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Thursday 21 April 2011


For more information and BBC radio discussions.                       

Medicine for shyness: Should NHS give patients anti-depressants to help them talk to strangers?
Is this a socially constructed problem rather than a significant problem in reality.Some of us have always been shyer than others.

-"How shyness became a disease!"

U.S. medical journal of A.M.A. coins term, "Disease mongering," for push by drug companies to categorise 'Shyness' as mental health condition using the DSM criteria.
The BPS says giving 'quick fix' drugs for conditions like shyness is wrong. 

By David Derbyshire - Mail on Line.
Last updated at 9:48 AM on 18th April 2011

Health watchdog N.I.C.E. is to investigate whether anti-depressants shou.ld be given to those suffering acute shyness.

Health watchdog Nice is to investigate whether anti-depressants should be given to those suffering acute shyness

The NHS drugs rationing body is to investigate whether anti-depressants should be given to those suffering from acute shyness, it emerged yesterday.

The Department of Health has ordered a review into treatments available for ‘social anxiety disorder’ – a condition that leaves sufferers terrified at the prospect of public speaking, talking to strangers or even going to parties.

In extreme cases, victims suffer panic attacks, blushing and sweats in any social situation.

The National Institute for Health and Clinical Excellence, which is heading the review, claims that one in eight will suffer from the disorder during their lifetime.

The body has previously come under fire for advising health authorities that they should not fund drugs for a range of patients including those suffering from the early stages of Alzheimer’s disease.

The growing use of drugs to treat extreme shyness has alarmed some experts who say pharmaceutical companies and doctors are ‘medicalising’ normal human behaviour.

Alone - a choice or no choice = key question.

The concept of ‘social anxiety disorder’ or ‘social phobia’ has entered mainstream medicine in the last couple of decades after the drugs industry began to promote it.

In the late 1990s and early 2000s, the amount of money spent on social anxiety drugs doubled, while in the last decade around £1.5billion has been spent on the condition.

Around 200 people a year who suffer from excessive blushing or sweating are given surgery on the NHS to sever the nerves which supply sweat glands on the face, hands and armpits.

Doctors and NICE recommend cognitive behavioural therapy as the most effective initial strategy to try.

Dr Joanna Moncrieff, a consultant psychiatrist and lecturer at University College London, told The Sunday Telegraph: ‘Some people will find parties and public speaking more difficult than others, but it can be extremely damaging to label them with a medical disorder that needs treatment.

'Effectively that is telling people that they can’t deal with things themselves.’

NICE will look at the effectiveness of all treatments offered for social phobia on the NHS – including drugs, counselling and surgery. It will also look at the use of the anti-wrinkle jab Botox to suppress underarm sweating.

A spokesman said: ‘It’s been referred to us by the Department of Health and it is still very early days.

'This condition is already being treated by doctors on the NHS and what we will do is find out which treatments are the most effective.’

Dr Tim Kendall, consultant psychiatrist at Sheffield Health and Social Care Trust, said: ‘For people who suffer from serious anxiety disorder, it can ruin their life.

'This isn’t about common shyness, this is about a level of anxiety that can prevent people from establishing relationships.’

But Dr Louise Foxcroft, author of Hot Flushes, Cold Science, said: ‘You have to question the role of the pharmaceutical industry and the influence they hold over the medicalisation of so many behaviours and emotions which are common to us. 

This is big business.’


Thursday 14 April 2011


1) The developmental antecedents of illicit drug use: Evidence from a 25-year longitudinal study

David M. FergussonCorresponding Author Contact Information, a, E-mail The Corresponding Author, Joseph M. Bodena and L. John Horwooda

aDepartment of Psychological Medicine, University of Otago, Christchurch School of Medicine and Health Sciences, Christchurch 8140, New Zealand
Received 19 December 2007;
revised 21 February 2008;
accepted 6 March 2008.
Available online 21 April 2008.


The present study examined the developmental antecedents of illicit drug use and abuse/dependence.

A 25-year prospective longitudinal study of the health, development, and adjustment of a birth cohort of 1265 New Zealand children. Measures included assessments of adolescent and young adult illicit drug use and abuse/dependence; cannabis use to age 25; measures of parental adjustment; measures of exposure to childhood sexual abuse, physical abuse, and interparental violence; novelty-seeking; childhood and early adolescent adjustment and substance use; and affiliation with substance-using peers.

Illicit drug use and abuse/dependence from ages 16 to 25 were significantly associated (all p values < .05) with a range of parental adjustment measures; exposure to abuse in childhood; individual factors; and measures of childhood and early adolescent adjustment including ADHD diagnosis /medication. Analyses using repeated measures logistic regression models suggested that parental illicit drug use, gender, novelty-seeking, and childhood conduct disorder including ADHD + medication predicted later illicit drug use and abuse/dependence. Further analyses revealed that these pathways to illicit drug use and abuse/dependence were mediated via cannabis use, affiliation with substance-using peers, and alcohol use during ages 16–25.


