ADHD drugs send thousands to hospital ERs

Their toxic “therapeutic” arsenal is posing a serious public health hazard. The psychotropic drugs they prescribe with
almost wanton abandon are undermining the physical and mental health of the American public–children in particular at high risk of abusive, forced
prescribing practices of mental health professionals.

The Associated Press reports that the U.S. Centers for Disease Control and
Prevention has issued a report estimating that nearly 3,100 people
prescribed psychostimulants–such as, Ritalin, Concerta and Adderall–
landed in hospital emergency rooms! The evidence from clinical practice
confirms the concerns raised by cardiologists on the basis of clinical trial
data.

These drugs are causing children and adults to suffer severe adverse
side-effects, including cardiac problems, chest pain, stroke, high blood
pressure and rapid heart beat.

The CDC report confirms earlier evidence that children who are prescribed
psychoactive drugs–such as stimulants or antidepressants are at increased
risk of suffering severe adverse drug effects requiring emergency
hospitalization. [1, 2]

This position taken by responsible cardiologists such as Dr. Steven Nissen
of the Cleveland Clinic, are validated. Dr. Nissen is in the forefront for
protecting children and the elderly from cardiac-related drug hazards. Dr.
Nissen has put his professional prestige on the line–advocating for black
box warnings on the labels of ADHD psychostimulant drugs–so that doctors
and parents are forewarned about the drugs’ hazards.

But psychiatry’s leadership opposes such warnings, demonstrating a
disconnect with the public whose trust they betray.  Dr. Nissen notes, they
“seem to ignore a fundamental fact that increasing heart rate and blood
pressure by the administration of powerful cardiac stimulants is inherently
risky”

A new Wall Street Journal-Harris poll shows the American public is far more
concerned about drug safety issues than they are concerned about bringing
innovative medicines to market by a 58-21 margin. (That’s a slight increase
than the 54-23 margin of two years ago).   But the FDA is preoccupied with
industry’s main interest. [3]

Thomas Anders, M.D. of the American Academy of Child and Adolescent
Psychiatry, Steven Sharfstein, M.D. of the American Psychiatric Association;
and Marsha D. Rappley, M.D. Michigan State University;  John W. Moore, M.D.
UCLA Medical Center expressed their opposition to black box warnings about
the cardiac risk associated with psychostimulants in letters to the New
England Journal of Medicine.

The Associated press quotes Dr. Tolga Taneli, a child and adolescent
psychiatrist at University of Medicine and Dentistry of New Jersey in
Newark, who said:

 “The numbers (of side effects) are puny compared to the numbers of
stimulant prescriptions per year. I’m not alarmed.”

There, in a nutshell the cultural norm within which American child
psychiatrists practice is exposed.

Protect your chidlren from today’s medical preditors.
Notes:

1.  Since the increased use of psychotropic drugs, physicians have observed
that children are increasingly being admitted to psychiatric hospitals.
See:  American Psychiatric Association. Position Statement: Psychiatric
Hospitalization of Children and Adolescents. APA Document Reference No.
890004. Online at:
http://www.psych.org/edu/other_res/lib_archives/archives/890004.pdf

2.  A 2001 retrospective review of 533 psychiatric hospital admissions over
a 14 month period found that 8.1% were admitted due to
antidepressant-induced mania or psychosis.
In 70% of those admissions, SSRIs induced these extreme symptoms. See:
Preda A, Maclein R, Mazure C, Bowers M. Anti-depressant associated mania and
psychosis resulting in psychiatric admissions. Journal of Clinical
Psychiatry, 2001. 62:30-33

See also ER-SSRI: http://www.ahrp.org/infomail/0403/15.php

  1. See: Americans Growing Less Confident In FDA’s Job on Safety, Poll Shows
    THE WALL STREET JOURNAL ONLINE May 24, 2006,
    http://online.wsj.com/article/SB114831296787359612.htm l

Contact: Vera Hassner Sharav
veracare@ahrp.org
http://news.yahoo.com/s/ap/20060525/ap_on_he_me/adhd_drugs;_ylt=AswbL4V.od90
jOVdkgXNj3Cs0NUE;_ylu=X3oDMTA2Z2szazkxBHNlYwN0bQ
May 24, 2006

Study: ADHD drugs send thousands to ERs
By LINDA A. JOHNSON,
Associated Press Writer

Accidental overdoses and side effects from attention deficit drugs
likely send thousands of children and adults to emergency rooms,
according to the first national estimates of the problem.

