Re: Science, vol 305, no. 5687, August 20, 2004, p 1088
News of the
Week
Human Subjects
Research
Pediatric Study
of ADHD Drug Draws High-level Public Review.
To the Editor: September 8, 2004 (submission
date)
The journal Science should be about science. Everything medical-biological about ADHD and
all psychiatric “disorders” is pseudo-science. Your article supporting
the administration of dextroamphetamine to normal children as well as ADHD
children, who, are just as normal,
reads:
· “A
trial that would give healthy children an amphetamine is prompting heated
debate…”
By “healthy” you must mean
normal/disease-free.
· “Early
next month, a newly formed FDA advisory panel will meet…to discuss the
proposal’s safety and ethics…”
What safety? What
ethics? All physicians go to medical
school to learn the difference between normal and abnormal/diseased, and how,
clinically, to distinguish the two. FDA
physicians know that no psychiatric disorder, is an abnormality/disease in a
medical-biological sense.
· “The
NIH study is designed to answer a long-standing question: Does a type of
medication prescribed for hyperactivity affect the brains of children with
ADHD differently than it does the brains of children without the
condition?”
“Children with ADHD” and “children without the condition”
are both physically normal/ disease-free, and, therefore, physically
indistinguishable. Both groups are to
be given addictive, dangerous, dextroamphetamine. It is presumed, but, never been proven, that an
abnormality/disease is present in the “children with ADHD.”
- “Her
project (that of Judith Rapoport, NIMH) ‘could tell us a lot about what’s
dysfunctional in ADHD,’ says F. Xavier Castellanos…”
Castellanos infers there is something
dysfunctional/abnormal/diseased in the brains of individuals with ADHD, knowing
full-well that no study, including the PET scan study of Zametkin et al (1990)
or the structural MRI study of Castellanos et al (2002) has been replicated,
meaning, that there is no evidence that ADHD is a disease having a
confirmatory, objective abnormality for which to test, by which to distinguish,
“children with ADHD” from “children
without the condition.”
- “Rapoport
and her colleagues aim to enroll 76 children, ages 9-18, including 24 sets
of twins, only one of whom in each pair has the disorder. Subjects will
receive a dose of dextroamphetamine and undergo functional magnetic
resonance imaging scans.”
In that there is no physical abnormality for which to test,
by which to distinguish, twins “with ADHD” from twins “without the condition,”
there is no justification for the study to proceed. All biological studies which presume that ADHD is an abnormality/disease
when this has never been proved, are destined to prove nothing, and, if carried
out, are unethical and immoral.
- “On
the one hand, he (D. Diekema
bioethicist) says dextroamphetamine has been used for decades for
ADHD and is generally considered safe.”
On the contrary, the DEA (1995) holds that all amphetamines
have a “very high” potential for abuse and are listed in Schedule II of the
Controlled Substances Act.
Moreover, between 1990 and the present, 16 structural-MRI
studies have been done, showing brain atrophy in ADHD subjects, claiming this
is the proof that ADHD is a brain disease.
However, only one of the 16 studies–that of Castellanos, et
al, (2002)– contained “a substantial
number of previously unmedicated
children and adolescents with ADHD,” and it was rendered invalid by the use of
control subjects more than two years older than the ADHD subjects, and not
comparable. In all of the
remaining 15 studies, the majority of the ADHD subjects were “treated ”
proving, not that ADHD is a disease, but that the amphetamines used to treat
them were the cause of the brain atrophy.
When it was divulged at the 1998, NIH, ADHD, Consensus Conference that
all such studies, to that date, dealt with “treated” ADHD subjects, the
Conference Panel was forced to conclude: “ …we do not have an
independent, valid test for ADHD, and there are no data to indicate that ADHD
is due to a brain malfunction.” In
1998, with no proof that ADHD was an actual abnormality/disease, the epidemic
stood at our million.
Whereas (1) ADHD is not a proven disease, and (2) the
Schedule II, psycho-stimulants (amphetamines, Ritalin, etc.) used to “treat” it
cause grossly-evident brain atrophy and are highly addictive–no
biological-medical research such as this is justifiable. For the same reasons, that is, because the
risk vs. benefit analysis is unacceptable, there should be an immediate embargo
of these, and all psychoactive drugs for the treatment of children said to have
ADHD, which, in fact, is not an abnormality/disease at all.
Bibliography:
F. Xavier
Castellanos, MD ; Patti P. Lee, MD; Wendy Sharp, MSW; Neal O. Jeffries, PhD;
Deanna K. Greenstein, PhD; Liv S. Clasen, PhD; Jonathan D. Blumenthal, MA;
Regina S. James, MD; Christen L. Ebens, BA; James M. Walter, MA; Alex
Zijdenbos, PhD; Alan C. Evans, PhD; Jay N. Giedd, MD; Judith L. Rapoport, MD Developmental
Trajectories of Brain Volume Abnormalities in Children and Adolescents With
Attention- Deficit/Hyperactivity Disorder.
JAMA.
2002;288:1740-1748.
Drug Enforcement Administration of the US Department of
Justice. Methylphenidate (A Background
Paper) October, 1995. Drug and Chemical Evaluation Section, Office of Diversion
Control.
NIH Consensus Development Conference on ADHD (transcript),
November 16-18, 1998, National Institutes of Health, Bethesda, MD.
Zametkin AJ, et al. Cerebral Glucose Metabolism in Adults
with Hyperactivity of Childhood Onset.
N Engl. J. Med. 1990;323:1361-6.