
Ritalin Gone Wrong - cs702
http://www.nytimes.com/2012/01/29/opinion/sunday/childrens-add-drugs-dont-work-long-term.html 
======
trotsky
When Sroufe suggests the brain disorder known as ADHD may simply be the result
of environment without providing a bit of supporting evidence, he ignores
mountains of data that show strongly correlated multi-generational symptoms
even when there was little or no contact. There is a reason science doesn't
get presented on opinion pages. Trying to convince parents that it may not be
a real disorder, or may not be developmental, or that drugs are ineffective
does a serious disservice to the diagnosed. Stimulant drugs are unlikely to be
the end all and be all for ADHD treatment, but they are currently the best we
have and they've been shown again and again to provide significant benefit.

~~~
chimeracoder
The same thing can be said about depression too - we don't really know _why_
SSRIs work, but they generally work enough that we use them as a first-line
treatment for depression. Like ADHD, depression is sometimes confused for
being a product of the environment, when in both cases the environment is
really just an exacerbating factor (clinical depression, unlike PTSD, cannot
be caused by environment alone).

The problem with studying ADHD like this is that we generally agree that ADHD
is over-diagnosed and over-prescribed, but then for evidence that ADHD exists
as a medical condition, we look to the existing pool of people who are
diagnosed or even taking medication to confirm that there is a difference
between those who are diagnosed and those who aren't. 'm not saying that this
means ADHD is a hoax - I agree with you that it's more than just the
environment. It's just very difficult to construct definitions for mental
conditions in particular, because there's usually no way to do a double-blind
randomized experiment.

The problem is that ADHD and depression are both heterogeneous conditions -
they're likely not single conditions themselves, but a bunch of somewhat
related conditions that we're currently unable to distinguish between. The
various hypotheses for what causes ADHD (and depression) may not be mutually
exclusive.

That makes studies that much harder to conduct, because you have a mixed
population, which makes identifying characteristic traits harder (and
sometimes impossible, depending on the mixture). It also means that anecdotal
evidence is that much more worthless, because what is true about one member in
the population could be completely false for another.

And, in some cases, having a mixed distribution can give you the exact
_opposite_ results; see Simpson's Paradox:
<http://en.wikipedia.org/wiki/Simpsons_paradox>

------
_delirium
On a more basic level before even getting to treatment, imo it'd be useful to
have more studies on what the distribution of some sort of trait called
"attention" is in the population to begin with, perhaps in various common
situations. That might provide some sort of baseline: if, for example, 90% of
people have "abnormally low" attention by some measure in some situation, then
the definition of "abnormal" is probably wrong. In that case, rather than
concluding that 90% of people need to be treated for a disorder, it might make
more sense to conclude that the alleged "normal" characteristics are actually
quite rare, demanding a characteristic that <10% of humans naturally have. Of
course, other numbers might lead to different conclusions.

Put differently, it feels like it'd be easier to have rigorous discussions
about deviations from normal mental functioning if we first had a good, data-
based picture of "normal mental functioning". I've looked but have had
difficulty finding any such studies.

~~~
bermanoid
I'm going to go against the grain here, and argue that "normal" is irrelevant
- "desired" is the target here.

If people want themselves/their children to think/act a certain way, and this
opinion is widespread, then it's completely valid to treat that as the target,
even if 90% of the people in society need to be chemically modified to make
them act that way.

Evolution isn't perfect, and at no point has it tried to optimize for
happiness, it only goes for reproductive success, which we as individuals
don't care too much about, at least in the short term. If there are
interventions that we can impose that better optimize for happiness than
letting us exist naturally would, we have no reason to avoid these
interventions.