The current study suggested that the illicit drug use and abuse/dependence were associated with a range of early life circumstances and processes that put individuals at greater risk of illicit drug use and abuse/dependence. However, the use of cannabis in late adolescence and early adulthood emerged as the strongest risk factor for later involvement in other illicit drugs.

Keywords: Illicit drug use; Cannabis use; Peer substance use; Family background; Longitudinal study
Article Outline

    1.1. Parental adjustment factors
    1.2. Exposure to abuse in childhood
    1.3. Individual factors
    1.4. Childhood and early adolescent conduct and attention problems
    1.5. Adolescent substance use and social processes
    1.6. Background to the present study

    2.1. Illicit (non-cannabis) drug use and illicit drug abuse/dependence
    2.2. Predictors of illicit drug use and illicit drug abuse/dependence

        2.2.1. Measures of parental adjustment and substance use Parental illicit drug use Parental criminality Parental alcohol problems

    2.2.2. Measures of exposure to abuse in childhood Childhood sexual abuse Parental use of physical punishment (childhood physical abuse) Interparental violence (0–16 years)

    2.2.3. Individual factors Gender Novelty-seeking

    2.2.4. Childhood and adolescent adjustment Child conduct and attention problems (ages 7–13) which is likely to have included medication.

    2.2.5. Time-dynamic measures of substance use and peer influence (ages 16–25) Annual frequency of cannabis use (ages 16–25) Affiliation with substance-using peers (ages 16–25) Frequency of cigarette smoking (ages16–25) Frequency of alcohol use (ages 16–25)

    2.3. Missing data

    3.1. Rates of illicit drug use and illicit drug abuse/dependence
    3.2. Factors associated with illicit drug use and illicit drug abuse/dependence, ages 16–25
    3.3. Multivariate analyses of risk factors for illicit drug use and illicit drug abuse/dependence, ages 16–25
    3.4. Effect size estimates and evaluation of interaction effects



Conflicts of interest



Corresponding Author Contact InformationCorresponding author at: Christchurch Health and Development Study, University of Otago, Christchurch School of Medicine and Health Sciences, PO Box 4345, Christchurch, New Zealand.

2) Abuse of prescription drugs and the risk of later addictions.

Trapped in a cycle of despair and drug dependance.How long for is the question?


Wilson M. ComptonCorresponding Author Contact Information, E-mail The Corresponding Author and Nora D. Volkow

National Institute on Drug Abuse, National Institutes of Health, Department of Health and Human Services, 6001 Executive Blvd., Bethesda, MD 20892, USA
Received 16 August 2005;
revised 6 October 2005;
accepted 17 October 2005.
Available online 23 March 2006.


Abuse of several categories of prescription drugs has increased markedly in the United States in the past decade and is now at alarming levels for certain agents, especially opioid analgesics and stimulants. Prescription drugs of abuse fit into the same pharmacological classes as their non-prescription counterparts. Thus, the potential factors associated with abuse or addiction versus safe therapeutic use of these agents relates to the expected variables: dose, route of administration, co-administration with other drugs, context of use, and expectations. Future scientific work on prescription drug abuse will include identification of clinical practices that minimize the risks of addiction, the development of guidelines for early detection and management of addiction, and the development of clinically effective agents that minimize the risks for abuse. With the high rates of prescription drug abuse among teenagers in the United States, a particularly urgent priority is the investigation of best practices for effective prevention and treatment for adolescents, as well as the development of strategies to reduce diversion and abuse of medications intended for medical use.

Keywords: Prescription drug abuse; Drug dependence; Later Addiction.



Crack cocaine.
ECSTACY TABS.                                                        COMMON SENSE WOULD SAY IT WOULD.

Tuesday 12 April 2011



How Do Prescription
Stimulants Affect the Brain?

All stimulants work by increasing
dopamine levels in the brain—dopamine
is a brain chemical (or neurotransmitter)
associated with pleasure, movement,
and attention. The therapeutic effect
of stimulants is achieved by slow and
steady increases of dopamine, which
are similar to the natural production of
the chemical by the brain. The doses
prescribed by physicians start low and
increase gradually until a therapeutic
effect is reached. However, when taken
in doses and routes other than those
prescribed, stimulants can increase
brain dopamine in a rapid and highly
amplified manner—as do most other
drugs of abuse—disrupting normal
communication between brain cells,
producing euphoria, and increasing
the risk of addiction.

