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Manufacturer,
psychiatric group accused of overdiagnosing to sell Ritalin
By AMY WESTFELDT, Associated
Press
NEWARK, N.J. (September 15, 2000 11:22
p.m. EDT http://www.nandotimes.com) - The American
Psychiatric Association and the makers of the drug Ritalin are encouraging
overdiagnosis of behavioral problems in children to boost sales of the
drug, according to two lawsuits filed this week.
Novartis Pharmaceutical Corp. and the psychiatric association promoted
the belief that a large number of children need to take Ritalin for
attention deficit disorder or attention deficit hyperactivity disorder,
the suits filed in New Jersey and California allege.
A similar suit against the East Hanover, N.J.-based maker of the drug
and the association was filed earlier this year in Texas. The latest suits
were filed Wednesday in state Superior Court in Hackensack and in San
Diego federal court by some of the same attorneys who filed huge lawsuits
against gun makers and the tobacco industry.
Novartis and Ciba-Geigy Corp., which produced Ritalin before the two
companies merged in 1996, also donated hundreds of thousands of dollars to
an organization of members with attention deficit or hyperactivity
disorder, the lawsuits say.
They also charge that the companies worked with the psychiatric
association to include the diagnosis of the two disorders and list it in
the Diagnostic and Statistical Manual of Mental Disorders in 1980,
creating a huge market for the drug.
The companies released misleading sales literature about Ritalin's
effectiveness "without ever advising ... that Ritalin usage would not
stimulate or improve academic performance and/or have any long-term effect
on the symptoms associated with ADD or and/or ADHD," the California suit
says.
Novartis released a statement Friday calling the charges "unfounded and
preposterous" and noted that attention deficit/hyperactivity disorder has
been recognized by medical experts worldwide.
The American Psychiatric Association also denied the allegations.
"The APA will defend itself vigorously by presenting a mountain of
scientific evidence to refute these meritless allegations and we are
confident that we will prevail," the association said in a statement.
Between 4 percent and 12 percent of school-age children - about 3
million, mostly boys - are believed to have attention
deficit/hyperactivity disorder. The symptoms of short attention span,
impulsive behavior and difficulty sitting still are also associated with
youthful rambunctiousness, which has raised questions of whether
youngsters are being overmedicated.
Congressional hearings recently examined whether Ritalin, a brand name
for the stimulant methylphenidate, is overprescribed for the disorders.
The American Academy of Pediatrics issued its first guidelines earlier
this year for diagnosing the disorders, stating that a child must show
symptoms in two settings for at least six months.
The lawsuits, filed on behalf of children who took the drug in both New
Jersey and California, say that Ciba-Geigy Corp. began a conspiracy to
boost the Ritalin market in the mid-1950s, leading to the creation of the
ADD diagnosis in the Diagnostic Statistical Manual. In 1987, the diagnosis
was expanded to attention deficit/hyperactivity disorder.
The lawsuits say that the drug's makers gave $748,000 to the California
advocacy group Children and Adults with Attention-Deficit/Hyperactivity
Disorder between 1991 and 1994 to help promote Ritalin sales.
Eye Disorder Linked to ADHD in Children
NEW YORK, Apr 14, 2000 (Reuters Health) -- An eye disorder appears to be
linked to attention-deficit/hyperactivity disorder (ADHD) in children,
according to University of California, San Diego researchers.
The eye problem, called convergence insufficiency, is a physical problem
of the eye that makes it difficult to keep both eyes focused on
a near target. The disorder affects less than 5% of children --
but the research team found that it is three times more common
in children with ADHD than in other children.
``This is the first report on the potential connection of these two
disorders,'' Dr. David B. Granet said this week during the American
Academy of Pediatric Ophthalmology and Strabismus meeting in San Diego.
Granet and colleagues reviewed the records of 266 children identified as
having an inability to keep both eyes focused on a close target. The
investigators found that 26 children (9.8%) also had a diagnosis of
ADHD. ``Twenty of these patients were on medication for ADHD when
diagnosed with convergence insufficiency,'' Granet told Reuters Health.
When the researchers reviewed their institution's records of 1,700
children diagnosed with ADHD, they discovered that about 176 also had
eye exams, Granet said. ``Of these, almost 16% or 28 children also had
convergence insufficiency,'' he added.
This analysis shows that ``children with ADHD had three times the
incidence of convergence insufficiency than what was expected in
children walking in off the street,'' Granet said.
Convergence insufficiency ``makes it more difficult to
concentrate on reading, which is also one of the ways doctors
diagnose ADHD,'' Granet commented.
``Convergence insufficiency may not be well known outside the field of
eye care specialists,'' Granet told Reuters Health. ``We don't know if
children are being misdiagnosed with ADHD when they truly have
convergence insufficiency or vice versa,'' he said. ``We also don't know
if one causes the other or if medications used for ADHD cause
convergence insufficiency,'' he added.
``More study needs to be completed to confirm the connection and to
answer these questions,'' Granet said.
Granet also noted that convergence insufficiency responds to eye
exercises that can be done at home.
#### -end- ####
Discussion:
Many eye care professionals know that a low plus "reading lens" can
often be very helpful in reducing the near-point-stress that some
readers experience.
Near-point-stress itself may be a factor in the collapse or reduction
in the peripheral visual fields. Use of a low plus lens for near-point
activity, like reading, can reduce the stress and relatively quickly
expand the fields. The Visual Field Instrument can show this.
Peripheral visual fields provide important visual information needed
by the visual areas of the brain with adequate information in order that
eye muscles can be directed to "line-up" the eyes so both eyes will be
able to work together.
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