That said, I have no idea what the optimal desired mental function would look
like...

~~~
_delirium
I have some sympathy for that argument, but I think we should still
distinguish the cases and talk about them accurately. If the situation really
is that 90% of people need some sort of intervention to reach the desired
mental functioning, then we could just say that and argue for it openly; the
pro-nootropics community makes those kinds of arguments, for example. I think
when loaded terms like "abnormal" or "ill" or "treatment" are used, though,
they're only really accurate if we're talking about pathological deviations
from a species norm.

But actually my interest in what constitutes the "norm" is somewhat more
basic; I think how human attention works is quite interesting as a subject of
scientific study, and I wish there were more aggregate data on how it varies
in different situations and across the population.

------
tokenadult
I was interested to see that the researcher who wrote the op-ed, a
psychologist based at my alma mater, has participated in some of the research
projects he reviews in the op-ed. As I read the comments here, I'll be
collecting ideas for questions to ask the local researcher in person as I try
to learn more about ADD. I was particularly interested to see that the op-ed
criticized several earlier studies for their study designs.

<http://norvig.com/experiment-design.html>

I first became interested in what adult ADD treatments do after seeing a
testimonial from an HN participant, a programmer, who said that his
productivity increased dramatically after beginning ADD medication as an
adult. I have since read parts of quite a few of the recent scholarly
publications on ADD, especially those that focus on adult ADD, to try to wrap
my mind around the trade-offs of medical treatment versus other approaches to
symptom management. (I'm also still trying to make sense of just how ADD is
defined, especially among adults who were not deemed to have ADD in childhood.
The definitional issues are rather complicated.)

<http://www.cdc.gov/ncbddd/adhd/diagnosis.html>

[http://www.nimh.nih.gov/health/publications/attention-
defici...](http://www.nimh.nih.gov/health/publications/attention-deficit-
hyperactivity-disorder/complete-index.shtml)

[http://www.mayoclinic.org/medical-edge-
newspaper-2011/mar-18...](http://www.mayoclinic.org/medical-edge-
newspaper-2011/mar-18b.html)

Another participant here has already commented that there may be other
interventions to consider when grappling with problems of attention focus.
What are the best sources on other interventions (diet, lifestyle, etc.)? What
are the trade-offs of those? For the occupations most pursued by participants
on Hacker News, do you find it helpful to seek ADD medication if you are found
to have ADD symptoms? What do your loved ones and colleagues think about your
performance on a before-and-after basis if you have tried treatment? On the
whole, ADD seems to involve a minority of participants in any occupation, but
perhaps a more significant minority among HN participants than among some
other subsets of the human population. I'm still trying to get a reality
check, and would like to learn more.

~~~
dlytle
I'm currently taking adult ADD meds (Adderall); it's a double edged sword, and
I'd personally really prefer to find another method.

The primary problem is, during any sort of transition I would be pretty
useless, and I can't afford to take that long being useless with my current
job.

I went cold turkey from 25mg of Adderall XR daily, and for about a week and a
half I was absolutely dead. I'd have a splitting headache due to dehydration,
but I couldn't summon the energy to get off the couch and walk 12 feet to
where I had bottles of water. I'm glad I went cold turkey rather than just
tapering the dose, though, because tapering the dose would have taken months
of feeling miserable, rather than 1.5 weeks of feeling like a dead man.

If you hear anything interesting from people about biofeedback/etc, long-term
non-medicinal adult ADD treatments, could you toss me a mail at
taloen@gmail.com? I'd really like to see other peoples' opinions on those
routes, and I don't lurk enough on HN to be likely to see a submission about
it.

