In a booklet published in 2004 “ Briefly about ADHD in children and adults ” the Swedish National Board of Health recommends the use of central stimulants as a treatment of ADHD. ADHD is a disorder distinguished by attention disorder, hyperactivity and impulsivity. The Board emphasizes how well documented these drugs are especially in large studies on children, how effective they are and how slight their side effects are.

Central stimulants like amphetamine and Ritalin are highly addictive narcotic drugs. Ritalin was originally introduced in Sweden but was withdrawn from the marketplace in 1968 because of its escalating abuse. During the last decade Ritalin has again become accepted by Swedish doctors and more and more children with symptoms of hyperactivity are now regularly medicated with central stimulants. The National Board writes:

“ Due to the rapidly growing knowledge about ADHD in Sweden and the fact that we now have taken part of international experience of medication the number of children treated with central stimulants has rapidly increased in the same way as in other countries. ”

It is certainly true that the knowledge about the effects of central stimulants increases, not least the knowledge about the great risks and adverse effects of these drugs. However the Swedish National Board of Health has chosen to say nothing about these risks and instead give an extremely flattering description of these drugs.

As a counterweight to this biased description of central stimulants I will, in a short summary, give an account of the very harmful effects of central stimulants that numerous research studies have found, effects that the Swedish National Board of Health has chosen to say nothing about.

The increased prescription of central stimulants in Sweden during the last years would be incomprehensible if it were not seen in the light of the development in the United States .

In the United States there is a long tradition of treating hyperactivity with central stimulants. Ritalin is the most prescribed central stimulant and is manufactured by Ciba Geigy. It has been used to treat hyperactivity since the 1950s but during the nineties the production of Ritalin increased tenfold. It has been estimated that between 7 and 10% of American school children nowadays are medicated with Ritalin or other central stimulants.

The promoters of this development have been the big pharmaceutical companies that market central stimulants and the National Institute of Mental Health (NIMH), a government agency, that advocates the increased diagnosing and drugging of America´s children.

NIMH gives millions in research funds to studies on central stimulants. Nearly all the money goes to ADHD/Ritalin advocates. None goes to critics. None of its funding is aimed at discovering the dangers of long-term use of Ritalin and other stimulants.

1998 NIMH organized a consensus conference on ADHD/Ritalin. According to the plans, side effects of central stimulants were not to be discussed during the conference and no critics of central stimulants were invited to speak at the conference. A Psychiatrist , Peter Breggin , appealed to the umbrella organization of NIMH, the National Institute of Health (NIH), to create more balance in the conference. NIH decided that Peter Breggin should be invited to speak as the scientific presenter on the overall subject of adverse drug effects in children. He made a thorough survey on the research of central stimulants, that he later published in his book “ Talking back to Ritalin ” . (1)

The most common drugs to be prescribed to hyperactive children in Sweden are central stimulants like Amphetamine and Methylphenidate or Concerta. On the whole all central stimulants have similar effects and adverse effects.

In its booklet the Swedish National Board of Health writes that there are no other psychoactive drugs that have been so thoroughly studied as central stimulants. However, the Board admits, that it is not yet known how effective these drugs are in the long run after many years treatment.

The National Board of Health praises central stimulants for increasing the power of concentration and decreasing hyperactivity. Moreover “ the drug seems to improve cognitive abilities like problem solving. ”

Concerning the danger of addiction and future abuse the National Board claims that treatment with central stimulants “ instead seem to diminish ” the risk of future abuse.

Concerning side effects the Board writes that in most cases they are slight. In rare cases may happen that the “ mind and behaviour of the child can be so adversely affected that the treatment must be interrupted ” .

Let us scrutinize these assertions by means of Peter Breggin´s survey on the research of central stimulants.

Ritalin was first approved in the 1950s, but the FDA has been unable to produce the original documents from that long ago. In 1982 FDA approved a long-acting modification of Ritalin that had been tested for two weeks on 90 children.

And in spite of the fact that central stimulants have been used in the USA for hyperactive children for more than fifty years and in spite of all alarming reports of serious adverse effects, including brain damage in monkeys who have been given small doses of central stimulants on rare occasions, no scientific research on long term effects of central stimulants has been made.

In 1976 a double blind study could show that central stimulants suppress “ desirable behaviours that facilitate learning ” . The authors found that even when childrens´ behaviours were rated as improved no improvement of scholastic achievement could be found.

In 1992 James Swanson, who is a prominent ADHD/Ritalin advocate, and his colleagues warned that “ cognitive toxicity may occur at commonly prescribed clinical doses “ . The children become withdrawn and over focused and may seem “ zombi-like “ . According to Swanson cognitive toxicity is common and may occur in 40% of treated cases and the over focusing of attention may impair rather than improve learning.

