children diagnosed with those disorders continues to rise. More from Time.com:
From the early 1990s to the early 2000s, the number of young children on psychotropic drugs, which include anti-depressants, stimulants, mood stabilizers and anti-anxiety agents, increased by two- to three- fold. Some drugs, including several ADHD medications, have been approved for use in children ages six to 12, while others have not studied long term in younger patients.
But in a new study published in the journal Pediatrics, researchers report that psychotropic drug treatments among children is stabilizing, according to data from a national sample of more than 43,000 kids between the ages of two and five. These drug prescriptions peaked between 2002 and 2005, and leveled off from 2006 to 2009.
While more refined guidelines for diagnosing mood and behavioral disorders among children may explain some of the change in medication use, more stringent warnings about the potential risks of psychotropic drugs on youngsters probably also played a role. In the mid-2000s, the Food and Drug Administration started adding its strictest black box warning to antidepressant medications, alerting doctors and patients to the serious risks these treatments could pose for children and adolescents. For those reasons, more pediatric groups advise doctors to start their youngest patients on behavioral therapies first, before relying on medications to treat their symptoms. “Our findings underscore the need to ensure that doctors of very young children who are diagnosing ADHD, the most common diagnosis, and prescribing stimulants, the most common kind of psychotropic medications, are using the most up-to-date and stringent diagnostic criteria and clinical practice guidelines,” the authors conclude.
However, some recent research showed that more than one in five specialists who diagnose and recommend treatment for preschoolers with ADHD turn to drug therapy first, either alone or in tandem with behavior therapy.
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Friday, July 26th, 2013
Breastfed babies may carry a lower risk of being diagnosed with attention deficit hyperactivity disorder (ADHD), which is the most commonly diagnosed behavioral disorder in children, according to new research conducted at Tel Aviv University. More from ScienceDaily.com:
Seeking to determine if the development of ADHD was associated with lower rates of breastfeeding, Dr. Aviva Mimouni-Bloch, of Tel Aviv University’s Sackler Faculty of Medicine and Head of the Child Neurodevelopmental Center in Loewenstein Hospital, and her fellow researchers completed a retrospective study on the breastfeeding habits of parents of three groups of children: a group that had been diagnosed with ADHD; siblings of those diagnosed with ADHD; and a control group of children without ADHD and lacking any genetic ties to the disorder.
The researchers found a clear link between rates of breastfeeding and the likelihood of developing ADHD, even when typical risk factors were taken into consideration. Children who were bottle-fed at three months of age were found to be three times more likely to have ADHD than those who were breastfed during the same period. These results have been published in Breastfeeding Medicine.
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