(Just to clarify; yes, I'm back on the Adderall XR again, although at 5mg
rather than 25 this time.)

~~~
tripzilch
I tried a few sessions of bio-feedback but quit because I got frustrated by it
and not being worth the time and money.

During the intake the therapist described Ritalin as "poison". I should have
probably gotten up and left right there. If you have the opinion that Ritalin
is overprescribed, or that it should not be given to small children, that's
all fine with me. But "poison" has a pretty clear definition, you'll find that
whenever someone refers to a drug as "poison", you're dealing with pseudo-
scientific quackery.

What made me quit was mostly that I couldn't find any correlation between the
signals received from the electrodes and my own state of consciousness, be it
more relaxed or more concentrated or alpha/beta waved, whatever.

When I watched the graphs on the monitor, I noticed a few things. There is a
LOT of noise. If I'd clench my jaw, move a muscle in my neck, my ears,
whatever, it'd cause an avalanche of noise, completely drowning out any
possible brain signal. Ok so you sit still, you're meant to focus or relax
anyhow. Except that muscles just seem to generate a whole lot more electrical
signal than your brain, and every time I even _blinked my eye_ there was a
burst of noise (probably also because the eye muscle is relatively close to
the electrodes). The software did nothing to filter out these noise-bursts,
even though it'd have been trivial to make at least a basic attempt that would
throw away the data during a burst so the other filters wouldn't trigger.

Ah, the _other_ filters. Well, it quickly became clear I knew a lot more about
DSP than this guy. He had no idea how his device operated, at least not how
the signals were transformed into whatever was displayed on the screen.
There's not really an excuse for this. Sure enough a surgeon might not know
about the algorithms used to convert an MRI scan into a picture, but the
radiologist _does_ (at least, on some level), which is why we have
radiologists.

So you know about these alpha/beta/theta/gamma brain waves right? They're at
12/10/7/3 Hz frequencies or something like that. Now I always had the idea
that by this they meant some fundamental Eigen-frequency of signals in the
brain, so you'd _think_ to apply some auto-correlation to determine the base
frequency and its harmonics. But instead he had a bunch of bandpass filters
running concurrently being graphed through some ancient MS-DOS program with
obvious leakage from one band to another and we were looking at the raw
filtered signal, not even its energy and as I said there was _no_ noise
suppression.

I'd have loved to take that device home, write some code for it and see what
it could detect though. Hell, even detecting muscle movements is already way
cool :)

Anyway, no correspondence between my state of focus or relaxation.

Staring at a computer screen (with a game, usually one frequency band was used
to control a game of some sort) for 1-2 hours per week, actively trying to
relax or focus would definitely have a result of course.

Which is why I'm doing a universal yoga meditation class. Dunno if it helps
with the ADD, but it can't hurt and it definitely has some other advantages
(notably: posture and stress/tension). One thing I do notice, yoga works best
if I haven't taken meds that day. You'd think it improves focus, but this yoga
class is mainly being able to really feel your whole body and muscles should
not be tense for that, but on meds I find I get way more fidgety and
subconsciously re-tense every muscle I relax as my focus shifts to the next
part of my body. Fortunately, noticing and being aware of such subtle effects
in your body is exactly what the class it about :-)

~~~
rms
The evidence is much more strongly in favor of amphetamine being actually
poisonous (neurotoxic) than ritalin. Even then, it only happens at higher
higher than a certain, not really well known dosage.

You might like playing around with Neuro-Programmer 3. You can get
substantially similar or even stronger effects to EEG neurofeedback with
simple audio brainwave entrainment. I actually question the value of EEG
neurofeedback not combined with audio brainwave entrainment, which serves the
purpose of teaching people what different brainwave states feel like.
<http://www.transparentcorp.com/products/np/index.php> You can hook up an EEG
to it to. Or build your own for a few hundred,
<http://openeeg.sourceforge.net/>, but the signal processing is actually the
hard part. Among the cheap commercial EEG products I've tried, only the
NeuroSky Mindwave filters out facial movements well, but it's one sensor is
not really useful for doing much of anything.

The kind of meditation that helps with ADD is concentration meditation, where
starting Vipassana, when you focus intently on watching your breath, is a
concentration meditation.

------
hop
I have a real problem labeling 10 year olds that get bored and fidgety in
boring situations with having a brain disorder and giving them speed.

