http://www.chicagotribune.com /news/opinion/letters/chi-0212120105dec12,1,1757926.story ?coll=chi%2Dnewsopinionvoice%2Dhed 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 ----------------------------------------------------------------------------- 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." 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.
|