Ritalin Gone Wrong

[flintlock]

Re: Ritalin Gone Wrong

I call it the Nintendo generation. If it doesn't flash, dance, or play catchy toons it is dismissed as boring. Learning has to be fun and fun is what is on TV. Slow careful analysis of boring facts is not done. I refer to a piece of study done by the fund manager John Hussman in finding causes of autism. "Autism A Noise-Reduction GWAS Analysis Implicates Altered Regulation of Neurite Outgrowth and Guidance in Autism". No school encourages this type of learning.

Look at the horrible windows 7 commercial on TV where dad has very nice presentation of growing sales on his old computer, and the kid makes it better by adding music and dancing bars available through win7. Just fluff that adds no new informatin and actually distracts from the real information presented.

When I was 10, I was finding all kinds of things in the trash and taking them apart to see how they work. Lawn mowers, bikes, phonographs sewing machines. Just not done anymore, of if it is it is done, it is by the man on TV (Jamie Hyneman), not by kids. In engineering classes in college, I always got B-/C+ on my tests, but I was the only one who could get my lab to work every time.

My first experimentation with electricity was taking apart my phonograph in the basement and getting the crap shocked out of me. Now I work with it everyday!

[flintlock]

Re: Ritalin Gone Wrong

I'm sorry to say I have this condition in my own family. My son and daughter-in-law, loving parents- - no question about that - took to us the bizarre route of letting their first born decide when it was time to go to bed. Turns out setting a consistent bedtime is the first important step in provide a nurturing environment with reassuring boundaries. Kids are hardwired to push boundaries and relieved when their parents, often after a struggle, hold the line. My son's parenting maxim is every day should be a happy one for his kids. The oldest was diagnosed ADD early in school and the 30 day treatment is now in its 4th year. We were and are appalled. As the "effectiveness" has worn away - see above - they now are touting Aspergers, a catchall label for any autistic-like symptoms, as her possible ailment. Her principal complaint - few friends. She's outgoing, quick with her mouth - the opposite of autistic behavior but hey, why learn about what friendship entails when there's a magic pharmaceutical at hand. She's on the verge of puberty. Her and her parents hell has just begun.

My wife teaches autistic and other behavioral problem kids. You are correct about aspergers being used as a catch-all. Autism is also. Half her kids are seriously messed up in the head and probably need drugs. A few are serial killers in the making. Just raving lunatics. The other half just have strong wills combined with weak parents. They can't handle "no" for an answer because they've never heard it at home.

My wife always was a stickler for strict bedtimes with our three kids. Much more than I would have been. But now they are extremely well behaved and I realize she must have known what she was doing. They really do need structure. If just for structure's sake. It seems to establish some sort of self-regulating behavior. But anyone familiar with military life could back this up.

[flintlock]

Re: Ritalin Gone Wrong

I had an adult friend who possibly had some mild ADHD. He started with the speed type meds prescribed by his doctor and soon his whole personality changed into a megalomaniac who turned a very successful business into bankruptcy and divorce. But the whole time, he was convinced he felt better and could concentrate better. He was delusional. He sold off his last possessions to pay for the meds, even while he was borrowing money from me to buy raisin bran to eat 3 times a day. Sounds like drug addict behavior to me.

[don]

Re: Ritalin Gone Wrong

My first experimentation with electricity was taking apart my phonograph in the basement and getting the crap shocked out of me. Now I work with it everyday!

My first up front and personal introduction to the electron was servicing an electric dryer. I was doing appliance repair while in high school. The dryer had been hooked up wrong (by the husband). The wife complained of shocks. I turned the dryer on and reached inside the drum - kapow! A solid 120 volt chaaaarrrrge. I've never forgotten that feeling. And I immediately improved my diagnostics approach . . .

[flintlock]

Re: Ritalin Gone Wrong

'fraid not. the mechanism is indeed the same, but i've never seen a patient with add or adhd who liked cocaine. frankly, they usually don't get any subjective pleasure from stimulants, and often they find them a bit uncomfortable. those who've tried cocaine say it just makes them sleepy. the data says they grow up at high risk for alcohol and drug abuse, but more likely downs or opiates in my experience. it's worth knowing a bit before making assertions. otoh, i suppose we can just state our prejudices and assumptions as if they were facts. who's to know the difference, eh?

So you are asserting that you are the definitive resource on this issue? I understand your profession may make you more qualified to speak on this subject, but didn't the article basically assert that sometimes medical "professionals" are not always correct about this issue? You could have left off the last two sentences and come off as more of an authority. Instead it merely makes you sound defensive . For all you know, Don is quoting another "professional" in the field. They have been known to disagree you know!

[flintlock]

Re: Ritalin Gone Wrong

i was very skeptical about s.a.d. and the use of light therapy for many years, but some excellent research out of the national institute of mental health finally convinced me that it was worth considering seasonal treatment with high intensity, broad spectrum lights. there is definitely a component of the population who experience seasonal mood swings*- sometimes just sluggishness without a lot of subjective depression, accompanied by increased sleep and appetite. for some just getting some morning sunshine will be helpful. for others a light supplement does wonders. if those don't work, i'd suggest bupropion, a stimulating dominergic and noradrenergic antidepressant, often taken bypeople with seasonal mood problems just from oct through february or so (in the northern hemisphere). ssri's, such as you mention, are less likely to be helpful. i've had a few patients with chronic depression but seasonal exacerbations, whose seasonal component was controlled with adjunctive lithium.

again, i suggest to all that you learn something about these subjects before displaying your prejudices. also, you need to be aware that humans constitute a diverse population, and there are people who experience things that you may be blessed to avoid.



* note, too, that the incidence of depression, alcoholism and suicide all correlate with latitude.