Find me 10 successful entreprenuers and I bet I can show you 10 people who had
a tough time sitting through unengaging lesson plans in school. Doesn't help
with ballooning class sizes either.

~~~
angstrom
I wouldn't be surprised if there is a correlation between children's
transition from asset to expense in the typical urban household.

As a child I would've been the perfect ADD candidate, but with plenty of
stimulation in the form of work on my parent's farm, I winded up learning how
to create outlets for my restless nature. There's nothing more boring or
repetitive than driving a tractor around a very large field. My mind
constantly wandered and in a few occasions led to damaged equipment because of
it. Lesson learned and relearned. Another example would be pacing back and
forth waiting to switch the milkers on the cows during the bi-daily 1-2 hr
chores. Cleaning equipment, feeding, manure removal, stacking hay bales by
hand. Repetitive, repetitive, repetitive, grueling.

School was fun by comparison. Even mundane lessons had their silver lining (at
least it wasn't manual labor). And when I wasn't occupied with chores or
school I found other stimulation; building a large purple martin bird house,
flying model rockets, helping with mechanical repair, drawing, reading,
shooting guns, exploring, painting ceramics, playing trumpet, and eventually,
playing with our computer. The avenues of stimulation were not forced, but
open. Most importantly: I could use the things I was learning in school to see
how they had purpose, if not for my own satisfaction.

Why do these kids fidget and lack focus? In my non expert opinion it's because
they lack both the perspective and a positive feedback loop to stimulate their
own minds. It's not a disorder of the brain by any means, but a lack of
purpose. Children reject the situations because they're contrived hoops with
no meaning. The constant question in any child's mind is "HOW AM I GOING TO
USE THIS?!" If they can't see the purpose of the lesson they haven't gained
anything more than a useless set of facts.

~~~
kpennell
Great points...

------
kghose
Though one could say "Another Nature vs Nurture"-er, this article is
interesting to me from a "responsibility" point of view.

Our children are our responsibility. As tempting as it is to put the child in
front of a TV, or pop it a pill, or (in the future I am involved in a small
way in building) stimulate neurons in the brain to get some effect, there is a
huge component of taking responsibility for actually nurturing a child: being
near him/her, empathizing and simply supporting.

This article reminds us, we are responsible for the kids, by leading through
example and by trying to understand and taking up the challenge of correcting
wrong behaviors and supporting correct ones.

------
pizza
Ritalin (methylphenidate) and Adderall (Dextroamphetamine / Levoamphetamine)
are interesting and powerful nootropics
(<http://en.wikipedia.org/wiki/Nootropic>). I haven't tried them yet, although
I am looking forward to the day I do. However, they do have some serious
negative aspects; they are addictive and come with a substantial 'crash'. This
is where the racetams come in!

The racetam family consists of nootropics that enhance mainly memory recall,
although I certainly feel there's an increase in ability to think of new ideas
and convey them lucidly. They're not all that new (first developed in the 60s)
and are widely regarded as non-toxic, in both the short and long term (sorry,
don't know how to find the study. However, as anecdotal evidence, this guy did
80 GRAMS of piracetam in one sitting, which is 100x the regular dose
<http://www.drugs-forum.com/forum/showthread.php?t=153468>).

The stimulation from piracetam, the racetam that is most commonly used, is
sort of similar to caffeine stimulation but less pronounced; I have also never
experienced a piracetam crash, even after nasal insufflation of a gram and a
half. Piracetam also makes me much more productive, much more than caffeine
ever did or probably will ever do, and I highly suggest it for anyone who is
interested in nootropics!

~~~
georgieporgie
I'm surprised I haven't seen more buzz about racetams on HN.

I recently started experimenting with Piracetam. It's too early to make a
judgment, but I did seem to get a heck of a lot more done in the two weeks
'on' than in several weeks prior. I'm currently doing about 2g in the morning,
and another 1.5g in the afternoon. I haven't directly noticed any effect,
aside from perhaps a short period of mild dizziness one day.

------
jayferd
I was diagnosed with ADD as a child, and have experienced firsthand the kind
of dependencies these drugs can create. I wasn't able to stop taking Dexedrine
(essentially the same as Ritalin) until halfway through my first semester of
college, when I undertook a daily practice of meditation.

Now I've come to realize that "lack of attentiveness" is part of the human
condition. We can make it worse by excessive stimulation and context-
switching, but this unscientific idea of an "inbuilt" disability simply
doesn't exist.

~~~
deno
If you can meditate, or sit still in one place without any stimulus for that
matter, you’re quite lucky. It’s an impossible task for most people with ADHD.

> Now I've come to realize that "lack of attentiveness" is part of the human
> condition.

No. ADHD is a hereditary neurological disorder. One of the first things that
you’ll see on Wikipedia’s page on ADHD is a PET scan comparing dopamine
transporter availability in a healthy brain and one of a person diagnosed with
ADHD.

