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ADHD Pill Faces High Hurdle in Europe as Stigma Persists

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Re: ADHD Pill Faces High Hurdle in Europe as Stigma Persists

#71

Post by code_duck »

bayesianhorse wrote: post #60
code_duck wrote: post #4

Earlier quoted context omitted.

What could be wrong with dosing children with amphetamines every day for years?

If you are not treating a child with severe or even moderate ADHD with Amphetamines, the risks are severe and not so rare at all. Almost by guarantee the child will not achieve remotely as well as it could. Both in school and within social groups. Both of these failures will almost by guarantee lead to further problems down the road. It has been shown that untreated ADHD multiplies the risk for other very real disord…

I disagree, and I'm confident sane history will eventually look back in horror at the idiots giving their kids amphetamines willy-nilly.

Perhaps some children need this. The vast majority receiving these drugs would benefit a lot more from realistic parenting and school situations than from a toxic, addictive stimulant pill.

Re: ADHD Pill Faces High Hurdle in Europe as Stigma Persists

#72

Post by wpietri »

com2kid wrote: post #49
wpietri wrote: post #28

Earlier quoted context omitted.

Personally, I'm pretty skeptical that most of the people diagnosed with it have a disease. I think it's a perfectly normal human variation that just doesn't match well with our Industrial Age approach to education. The way I think of it is like height. There's a normal range of tall and short. There are also diseases that make people unusually tall or short. But mere shortness doesn't prove disease. And just because…

People with ADHD have reduced brain growth in areas associated with executive control. ADHD is very real. So is the 50%+ of untreated people with ADHD having substance abuse problems. So is the higher suicide rate. So is the reduced rate of high school and college graduation. So are the dramatically increased rates of depression. Then there is the incredibly high rate of co-morbidity of ADHD with other psychological…

Those are interesting facts, but I don't think they prove anything about existence of ADHD as an actual disease. Lower-than-average height is also correlated with many diseases but it isn't a disease on its own.

Re: ADHD Pill Faces High Hurdle in Europe as Stigma Persists

#73

Post by wpietri »

saosebastiao wrote: post #34
wpietri wrote: post #28

Earlier quoted context omitted.

Personally, I'm pretty skeptical that most of the people diagnosed with it have a disease. I think it's a perfectly normal human variation that just doesn't match well with our Industrial Age approach to education. The way I think of it is like height. There's a normal range of tall and short. There are also diseases that make people unusually tall or short. But mere shortness doesn't prove disease. And just because…

I think it is perfectly reasonable to take that viewpoint. It certainly might be over-diagnosed. However, as with all neurological disorders, there is often quite a bit of mutability in the actual diagnosis; It isn't uncommon for people to be initially diagnosed with ADHD, only to be later diagnosed with something else. There are a lot of overlapping symptoms with other disorders, varying from OCD to Bi-Polar to Aspe…

Sure. And that's a sign to me that we don't really understand what's going on yet.

Those are interesting to mention in this context. It's a commonplace among hackers that a little OCD or a little Asperger can be beneficial in some circumstances. Indeed, Temple Grandin, perhaps the world's best-known high-functioning autistic, recommends computer programming as a career for people like her. Among artists, the same is true about Bipolar (the book Touched with Fire is an interesting study of why and how that's true).

I think it's relevant that Asperger was a valid diagnosis for a few decades, but it no longer is. (As of DSM-5, people are just placed somewhere on a spectrum of autism.) That's a great sign that we still have a lot to learn.

I'm sure you get this, but I worry that others will misunderstand me, so let me be clear here: I'm not saying that any of these things aren't a problem for people in today's society.

With attention span, for example, high-end classroom-style education and many high-end jobs require a great deal of focus. But that doesn't imply that people with lower-than-average levels of focus are diseased. Indeed, more than half of Americans consume stimulants daily, and many workplaces provide their staff with free stimulants (coffee, Coke) so they can keep up. Many unarguably normal students consume ADHD meds as study aids. If stimulants improve performance for everybody, they can't be considered diagnostic for a problem.

My concern here isn't that people are choosing that. We're half-evolved monkeys; it's great that we can choose who we want to be. My concern is that we're taking natural human variation and medicalizing it mainly because our current educational system finds some of that variation inconvenient.

Re: ADHD Pill Faces High Hurdle in Europe as Stigma Persists

#74

Post by wpietri »

bayesianhorse wrote: post #57
bradleyjg wrote: post #51

Earlier quoted context omitted.

