Children and medication

| November 7, 2010

By Dr Bernard Brom

MB CHB (UCT), CEDH (FRANCE), DIP ACUP
This article f irst appeared in Natural Medicine and is reprinted here with the author’s permission.

“It’s a strange, strange world we live in, Master Jack.” These words from an old 1960’s song remain as poignant as ever. In the area of child health, the public is now inundated with confusing information, while the numbers of diagnosable conditions (especially behavioural disorders) and the numbers of children on medication continue to escalate. What’s going on?

Common sense gives way to complex regimens

Like adults, children are being medicated not just for acute conditions but for a range of chronic behavioural conditions that don’t seem to have existed previously. Before the advent of prescription drugs, doctors (and lay people) applied common-sense approaches to most childhood illnesses. These days, however, I have seen babies prescribed antihistamines or headache pills like Panado for sleep problems, and oral cortisone for allergic conditions.

They receive a range of vaccinations (up to 12 different vaccines are given before the child reaches the age of two) containing antibiotics, preservatives and possibly other contaminants. As they get older, they may be prescribed antidepressants, antibiotics (a frequent ‘antidote’ for acne), Ritalin, hormones or other stimulants to help them cope with life. Many children today are drugged, either directly by their general medical health practitioner or by their parents using over-the-counter medication.

Illicit drugs directly or indirectly kill an estimated 19 000 people annually in the USA and nearly US$12 billion is spent on the war against them. In comparison, prescription drugs kill an estimated 105 000 people each year1 and make one heck of a lot of money for pharmaceutical companies. Are the benefits of medication
for children worth the risks? To answer this question, it is important to recognise what has happened over the last 20 years within the medical fraternity.

The creation of disease syndromes

The Diagnostic and Statistical Manual of Mental Disorders listed 226 diagnosable conditions in 1980. By 1994, this number had swelled to 365 as new conditions were identified. This meant that more and more people were being diagnosed with ill health and were being treated with drugs.

The redefinition of attention deficit hyperactivity disorder (ADHD) in 1994 led to a near doubling of the number of children diagnosed with this condition, and an equal increase in the sales of Ritalin. Even pre-school children were given this drug, and sales soared. Children were also being increasingly diagnosed with depression and treated with the same drugs as their parents, despite the lack of scientific study to support safety and effectiveness protocols.

In the United States, over 500 000 prescriptions for selective serotonin reuptake inhibitors (SSRIs) are written each year for children and adolescents. The reasons for all this are quite complex, but have a lot to do with the way doctors work and the way the pharmaceutical giants define their business objectives. Doctors give drugs – this is
what they are trained to do. Many are not trained in lifestyle management, have inadequate knowledge of nutritional supplements, do not have time to advise parents,
and have little training in this regard. In addition, many parents want a quick fix and don’t want to have to spend much more time than they already do with their children.

The solution for everyone is a prescription for drugs. If a label can be attached to the child, then parents are relieved, teachers feel justified and doctors can get on with the
next patient. The child is not just naughty, playful or sad but has been given a medical diagnosis and can be treated appropriately with chemical drugs. Albert Einstein did not speak until he was four years old and didn’t read until he was seven. He was described by his teacher as “mentally slow, unsociable and adrift in his foolish dreams”.

Isaac Newton apparently did very poorly in grade school, and Winston Churchill failed the sixth grade. It would be interesting to know how these geniuses would have
turned out if they had been given Ritalin or other drugs.

Labels or real problems?

Is there a real epidemic of childhood dysfunctional problems, or has the medical profession created the problem by re-labelling a whole lot of conditions that were once seen as variants of normal childhood behaviour? Labels also become increasingly complex as new disorders are differentiated, for the simple reason that each child is unique and no condition will be exactly like another. Some psychiatrists believe, for example, that many children have bipolar disorder, causing them to switch from hyperactivity and mania to crying spells and depression. These children are frequently diagnosed with ADHD and treated with a stimulant such as Ritalin, which will aggravate the bipolar condition and often lead to the child being prescribed yet another drug to counteract this symptom.

Expert committees of specialists generally find ways to particularise and differentiate new groups of children to add to their pool of potential patients. This process does have a positive side. For instance, world-renowned specialist Dr Cheri Florance was able to differentiate a group of children who were previously labelled autistic (now said to have the ‘Florance syndrome’).

These children are often uncontrollable and therefore treated with drugs. She found a way to ‘rewire’ their brains without drugs, using a teaching programme she developed that can easily be taught to parents. Drugs are the easy way out. Parents need to become knowledgeable and to recognise what they are doing to their child.

A massive investigation reviewing 2 287 studies on ADHD drugs concluded that there was no evidence on long-term safety in young children or adolescents, and that the evidence was not compelling that the drugs improved the thinking or quality of life of adults or helped to alleviate adult anxiety or depression.

Over-treated children

In 2002, doctors wrote nearly 11 million prescriptions for psychotropic drugs (drugs that affect mood) for children between the ages of one and 17 in the USA. Twenty years ago, such young patients would have been labelled naughty, overactive or having poor concentration – today they are classified ill and even qualify for medical insurance cover for drug treatments.

Professor Sharna Olfman, an outspoken critic of the present general medical approach to treating children, had this to say in a recent interview: “We have come almost
to the point where every dreamy kid is at risk for an ADHD diagnosis, and every emotionally intense child is at risk of bipolar diagnosis. The pharmaceutical industry, driven by runaway greed, is contributing to the steep rise in the number of children in the USA – now numbering in the millions – who are being inaccurately diagnosed
and drugged. Many of these children may indeed be suffering, but their suffering cannot be ‘cured’ with a diagnosis or a drug.

