Tuesday, September 20, 2016

Sally Satel, MD reviews "ADHD Nation" by Alan Schwarz

9/20/16. My two cents:

         Psychiatrist Sally Satel in her review of NYT reporter Alan Schwarz’s book, “ADHD Nation,” (WSJ 9/12/16) describes the long simmering plague of American children who have been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and take pills to treat the disorder.


          Dr. Satel tells us --- in one sentence of her 1000 word review --- that “Mr. Schwarz readily concedes that many children have benefited from the medications for ADHD.” I am surprised that Mr. Schwarz has made this concession given some of his previous articles on ADHD:  “The Rise of the Good Grade Pill” (NYT 6/9/2012); and “Drowned in the Stream of Prescriptions” (NYT 2/2/13).   


          In my experience of forty years as a child psychologist, most parents are leery about giving psychiatric drugs to their children --- such as Ritalin or anything else. In fact, it’s hard for kids to comply with eight days of required antibiotic treatment for an infection. There is no questions that stimulant medication significantly improves the social, emotional, and academic lives of many children, adolescents, and adults. This view fits my experience and more importantly, the many years of scientific research.


          In you journal a few weeks ago (8/17/16: “Medicating Children With ADHD Keeps Them Safer”) psychologist Susan Pinker describes a 2015 study of over 710,000 Danish children finding that 10- to 12-year-olds with ADHD were far more likely to be injured than other children their age. With drug treatment, the number of emergency room visits by children with ADHD was cut in half – some plague.


That doctors promiscuously drug children whose problems stem from temperamental sensitives rather than psychiatric disorders, assisted by intolerant, label craving teachers --- is wildly exaggerated, a view helped along by the anti-psychiatric medication crowd --- that includes the wealthy Scientology cult  --- claiming that the biology of mental illness is a myth. If it is a myth, it is a myth with a strong genetic component.


Symptoms of ADHD --- restlessness, distractibility, and impulsivity --- must be chronic (date back to childhood) and pervasive (occur at home, school, and with peers) to fit the diagnosis.


A comprehensive psychological and medical evaluation is needed to diagnose ADHD or any other psychiatric disorder.

Until we have a medical test to identify ADHD, no amount of scientific knowledge – and there is plenty, clinical experience, or testimonies from parents and youngsters will convince some citizens of the validity of the neurophysiological disorders such as ADHD.

Most children, adolescents, and adults with ADHD and coexisting conditions never get help --- and some are not lucky enough to get to the emergency room.

      I appreciate the concerns raised in Dr. Satel’s review. Children should be protected from the risks of taking medications they don’t need.

      I hope this protection does not help to generate the side effects of growing up with untreated ADHD --- side effects such as school failure, depression, delinquency, substance abuse and suicide.








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