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I don't like this fearmongering about central stimulant treatment of ADHD in children. Stimulant treatment in childhood is the best verified psychiatric treatme

I don't like this fearmongering about central stimulant treatment of ADHD in children. Stimulant treatment in childhood is the best verified psychiatric treatment we have, period. Long term studies have shown a significant reduction of neurological abnormality and executive dysfunction. Remember, ADHD is a neurodevelopmental disorder. Treating it early can be the difference between a good life and a life plagued with comorbidity, unemployment and poor executive function. Don't be so hasty to condemn kids to this miserable existence based on some vague worries about stimulant psychosis, which is very rare with current treatment protocols and most cases are due to abuse.

photochemsyn 4y ago
A few things to keep in mind: 1) ADHD diagnoses are a relatively new phenomenon, which did not exist before the early 1980s. The fact that these diagnoses created a multi-billion dollar market for amphetamine manufacturers can hardly be ignored when discussing this issue. 2) A specific neurological problem is very hard to diagnose accurately, and there's no independent biochemical/molecular test for ADHD. Assuming real examples of ADHD do in fact exist, massive levels of overdiagnosis are entirely possible. 3) It's entirely possible that some people do find these drugs helpful in their day-to-day lives, even if they have nothing like 'clinical pathology' to excuse or justify their use of such substances. For example, caffeine is not considered an ADHD treatment, although it may help with focus for some people.
- cafard 4y ago
  They didn't use the term in the 1960s, but they did talk about kids who could not sit still in the classroom. And they didn't, as far as I know, use speed then, but they did try other stuff. Sorry for no details, but I was a kid myself.
  - mtlmtlmtlmtl 4y ago
    It was known as Minimal Brain Dysfunction in the original DSM(1952) and Hyperkinetic Reaction of Childhood in DSM-II(1968). But in fact use of amphetamine as a treatment goes all the way back to the 30s! And Ritalin(methylphenidate) appeared in the 1950s.
- weakfish 4y ago
  > it’s entirely possible that some people find these drugs helpful in their day to day lives This is a dishonest representation. It’s a gross understatement to say “some people” find it helpful when I and many people personally know those who have had their lives radically changed by prescription ADHD treatment
- mtlmtlmtlmtl 4y ago
  >did not exist before the early 1980s Not really true. The name ADHD and the now deprecated ADD originated in DSM-III in 1980 but the actual disorder has been discussed in the literature since the 19th century, and was present under a different name(minimal brain dysfunction) already in the original DSM. > Assuming real examples of ADHD do in fact exist You implying this needs to be an assumption when there is broad scientific consensus that ADHD is a real disorder, only makes you seem biased. I'm not saying overdiagnosis isn't an issue. The US is particularly bad here, just like with every other instance of oversized corporate influence. But implying ADHD is some big pharma hoax is needlessly dichotomous and not at all supported by evidence. 3) Just because something is "entirely possible" doesn't mean it's the case. And once again research into amphetamine has shown that healthy subjects have little if any measurable benefit from taking it whereas people with ADHD can have life-changing benefits. You seem to enjoy listing things that are "entirely possible". Might I suggest reading some research?
  - photochemsyn 4y ago
    I'd refer people to: The Global Market For ADHD Medications (2007) https://sci-hub.se/10.1377/hlthaff.26.2.450 https://sci-hub.se/10.1377/hlthaff.26.2.450 > Several key issues are salient. > First, objective tests for ADHD are lacking, a problem shared with most other psychiatric conditions. Guidelines for proper diagnosis must be followed, so that disorders with similar symptoms (such as conduct disorder or bipolar disorder) do not receive inappropriate stimulant treatment. > Second, prescription rates of stimulants (and other psychotropic medications) have greatly increased, at least in the United States, even for preschoolers. About half of U.S. children and adolescents diagnosed with ADHD receive stimulant medications or related agents. > Third, unintended side effects may accompany stimulant use. Most are mild, but public health concerns have arisen about the potential for negative cardiovascular effects and suicidal thoughts [this is relevant to PKD's history, note he died of a stroke, and had at least one suicidal episode] > Fourth, questions abound about the potential for “diversion” of prescription stimulants to people without ADHD, related to improvement of study skills and possible euphoriant effects. As far as the 'clincal reality' of ADHD, I'd argue that the scientific basis of psychiatric disorder classifications and the efficacy of treatments is not that clear, relative to say, a diagnosis of drug-resitant tuberculosis infection. For example, the entire serotonin theory of depression is now on shaky ground due to apparent fraud in historical studies. This doesn't mean anti-depressants and amphetamine derivatives don't provide some benefit to people, but the whole field's not on very solid ground.

