Good Job!

Urging caution regarding a pharmaceutical cash cow will never be easy.

Contributing to the problem is how difficult it can be to live with children who have extensive ADHD symptoms. Their constant impulsivity and inability to appreciate consequences is enough to drive the finest of parents bonkers. (While I'm not the finest of parents, I have been a foster parent and am an adoptive parent, and can well appreciate the promise of a magic bullet--or any bullet that might help a child with ADHD to slow down just a bit, and to be able to listen and focus and think.)

I've also heard time and again that children with ADHD will go on to self-medicate with something illegal if we don't medicate them with something legal. I think this reasoning his horribly flawed, but it makes a certain amount of sense to desperate parents.

As for the effectiveness of drugs like Ritalin, while I've seen a much appreciated slowdown in the child's activity level, I've also seen a corresponding dulling which has been of concern. Also my awareness of the neurological immaturity of a child's brain and how it is still a neurological work in progress until early adulthood concerns me about the impact of drugs on it. However, my experience is anecdotal and observational rather than scientific, so it isn't of much value.

I do believe it is important that studies like those you mention be part of our decision-making process. I also think it never hurts to look carefully at the funding sources or funding trail (which can be much more subtle) of studies on drugs that promise to change unwanted behavior.

While I have faith in the integrity of the scientists at the big drug companies, I sometimes wonder if our desperate need as consumers--combined with the exuberance of the drug company marketing and sales teams and the demands of stock holders--always results in the best of outcomes.

Dr. Ghaemi, at the risk of your becoming a Tom Cruise protege, I think your voice of caution is an important one.

Paul Joannides, Psy.D.