prescribing ADHD drugs to young people like never before. But one
psychiatrist is dedicated to weaning children off the drugs which
he describes as "highly addictive". Sami Timimi explains
to Adam James why
he believes ADHD is a "cultural construct" and the result
of speculative "biobabble".
hard-to-parent children are popping psychiatric pills like never
year UK psychiatrists and pediatricians wrote out 329,000 prescriptions
for Ritalin and Concerta, the psycho-stimulant drugs to treat diagnoses
such as attention-deficit-hyperactivity-disorder (ADHD). This is
a massive 57 times more than they wrote out in 1994.
one child psychiatrist is bucking the trend. In fact Dr Sami Timimi
is dedicated to weaning children off the drugs. For him, the medication
is "highly addictive" and has chemical properties which
are "virtually indistinguishable" from amphetamines like
cocaine and speed.
who works for Lincolnshire Partnership NHS Trust, is arguably the
leading UK psychiatrist critical of the ADHD diagnosis.
book, 'Naughty Boys; Anti-Social Behaviour, ADHD and the role of
culture' is the first authoritative critique of the ADHD diagnosis
- and related prescribing - by a UK psychiatrist.
co-written chapter in a new book, Making and Breaking Children's
Lives, is exclusively published today at psychminded
simply Timimi does not believe ADHD is a valid medical diagnosis.
Instead ADHD is a "cultural construct"; the result of
year he wrote in a academic paper: "ADHD is a 'dumping ground'
allowing all of us to avoid the messy business of understanding
human relationships and institutions and their difficulties, and
our common responsibility for nurturing and raising well behaved
can society therefore justify prescribing potentially dangerous
drugs to treat a pseudo diagnosis, asks Timimi? Moreover, Timimi
says he has children referred to him who have been made worse by
fanatics have been overplaying the evidence of the effectiveness
of Ritalin," he states. "The most recent metanalysis concluded
that evidence that Ritalin was useful for more than four weeks has
yet to be demonstrated."
children do not want to be on medication. They get called names
like 'druggie'. And they do not like the effects of the drug. They
feel light-headed, dizzy or complain of being 'not me'
can use [the ADHD diagnosis] as an excuse to get away with things
they do not want to do. They might say 'I am sorry I can not do
it, I have got ADHD'."
certainly puts his money where his mouth is. Over the last two years
he has weaned dozens of ADHD youngsters off stimulant medication.
chooses, instead, to work with families - and schools - to discover
what dynamics within the child's environment is resulting in their
try to enter into a dialogue and talk to parents about the fact
that ADHD is a controversial diagnosis," he says. "It's
about trying to understand their child from a parent's objective
and not the doctor's."
examines what lies behind a child's problematic behaviour. It could
be learning difficulties, a high sugar diet, domestic violence,
extreme lack of exercise or poor discipline.
don't say people are bad parents, because for me bad parents are
those who go out to intentionally damage their children," Timimi
England and Wales health bodies do not seem overly concerned by
the escalation of ADHD drugs on children, the Scottish Executive
January it launched an inquiry into ADHD and Ritalin following its
own tenfold increase in Ritalin prescribing over eight years.
in clinics all over the UK there's no end to the fierce upwards
prescribing curve of ADHD drugs. Timimi is - at the moment - demonstratively
The Rise and Rise of ADHD, by Sami Timimi and Nick Radcliffe, in
Making and Breaking Children's Lives, published by PCCS books (pdf)
Making and Breaking Children's Lives, published by PCCS books
Naughty Boys: Antisocial Behaviour, ADHD and the role of culture
is published by Palgrave MacMillan.
5, 2005: Watch out for suicidal behaviour for children on ADHD drug,
regulator warns - new clinical trial data shows increased risk
of suicidal tendencies in children on Strattera
10, 2005: Inquiry into ADHD treatment in Scotland - following
huge rise in Ritalin prescriptions
4, 2004: Clinical psychology publishes landmark critique of ADHD
and use of psychiatric medication for children - "overzealous"
mental health professionals prescribe "addictive and brain-disabling"
drugs, argue clinicians
If ADHD drugs
are so addictive why do teenagers refuse them?
Fowlie, community paediatrician, South West Kent Primary Care Trust
October 20, 2006
If methylphenidate was so addictive, why do we commonly find oppositional
teenagers refuse to take it, often with drastic effects.