In children, the biological differences are real, and can by no means be
explained by “experience.” E.g.

[http://www.msnbc.msn.com/id/21757514/ns/health-
mental_health...](http://www.msnbc.msn.com/id/21757514/ns/health-
mental_health/t/adhd-kids-brains-mature-more-slowly/)

~~~
jayferd
That's fair. Meditation is hard, and I don't claim to be particularly good at
it. On the other hand, I would say it's an extremely difficult task for just
about anyone.

The study the article you posted cites successfully correlates brain
differences with AD(H)D diagnosis. Part of the argument in the original
article, though (which I can verify in my own case at least), is that while
the brain affects observed behavior, behavior also affects the brain. So it's
a very real possibility that experience and learned behavior are causing both
the observed behavior and the brain chemistry differences.

------
tim_h
I was diagnosed with ADHD at age 18. At that point in my life I had developed
pretty much a hatred for school, and had resolved to never go to college.
Spending 8 hours/day at school was akin to torture for me. I found it to be
mind-numbingly boring.

My doctor had me try various medications. Adderall was too intense. It got me
high and gave me a tendency to focus too much on the wrong level of a problem
(I would obsess over details). Worse, my body acclimated and I found that I
needed a higher and higher dosage to have the same "benefit".

Everything turned around for me when I found out about a different medication
from a friend - Dexadrine. My doctor never mentioned it to me but once I asked
him about it he agreed to let me try it. Boy am I glad he did. To make a long
story short, I finally went to college, graduated at the top of my class, then
went on to Stanford to earn an advanced degree. Now I have a job that I love.

I've been on this medication for almost 10 years. I never acclimated to it (in
the sense of needing a higher dosage for the same effect) and the side effects
are very mild (slight loss of appetite, slightly harder to sleep).

Recently I decreased the dosage by almost 50%. I've found that over the years
I've somehow learned how to concentrate better, and that therefore my need for
the med has decreased. This makes me think that my brain has somehow changed
for the better. Perhaps all the concentrating I did while on a higher dosage
served as practice and that the benefits from all this practicing apply even
without the medication. Maybe some day I'll be able to get off of it
completely. But for now I still have a tough time concentrating without it.

------
BasDirks
I have taken Concerta for about 3 years and it helped a great deal in getting
more organized. I periodically go without it, which is getting easier and
easier with time (I guess because I have been able to structure life better).
Eventually I will probably quit completely.

There is a danger in throwing pills at a common problem. But there is also a
danger in dismissing medication as part of a solution. People for who
Concerta/Ritalin didn't work often bash these drugs as dangerous or evil.

------
vlad
If I remember correctly, a recent article pointed out that prescriptions in
every category of drugs have increased year over year at a similar or greater
rate, and that prescriptions for ADHD and ADD have actually been increasing
slower than expected compared to other categories of drugs. An article like
this should qualify the magnitude this way.

Secondly, as companies release new drugs that can target specific conditions
better or safer than ever, treat conditions that were not treatable before, it
makes sense that doctors prescribe medicines more and more often every year,
especially as patents on proven drugs expire and the medications become
available as cheap generics.

------
jdefr89
I am currently on two medications. VyVanse for ADD and Anafranil for OCD. As
far as effectiveness, yes the medication is helpful at the beginning. However,
after being on it for two years the effect of the drugs wear off and you end
up _doubling your dose_. __That seems to be the pattern with all the
medications I take, even those not concerned with ADD __. Honestly I really
improve my productivity through therapy related techniques; meditation,
therapist, developing my _focus muscle_.

Strangely, I don't have attention problems when it comes to the things I have
interest in such as coding and computer science.

~~~
watmough
If it's not too personal, can you outline some of your OCD symptoms and
behaviors?

------
CChristie
Physical activity -> exhaustion = improved concentration. Practiced this in
college and still to this day. Otherwise, I'm all over the place.

