From the Los Angeles Times:

A new series of studies of children in Finland and the United States raises provocative questions about the benefits of medicating children with ADHD. Among the findings: by the time they’re in their late teens, people who received drugs for attention problems seem to fare about the same as those who do not.

The study also found that a child’s likelihood of having adult ADHD is significantly greater if they have a parent — especially a father — who also has attention problems.

Study co-author Susan L. Smalley, a neuropsychologist from UCLA, said the studies show that ADHD is “an extreme on the continuum” for humans, and that people with ADHD may have compensating strengths.

If better medication or specialized therapy, or both, can drive down the risks that these children will be hobbled by academic failure, ill-chosen impulses and other psychiatric problems, their other talents could shine through, Smalley said. And the world would be a better place for it, she added.

“We need to step back and embrace neurodiversity, diversity in human behavior and try to work on ways to embrace and enhance being at the extreme, instead of only focusing on the deficits and disorder aspects of ADHD,” Smalley said.

From the Los Angeles Times:

At a time when major league baseball players are taking ADD medications in record numbers, LA Clippers center Chris Kaman offers an opposing view. He says he found out recently that he was misdiagnosed with ADD as a child, and wishes he hadn’t spent years taking Ritalin and Adderall.

Kaman says he actually had an anxiety disorder, and is now using neurofeedback to reinforce calm thoughts. He hopes to become a spokesman for children who are misdiagnosed or are looking for another alternative instead of taking medication for hyperactivity.

From the Associated Press, New York Times, USA Today and elsewhere:

A congressional committee investigating doping in baseball was told yesterday that ADD and ADHD have increased sharply among major league players — whose diagnoses make them eligible to use otherwise banned amphetamines.

The number of major leaguers claiming therapeutic use exemptions for adult ADD has mushroomed to 103 this past season from 28 in 2006, the year that the stimulants were banned.

Rep. John Tierney (D-Mass.) charged that players are using ADD claims to evade the amphetamine ban and use use stimulants like Ritalin and Adderal. He said the players are using these drugs at a rate that is eight times that of the general population.

“This demands an explanation. There’s something fundamentally wrong them going from 28 to 103,” said Dr. Gary Wadler, chairman of the committee that determines the World Anti-Doping Agency’s banned-substances list. “If we had this percentage increase in the general population, it would be on the evening news as a national epidemic. It’s an outrageous number.”

From the New York Times, a review of “The Medicated Child,” scheduled for tonight on “Frontline.” As bipolar disorder has become a trendy diagnosis among the young, parents are increasingly turning to antipsychotic drugs for their children.

The result: kids are turned into guinea pigs, taking drugs with unknown efficacy and well-known risks. “I’m not sure that that’s progress,” says Thomas R. Insel, director of the National Institute of Mental Health.

See recent posts on antipsychotic medications here and here.

From the New York Times, BBC:

The drugs most widely used to manage aggressive outbursts in intellectually disabled people are no more effective than dummy pills for most patients and may be less so, researchers are reporting.

The finding, being published Friday in the journal Lancet, sharply challenges standard medical practice in mental health clinics and nursing homes in the United States and around the world.

(more…)

New therapies sought for dementia sufferers; music and massages

From the Wall Street Journal: Some nursing homes are now experimenting with strategies to wean patients off antipsychotics.

Use of a new generation of antipsychotic drugs to control the behavior of dementia patients has surged in recent years, despite the Food and Drug Administration’s “black box” warning labels that these drugs can increase the risk of death for elderly dementia sufferers. About 30% of nursing-home residents are on antipsychotic drugs, according to the Centers for Medicare & Medicaid Services, most of them on newer ones called atypical antipsychotics.

… The challenge of caring for rising numbers of seniors who suffer from dementia and the behavior problems that can stem from it has provoked a wrenching debate among nursing-home operators, regulators and families.

The story follows one earlier in the month that detailed the breadth of the problem: Prescription abuse seen in U.S. nursing homes; Powerful antipsychotics used to subdue elderly; huge Medicaid expense.

Sam Hutchison has cancer. His father is seeking a cure beyond the edge of medicine

From the Wall Street Journal, a feature on Neil Hutchison, San Diego defense-contractor recruiter who is dosing his son’s cancer with a cocktail of drugs that he concocted himself.

… he’s part of a growing underground pushing the edge of medicine to find combinations of anticancer agents to save themselves or loved ones. Many of the medicines Sam takes haven’t been tested in clinical trials for his disease. Some are meant for other illnesses; others are still in animal testing for safety and efficacy. But the fact is that Sam, who suffers a rare and often-deadly cancer of the nerves, is otherwise almost certain to die. Hence Mr. Hutchison’s decision, as he puts it, to play “lab rat” with his son.

… The practice is particularly worrisome to those running clinical trials. While only a small minority of cancer patients are cobbling together their own cocktails, they’re often the same people — the desperate and the risk-takers — who would otherwise volunteer for new drug trials.

Just one of those coincidences: David Kessler, who’s quoted in this story as dean of the school of medicine at UCSF, was fired yesterday. Story here.