I've always suspected my brother suffers from some form of this. He works outside 3/4 of the year but suffers horribly from depression during the winter months he is not out. I suppose some of it could just have to do with activity levels in general, but I'm sure this has been considered!

[jk]

Re: Ritalin Gone Wrong

So you are asserting that you are the definitive resource on this issue? I understand your profession may make you more qualified to speak on this subject, but didn't the article basically assert that sometimes medical "professionals" are not always correct about this issue? You could have left off the last two sentences and come off as more of an authority. Instead it merely makes you sound defensive . For all you know, Don is quoting another "professional" in the field. They have been known to disagree you know!

point well taken. my field is subject to so many abuses, from both inside and outside, that sometimes i get cranky about it.

[lakedaemonian]

Re: Ritalin Gone Wrong

i was very skeptical about s.a.d. and the use of light therapy for many years, but some excellent research out of the national institute of mental health finally convinced me that it was worth considering seasonal treatment with high intensity, broad spectrum lights. there is definitely a component of the population who experience seasonal mood swings*- sometimes just sluggishness without a lot of subjective depression, accompanied by increased sleep and appetite. for some just getting some morning sunshine will be helpful. for others a light supplement does wonders. if those don't work, i'd suggest bupropion, a stimulating dominergic and noradrenergic antidepressant, often taken bypeople with seasonal mood problems just from oct through february or so (in the northern hemisphere). ssri's, such as you mention, are less likely to be helpful. i've had a few patients with chronic depression but seasonal exacerbations, whose seasonal component was controlled with adjunctive lithium.

again, i suggest to all that you learn something about these subjects before displaying your prejudices. also, you need to be aware that humans constitute a diverse population, and there are people who experience things that you may be blessed to avoid.



* note, too, that the incidence of depression, alcoholism and suicide all correlate with latitude.

Just to clarify......if treatments like light therapy work....I say crank up the lights.....if therapy works....I say crank up the visits to the therapists....but my concern lies mostly with examples of reformulated off patent pharmaceuticals to treat conditions mankind has successfully dealt with for thousands of years prior to modern pharmacology.

I definitely believe there are people who's lives are improved through modern chemistry...my concern is the seeming creation of what I perceive as artificial market niches for pharmaceuticals.

Proper diet, exercise, rest, and even light as you mentioned are important components for an improved quality of life.

I just find the concept of better living through chemicals unnecessary/redundant for many in many cases.

To me it's a bit like the search for the $$fat pill$$ and massive demand for people searching for happiness in illegal drugs.......robust solutions for many lie in the more difficult treatment plans.....a comprehensive plan of proper diet, exercise, rest, time outside, etc.....pills solving problems(beyond those who truly can have dramatic quality of life or life sustaining improvements) rings hollow with me.

I guess the way I see it is a single pill "solution" can be scaled easily and quite profitably......A life coach/therapist/nutritionist offering direct peer to peer solutions can't

It feels a little bit like that scene in THX1138 when Robert Duvall's mate is weaning him off his meds and he's having a chat with the Electronic Jesus Confessional.

[jk]

Re: Ritalin Gone Wrong

i agree with you about the creation of artificial market niches. in the u.s. this is the byproduct of the structure of the fda approval process and big pharma marketing.

my favorite anecdote here involves "pmdd" = "pre-menstrual dysphoric disorder". the eli lilly company discovered that fluoxetine, i.e. prozac, helped women who were moody and irritable prior to their menses.* they then arranged that severe instances of pms be given a clinical label, a new "diagnosis," pmdd. they then applied for fda approval to market fluoxetine for this "diagnosis", except that they didn't call if prozac for this purpose, they called it serafem and colored the capsule pink.

broadly, though, i think that as a society we overmedicate ourselves to avoid difficult life choices. i can't count the number of times i've thought to myself: "here i am raising someone's dosage so that he can tolerate his overly stressful job."


*btw, fluoxetine and other ssri's actually do help women with premenstrual mood and irritability problems, and interestingly, while these meds take a month to help anxiety or depressive disorders, they work the same day for pms.

[lakedaemonian]

Re: Ritalin Gone Wrong

i agree with you about the creation of artificial market niches. in the u.s. this is the byproduct of the structure of the fda approval process and big pharma marketing.

my favorite anecdote here involves "pmdd" = "pre-menstrual dysphoric disorder". the eli lilly company discovered that fluoxetine, i.e. prozac, helped women who were moody and irritable prior to their menses.* they then arranged that severe instances of pms be given a clinical label, a new "diagnosis," pmdd. they then applied for fda approval to market fluoxetine for this "diagnosis", except that they didn't call if prozac for this purpose, they called it serafem and colored the capsule pink.

broadly, though, i think that as a society we overmedicate ourselves to avoid difficult life choices. i can't count the number of times i've thought to myself: "here i am raising someone's dosage so that he can tolerate his overly stressful job."


*btw, fluoxetine and other ssri's actually do help women with premenstrual mood and irritability problems, and interestingly, while these meds take a month to help anxiety or depressive disorders, they work the same day for pms.

Interesting example...makes my blood boil thinking there are folks employed to repurpose/rebrand off-patent drugs where the quality of life improvement is questionable at best.

But it is good to see drugs finding new legitimate purposes rather than just ones that seem more "forced".......like the example you gave......and for mountaineering/climbing I've had the standard issue diamox in my kit....but it sounds like some studies have been done with some decent results on the use of Viagra at altitude...but I wouldn't call that much of a profitable niche to exploit.

Not necessarily a drug to counter AMS/HAPE/HACE like Diamox or Decadron....but Viagra appears to increase the lungs ability to absorb oxygen...who knew?