> The science on this is very strong. You see "clusters" of similar conditions in millions of human beings, where each of these clusters/diseases have similar problems, and they share potential remedies. Would that were true! In fact the science is not very strong at all. We have descriptive sets of symptoms and we have classes of drugs discovered serendipitously that seem to help some sufferers, but despite 30+ year…

Depression for example is a very real problem for those affected. Several drugs are available which provide repeatable relief. Countless studies show, that suicide can be prevented through anti-depressants which mostly don't cause major side effects, leaving the patient much better off. A lack of understanding why these drugs work does not mean that the diseases they are often successfully treating is "phony".

I certainly agree that major depressive disorder is a real problem, and drugs help it.

But there are two problems with the current consensus that I take issue with.

One is the that it's easy to medicalize normal human variation. Two years ago after an intense battle, I lost my mom to brain cancer. That same year, I lost three other people and had some other majorly bad things happen. At some point I talked to a therapist about depression. She agreed I matched the symptoms, but disagreed that I was depressed. I was grieving, and in her view I should work through it, no matter what other people thought.

I retrospect I can see she was right; I had work to do. But at the time, it would have been very tempting to take a pill that suppressed the symptoms. That's certainly what some people who told me I should be "over it by now" thought I should do. Our current society just doesn't have a lot of room for that.

The other problem I have is that we are putting things like depression all on the individual and some posited internal flaw. I think that's a lazy and disrespectful conclusion given the state of the art. For example, we are discovering that nighttime artificial light triggers depression in animal studies, and we know simulated extra daylight during the day can treat it in humans. For those people, their depression isn't a disease, it's an unintended consequence of our artificial environment. Daily pills to shift brain chemistry are one solution to the problem, but they aren't the only solution.

I think the disease model of medicine has been incredibly successful in improving human lives. But it has limits, and I think mental health is one area where we are overfitting the data to our model.

Re: ADHD Pill Faces High Hurdle in Europe as Stigma Persists

#75

Post by UK-AL »

nav1 wrote: post #37
ginko wrote: post #30

Earlier quoted context omitted.

Because I don't believe it's a disease.

Of course. Never mind all the evidence. What you believe is more important than any research could ever be.

What evidence says it disease? rather simply a normal difference.

Re: ADHD Pill Faces High Hurdle in Europe as Stigma Persists

#76

Post by tekalon »

bayesianhorse wrote: post #60
code_duck wrote: post #4

Earlier quoted context omitted.

What could be wrong with dosing children with amphetamines every day for years?

If you are not treating a child with severe or even moderate ADHD with Amphetamines, the risks are severe and not so rare at all. Almost by guarantee the child will not achieve remotely as well as it could. Both in school and within social groups. Both of these failures will almost by guarantee lead to further problems down the road. It has been shown that untreated ADHD multiplies the risk for other very real disord…

My mother was only just recently diagnosed with ADD (After having 2 out of her 5 children with the same ADD/ADHD diagnosis). This was AFTER dealing with depression and various diagnoses including bipolar. She is in therapy to not only manage her ADD, but also deal with all the issues as a result of a lifetime of unmanaged ADD. I have ADD, but was diagnosed young, I learned how to manage and only went on meds when I was mid 20's since my non medical management didn't work well outside a structured school setting (and barely did in highschool/college). My depression and anxiety are made worse if not caused by ADD and has affect social and work life (good and bad). While I agree that ADD/ADHD can be overdiagnosed and even possibly overmedicated, I agree that not having a diagnosis can cause a worse life than otherwise.

Re: ADHD Pill Faces High Hurdle in Europe as Stigma Persists

#77

Post by tekalon »

coopaq wrote: post #9

Some of the signs for ADHD from wikipedia: "Become bored with a task after only a few minutes, unless doing something enjoyable" "Have trouble completing or turning in homework assignments" "Struggle to follow instructions" "Be very impatient" "Be constantly in motion" "Thinks constantly being told what to do by others for 18 years kinda sucks" http://en.wikipedia.org/wiki/Attention_deficit_hyperactivity...

Personal signs:

- Not able to drive unless taken medication since every sign, pedestrian, other cars and movement keeps you from paying attention to what is in front of you (including lights, cars and pedestrians). (Like running into a tree since you were trying to admire the forest and not paying attention to where you were going).

-Stopping mid sentence/conversation to finish a sentence/conversation (whether or not with the same person) that may have happened weeks or years ago.