I have worked as a psychiatrist, but I never managed to improve
the quality of my patients' lives in any way close to prescribing
methylphenidate for ADHD.
agree we didn't need to recognise ADHD in the past, since most kids
were half starved, half ill, and over-worked. If they had an impulsive
accident down some mine or up some chimney, there was no health
and safety to care all that much. Impulsive crime could easily be
dealt with by hanging or deportation. No bother, no ADHD, no methylphenidate.
Is that really what you want?
methylphenidate is addictive...
Turner lecturer in forensic and biomedical sciences, University
August 27, 2007
answer Trish Fowlie's question, methylphenidate is addictive because
of its pharmacodynamics. All psychostimulants if taken habitually
cause an adapative change in the dopamine and noradrenaline function.
This is because this drug causes an increase in the release of these
neurotransmitters. Incidentally. before anyone thinks this is evidence
for a pre-existing dopamine or noradrenaline imbalance. this happens
in everyone that takes these drugs, not just those labelled with
As for why do oppositional teenagers refusal to take it. Well that
is their right and it is a fundamental breach of ethics to force
treatment onto a non-consenting patient. Why do we find heroin addicts
who want to kick the habit refusing heroin? It is the norm for addicts
to want to quit because they don't like the side effects or ever-present
danger to health and well being that drug addiction causes.
Trish Fowlie uses dramatic language in suggesting drastic effect.
It is strange that these are not illustrated by examples. She says:
" I have worked as a psychiatrist, but I never managed to improve
the quality of my patients' lives in any way close to prescribing
methylphenidate for ADHD." This is difficult to follow as there
is no actual measure quoted for quality of life. What needs to be
understood is that children do not voluntarily present with ADHD.
They are taken to the doctors usually because someone else is complaining
of their own 'quality of life'. It might be an idea before inflicting
methylphenidate onto children, some of whom are incapable of metabolising
it, that THEY are asked to comment on their 'quality of life'
Fowlie says: "I agree we didn't need to recognise ADHD in the
past, since most kids were half starved, half ill, and over-worked.
If they had an impulsive accident down some mine or up some chimney,
there was no health and safety to care all that much. Impulsive
crime could easily be dealt with by hanging or deportation. No bother,
no ADHD, no methylphenidate. Is that really what you want?"
I was at school there were no half-starved children in my class
and I did not see many sweeps' boys or child miners plodding their
way to work. I am not aware of any of my generation being hanged
for sheep stealing or transported for life. Neither were we aware
of any such thing as ADHD. We had disruptive children, even delinquent
ones, but we and our parents and teachers thought that was humanity
in all its shapes and forms. I am immeasurably grateful to have
been brought up in an era when there was still reason in medicine
and before it was totally highjacked by big pharma.
releases 5-hydroxytryptamine (5-HT, serotonin) and dopamine which
eventually causes degeneration in neurones containing serotonin.
This is real brain damage, damage to the actual brain tissue. This
damage is irreversible and 'chemical balancers' will not repair
the destroyed brain tissue or make it function normally again.
the pro-drug lobby actually believe in chemical imbalances they
should understand that serotonin function deficiency is associated
with depression. Great marketing idea though, if the children treated
with methylphenidate do go on to be depressives then they can still
provide a market for even more psych drugs.
it is likley that this iatrogenically-induced clinical depression
will not respond to the current ragbag of SSRI snakeoil therapies.
We should be finding out real soon as the first generation of methylphenidate
victims are just about maturing into the next generation of depressives.
What we should expect to see is that these people presenting with
depression will go straight onto the atypicals and anti-psychotics
to subdue them rather than even purport to treat.
think the moral of the story is that 'chemical imbalances' pose
a real risk of serious mental illness especially where they are
induced iatrogenically by faulty medical treatment.
can be lesser of two evils
Tracy Pankhurst, parent of ADHD child, UK
January 16, 2009
have read many articles criticising the use of stimulant medication
in ADHD; most were over-simplifications of the problem and, I believe,
show a lack of understanding.
is not just about naughty boys acting out. ADHD also occurs without
hyperactivity, in adults and in girl children. How many predominantly
inattentive ADHD children quietly day dream at the back of our classrooms
and under achieve?
