The Dark Side of ADHD Drugs

Most of the medications prescribed for ADHD are either closely related to cocaine (Ritalin and similar drugs), or are classified as amphetamines (Adderall and others).

Amphetamines and cocaine alike are known troublemakers, causing such undesirable side effects as permanent brain damage, heart valve damage, and other serious problems. However, ADHD drugs have been consistently hailed as breakthroughs, marvels of modern science, and their safety was rarely questioned.

In reality there were simply no long-term safety studies on these medications. I have searched for such studies on Medline and was surprised to find that many of the studies relating to safety lasted a grand total of two weeks. If you have a little time, go to www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed and find out for yourself.

Consider also that brain damage caused by long-term use of a drug is one of the hardest things to prove without cutting the brain open and looking for physical evidence. Consequences may be such hard-to-define events as decreased initiative, tendency towards depression, and so on.

To clearly identify such effects in humans we would need to have groups of children, all with the same diagnosis, some of whom are treated with a medication and others with a placebo, and they would have to be followed for a decade or longer. Such studies may be desirable but they are simply not going to happen.

At long last, several recent rat studies at least raise legitimate concerns that the long-term use of Ritalin causes some form of brain damage. Juvenile rats were administered Ritalin at doses equivalent to those most commonly prescribed for children. In adulthood, treated rats showed large increases in learned-helplessness behavior, suggesting a tendency toward depression.

Another observed difference was that previously medicated adult rats had no interest in cocaine. This might seem like a positive outcome but in this circumstance it really isn’t. Rats generally like cocaine and the loss of interest suggests that treated rats lost some degree of their capacity to experience pleasure.

William Carlezon of McLean Hospital and Harvard Medical School, author of one of the studies, stated in his conclusions that he does not believe these results are specific to Ritalin and it is more likely that they are an effect of all stimulant drugs. (Carlezon, W. A. Jr. Biol Psychiatry, 2003 Dec 15; 54 (12): 1330-1337, also see same journal pages 1317-29).

You may wonder why these studies were performed only now. It may be a coincidence, but patents of many older stimulant drugs have either expired or are in the process of expiring and a newly patented non-stimulant drug for ADHD has recently been released.

Many doctors and parents are excited about this new drug, precisely because it is not a stimulant. But are we again jumping to premature conclusions? Are we again assuming safety when we simply do not have all the facts?

The new drug is called Strattera and its mechanism of action is through norepinephrine (NE) reuptake inhibition. NE is a derivative of the neurotransmitter dopamine that is widely known to be the centerpiece of attention.

Marty Hinz, MD, a researcher and expert on the use of amino acids in neurotransmitter disorders (see www.neuroreplete.com makes the following points regarding Strattera:

“One: while we have not fully tested Strattera, due to genetic polymorphism 20% of people Strattera are compromised in metabolizing the drug”. In layman’s terms this means that some people have normal genetic traits that make it difficult for them to break down this drug, and as a result it may be especially toxic for them.

“Two: All reuptake inhibitors (that work by redistribution of neurotransmitter molecules) have the ability to deplete neurotransmitters in the long run.” This implies that in the long run these drugs aggravate the original deficiency of neurotransmitters.

“Three: In our eight years of studies with amino acids and drugs whose mechanism of action is by reuptake it is apparent that norepinephrine drugs are associated with the most long-term problems (problems after the drug has been discontinued). Again we see no evidence to the contrary with regards to Strattera.”

Perhaps instead of searching for the perfect drug we should look at the basics a little more closely. Although focus is a complex and multi-factorial process, its foundation is the neurotransmitter dopamine. Dopamine comes from the amino acid tyrosine that in turn is derived from protein in food (see footnote 1 below).

To put things in perspective, three scrambled eggs contain 840 mg of tyrosine while a chicken breast contains 900 mg. Other types of animal protein contain similar amounts of this amino acid.

By contrast, it takes 24 almonds to get a scant 140 mg of tyrosine even though almonds are an excellent source of vegetable protein. Soy, often hailed as the king of vegetable proteins, actually contains chemicals that inhibit the conversion of tyrosine to dopamine (Biochem Pharmacol 1997, Nov 15; 54 (10): 1087-96).

Foods that are widely regarded as “kid foods” like pizza, noodles, French fries, donuts, etc. only contain negligible amounts of this all-important nutrient. These are nutrient-depleted foods that also interfere with absorption of dopamine and other proteins by inducing food allergies and poor intestinal health. For more information on this topic read “The Crazy Makers: How the Food Industry Is Destroying Our Brain and Harming Our Children” by Carol Simontacchi.

From this perspective it is clear that many children with attention problems simply do not get enough tyrosine from their diets. In many of these cases a higher-protein diet, combined with temporary supplementation with tyrosine and associated nutrients, can correct the problem.

In more complex cases, a broader assessment is necessary and less-obvious culprits may include food allergies or environmental toxins. In a portion of these cases medications a re unavoidable because they are the only way to achieve adequate performance in school. Even in these cases, medications should be seen as a short-term remedy, while more fundamental nutritional approaches are given time to work.

The efficacy of nutritional approaches for ADHD was again confirmed in a study that used objective assessment tools to compare improvements among children who took Ritalin and children who received a combination of dietary supplements. The study found comparable results but with negligible side effects in the supplement group (Altern Med Rev 2003 Aug; 8 (3): 319-30).

(1) Technically speaking, the body can also make tyrosine from the related amino acid phenylalanine. I haven’t made this point here because phenylalanine is contained in the same foods that also contain tyrosine.

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