Breggin draws the following conclusion: “ There is no evidence that Ritalin or any other stimulant enhances real-life learning and academic performance, while there is convincing evidence that it can impede them. ”

The assertion that central stimulants diminish the risk of future drug abuse should not remain unchallenged. The US Drug Enforcement Administration (DEA) repeatedly has expressed great concern that treatment with Ritalin will lead to abuse of other drugs. 1995 DEA reported that “ a number of recent studies, drug abuse cases, and trends among adolescents from various sources, indicate that methylphenidate (Ritalin) use may be a risk factor for substance abuse.

At the 1998 Consensus Conference Professor Nadine Lambert of the University of California , Berkeley , presented a unique long-term study comparing future drug abuse in two groups labelled ADHD. The study compared one group who had been prescribed stimulants as children with another group that had not been given medication.

She found a significant correlation between stimulant treatment in childhood and later drug abuse. She told the conference that the prescription of stimulants to children for a year or more was correlated with increased “ lifetime use of cocaine and stimulants ” . She concluded in her paper that childhood use of stimulants “ is significantly and pervasively implicated in the uptake of regular smoking, in daily smoking in adulthood, in cocaine dependence, and in lifetime use of cocaine and stimulants. ”

From Breggin´s survey it is evident that the side effects of stimulants far from being insignificant are both serious and extremely common. In several studies the frequency of side effects is more than 50 %. The most common side effects are loss of appetite, drowsiness, withdrawal, loss of interest in others and depression. In one study of 41 children between 4 and 6 years of age 75% suffered from loss of appetite, 62% of drowsiness and 62 % were uninterested in others. In another study of 83 somewhat older children 45 % had side effects mostly as withdrawal, sadness or crying.

Obsessive compulsive symptoms are very common side effects. They appear as a compulsive repetition of simple activities like endlessly playing games on the computer. In one study with 45 children 51% developed compulsive symptoms that in certain cases were very serious. One child became so obsessed with doing a good job raking leaves, he would wait for each one to fall from the tree. Another played Legos for 36 hours without breaking to eat or sleep.

In another study 42 % of the children produced an obsessive over-focusing after a single dose of stimulants. The children were sometimes unable to stop performing a task that had been assigned to them.

Tics and movement disorder are also very common side effects. In a study with 45 children 58% developed tics and abnormal movements. In another study with 122 children 9% developed tics and abnormal movements. One child did not recover and developed an irreversible syndrome with facial twitching, head turning, lip smacking, forehead wiping and vocalizations.

Many animal studies during the last 30 years have shown that relatively low doses of amphetamine kill brain cells and cause permanent brain damage. The drug will cause a lasting loss of receptors for the neurotransmitter dopamine due to the fact that the dopamine transmitter system is over-stimulated by amphetamine.

In one study with monkeys it could be shown that administration of two relatively low doses of amphetamine, 2 mg/kg body weight four hours apart, produced persistent, marked decreases in dopamine synthesis and concentration up to three months later. In one of the animals the dysfunction still continued after eight months. A dose of two mg/kg is not much more than a child on treatment will get per day.

This study is not an exception. Drug levels of amphetamine on a mg/kg basis can be as high as those reported to cause brain damage in animals according to a scientific report.

According to a textbook of psychiatry by Jaffe chronic amphetamine use in monkeys causes damage to cerebral blood vessels, brain cell death and microhemorrhages.

It is not unusual that children are medicated with central stimulants all through childhood and adolescence. No studies have been made what brain damage such chronic amphetamine use will cause in humans. For the time being we must therefore draw our conclusions from animal studies. Animals who get central stimulants in equivalent doses to children get permanent brain damage.

The Swedish national Board of Health says nothing about these facts and confines itself to assert that the side effects of central stimulants are insignificant.

With nearly 10 % of America´s children being treated with central stimulants the market has reached saturation point. The big pharmaceutical companies have therefore turned to other markets in Canada and Europe where the share of children who are treated with these drugs is rapidly increasing. In Sweden the marketing of central stimulants is greatly helped along by the National Board of Health.

At the same time there is growing resistance and protests against this mass drugging of children. It is therefore not surprising that some of the most experienced and resourceful American attorneys have had their eyes opened to the marketing of central stimulants as a treatment for ADHD. A consortium of attorneys is bringing a series of class action suits against Novartis (the manufacturers of Ritalin) and the American Psychiatric Association.

One of these attorneys writes in the forward of Peter Breggins book “ Talking back to Ritalin ” :

“ I asked myself if the large sums of money earned by the pharmaceutical industry could corrupt their research in the same way as in the tobacco industry. Much as the tobacco industry promoted and marketed its products with children in mind, I began to wonder if our vulnerable children were again being targeted for corporate profit.

Ultimately stimulants steal childhood. They make children more manageable at the cost of their spirit. ”

1. Peter Breggin, Talking Back to Ritalin, Da Capo Press 2001