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360 pages, Paperback
First published October 12, 2011
The study that was most widely quoted as the study that ‘proved’ that ADHD should be treated with medication as a first line treatment has actually found that such a treatment (when compared to nonmedication based first line treatments) is associated with the worst outcomes and the greatest need of extra school support. This adds to the accumulating evidence on stimulants for ADHD, which, despite being the most researched drug treatment for a child psychiatric disorder, has failed to find long-term benefits accruing from their use. In the face of such findings it is impossible to continue to claim that using stimulants for treatment of ADHD is evidence-based with the benefits outweighing the risks. Unfortunately practice is already so strongly established in some countries that reversing this trend is proving very difficult to achieve.
Doctors frequently tell patients that their problems are due to a ‘chemical imbalance’. However, there is no rigorous corroboration of any chemical-imbalance theory, such as the serotonin theory of depression. In fact, there is a significant body of contrary evidence to the simple notion that depression is due to a deficiency of serotonin in the brain. The serotonin theory of depression is no more than a theory, and most of the evidence is against it.
Psychiatry appears to be the top ‘offender’ among medical specialities with regards use of, and sponsorship from, drug companies. Perhaps this is not surprising given the enormous potential markets that can be (and have been) developed if psychiatry is successful in medicalizing peoples’ emotional responses and behaviour, in a field so reliant on subjective interpretations of normalcy and deviance. Child psychiatry seems particularly vulnerable, with, most recently, an influential group of child psychiatrists at Harvard, extensively involved in research promoting the use of psycho-pharmaceuticals (particularly for ADHD and paediatric bipolar disorder), found to have received millions of dollars of income from pharmaceutical companies most of which they had not disclosed.