Children more often need more time with their parents, less time with violent media, better health coverage, a less stressful public school system, and families need subsidised daycare, a higher minimum wage, universal healthcare, etc.”4Well said! The cover of a 2008 issue of Time magazine carried the following headlines with reference to young people: ‘Unhappy, unloved and out of control: an epidemic of violence, crime and drunkenness has made Britain scared of its young.’ Britain is not alone – what’s causing the crisis? It is not uncommon for schoolchildren to be using illicit drugs, smoking cigarettes and drinking alcohol.

Hundreds of industrial toxins in the environment are also known to affect the brain. The synergistic effects of these chemicals on the developing brain, and their interaction with prescription drugs, have not been explored. I believe that a combination of environmental pollutants, vaccinations, nutritional deficiencies and poor parenting contribute to behavioural problems.

What’s the truth?

I believe further that the truth is that we want our children to behave in particular ways conducive to learning in a school system. The system fails those children who don’t conform, as do parents who become impatient and don’t have the time to give to their children a warm and nourishing environment.

Nevertheless, there remains a group of children who really do have serious problems. A hyperactive child in one’s consulting room is extremely tiring, but that is very different from a child who is just curious about everything. The question, however, is should the child be drugged just because they now have a medical label? The danger with medical labels is that they become labels of disease rather than labels that are just a call for help. Treating the disease label without looking at the underlying causes is
again symptomatic medicine, and therefore will always have its downside in terms of side effects of the drugs given.

The Food and Drug Administration (FDA) in the US has issued a ‘black box warning’ (the strongest form of warning issued by the FDA about a drug, just short of removing the drug from the market) on all ADHD medications as more and more side effects become apparent – including a growing incidence of heart attacks, strokes and  hypertension in both adults and children who have taken these drugs.

What does science have to say?

Many scientific studies look at the drugversus-drug effect or drug-versus-placebo effect, but few studies have compared drugs with nutrition and nutritional supplements.
One conducted by Dr Bernard Rimland on children treated with different drugs showed that as many ADHD sufferers were made worse by medication as were helped. None of the drugs, however, were as effective as vitamin B6, magnesium, or the brain nutrient DMAE.6 In another study comparing 10 children on Ritalin with 10 children taking a comprehensive combination of dietary supplements for four weeks, the children taking the supplements made significant improvement compared with children on the drugs.

Other studies have shown that when children were given better diets or the addition of nutrients and when tuck shops were removed from school premises, then their intelligence quotient (IQ) scores improved significantly. Together with this comes better behaviour and concentration.

No easy answers

There is no doubt that drugs do work in some cases, but it would be an assumption to say that behavioural disorders in children are a drug-deficiency problem simply because the drugs seem to work. What the drugs do seem to do is to influence the way various brain hormones like serotonin, dopamine and adrenalin work. What is really going on in the brains of our children?

There is no easy answer here. I have a feeling that children coming into the world now are fundamentally different from us older folk. We need to spend more time discovering what they are trying to say to us rather than trying to make them conform to our standards of normality.

NUTRITIONAL HELP FOR CHILDREN

1. Dietary adjustment is essential. Remove all colouring matter, preservatives, junk food, refined sugar and products containing sugar and processed juices from their diets.

2. Introduce omega 3 fatty acids and/or increase intake of oily fish and seeds such as flax, sunflower and pumpkin.

3. A good multivitamin/mineral supplement is essential.

4. Probiotics are recommended, especially after any antibiotic use.

5. Extra zinc and magnesium may be important.

6. Tryptophan or 5 hydroxytryptophan influence serotonin levels in the brain.

7. GABA has a calming influence in cases of hyperactivity.

8. DMAE is a stimulating brain nutrient and may be used instead of Ritalin.

References

1 Starfield, B. (2000) ‘Is the US Health System Really the Best in the World?’ in Journal of the American Chemical Society, 26 July 2000, 284(4).

2 Soutullo, C.A. et al (2005) ‘Bipolar Disorders in Children and Adolescents: International Perspective on Epidemiology and Phenomenology’ in Bipolar Disorders, 7: 497-506.

3 Drug Class Review on Pharmacologic Treatments for ADHD. Final Report. September 2005. www.ohsu.edu/drugeffectiveness

4 http://ednews.org/articles/19695/1/An-interviewwith- Sharna-Olfman-Bi-Polar-Epidemic/P

5 Nissen, S. (2006) ‘ADHD Drugs and Cardiovascular Risk’ in New England Journal of Medicine, 354: 1445-8.

6 www.autismwebsite.com/ari/treatment/form34q.htm

7 Harding, K.L. et al (2003) ‘Outcome Based Comparison of Ritalin Versus Food-supplement Treated Children with AD/HD’ in Alternative Medical Review, 8: 319-30.

8 Benton, D. (2001) ‘Micro-nutrient Supplementation and the Intelligence of Children’ in Neuroscience and Behavioral Reviews, 25: 297-309.

9 Schoenthaler, S.J. et al (1997) ‘The Effect of Randomized Vitamin-mineral Supplementation on Violent and Non-violent Antisocial Behaviour among Incarcerated Juveniles’ in Journal of Nutritional and Environmental Medicine, 7:343-52.

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