ADD: Drugs Don't Work Long Term

L. Alan Sroufe has an oped in today's NYTimes on the use of drugs to treat ADD (attention Deficient Disorder) in children: Ritalin Gone Wrong.

Attention-deficit drugs increase concentration in the short term, which is why they work so well for college students cramming for exams. But when given to children over long periods of time, they neither improve school achievement nor reduce behavior problems. The drugs can also have serious side effects, including stunting growth.

Sadly, few physicians and parents seem to be aware of what we have been learning about the lack of effectiveness of these drugs.

He suggests that experience may be the cause:

Policy makers are so convinced that children with attention deficits have an organic disease that they have all but called off the search for a comprehensive understanding of the condition. The National Institute of Mental Health finances research aimed largely at physiological and brain components of A.D.D. While there is some research on other treatment approaches, very little is studied regarding the role of experience. Scientists, aware of this orientation, tend to submit only grants aimed at elucidating the biochemistry.

Thus, only one question is asked: are there aspects of brain functioning associated with childhood attention problems? The answer is always yes. Overlooked is the very real possibility that both the brain anomalies and the A.D.D. result from experience.

Here's some informal notes I did some years ago on the experience angle: Music and the Prevention and Amelioration of ADHD: A Theoretical Perspective:

Russell A. Barkley has argued that ADHD is fundamentally a disorientation in time. These notes explore the possibility that music, which requires and supports finely tuned temporal cognition, might play a role in ameliorating ADHD. The discussion ranges across cultural issues (grasshopper vs. ant, lower rate of diagnosis of ADHD among African-Americans), play, distribution of dopamine and norepinephrine in the brain, neural development, and genes in culture (studies of the distribution of alleles for dopamine receptors). Unfortunately, the literature on ADHD does not allow us to draw strong conclusions. We do not understand what causes ADHD nor do we understand how best to treat the condition. However, in view of the fact that ADHD does involve problems with temporal cognition, and that music does train one’s sense of timing, the use of music therapy as a way of ameliorating ADHD should be investigated. I also advocate conducting epidemiological studies about the relationship between dancing and music in childhood, especially in early childhood, and the incidence of ADHD.