------
bocmaxima
I've been using stimulants for almost five years (age 20 now). The last year
or so I reached a point where like the article said — the effects of the drugs
tapered off — and there was really nothing I could do about it. As a kid I
exemplified the most extreme kind of inattention, behavioral, and regulatory
problems that classify ADD, but once I began taking the meds I went through an
equally extreme transformation, so I'm skeptical of any article that derides
the use of stimulants. I'm also reminded of what the late Christopher Hitchens
said in defense of his heavy drinking and smoking:

“Writing is what’s important to me, and anything that helps me do that—or
enhances and prolongs and deepens and sometimes intensifies argument and
conversation—is worth it to me.”

I recently met someone who has tourette's syndrome, which means he has
increased production of dopamine. In other words — the inverse of ADD. The
drugs he took induced a state of ADD that was identical to what I what I
experienced sans-stimulants. It's crucial for those of us with the kind of
dramatic impairment that comes with ADD to get by with as much help as
possible from competent practitioners (of which there seems to be a very short
supply of).

------
mynegation
While I am not prepared to discuss specifics of Ritalin's effects, the article
raises very important point: a lot of problems happening with children are due
to the neglect on their parents' (or primary caregivers') side.

I've always wondered how you have to be licensed to drive any more or less
complicated mechanism, but yet you can become responsible for things thousand
times more complicated and important, like children, just like that.

Having children requires a lot of knowledge, but somehow our education system
is not designed to prepare us to deal with that. How many parents read books
on child psychology or development? The proper alignment of incentive could
help here: e.g. having some kind of a test could be a prerequisite for getting
children-related tax credits and benefits.

~~~
harryf
> a lot of problems happening with children are due to the neglect on their
> parents' (or primary caregivers') side.

That nails the problem but I disagree strongly with your conclusion this is a
problem of individual responsibility. Its a social problem which we have to
solve as a society by understanding why parents are having problems giving
enough attention to their kids. The problems here are far more fundamental and
pervasive to blame any individual parents for "failing".

Great video on the topic here
[http://www.youtube.com/watch?v=_-KqeU8nzn4&feature=youtu...](http://www.youtube.com/watch?v=_-KqeU8nzn4&feature=youtube_gdata_player)

------
gruseom
"To date, no study has found any long-term benefit of attention-deficit
medication on academic performance, peer relationships or behavior problems".

~~~
jey
Are there any long-term studies of these issues? I'd be surprised if there's
actually enough good ones to draw conclusions.

~~~
adamjernst
A great point. Our brains parse "no study has found any long-term benefit" as
"studies have found no long-term benefit", which is not accurate.

------
jonhendry
Remember: Real science and medicine don't happen in newspaper op-eds.

------
sek
So Ritalin is just a usual mind boosting drug, it has rebound effects and
people develop a tolerance.

Like cocaine, MDMA, ephedrine and meth. It differs in it's euphoric and
adverse effects, but the positive influence is not permanent.

Not a single drug can help you in the long term, you have to develop the
abilities yourself. These drugs have the opposite effect, because as long as
you take them you don't evolve. The worst thing is when you get used taking
this stuff. You give up faster and think you are unable to deal with it
yourself, what leads very fast to an addiction.

So many of my fellow students are taking drugs now for learning, especially
Ritalin (but also the other stuff i mentioned earlier). I tried Ritalin once
and the results were impressive, but i always had a bad feeling about this.
This article proves my concerns right, Ritalin is not without downsides.