I agree that, in an ideal world, we wouldn't have to consider medicating
our children. Given enough support in school, and a learning environment
which makes the best use of the childs attention, minimises peer
bullying and teacher frustration and protects the child's self esteem
Unfortunately this kind of schooling would be prohibitively expensive
to provide. Medication is often considered the lesser evil by worried
parents...it’s never an easy decision to take. However 30-50%
of those with ADHD (adults and children) do not respond to stimulant
medication [Prim Care Companion J Clin Psychiatry. 2006; 8(4): 224–233.]
I had to relearn my parenting
From: Sally Roberts,
Date: November 29, 2010
I agree with Sami Timimi and let me
explain why. My son is nearly 20 and was diagnosed with ADHD when
he was 5. He was placed on Ritalin and later Concerta and was on
meds until he was 17.
I was like any other parent trying to find what was wrong, but at
the age of 10 and high amounts of Concerta, the complaints were
still coming in, my son's behaviour was worsening, he was about
to be excluded from his special school, he did not sleep and I was
I had to find something else and this began a slow road to truly
understanding ADHD. I began with diet, removing foods that exasperated
his behaviour, I had to relearn my parenting skills, what had worked
with my other child was not going to work with my son and especially
now his self esteem was low. I had to get inside the head of my
ADHD son. I researched and studied until I believe I found what
i needed to help him and give him a good quality of life, without
drugs. It was not easy but I believe I did it. I am now a teacher
of kids with challenging behaviour and have a good success rate
in my opinion. I learn more every day and one thing i am sure is
that the diagnosis for ADHD is incorrect and needs to be reassessed.
I came in contact with Dr Tamimi when I was weaning my son off his
medication as I could not find a doctor to help us. They just wanted
to give us more.
Dr Tamimi could not help us as we were out of his area but I have
followed his work and still agree with what I am reading.
I am not saying that a child with a different diet, different lifestyle,
upbringing, etc would not have challenging behaviours, or learning
and social difficulties but I do know for sure that they would not
be as exasperated as they are, and the severe behaviours we see
in today's society would not be around. We are trying to find an
easy way out, when most of the problem lies in today's lifestyles
21st century lifestyle is the major contributor to the ADHD. I had
to learn, this information was not available to me but then who
is listening when you try to explain?
should look at emotional responsibility
Christine P, CAMHS worker, parent
Date: February 8, 2012
have read with interest the previous posts, which are so very relevant
to my own and my son's story.
He was diagnosed
with ADD when he was 6 and started on Ritilin when he was 8.
He really found
it difficult to concentrate and focus, he was not really naughty
as such but got into a lot of trouble as he was so disorganised.
I was constantly
trying to find answers which led me to different treatments for
example neuro feedback and trying out different diets, none of these
seemed to work that well, although we only managed half of the neuro
feedback course, so the verdict was still out on that one.
led me on a journey into studying psychology, social sciences and
then on to social work ending up with a Masters degree and working
Every day I
struggle with the questions around diagnoses of ADHD and ASD and
in my heart of hearts agree with what Dr. Sami says, which is difficult
as most of my work team particularly those from a medical background
think the opposite and when I have expressed my views there is a
look of disbelief.
to my son, he has taken medication for some time but tended not
to take it at weekends or holidays and now he is at university probably
dosent take it at all and seems to be getting on ok.
This may be
because he is studying marketing which really suits his personality
and creativity. The medication did help him focus which in turn
built up his self esteem, he was better liked and had more friends
because his impulsiveness was reduced.
So in one way
it helped but having read the above comments regarding potential
depression - it-s worrying.
My son was 6/7
weeks premature and had a difficult birth, I was stressed it was
an IVF pregnancy and his whole early infanthood was difficult, my
parenting skills were probably dubious, as my own parenting from
my mother was somewhat lacking emotionally.
I've had therapy
for over 4 years now and am coming to terms with my past, I have
been on a spiritual path and used meditation and Buddhist principles
to guide my life and feel a lot better for it.
I deal with
a lot of parents that just see their children as a problem and want
a diagnosis, however I really feel that they need to look at their
parenting and how they were parented and try to increase their capacity
for emotional responsibility for themselves and their children,
this sounds judgemental but its not supposed to be, as you can imagine
not many parents like this approach.
I am not trying
to blame parents but just really trying to help them recognise that
the emotional wellbeing of their family and their child is the responsibility
of parents/family/school/community and nation.
It is difficult
to come to terms with this approach because we do tend to live in
emotionally illiterate and narcissistic times. Thanks for reading
- hope it makes some sense
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