Methylphenidate can like cocaine cause dopamine build up in the synapses causing toxicity.

What Is the Role of
Stimulants in the Treatment
of ADHD?

Treatment of ADHD with stimulants, often
in conjunction with psychotherapy, helps
to improve the symptoms of ADHD, as
well as the self-esteem, cognition, and
social and family interactions of the
patient. The most commonly prescribed
medications include amphetamines (e.g.,
Adderall—a mix of amphetamine salts)
and methylphenidate (e.g., Ritalin and
Concerta—a formulation that releases
medication in the body over a period
of time). These medications have a
paradoxically calming and “focusing”
effect on individuals with ADHD.
Researchers speculate that because
methylphenidate amplifies the release of
dopamine, it can improve attention and
June 2009 

What Adverse Effects Does
Prescription Stimulant
Abuse Have on Health?

Mathew Smith died of heart failure in 2002 after six months on Methylphenidate.

Stimulants can increase blood
pressure, heart rate, body temperature,
and decrease sleep and appetite,
which can lead to malnutrition and
its consequences. Repeated use of
stimulants can lead to feelings of
hostility and paranoia. At high doses,
they can lead to serious cardiovascular
complications, including stroke.
Addiction to stimulants is also a very
real consideration for anyone taking
them without medical supervision. This
most likely occurs because stimulants,
when taken in doses and routes other
than those prescribed by a doctor, can
induce a rapid rise in dopamine in the
brain. Furthermore, if stimulants are used
chronically, withdrawal symptoms—
including fatigue, depression, and
disturbed sleep patterns—can emerge
when the drugs are discontinued.

How Widespread Is
Prescription Stimulant

Monitoring the Future Survey†
Each year, the Monitoring the Future
(MTF) survey assesses the extent of drug
use among 8th-, 10th-, and 12th-graders
nationwide. For amphetamines and
methylphenidate, the survey measures
only past-year use, which refers to use
focus in individuals who have dopamine
signals that are weak.

One of the most controversial issues in
child psychiatry is whether the use of
stimulant medications to treat ADHD
increases the risk of substance abuse in
adulthood. Research thus far suggests
that individuals with ADHD do not
become addicted to their stimulant
medications when taken in the form and
dosage prescribed by their doctors.
Furthermore, several studies report that
stimulant therapy in childhood does not
increase the risk for subsequent drug and
alcohol abuse disorders later in life.5,6,7
More research is needed, however,
particularly in adolescents treated with
stimulant medications.

Why and How Are
Prescription Stimulants

Stimulants have been abused for both
“performance enhancement” and
recreational purposes (i.e., to get
high). For the former, they suppress
appetite (to facilitate weight loss),
increase wakefulness, and increase
focus and attention. The euphoric
effects of stimulants usually occur when
they are crushed and then snorted or
injected. Some abusers dissolve the
tablets in water and inject the mixture.
Complications from this method of use
can arise because insoluble fillers in the
tablets can block small blood vessels.
June 2009 Page 3 of 4
is declining in this group, when asked,
“What amphetamines have you taken
during the last year without a doctor’s
orders?” 2.8 percent of all 12th-graders
surveyed in 2007 reported they had
used Adderall. Amphetamines rank third
among 12th-graders for past-year illicit
drug use.

Other Information Sources

For more information on treating ADHD,
visit the Web site for the National
Institute of Mental Health, National
Institutes of Health, at
For street terms searchable by drug
name, street term, cost and quantities,
drug trade, and drug use, visit
at least once during the year preceding
an individual’s response to the survey.
Use outside of medical supervision was
first measured in the study in 2001;
nonmedical use of stimulants has been
falling since then, with total declines
between 25 percent and 42 percent at
each grade level surveyed. MTF data for
2008 indicate past-year nonmedical use
of Ritalin by 1.6 percent of 8th-graders,
2.9 percent of 10th-graders, and 3.4
percent of 12th-graders.
Since its peak in the mid-1990s, annual
prevalence of amphetamine use fell
by one-half among 8th-graders to 4.5
percent and by nearly one-half among
10th-graders to 6.4 percent in 2008.
Amphetamine use peaked somewhat
later among 12th-graders and has
fallen by more than one-third to 6.8
percent by 2008.

Saturday 9 April 2011


         School  staff,either teaching or non teaching should not,in my opinion, be administering psychotropic drugs for kids' behaviour on behalf of the parents,especially if they don't agree with the label.More and more headteachers agree with this stance. They have plenty of alternatives to use such as, Nurture Groups,meditation, deep breathing techniques, personalised sport programmes, Social Pedagogy  and yoga.All are tried and tested approaches.

See other posts on these strategies.

