Chiropractic Instead of Drugs for ADHD

A study published in the American Journal of Psychiatry suggests certain stimulant medications used to treat attention deficit hyperactivity disorder (ADHD) may cause sudden, unexplained death,¹ adding to previous reports emphasizing the potential dangers of such medications.^1-2 Combined with recent research from the International Pediatric Chiropractic Association (ICPA) suggesting the benefits of chiropractic care for ADHD sufferers and a CBS Early Show segment following the study's release that mentions chiropractic and other natural options, drug-free management of this complex condition may be one small step closer to becoming reality.

Funded by the Food and Drug Administration (FDA) and the National Institute of Mental Health, a branch of the National Institutes of Health, the study by Madelyn Gould, et al., evaluated stimulant use in 564 children and teenagers ages 7-19 who died unexpectedly, but had no known history of life-threatening illness or defined cause of death, such as homicide or accident (the study group); and 564 age-matched children/teens who died in motor vehicle accidents (the control group).

Comparing the two groups, researchers found that a significantly higher number of children/teens in the study group had taken methylphenidate prior to their death compared to the control group. Methylphenidate is the generic form of brand-name ADHD drugs such as Ritalin, Concerta and Daytrana.

In their conclusion, the study authors state: "This study reports a significant association or 'signal' between sudden unexplained death and the use of stimulant medication, specifically methylphenidate. While the data have limitations that preclude a definitive conclusion, our findings draw attention to the potential risks of stimulant medications for children and adolescents." They add: "Although sudden unexplained death is a rare event, this finding should be considered in the context of other data about the risk and benefit of stimulants in medical treatment."

"Previous evidence related to the side effects of these drugs have kept us wary of their justified use for many years," said Jeanne Ohm, executive director and spokesperson for the ICPA. " We are pleased to finally see these concerns made public so parents are aware of the potential consequences of these drugs and can make informed decisions accordingly."²

In a press release, the ICPA noted that last year the American Heart Association recommended that children with ADHD undergo cardiac screening tests prior to taking stimulant drugs for their condition and called for research to assess the potential risk of sudden death. And according to the Gould study, there have been case reports of stroke and myocardial infarction in patients taking Ritalin within therapeutic ranges. While the FDA asserts that the benefits of these drugs outweigh the risks and says there were problems with the study's methodology - particularly that the numbers were small; only 10 children in the study group were found to be taking stimulant drugs, compared to two children in the control group - it also says current guidelines recommending physicians evaluate for cardiac risks before prescribing ADHD drugs need to be strengthened.³

A Washington Post article³ discussing the study paraphrases Benedetto Vitiello of the National Institute of Mental Health, who believes the findings have relevance despite the study limitations: "[G]ould's study underscores that ADHD drugs are not innocuous. Indiscriminate prescription of the drugs for general behavioral problems and the growing number of healthy teenagers and adults using the drugs to boost mental performance could have deadly consequences."

Where can children with ADHD turn besides potentially dangerous medications? Chiropractic care, says the ICPA in its release, referencing a recent study titled "The Chiropractic Care of Patients With Attention Deficit Disorder: A Retrospective Analysis." According to the ICPA, the study, which has been accepted for publication, "shows promising results for children under chiropractic care." Dr. Ohm also references "Adverse Effects Associated With Chiropractic Care for Children," accepted for publication by a "major biomedical journal," which reports only "minimal and minor adverse effects associated with care."

The CBS Early Show's June 15 "Healthwatch" segment also recommended chiropractic care as a potential treatment option for children with ADHD.⁴ In a segment titled "ADHD Drug Warning,"  medical correspondent Dr. Jennifer Ashton told CBS anchor Julie Chen, "There have been studies that have shown complementary or alternative therapies [such as] chiropractic care or dietary changes can be beneficial in some children who are on ADHD medication  ... either in place of or in conjunction with [medication]." Dr. Ashton also emphasizes the risks associated with ADHD drugs, stating that they can have "potent effects on the body," including elevated heart rate and blood pressure, which she says may account for the connection between stimulant use and sudden death (what she refers to as sudden cardiac death) seen in the study.

The CBS segment mentions that 4.5 million children and adolescents in the U.S. have been diagnosed with ADHD, an estimated 2.5 million of whom are taking medication for their condition. With those staggering numbers and the latest research suggesting the potentially lethal dangers of prescription drugs in mind, all parents and patients should be aware of natural alternatives such as chiropractic care and weigh the risks vs. benefits associated with ADHD medications.

References

1. Gould MS, Walsh T, Munfakh JL, et al. Sudden death and use of stimulant medications in youth. American Journal of Psychiatry, June 15, 2009; published online ahead of print.
2. Press release from the International Chiropractic Pediatric Association, received June 18, 2009.
3. Vedantam S. "Study Shows Possible Link Between Deaths and ADHD Drugs."  Washington Post, June 16, 2009.
4. "ADHD Drug Warning." CBS Early Show, June 15, 2009.