Scientists at the U.S. Centers for Disease Control and Prevention
estimated problems with the stimulant drugs drive nearly 3,100 people to
ERs each year. Nearly two-thirds – overdoses and accidental use – could
be prevented by parents locking the pills away, the researchers say.

Other patients had side effects, including potential cardiac problems
such as chest pain, stroke, high blood pressure and fast heart rate.

Concerns over those effects have led some doctors to urge the Food and
Drug Administration to require a “black box,” its most serious warning,
on package inserts for drugs such as Ritalin, Concerta and Adderall. Yet
even doctors advising the FDA don’t agree on whether that’s warranted.

The issue was discussed in a series of letters in Thursday’s New England
Journal of Medicine, including some from doctors worried about the
dangers of not treating attention deficit hyperactivity disorder.

“The numbers (of side effects) are puny compared to the numbers of
stimulant prescriptions per year,” said Dr. Tolga Taneli, a child and
adolescent psychiatrist at University of Medicine and Dentistry of New
Jersey in Newark. “I’m not alarmed.”

An estimated 3.3 million Americans who are 19 or younger and nearly 1.5
million ages 20 and older are taking ADHD medicines. Ritalin is made by
Novartis Pharmaceuticals Corp. of East Hanover, N.J.; Concerta by
Johnson & Johnson of New Brunswick, N.J., and Adderall by Shire US Inc.
of Newport, Ky.

Twenty-five deaths linked to ADHD drugs, 19 involving children, were
reported to FDA from 1999 through 2003. Fifty-four other cases of
serious heart problems, including heart attacks and strokes, were also
reported. Some of the patients had prior heart problems.

Still, there hasn’t been a clear estimate of the scope of side effects.
The CDC report, while not a rigorous scientific study, attempts to
provide that by using a new hospital surveillance network.

From August 2003 through December 2005, the researchers counted 188 ER
visits for problems with the drugs at the 64 hospitals in the network, a
representative sample of ERs monitored to spot drug side effects.

Doctors linked use of stimulant ADHD drugs to 73 patients with side
effects or allergic reactions. Another 115 accidentally swallowed ADHD
pills, including a month-old baby, or took too much.

“These are cases where a young child took someone else’s medication or
they took too much of their own,” CDC epidemiologist Dr. Adam Cohen said
of the second group.

Nearly 1 in 5 patients was admitted to the hospital, 1 in 5 needed
stomach pumping or treatment with medicines, and 1 in 7 had cardiac
symptoms. Sixteen percent of the side effects involved interaction with
another drug.

Besides cardiac problems, common symptoms included abdominal pain,
rashes and spasms, pain or weakness in muscles, according to Cohen. No
patients died.

Extrapolating to all U.S. hospitals, the researchers estimated 3,075 ER
visits occur each year.

In another letter in the journal, the heads of the American Psychiatric
Association and the American Academy of Child and Adolescent Psychiatry
wrote they are concerned a black box warning would discourage use of
ADHD drugs, raising patients’ risks of academic failure, substance abuse
and other problems.

This past February, an FDA drug safety advisory panel voted 8-7 for a
black box warning. The next month, another FDA panel instead recommended
data on cardiac and other risks go in a new “highlights” section the
agency plans to add to the top of drug inserts.

Dr. Marsha Rappley, pediatrics professor at Michigan State University,
and two other doctors on the advisory panels believe the vote for a
black box was premature.

She said studies show the drugs raise blood pressure and pulse rates a
bit, but it’s unknown whether that would harm children taking them for
years, and that cardiac risks may be higher for adults.

Dr. Steven Nissen, cardiology chief at the Cleveland Clinic, who had
pressed for a black box warning at the FDA panel meeting, said ADHD
drugs are powerful stimulants and inherently risky. Nissen and other
doctors say the drugs are being prescribed to some who don’t need them.

This week, the FDA said it is “working diligently” on “labeling changes
that we feel accurately reflect the available data and the advice of the
committees.” The agency declined interview requests.
On the Net: http://www.nejm.org

American and Academy of Pediatrics ADHD site:
http://www.aap.org/healthtopics/adhd.cfm

Copyright C 2006 The Associated Press.

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