-Being verbally told something, and remembering it until someone else tells you something/asks for something or you see something else 'shiney'.

-Finishing someone else's sentences due to them being too slow to finish it (whether or not what I say is correct)

-Having many projects half finished- not necessarily since I got bored with them, but it took to long to finish and something else more shiney/important happened.

-Finishing a book 4 years later, always knowing where in the plot you are and what is going on, but not finishing because another book wanted to be read first.

-Saying/writing a sentence wrong since you try to say the same thing 2-3 different ways ALL AT ONCE. Also works trying to move 2-3 different directions all at once.

-Impulsivity- trying to do Everything RIGHT NOW.

Re: ADHD Pill Faces High Hurdle in Europe as Stigma Persists

#78

Post by Bluestrike2 »

code_duck wrote: post #67
Bluestrike2 wrote: post #32

Earlier quoted context omitted.

Are you honestly comparing crystal meth from the street to something prescribed under the guidance of one's doctor? Your post strikes me more along the lines of hysterics than a rational foray into discussion. For shits and giggles, let's compare apples to apples. Desoxyn (Methamphetamine HCl). There you get the scary M word, but one that's FDA-approved and prescribed--though, admittedly, not commonly--by doctors. Sa…

I am absolutely comparing dextroamphetamine to methamphetamine. It doesn't matter by whom it was synthesized. They are very similar in pharmacology, so you'd be deluded to not compare the two. Same addictive properties, same deleterious effects on health, similar abuse potential.

And yet, different contexts lead to vastly different results. One is prescribed under a doctor's guidance at therapeutic doses and administered orally; the other is smoked, at [i]significantly[/i] higher dosages, to speed up absorption with much higher concentration levels accumulating directly in the brain.

In other words, your argument is inherently simplistic and purposely misleading. Despite similarities in structure, the pharmacodynamics differences between therapeutic usage of Adderall and illicit meth are significant. When you gloss over the differences, you're radically undermining your position. My point with Desoxyn, which you completely ignored, rebuts your position even more clearly.

Most medications have the potential for hazardous effects higher up the dose-response curve. That potential, however, doesn't magically negate clinical effects lower on the curve. A little is good, a lot (or with acetaminophen for instance, a little more) can be deadly. That's nothing new. Just as with potential for side effects, you and your doctor work to manage it during treatment.

On another note, when you raise the specter of crystal meth usage, you aren't just isolating it to matters of pharmacology. Especially when you're talking about usage externalities and societal benefits: the external costs associated with manufacture and distribution all come along as mental baggage with the words "crystal meth." Your hysterics purposely ignore this in order to make the comparison seem more damning on a purely emotional level.

Re: ADHD Pill Faces High Hurdle in Europe as Stigma Persists

#79

Post by bayesianhorse »

code_duck wrote: post #71
bayesianhorse wrote: post #60

Earlier quoted context omitted.

If you are not treating a child with severe or even moderate ADHD with Amphetamines, the risks are severe and not so rare at all. Almost by guarantee the child will not achieve remotely as well as it could. Both in school and within social groups. Both of these failures will almost by guarantee lead to further problems down the road. It has been shown that untreated ADHD multiplies the risk for other very real disord…

I disagree, and I'm confident sane history will eventually look back in horror at the idiots giving their kids amphetamines willy-nilly. Perhaps some children need this. The vast majority receiving these drugs would benefit a lot more from realistic parenting and school situations than from a toxic, addictive stimulant pill.

Those enlightened future beings will have to discover some theoretical side effects which justify the obvious disadvantages of denying treatment and just haven't been seen yet despite of decades of experience with these drugs.

These side effects need to be severe, given the massive amount of consequences of untreated ADHD.

Re: ADHD Pill Faces High Hurdle in Europe as Stigma Persists

#80

Post by anigbrowl »

linuxhansl wrote: post #48
anigbrowl wrote: post #39

Earlier quoted context omitted.

thanks to uninformed attitudes like yours, I was unable to get any treatment for my ADHD for years while living in Europe. Instead I was told that I was stressed because I was depressed, and depressed because I was stressed, and made to feel like it was my fault for not being easily treatable. Maybe we can stop growing a monoculture of humans where the slightest deviation from the norm must be treated with some kind…

Yes, yes, and vaccines are a pharmaceutical industry plot, and all the rest. I have neither said nor implied this anywhere.

And yet you're employing the same basic argument.
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