Friday, October 20, 2006
Last Updated: Friday, October 20, 2006 | 10:17 AM ET
The first long-term U.S. government study of preschoolers who take Ritalin, the popular attention deficit disorder drug, warns of side-effects but also found benefits in children with severe problems.
The drug isn't approved for use in children under age six, and the researchers said those youngsters need close monitoring because preschoolers are more likely than older children to develop side effects.
The research was done because of concerns over reports that soaring numbers of very young children are being given psychiatric drugs, including Ritalin.
The study's message is, proceed with caution, said Dr. Thomas Insel, director of the National Institute of Mental Health.
"We're not talking about fidgety three-year-olds," said Insel, whose agency funded the study. The research involved children with severe cases of attention deficit hyperactivity disorder — cases that included hanging from ceiling fans, jumping off slides or playing with fire.
The researchers say the benefits of low-dose treatment outweigh the risks for these youngsters.
Safety not established, critic contends
But critics disputed that.
"I hope publication of this does not lead to more overprescribing," said Dr. Sidney Wolfe of the watchdog group Public Citizen. "The safety isn't adequately established, the efficacy even less."
About 40 per cent of children developed side effects and roughly 11 per cent dropped out because of problems including irritability, weight loss, insomnia and slowed growth.
Preschoolers on methylphenidate, or generic Ritalin, grew about half an inch less and gained about two pounds less than expected during the 70-week study.
Doctor calls study a catastrophe
"This is a catastrophe. It just opens up the way for drugging the younger kids," said Dr. Peter Breggin, a New York psychiatrist and longtime critic of psychiatric drug use in children.
Breggin said the research is part of a marketing push by the drug industry to expand drug use to the youngest children.
The study appears in the November edition of the Journal of the American Academy of Child and Adolescent Psychiatry. Several of the researchers have financial ties to makers of ADHD drugs, including Ritalin.
Lead author Dr. Laurence Greenhill, a psychiatrist with Columbia University and New York State Psychiatric Institute, has been a paid speaker for most companies that make the drugs.
Roughly eight per cent of U.S. children have ADHD, including about three per cent of preschoolers. In Canada in 2005, two million prescriptions for stimulants such as Ritalin were written to treat ADHD.
Study outlines pros, cons
Previous research found that about one in 100 preschoolers had been prescribed Ritalin, which has only been approved for use in children aged six and older. Use in younger children is considered "off-label" but is not illegal.
Dr. David Fassler, a psychiatry professor at the University of Vermont, said the study does a good job of outlining pros and cons of Ritalin treatment in preschoolers.
"This is exactly the kind of information we need to help parents make informed decisions about treatment options for young children with ADHD," Fassler said.
The study included 10 weeks of behavioural treatment along with parent training and about one year of drug treatment. Nearly 300 families were enrolled, but many dropped out after the first phase, either because the behaviour treatment worked or because they didn't want to put their children on drugs.
The drug phase started with 165 children, more than a dozen dropped out because of side-effects.
Behaviour improvements were seen in children taking 7.5 to 30 milligrams daily, but the optimal dose was 14 milligrams daily — less than half the usual Ritalin dose for older children, Greenhill said.
Keep up the good work. A lot of people are saying the pipeline is a done deal.
I hope they are wrong. If they go ahead with the pipeline route being proposed and a second refinary? The rest of the population might as well move away and give the whole city to Irving.
Of course nothing would be said because the local newspaper has a policy of not reporting negative news about The Irvings I would not want to be around if it ever explodes.
Maybe they should paint a big bulls eye on all map references for Saint John
I got this one from
All they had to do was to sign papers and the Government would pay for it.
I was told from a lot of citizens that many people who were hooked on Dilaudid lined up for the course.
They got their computer and sold it for drugs!
The problem was this?
There were no courses!!! It was all a scam!!!
Guess what? I haven’t heard or read nothing about this issue in the courts.
I’m certain that we’re talking between $250,000 to $500,000!!!!
Does anyone out there know the reason the Saint John Police Force or the office of the prosecutor never pursue this case????
Yes, if the Saint John Police Force are proven they did the right action by arresting and deleting the pictures from a blogger.
Then it's over in New Brunswick!!
Since the Irvings owns all the newspapers in this Province? Only Irving's employees will be allowed to take pictures of different events in New Brunswick.
Which reminds me? Jamie Irving didn't print my letter. See what I mean? Old Germany all over again!