Principles of Nurture Group Practice.


Attractive spaces for a nurturing environment.
•1. Children's learning is understood developmentally
In nurture groups staff respond to children not in terms of arbitrary expectations about ‘attainment levels' but in terms of the children's developmental progress assessed through the Boxall Profile Handbook. The response to the individual child is ‘as they are', underpinned by a non-judgemental and accepting attitude.

'Human bridge' staff form positive relationships.

•2. The classroom offers a safe base

'Small really is beautiful!'

The organisation of the environment and the way the group is managed contains anxiety. The nurture group room offers a balance of educational and domestic experiences aimed at supporting the development of the children's relationship with each other and with the staff. The nurture group is organised around a structured day with predictable routines for a maximum of eight children. Great attention is paid to detail; the adults are reliable and consistent in their approach to the children. Nurture groups are an educational provision making the important link between emotional containment and cognitive learning.

Aim: to make every child a 'super hero.'

•3. Nurture is important for the development of self-esteem
Nurture involves listening and responding. In a nurture group ‘everything is verbalised' with an emphasis on the adults engaging with the children in reciprocal shared activities e.g. play / meals / reading /talking about events and feelings. Children respond to being valued and thought about as individuals, so in practice this involves noticing and praising small achievements; ‘nothing is hurried in nurture groups‘.

Regular support and agreeing personal targets helps maximise progress.

•4. Language is understood as a vital means of communication
Language is more than a skill to be learnt, it is the way of putting feelings into words. Nurture group children often ‘act out' their feelings as they lack the vocabulary to ‘name' how they feel. In nurture groups the informal opportunities for talking and sharing, e.g. welcoming the children into the group or having breakfast together are as important as the more formal lessons teaching language skills. Words are used instead of actions to express feelings and opportunities are created for extended conversations or encouraging imaginative play to understand the feelings of others.
•5. All behaviour is communication

What is this communicating?
What is she saying?Loud and clear!
What is the adult's full message here?
Great book about Nurture Groups.
Learning should be fun and co-operative.

This principle underlies the adult response to the children's often challenging or difficult behaviour. ‘Given what I know about this child and their development what is this child trying to tell me?' Understanding what a child is communicating through behaviour helps staff to respond in a firm but non-punitive way by not being provoked or discouraged. If the child can sense that their feelings are understood this can help to diffuse difficult situations. The adult makes the link between the external / internal worlds of the child.


•6. Transitions are significant in the lives of children

The nurture group helps the child make the difficult transition from home to school. However, on a daily basis there are numerous transitions the child makes, e.g. between sessions and classes and between different adults. Changes in routine are invariably difficult for vulnerable children and need to be carefully managed with preparation and support.
Aromatherapy creates a warm calming atmosphere.

Thursday 7 April 2011


Dave Traxson is sitting in
his Victorian house in
the West Midlands with his foot
in a cast and a pile of books next to him
on the sofa. He is currently off work
recovering from an operation and is using
the time to catch up on his reading. He
has just started Shyness: How Normal
Behavior Became a Sickness by Christopher
Lane (Yale University Press 2007), and
enthusiastically recommends it to me.

I can tell from the title alone that he and
Lane probably have a lot in common.
Traxson is a chartered educational
psychologist and has been for over 30
years. He has spent nearly all of this time
in the West Midlands working for a series
of local authorities and continues to be
a contributor to the training course for
educational psychologists at Birmingham
University. Before becoming an EP
himself he spent six years teaching. It
seems fair to say that if it wasn’t for a
conversation in a school corridor in spring
2009, few outside his current authority
would have heard of him. As it is, he’s
become something of a media celebrity
– even appearing on Woman’s Hour.


Rise of the prescription
I start by asking him about that significant
meeting. ‘I bumped into this head of year
and he just asked me the question,’ he
explains. ‘“Dave,” he said, “I have got six
young people that have been diagnosed
with bipolar disorder in my year group of
120 kids – do you think that’s normal?”
And I said no, I was very surprised.’ Prior
to this, Traxson says he had come across
about six children with bipolar disorder in
his entire career. ‘To get six as a cluster in
one year group I found very concerning.’
At the time he says he was already
aware of the exponential increase in the
number of methylphenidate prescriptions
being issued for children diagnosed with
conditions like ADHD. Methylphenidate
is the active component of a range of
psychostimulants better known by
their brand names; they include Ritalin,
Concerta, Daytrana, Methylin, Equasym
and Metadate. It wasn’t until later, he
says, that he realised the true scale of
what was happening. ‘When I started
researching it, the evidence was clear.
From 1994 to 2009 there had been
a 120-fold increase in prescriptions,
which is phenomenal in just 15 years.’
Traxson says an increasing number
of headteachers were also sharing their
concerns with him: ‘It was becoming
a more and more common topic of
conversation on my regular school
visits.’ One worry headteachers had was
that they were not being consulted by
medical practitioners, a practice Traxson
says was widespread at the time. The
psychology service in his own authority
carried out a comprehensive survey to
assess the experience of heads locally:
‘Questionnaires were sent out to schools
and the returns showed that in only
47% of cases did the prescribing doctor
send a checklist to the school, let alone
have a telephone conversation with
them, which was incredibly rare.’ This
meant doctors were not ‘triangulating
the data’, ie moderating their own
observations on the basis of those
of the child’s parents and school.