photochemsyn 4y ago

A few things to keep in mind: 1) ADHD diagnoses are a relatively new phenomenon, which did not exist before the early 1980s. The fact that these diagnoses created a multi-billion dollar market for amphetamine manufacturers can hardly be ignored when discussing this issue. 2) A specific neurological problem is very hard to diagnose accurately, and there's no independent biochemical/molecular test for ADHD. Assuming real examples of ADHD do in fact exist, massive levels of overdiagnosis are entirely possible. 3) It's entirely possible that some people do find these drugs helpful in their day-to-day lives, even if they have nothing like 'clinical pathology' to excuse or justify their use of such substances. For example, caffeine is not considered an ADHD treatment, although it may help with focus for some people.

cafard 4y ago
They didn't use the term in the 1960s, but they did talk about kids who could not sit still in the classroom. And they didn't, as far as I know, use speed then, but they did try other stuff. Sorry for no details, but I was a kid myself.
- mtlmtlmtlmtl 4y ago
  It was known as Minimal Brain Dysfunction in the original DSM(1952) and Hyperkinetic Reaction of Childhood in DSM-II(1968). But in fact use of amphetamine as a treatment goes all the way back to the 30s! And Ritalin(methylphenidate) appeared in the 1950s.
weakfish 4y ago
> it’s entirely possible that some people find these drugs helpful in their day to day lives This is a dishonest representation. It’s a gross understatement to say “some people” find it helpful when I and many people personally know those who have had their lives radically changed by prescription ADHD treatment
mtlmtlmtlmtl 4y ago
>did not exist before the early 1980s Not really true. The name ADHD and the now deprecated ADD originated in DSM-III in 1980 but the actual disorder has been discussed in the literature since the 19th century, and was present under a different name(minimal brain dysfunction) already in the original DSM. > Assuming real examples of ADHD do in fact exist You implying this needs to be an assumption when there is broad scientific consensus that ADHD is a real disorder, only makes you seem biased. I'm not saying overdiagnosis isn't an issue. The US is particularly bad here, just like with every other instance of oversized corporate influence. But implying ADHD is some big pharma hoax is needlessly dichotomous and not at all supported by evidence. 3) Just because something is "entirely possible" doesn't mean it's the case. And once again research into amphetamine has shown that healthy subjects have little if any measurable benefit from taking it whereas people with ADHD can have life-changing benefits. You seem to enjoy listing things that are "entirely possible". Might I suggest reading some research?
- photochemsyn 4y ago
  I'd refer people to: The Global Market For ADHD Medications (2007) https://sci-hub.se/10.1377/hlthaff.26.2.450 https://sci-hub.se/10.1377/hlthaff.26.2.450 > Several key issues are salient. > First, objective tests for ADHD are lacking, a problem shared with most other psychiatric conditions. Guidelines for proper diagnosis must be followed, so that disorders with similar symptoms (such as conduct disorder or bipolar disorder) do not receive inappropriate stimulant treatment. > Second, prescription rates of stimulants (and other psychotropic medications) have greatly increased, at least in the United States, even for preschoolers. About half of U.S. children and adolescents diagnosed with ADHD receive stimulant medications or related agents. > Third, unintended side effects may accompany stimulant use. Most are mild, but public health concerns have arisen about the potential for negative cardiovascular effects and suicidal thoughts [this is relevant to PKD's history, note he died of a stroke, and had at least one suicidal episode] > Fourth, questions abound about the potential for “diversion” of prescription stimulants to people without ADHD, related to improvement of study skills and possible euphoriant effects. As far as the 'clincal reality' of ADHD, I'd argue that the scientific basis of psychiatric disorder classifications and the efficacy of treatments is not that clear, relative to say, a diagnosis of drug-resitant tuberculosis infection. For example, the entire serotonin theory of depression is now on shaky ground due to apparent fraud in historical studies. This doesn't mean anti-depressants and amphetamine derivatives don't provide some benefit to people, but the whole field's not on very solid ground.