Stimulant medication helped
Proper A.D.H.D. diagnoses and medication have helped millions of children lead more productive lives, concerns remain that questionable diagnoses carry unappreciated costs.
Studies had shown that stimulant medication helped some elementary school children with carefully evaluated A.D.H.D. to improve scores in reading and math tests, primarily by helping them concentrate. The concern, some doctors said, is that long-term, wider academic benefits have not been proved -- and that ads suggesting they have can tempt doctors, perhaps subconsciously, to prescribe drugs with risks to healthy children merely to improve their grades or self-esteem.
A.D.H.D. patient advocates often say that many parents resist having their child evaluated because of the stigma of mental illness and the perceived risks of medication. To combat this, groups have published lists of "Famous People With A.D.H.D." to reassure parents of the good company their children could join with a diagnosis. One, in circulation since the mid-1990s and now posted on the psychcentral.com information portal beside two ads for Strattera, includes Thomas Edison, Abraham Lincoln, Galileo and Socrates.
Shire's long-acting version of Adderall, Adderall XR:
Drug companies used the research of Dr. Biederman and others to create compelling messages for doctors. "Adderall XR Improves Academic Performance," an ad in a psychiatry journal declared in 2003, leveraging two Biederman studies financed by Shire. A Concerta ad barely mentioned A.D.H.D., but said the medication would "allow your patients to experience life's successes every day."
If a psychiatrist asked about issues like side effects or abuse, Mr. Lutz said, they were played down. He said he was told to acknowledge risks matter-of-factly for legal reasons, but to refer only to the small print in the package insert or offer Shire's phone number for more information.
"It was never like, 'This is a serious side effect, you need to watch out for it,' " Mr. Lutz recalled. "You wanted to give them more information because we're talking about kids here, you know? But it was all very positive."