So are medical practitioners to blame?
Traxson says no one group is responsible.
As with most things it’s a combination
of factors. He points out that some
critics, like Professor Steven Rose of
the Open University, point to parental

‘Usually there is a genuine concern
about the child’s pattern of behaviour,
but sometimes parents might have been
influenced by information they have seen
on the internet or in the media. As a result
they might have a skewed perception of
what the normal range of behaviour is or
they may have too high an expectation of
their child.’ He says there’s also anecdotal
evidence from headteachers that some
parents are aware they can claim disabled
living allowance (DLA) if their child has a
firm diagnosis of ADHD. ‘I am not saying
that a majority are doing it for that reason
but there is a significant minority that is
very aware of that possibility,’ he adds.

Out of control
‘Out of control’ is a familiar description for badly behaved
children, but chartered educational psychologist Dave
Traxson thinks it’s the over-prescription of psychotropic
drugs that needs reining in.

Whatever the explanation, headteachers
were becoming uneasy because children
were being diagnosed with conditions
they hadn’t shown signs of in school.
Traxson even questions the view
that behaviour standards in schools
have declined. He says he witnessed
far more aggression and violence in
the Birmingham grammar school he
attended in the 60s than he sees in
most of the schools he visits now: ‘You
don’t see the widespread disruption,
rudeness or fighting that people seem
to think is happening in schools.’ In
the schools he visits, most discussions
focus on low-level disruptive behaviour,
not verbal or physical aggression.

Upping the dosage

When Traxson looked into the case of
children diagnosed with bipolar disorder,
other worrying trends began to emerge.
One was a cluster of children who were
on higher levels of medication than was
recommended by the manufacturers.
Another was children who were on a
cocktail of drugs: anti-psychotic drugs
and/or anti-depressants combined with
methylphenidate. Traxson wasn’t only
concerned with what was happening,
he was concerned about the language
being used to ‘normalise’ these practices.
‘When some children were on a high dose
of methylphenidate some doctors were
choosing to give them an extra dose in
the morning, which they referred to as a
“kickstart”. They would give them another
dose at lunchtime, which they would call a
“booster” or a “top-up”. I began to feel very
uncomfortable about the language being
used. It might have just been a way of
explaining it to the parents but it seemed
a way of minimising what was happening.’
Traxson’s concerns came to a head in
the summer of 2009 when he set about
investigating the use of methylphenidate.
He was shocked to find that in the USA,
12% of the school population is on
the stimulant at any one time and that
40% of school-age children (2-18) will
have been on it for at least two of their
school years. He also discovered that
professional tensions were running high
in the USA over the intention to widen the
net of mental health problems with the
introduction of new categories in DSM-V
– the revised version of the Diagnostic
and Statistical Manual of Mental Disorders,
which is due to be published in 2013.

‘Piecing all this anecdotal information
together with what I was discovering
myself I started to think, “We have got to
raise the public profile of this issue,”’ he
says. ‘I think sometimes in your career
you have got to go back to fundamentals
and I think one of the fundamentals for
me is that the over-prescription of drugs
is a potential danger to children. More
fundamentally than that, I think it’s
basically wrong to be giving broad swathes
of children psychotropic medication
when their brains haven’t yet fully formed
and these toxic substances could have a
negative impact on their development.’


