OISM Press Release on Castellanos’ Experiment on ADHD

Press Release 01.01.2003

Subject: F. Xavier Castellanos et al, Developmental Trajectories of Brain Volume Abnormalities in Children and Adolescents With Attention- Deficit/Hyperactivity Disorder, Journal of the American Medical Association (JAMA 2002;288:1740-1748).

This study has the pretence of having demonstrated that the size of the brain of people with ADHD is shrinked (brain atrophy) in rispect to people who have not this supposed “mental disease”, that stimulant drugs are not its cause, and the hypothesis that they might favour brain development. We do not feel like sharing these conclusions.

Study authors claim to have tested all subjects with DSM-IV. The study covers a time span that ranges from 1991 to year 2001. DSM-IV was first published in 1994. How is it then possible that subjects observed between 1991 and 1993 receive an ADHD diagnosis in accordance to DSM-IV? Each new release of the diagnostic manual brings about major changes in the diagnostic criterions, to the point that the diagnosis are not comparable, nor are the different studies.

The cohort of ADHD children who it’s claimed had never received drugs seems unlikely so. Many official sources indicate that do not exist any studies implementing MRI on subjects not treated with drugs before 2000. Dr. Freud A. Baughman Jr., MD, an american neurologist and scientist, in one of his articles provides us with a precise and brilliant analysis of this bewildering situation ^[1].

Significant differences amongst the three employed cohorts forced investigators to undertake many correptive statistical calculations. The emerged data express heavilly a statistically manipulated reality. Professo Bartzokis G., Dept. of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, USA, has prooven in an experiment employing MRI that amphetamines cause brain atrophy.^[2]

It is not tenable the assertion that stimulant drugs can favour brain development. It is instead reknown that they inhibit production of growth hormone, whose effects repercuss on the whole body, brain included. Methylphenidate (Ritalin), which has 2.900 side-effects, is listed amongst the 300 drugs considered dangerous by WHO. The damage it causes to the heart^[3] and the liver cancers it is suspected to be caused by it^[4] must induce us to believe that its damaging effects are extensable to the brain. Furthermore, it is stronger than cocaine^[5], and is included in the Schedule II of USA drugs classification. Amongst the greater risks resulting from discontinuation of its assumption ranks suicide, a risk that was pointed out in DSM-III, but no longer mentioned in DSM-IV.

By admission of the study conductors themselves, it does not show biological causality and does not confirm brain-atrophy as a biological marker^[6]. MRI is a brain anatomical measure and not a functional one. Data collected with this instrument have not been confirmed by PET. The brain of the examined subjects are functionally within normal standards, and MRI is not a diagnostical instrument. Paradoxically, there are other “menthal diseases” that are being correlated to brain atrophy, as psychologist Alan A. Baumeister, Louisiana State University, Baton, states. He believes that the study has to be replicated^[7].

An exhaustive critical analysis of this study, rich in technical cues and considerations on the ideological aspects, is freely available in an article wirtten by Dr. Freud A. Baughman Jr. MD^[8].

In 1993 the US Department of Education appointed Dr. James M. Swanson, Director of the Attention Deficit Disorder Center at the University of California at Irvine (UCI), to carry out a research that would the point of the situation pertaing Ritalin’s efficacy. 300 reviews and 9000 articles -- spanning nearly 55 years of litterature -- were reviewed. These the dissapointing results:

Long-term beneficial effects have not been verified by research. Short-term effects of stimulants shoul dnot be considered a permanent solution to chronic ADD symptoms. Stimulant medication may improve learning in some cases but impair learning in others. In practice, prescribed doses of stimulants may be too high for optimal effects on learning, and the length of action of most stimulants is viewed as too short to affect academic achievements. No large effects on skills or higher order processes—Teachers and parents should not expect significantly improved reading or atletic skills, positive social skills, or learning of new concepts. No improvement in long-term adjustment—Teachers and parents should not expect long-term improvement in academic achievement or reduced antisocial behavior.^[9] Professor Cesare Cornoldi, Psychology Department of the University of Padova, states, in regard to prescribing Methylphenidate (Ritalin): “It’s worth remembering that positive effects in controlling impulsiveness, hyperactivity and attention can be registered during drug subministration; while learning and behaviour disorders and difficulty in social interaction require interventions of a different nature. Generally, pharmacological therapy is chronical, since when drug subministration is discontinued, unless substained by interventions of the psychological and pedagocical-didactic type, the child soon tends to manifest the same syntomatology.”^[10]

This research’s results, however interpreted, must not make us forget the underlying error of this study that subtends the pharmacological approach to children’s problems. These drugs are the new form of punishment for social-order transgressors, they are a solution only for parents, teachers, health specialists, lazy and uncapable of understanding and helping. To delegate to drugs educational responsabilityes it’s a failure for the educational and helath systems, a violation of people’s rights to riceive a cure instead of what does not cure. Surely, psychiatric drugs are not a cure for any mental disorder.

Communications:

Psychiatrist Loren Mosher, founder of the “Soteria House” project, Professor of psychiatry at San Diego University, California, member of OISM’s Scientific Committee, in a personal letter sent to me on the 11th of November 2002 informed me: “I have studied the Castellanos material carefully and am in full agreement with dr. Baughman’s superb critique of the research.”

Dr. Claudio Ajmone

Notes:

1. Freud A. Baughman Jr., MD, “THE ADHD-AS-A-“DISEASE” FRAUD ROLLS ON”.

2. Bartzokis G, Beckson M, Lu PH, Edwards N, Rapoport R, Wiseman E, Bridge P. Age-related brain volume reductions in amphetamine and cocaine addicts and normal controls: implications for addiction research. Psychiatry Res. 2000.10;98(2):93-102.

3. Henderson TA, Fischer VW, Effects of Methylphenidate (Ritalin) on Mammalian Myocardial Ultrastructure, The American Journal of Cardiovascular Pathology. 1994;5:68-78.

4. Comunicato stampa del dott. Samuel S. Epstein, del “Cancer Prevention Coalition” di Chicago

5. Ricerca della Dott.sa Nora Volkow, del Brookhaven National Laboratory, Upton, New York

6. Intervista di FRONTLINE a Castellanos, 10 Ottobre 2002.

7. Science news, Intervista allo psicologo Alan A. Baumeister, Louisiana State University

8. Freud A. Baughman Jr, MD, analisi critica esaustiva della ricerca di Castellanos.

9. Peter Breggin, Talking back to Ritalin, Persues Publishing, 2001, pag.126.

10. Cesare Cornoldi, Iperattività e autoregolazione cognitiva, Erickson, 2001, pag. 188.

11. Approfondimenti sul DDAI/ADHD

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