~~~
tokenadult
_because as long as you take them you don't evolve._

Homeostasis of the human body does make any intervention hard to keep long-
lasting. I take it you mean "develop" (the word you used in the preceding
sentence) for where you wrote "evolve," because of course individuals don't
evolve (in the biological sense of the word) but rather populations do by
changes in gene frequencies. The story of obesity seems to be that change is
hard for human beings, period, whether the intervention is medical or a
lifestyle intervention. If a person has a personal tendency that is truly a
disorder for adaptation in current society, maybe nothing should be taken off
the table for the person seeking help. But, yes, I agree with you that
willpower-developed kinds of personal behavior changes are surely helpful for
ADD and for other problems too, perhaps more possible if they are backed up by
external helps of one kind or another.

~~~
sek
The word develop is the right one. It is the same translation in German, my
mistake.

The big problem is that while you take it, it feels like it. To make the
observation that this is not permanent, while influenced, is very difficult.
The feeling is very subtle and not obvious like being drunk for example.

You are right, there are extreme forms who need medication. The article
suggests, that the whole ADD existence is still not clear and i was diagnosed
myself as a kid. I assume that just a little part of the people who take
Ritalin really need and benefit from it.

------
itmag
I'd be interested in hearing what a (non-kooky) fringe scientist like Seth
Roberts has to say on ADD.

It always seemed weird to me that huge amounts of people should be taking
Speed on a daily basis. Has there been any research into treating ADD with
stuff like low-carb diets, vitamin D, limiting EMF exposure, limiting
videogames, fish oil, filtering chemicals out of drinking water? I'm just
throwing those out there as hunches; I have no idea if they're scientifically
valid.

~~~
jinushaun
I graduated with a degree in biochemistry hoping to get into the
biotech/pharmaceutical industry, but was turned off by the emphasis on
treaments instead of cures. Ritalin and Aderall seems analogous to taking pain
killers to treat an open wound—masks the symptoms (pain) but doesn't address
the cause (open wound).

With the explosion of ADD prescriptions, one has to wonder if our
society/environment is causing this problem. Is it diet? HFCS? Modern
parenting styles? The internet and information overload?

~~~
deno
> Ritalin and Aderall seems analogous to taking pain killers to treat an open
> wound—masks the symptoms (pain) but doesn't address the cause (open wound).

And how are you going to address the open wound? There’s no brain surgery for
ADHD.

A better analogy is that of wearing glasses. Glasses don’t actually fix your
eyesight, and you need them all the time, but they allow you to function
normally. Medications used for ADHD treatment are exactly like that.

> With the explosion of ADD prescriptions

There’s an explosion of sensationalist reporting by general media. ADHD is
still under-diagnosed in USA, and it’s even worse in Europe.

It’s exactly the same as the “explosion” of autism. No, the vaccines are not
causing autism, just because there’s more data and a better awareness of the
disorder.

~~~
jinushaun
But if everyone is getting health problems from the factory down the road,
maybe instead of only treating the problem with medication, we also shut down
the factory causing the health problems.

~~~
deno
I suppose if we can determine the exact combination of genes that causes ADHD,
at some point we’ll be able to eliminate it completely, at least in first
world countries. It’s not really an option right now.

------
laserson
Wow, 3 million "children". There are over 62 million children in the US. That
means almost 5% of all kids are getting medicated...

[http://www.wolframalpha.com/input/?i=US+population+under+age...](http://www.wolframalpha.com/input/?i=US+population+under+age+18)

~~~
Alex3917
It's worth noting though that three year olds aren't taking these drugs, so
the actual rate is more like 9% of kids have ADHD, and a good percentage of
those (60%?) are currently taking drugs for it.

------
vintagius
What i never understood over the years was, why Ritalin was given to kids with
ADD and ADHD.All though those two disorders are related,they do not have the
same effect on a person.

People with ADD tend to be tooo calm and appear to be slow ,on the other hand
those with ADHD (including me) tend to be too Hyper , our minds are at full
speed all the time which affects concerntrating on things we do not enjoy.I
found out that Ritalin works well for me by relaxing the pace of my thoughts
,which in turn allows me to focus on a BORING thing like a volumous book.

So now how can you give a person with ADD (Slow thoughts) a drug that will
make them more slow and expect results.

My conclusion is that Ritalin works better for people who have ADHD then those
with ADD,and the reason why results on the improvement that Ritalin has ,have
varied time and again is because a drug that work for one group (ADHD) was
also given to those (ADD) it does not work for.In such a situation results
will never be consistant.

------
Volpe
Why is this on HN?

~~~
Volpe
why the downvotes? its a link from mainstream news on something unrelated to
tech... can someone explain?

~~~
tim_h
The site guidelines ( <http://ycombinator.com/newsguidelines.html> ) say "On-
Topic: Anything that good hackers would find interesting." Judging by the
comments on this thread, such is the case here.