Raising awareness
To raise the level of public debate about
over-prescription Traxson started his own
awareness-raising campaign. Using the
slogan ‘Pastoral care, have a duty of care
to be aware’ he set out to raise the issue
with staff in schools. He says he did so
after consulting hundreds of headteachers,
70% of whom felt that pastoral care staff
did have a duty to monitor the number
of children in their school who were
taking prescribed psychotropic drugs.
His next step was to formulate a set of
20 questions that pastoral staff should ask
themselves. The full list can be found on
his blog (http://cope-yp.blogspot.com),
but among the issues they raise is whether
there is a link between the early use of
prescribed drugs like methylphenidate
and later illegal drug use among young
people. Traxson says that when he raises
this with medical professionals it often
stops them in their tracks and they ask
him whether there is any evidence of
such a link. After a lengthy pause, one
senior medical colleague suggested
that his own professional group should
do more research into the issue.
Evidence of such a link exists, he
says, giving the example a longitudinal
study carried out in 1999 by the late
Berkeley psychology professor Nadine
Lambert. Lambert followed 492 San
Francisco Bay Area children, half of whom
suffered from some degree of ADHD
and half of whom did not have ADHD.
The study found that children treated
with stimulant drugs such as Ritalin to
control attention deficit/hyperactivity
disorder (ADHD) take up cigarette
smoking earlier, smoke more heavily and
are much more likely to abuse cocaine
and other stimulants as adults (http://
Traxson also trialled another of his
20 questions in one of the two schools
where he is a governor. ‘At one governors’
meeting, under “any other business” I
just asked if the headteacher and the
pastoral staff were aware of how many
children in the school are on psychotropic
medication for their behaviour. The
head had no problem with me asking
the question but said he couldn’t answer
it. He said he felt slightly embarrassed
he couldn’t answer it here and now but
promised he would look into it and report
back. At the next meeting he reported
that there were 13 and he, as a science
teacher, was quite alarmed by that.’
Having formulated the questions,
Traxson set about publicising them far
and wide, first through articles, then
through his blog and eventually on radio
and as a guest speaker at two major
national conferences, one organised by the
Association of Educational Psychologists
(AEP) and the other by the British
Psychological Society (BPS). In terms of
day-to-day practice, he says his first big
breakthrough came in September 2009
when the paediatricians in the local
authority he works for agreed a new
protocol to the effect that any concerned
professional – an educational psychologist
or a teacher, for example – can ring
the prescribing doctor to share their
concerns. Hundreds of telephone calls
or face-to-face meetings later he says the
most common response from medical
professionals is actually, ‘Thank you for
taking the time to share your concerns.’
Professionals working together
It’s clear from Traxson’s accounts of
this episode that he doesn’t see medical
professionals as adversaries. On the
contrary, he believes everyone has the
best interests of the children they deal
with at heart. What distinguishes the
different approaches he suggests is that
medical practitioners and paediatricians
will pursue a medical model and look for
an explanation for the problem within
the child whereas a psychologist will
look for a broader explanation, including
social factors. Time pressures on medical
practitioners and lack of access to ‘talking
therapies’ can also result in medication
being seen as the first and only option.
This is despite guidelines from the
National Institute for Health and Clinical
Excellence (NICE) stating this shouldn’t
be the case with children with ADHD.
As it is, Traxson’s practice of asking
simple but powerful questions has
sparked something bigger. 

His own
professional association, the BPS, has
now given its support to a call for a
national review into the use of medication
to help treat children’s behavioural
issues. With a major reorganisation of
the NHS under way, Traxson agrees.
‘While all budgets are under scrutiny
I would argue that a good percentage of
the £32m that we spent last year just on
psychostimulants could be redirected to
better uses, such as talking therapies,’ he
says. ‘There’s also the tens of millions of
pounds being spent on disabled living
allowance that could possibly be used
more efficiently and more appropriately
for school-based interventions. There
are many, many good practices such as
nurture groups that schools can explore.
The time is ripe with all these changes
to put this issue under the microscope
and to have a proper national review.’
He was shocked to find that in the USA,
12% of the school population is on
methylphenidate at any one time and that
40% of school-age children (2-18) will have
been on it for at least two of their school

As it is, Traxson’s practice of asking
simple but powerful questions has
sparked something bigger. 

His own
professional association, the BPS, has
now given its support to a call for a
national review into the use of medication
to help treat children’s behavioural
issues. With a major reorganisation of
the NHS under way, Traxson agrees.
‘While all budgets are under scrutiny
I would argue that a good percentage of
the £32m that we spent last year just on
psychostimulants could be redirected to
better uses, such as talking therapies,’ he
says. ‘There’s also the tens of millions of
pounds being spent on disabled living
allowance that could possibly be used
more efficiently and more appropriately
for school-based interventions. There
are many, many good practices such as
nurture groups that schools can explore.
The time is ripe with all these changes
to put this issue under the microscope
and to have a proper national review.’

Find the full B.P.S. statement calling for a National review on separate Post.


for more information and BBC radio programme commentaries.

