Ritalin is effective and safe treatment for ADHD by Rafael Muniz, MD, Associate medical director, Novartis Pharmaceuticals Corp Published December 12, 2002, Chicago Tribune - Letter to Editor, Chicago Tribune by Fred A. Baughman Jr., MD

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Ritalin is effective and safe treatment for ADHD 
 
Rafael Muniz, MD, Associate medical director, Novartis Pharmaceuticals Corp 
Published December 12, 2002  
 
East Hanover, N.J. -- I'm concerned about the Chicago Tribune's decision to 
reprint a HealthScout News Service report on a study in the Journal of 
Neuroscience.  
 
The news brief, "Drugs and young brains" (Q, Nov. 10), included information 
that could potentially mislead and misinform patients, parents and the 
general public about medical treatments for attention deficit hyperactivity 
disorder. Specifically the article stated that ADHD treatments such as Ritalin
may "upset brain chemistry" during adolescence. It is important to point out 
that the study in question, which investigated the effects of cocaine and 
amphetamine on the brains of adolescent mice, did not include Ritalin. 
 
Contrary to what the article implies, Ritalin is not an amphetamine.
Therefore, it is misleading to make conclusions about Ritalin, which has 
been used safely and effectively in the treatment of ADHD for more than 45 
years.  
 
Moreover, neither the researchers nor the article mention other published 
peer-reviewed human studies demonstrating that stimulant treatment for ADHD 
actually reduces the risk for substance abuse among ADHD patients, who are 
at an increased risk for this behavior when left untreated. One such study, 
conducted by researchers at Harvard, was published in the August 1999 issue 
of Pediatrics and found a significant decrease in substance abuse among 
adolescent and adult ADHD patients who were treated with stimulants.  
 
Copyright © 2002, Chicago Tribune 
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Letter to the Editor, Chicago Tribune December 16, 2002

From: Fred A. Baughman Jr., MD, Neurology/Child Neurology; author of forthcoming
book: “The ADHD Hoax.”

1303 Hidden Mountain Drive

El Cajon, CA 92019

619 440 8236

Rafael Muniz, MD, Associate medical director for Novartis, manufacturer of Ritalin,
wrote to the Chicago Tribune, December 12, 2002, concerned about their having
reprinted a study suggesting that Ritalin might cause brain damage.
As a Novartis employee, Muniz speaks for Novartis and would say nothing but that
“Ritalin is effective and safe treatment for ADHD.”

Referring to “medical treatments for attention deficit hyperactivity disorder”, Muniz
conveys that ADHD is a disease/abnormality in need of medical
treatment/medication/normalizing. This is the first lie of the Novartis sales pitch, and a
complete lie, for ADHD has never been validated as a disease having a physical
(including chemical) abnormality within the individual. Without a demonstrable
abnormality, the individual has no disease, but is normal.

Next, Muniz takes issue with the statement that Ritalin “may upset (the) brain
chemistry.” In that no child/person said to have ADHD has been shown to have an
abnormality/disease, and, in that every drug/exogenous compound is known to alter brain
and body function, there can be no doubt that, upon ingestion, Ritalin alters/renders
abnormal, the brain and body of everyone taking it.

Stating “Ritalin is not an amphetamine”, Muniz/Novartis misleads again. The Drug
Enforcement Administration [Methylphenidate (A Background Paper) October, 1995]
states: “Methylphenidate is a Schedule II stimulant which is structurally and
pharmacologically similar to the amphetamines.”

Muniz/Novartis close with yet another lie; that Ritalin (methylphenidate) is not addictive.
He/they state:

“Moreover, neither the researchers nor the article mention other published
peer-reviewed human studies demonstrating that stimulant treatment for ADHD
actually reduces the risk for substance abuse among ADHD patients, who are
at an increased risk for this behavior when left untreated. One such study,
conducted by researchers at Harvard, was published in the August 1999 issue
of Pediatrics [Biederman, et al] and found a significant decrease in substance
abuse among adolescent and adult ADHD patients who were treated with
stimulants.

Biederman, et al, researchers long-time ties to Novartis and CHADD, compared 56
medicated and 19 (nineteen) non-medicated ADHD subjects, and concluded (1) that the
never-validated “disease” ADHD was a risk factor for substance use disorder (SUD) in
adolescence, and (2) that Ritalin/amphetamine treatment—treatment with substances of
addiction–was associated with an 85% reduction in risk for SUD in ADHD youth. With
this single, small, contrived, study, Biederman, et al, Muniz and Novartis claimed to
negate a half-century of addiction/pharmacological literature on Ritalin/methylphenidate.
Despite petitions by Ciba/Novartis and CHADD, the DEA and INCB continue, as the
evidence demands, to classify Ritalin as a Schedule II, controlled substance. The DEA
states [Methylphenidate (A Background Paper) October, 1995]:

In the United States, methylphenidate was placed in Schedule II of the Controlled
Substances Act in 1971. This action was based, in part, on a review by the
Department of Health and Human Services (DHHS). The recommendation by the
Secretary reflected advice from the National Academy of Science/National
Research Council Committee on Problems of Drug Dependence and the
Commissioner of the Food and Drug Administration. Both recommended that
methylphenidate be placed in Schedule II of the CSA. It was found that
methylphenidate’s pharmacological effects are essentially the same as those of
amphetamine and methyamphetamine and that it shares the same abuse potential
as these Schedule II stimulants.”

Novartis, CHADD, and the NIMH continue their fraudulent mis-representation of this
single, contrived, study to be the consensus of the addiction/pharmacological literature on
Ritalin/methylphenidate and all Schedule II amphetamines used in the treatment of the
never-validated “brain disease” ADHD.

End-notes:

[PEDIATRICS Vol. 104 No. 2 August 1999, p. e20 Pharmacotherapy of
Attention-deficit/Hyperactivity Disorder Reduces Risk for Substance Use Disorder
Joseph Biederman, MD et al]

The cumulative incidence of SUD throughout adolescence was compared in
56 medicated subjects with ADHD, 19 nonmedicated subjects with ADHD, and 137 non-
ADHD control subjects. Results. Unmedicated subjects with ADHD were at a
significantly increased risk for any SUD at follow-up compared with non-ADHD control
subjects (adjusted OR: 6.3 [1.8-21.6]). Subjects with ADHD medicated at baseline were
at a significantly reduced risk for a SUD at follow-up relative to
untreated subjects with ADHD (adjusted OR: 0.15 [0.04-0.6]). For each SUD subtype
studied, the direction of the effect of exposure to pharmacotherapy was similar to that
seen for the any SUD category.

Conclusions. Consistent with findings in untreated ADHD in adults, untreated ADHD
was a significant risk factor for SUD in adolescence. In contrast, pharmacotherapy was
associated with an 85% reduction in risk for SUD in ADHD youth.

Nadine Lambert’s research presented at the NIH Consensus Development
Conference. In her paper, Stimulant Treatment as a Risk Factor for
Nicotine Use and Substance Abuse, she concluded:” This prospective
longitudinal study of ADHD and age-mate control subjects…has provided
evidence that childhood use of CNS treatment is significantly and
pervasively implicated in the
uptake of regular smoking, in daily smoking in adulthood, in cocaine
dependance, and in the lifetime use of cocaine and stimulants”
(p.198).

Dr. Lambert is a professor and the Chairperson of the UC-Berkeley
School Psychology Program.