------
rkon
Parents should really take note of the studies and conclusions in this
article. As someone diagnosed with ADHD who has tried numerous medications
(Adderall regular and XR, Vyvanse, Strattera, Focalin, and Wellbutrin) I have
to say I would never ever _EVER_ allow a young child of mine to take any of
them. I can't even fathom how confusing and damaging the side effects of these
medications could be to the fragile psyche of a child -- anxiety, mood swings,
depression, sleep loss, etc. I was diagnosed at the age of 23, so I knew my
own personality well enough to tell when it was being altered by the
medications, but how would a child know this? The answer is simple: they
wouldn't, and in many cases they're prescribed _additional_ medications
(usually anti-depressants and/or anti-anxiety pills) to deal with it.

I cannot respect any parent who allows their minor child to take these types
of psychotropic drugs in any but the most dire of situations. Reading ADHD
forums was an absolutely horrifying experience for me: parents list the
_multiple_ drugs their children are taking in their signatures as if they're
badges of honor.

After 2.5 years of trying various ADHD medications I gave up on them
completely and have never looked back. Yes, most of them did have the benefits
they promised, but the types of side effects they're capable of producing can
absolutely wreak havoc on your emotional well being even in their most mild
forms.

~~~
cullenking
To get through college, while working, I used adderall and ritalin on and off
as needed. I was floored when I first got on it, my doctor tried me on the
ritalin patch at the highest dose (32 mg I think). I dropped down and was
still amazed with how hard hitting this stuff was. Granted, people have
different skin and uptake I am sure, but I couldn't imagine giving a kid a
patch which basically made me feel like I had a 12 hour cocaine high. Yes, I
plowed through work I couldn't of done in twice the time, but I was HIGH. I
was able to understand how I felt, but the 12 year old that gets the same dose
wouldn't...Yet their parents might think it's a wonder drug, since that kid
would most likely be able to finally do their homework in one sitting.

~~~
deno
The ‘high’ goes away after two weeks of continuous use, but the cognitive
benefits persist. This is exactly why ADHD medications work long term.

> But in fact, the _loss of appetite_ and _sleeplessness_ in children first
> prescribed attention-deficit drugs do fade (…). They apparently develop a
> tolerance to the drug, and thus its efficacy disappears.

Those are side effects in the context of treating ADHD.

Here’s a great summary:
[http://www.reddit.com/r/ADD/comments/no6hp/would_anyone_be_i...](http://www.reddit.com/r/ADD/comments/no6hp/would_anyone_be_interested_in_an_ama_ive_been/c3aqxwh)

~~~
cullenking
I know this is another anecdotal response, but, the high definitely didn't go
away, I just became more mentally accustomed to it. It's exactly the same for
an alcoholic who drinks excessively everyday. After a month, the same amount
of alcohol has less effect (to an extent).

I strongly feel that if the parents of children on ADD meds actually used the
meds themselves, many of them would decide on alternative treatments.

~~~
deno
You’re not supposed to use the medication “on and off,” if you want to avoid
such side effects.

~~~
cullenking
"on and off" for a period of 4 years can mean anything from every other day to
3 months on and 3 months off. I've experimented with them all, and for
something which isn't built up systemically, like many antidepressants, as
needed is 100% the way to go.

------
psaccounts
It is a shame that most people are unaware of the efficacy of Homeopathy to
treat ADD, ADHD and autism-spectrum disorders. Do some research and you'll see
how hundreds of thousands of people have been cured of these ailments using
Homeopathy alone.

~~~
wahnfrieden
Do some research and you'll find homeopathy is bunk. There's no science behind
it, studies have shown it completely ineffective, and besides, it's just clean
water.

~~~
psaccounts
You are saying this out of the research you have done yourself, right? And
yes, I have done the research and also have experienced it first hand --
something that Stanford doctors could not do (and an army of 3 different
specializations nonetheless) was cured using Homeopathy. Is this placebo
effect?

~~~
marshray
Give it up. It doesn't matter if you're right or wrong, or it cured your
cancer or whatever, you'll never get past the skeptics.