FEDERAL DRUG AGENCY - WARNING NON-STIMULANT ADHD DRUG = Atomoxetine has increased Suicide risk! (2006)

Red is natures colour warning - danger!
The FDA  approved Atomoxetine, a new non-stimulant drug in 2005 to treat ADHD in adults and children over age 6. This was not the first non-stimulant medication for ADHD though. Antidepressants, including Wellbutrin (bupropion hydrochloride) and tricyclics, like Desipramine and Imipramine, have long been considered second line medications, and are sometimes used when two or more stimulants don't work, are contraindicated, or cause too many side effects. Antidepressants are usually not considered to be as effective as stimulants though. And these medicines aren't FDA approved to treat ADHD, so Strattera's(Atomoxetine) claim of being 'the first non-controlled medication that's FDA-approved to treat ADHD' is technically true.

The introduction of Atomoxetine

was going to be welcome news for most parents. Although widely known to be safe and effective, stimulants like Adderall and Ritalin, have long had a bad reputation and many parents are anti-Ritalin and hesitant to put their kids on a stimulant. So if it isn't a stimulant, how does Atomoxetine work? It is thought to be 'a potent inhibitor of the presynaptic norepinephrine transporter,' which causes more norepinehrine to be available to increase attention and control hyperactivity and impulsivity. Like the stimulants, it is not yet known exactly how Strattera works though.

Although a new medicine, six research studies have already been done that show that Atomoxetine is safe and effective.

One of these studies, Atomoxetine and methylphenidate treatment in children with ADHD: a prospective, randomized, open-label trial, compared Strattera and Ritalin. These children with ADHD, 228 in all, received either Atomoxetine or Ritalin for 10 weeks, and those who took Atomoxetine were found to have 'symptom reduction' and 'tolerability' that were 'comparable to that observed with' Ritalin.

Atomoxetine Suicide Warning
Adrian Wade committed suicide 2006 after taking Atomoxetine for 115 days.

The drug's manufacturer  has admitted  that their drug  prescribed to treat ADHD and hyperactivity causes more children to have suicidal thoughts. This is after the FDA requested that they provide the data that they apparently had not disclosed showing the link between suicide and this ADHD drug. After reviewing this information the FDA seems to have requested that it carry a warning on it’s label.

THE WASHINGTON POST — The Food and Drug Administration warned doctors recently about reports of suicidal thinking in some children and adolescents who are taking Atomoxetine, a drug used to treat attention deficit hyperactivity disorder in children.

  The drug'smanufacturer announced that a black-box warning will be added to the drug’s label in the United States. Such a warning is the most serious that can be added to a medication’s label, and similar warnings will be added to the drug’s labels in other countries. The company said a study showed instances of suicidal thinking were rare.

In a statement, the FDA said it “is advising health care providers and caregivers that children and adolescents being treated with Atomoxetine should be closely monitored for clinical worsening, as well as agitation, irritability, suicidal thinking or behaviors, and unusual changes in behavior, especially during the initial few months of therapy or when the dose is changed.”

From studies in the U.S. that were provided the FDA results from Atomoxetine clinical trials of 1,357 patients that found five youths taking the medication reported having suicidal thoughts, while none of 851 patients taking a placebo reported having any. One young person taking Atomoxetine attempted suicide, but survived, company and FDA officials said.

There was no evidence of increased suicidal thoughts in adults taking Atomoxetine, which also goes by the generic name atomoxetine.

“The actual risk is very low,” said Dr. Thomas Laughren, head of the FDA’s psychiatric drug unit. Despite the warning, he said, “FDA still views Strattera as an effective drug.”

At the FDA’s request, a guide will be published for doctors and pharmacists to give to people who are prescribed Atomoxetine.

Based on the information that was provided to the FDA on  the statistics are very concerning. If you take the total number of children being treated for ADHD and hyperactivity with drugs like these (over 5 million kids) you get some alarming numbers. Assuming that similar drugs have the same side effects there are  thousands of kids experiencing suicidal thoughts from these drugs. Statistically using the same figures that were  provided in their press release you get these numbers:

  Thousands of children will have been having suicidal thoughts as a direct side effects of these medications. The most horrific number is the nearly 4,000 children who have been likely to act on these thoughts and attempted suicide.What are the figures for deaths as a result?

Drugs often lift the childs energy level before their mood is enhanced so they then have the energy to carry out their black thoughts.

The facts are there to be seen in the press and pharmaceutical company reports that have often been based on 'selected / or cherry picked'studies. The drug treatments can sometimes cause suicide and psychosis as direct side effects. The amount of potential damage inflicted on society for these children is huge. It’s time that the psychiatry profession and the drug companies re-evaluate this risk of damage and reduce the  harm to our children in this way in the future.

Shareholders - the question of ethical investments. 

 The manufacturer said it is working with the FDA to finalize the product label. It also is working with regulators outside the United States.

ADHD affects 3 to 7 percent of school-age children and manifests itself in inappropriate levels of attention, concentration, activity, distractibility and impulsivity.

This makes prescribing expensive drugs an ever expanding "market opportunity" for sale of these drugs with consequent increases in share values.Is this ethically acceptable? 

Companies with ethical investment portfolios like the Co-Op would review buying these shares.

Some of the manufacturer's own warnings published-2011.

WARNINGS AND PRECAUTIONS-----------------------
• Suicidal Ideation – Monitor for suicidality, clinical worsening, and
unusual changes in behaviour.
• Severe Liver Injury – Should be discontinued and not restarted in
patients with jaundice or laboratory evidence of liver injury.
• Serious Cardiovascular Events – Sudden death, stroke and myocardial infarction have been reported in association with atomoxetine treatment.
Patients should have a careful history and physical exam to assess for presence of cardiovascular disease. Atomoxetine generally should not be used in children or adolescents with known serious structural cardiac abnormalities, cardiomyopathy, serious heart rhythm abnormalities, or
other serious cardiac problems that may place them at increased vulnerability to its noradrenergic effects. Consideration should be given
to not using Atomoxetine in adults with clinically significant cardiac abnormalities.
• Bipolar Disorder – Screen patients to avoid possible induction of a mixed/manic episode.
• Aggressive behaviour or hostility should be monitored.
• Possible allergic reactions, including anaphylactic reactions,
angioneurotic edema, urticaria, and rash.
• Growth – Height and weight should be monitored in pediatric patients.



For more information on this topic with BBC Radio programme commentaries from recent 'Womans' Hour' and Adrian Goldberg Investigates debating the issue.

Saturday 2 April 2011

DENMARK - EUROPEAN EXEMPLAR OF GOOD PRACTICE : Re Mental Health Incidence / strategies.

Denmark tops the U.N.'s World Health Organisations' Mental Health Survey statistics( W.H.O. 2004)
for positive mental health  and psychological treatment / preventitive care options.
U.K. ranks in the lower end of the middle of the tables.
Which way shall we choose to go? Up or down?
Should we invest more in 'Talking Therapies,' as NICE recommends or  use medication as the primary response of doctors as in the U.S.(strongly advised against by the NICE Guidelines.)

The U.S. was towards the bottom on the U.N.'s W.H.O.  statistics(2004) having poor mental health outcomes, high incidence rates and poor preventitive treatment options.


For more information on alternatives to medication visit my YOUTUBE videos with BBC radio commentaries from Radio 4 'Womans' Hour,'or Radio 5 Investigates.
The Danish prescription rate of psychostimulants in 2009 was 10,000 for a population of  5.5 million (i.e. 200 per 100,000) (0.2%)compared to 600,000 for a population of 65 million (i.e. 1,200 per 100,000)(1.2%) in the U.K. So Denmark medicates one sixth of the rate of children compared to the U.K. prescription rate and one forty eighth  of the U.S. prescription rate of psychostimulants where 12% of the total school population are on psychostimulants at any point in time, and 40% of young people aged 6 -18 have had stimulants for at least two years in their school career.What a shameful statistic!It is a clear indicator of its chosen use as a means of social control.

Denmark uses a range of  socially democratic approaches as alternatives to drugs, such as Social Pedagogy which has very high success rates with disadvantaged and behaviourally disturbed young people.This approach is a totally psychologically based and is an intensive model (as recommended by NICE) which gets one in six YP to university against our appalling figure for Looked after 
children in the U.K. of one per thousand (a hundred fold difference or 10,000% between Denmark and the U.K.)

For Depression which is the largest reported Mental Health problem in the world today again the cross cultural rates are very different.

Denmark had 1,000 per 100,000 adults with severe depression in 2009, compared to 10,000 per 100,000 in the U.K. ( a ten fold difference = 1,000%) and 16,000 per 100,000 in the U.S.( a sixteen fold difference = 1,600%)

So what is happening in Denmark that make it potentially one of the 'Healthiest' countries in W.H.O. (World Health Organisation) tables and the U.S. one of the unhealthiest.

Is it the predisposition in the U.S. to high rates of  mental health diagnosis using DSM4 ( soon to be DSM5 with wider spectra) and medication compared to Denmark or due to the social values and models that distinguish the two social systems? in the seminal book," The Spirit Level" 2009 ,Professor Richard Wilkinson et al. suggests that social inequality may be a big factor, as there are state to state variations as well as country to country differences in all these measures.

We need to know the answers to these questions so we can make the right choices here in the U.K. for intervening effectively for the long term benefit of our children and young people.

Clearly Denmark is doing something right and they willingly choose to pay an average tax bill of 50% in order to fund this progressive and much admired system. The choice is ours and we need to make it soon in the U.K. to avoid further harm to our society's children in the future.