Adult ADD: New Disorder or Marketing Ploy?

Health News

(CNN) Do you feel distracted? Disorganized? Misplace things? Lose things? Interrupt conversations? Maybe you have adult attention deficit disorder, or adult ADD, and need to see a doctor.

Huh, what? Gimme the drugs. Now.

See how easy that is? I have the newest and best medical disorder ever, adult ADD. At least I do ever since the pharmaceutical companies realized they could sell a slew of drugs by advertising direct to the consumer. You see, I took the quiz. Have you taken it? (I just thought it was so thoughtful of Eli Lilly to put that quiz on their site!)

Where was I? Oh, I know.

Just to think, all this time I thought it was because I was leading such a busy life: traveling, working, spending time with grandchildren. Who knew I had something that would create such a financial windfall for... uh...

Strattera
First called by the brand name tomoxetine, Strattera was a compound knocking around in Lilly’s lab in search of an indication for over two decades. It was first developed to be an antidepressant in the mid 1980s; however, Lilly pulled it from clinical trials after the compound failed to show efficacy. Then, in the mid 1990s, just before the expiration date was up, researchers started looking at the compound as a novel treatment for ADD, and reintroduced it with a new brand name, atomoxetine.

The atomoxetine (Strattera) molecule is a selective noradrenaline reuptake inhibitor antidepressant. It is a hybrid of two antidepressants: fluoxetine (Prozac) and reboxetine (Vestra), an antidepressant not yet approved in the U.S.

What is unique about Strattera is that it has been FDA approved as a “non-stimulant” treatment for ADD; certainly good news to the parents of children using Ritalin and other amphetamines (given the recent press about adolescents using Ritalin illegally as a cocaine substitute).

However, the truth of the matter is — while the drug is not classified as a stimulant — if you look at Strattera’s side effects, you can readily see the side effects are virtually the same as for any stimulant treatment.

It is also wise to keep in mind that Strattera is a new drug, and to date, studies have only been done on a few thousand children showing “effectiveness for nine weeks and safety for one year.” And studies on adults showed “effectiveness for 10 weeks and safety for a year.” (We do know the drug increases both heart rate and blood pressure in both adults and children.)

Something else worth noting here are the side effects to sexual functioning reported in adults and how that will affect children (who the drug is also approved for) and whose sexual organs are still developing.

Adult ADD
Can’t say that I blame drug companies for coming up with adult ADD. After all, what would you do if you’d spent $50 million on a drug and still couldn’t find a way to bring it to market? And it makes sense, you know — children with wandering brains growing into adults with wandering brains. Now we have a pill for the grown ups.

Thanks to Lilly, we now know ADD is an equal opportunity disorder. (Wonder who figured that out, marketing people or research people?) From a marketing point of view, it is absolutely brilliant. High uptake of the drug will certainly narrow revenue deficit for Lilly; something that’s really needed because of recent setbacks. Those include manufacturing problems at some of Lilly’s plants and last summer’s loss of patent protection for Prozac. However, I doubt Lilly will suffer depression now.

The drug’s first-year results have been awesome. Introduced in January, doctors wrote one million prescriptions in the first six months of this year. By July, Strattera had claimed 13% of the U.S. market for ADHD (Attention Deficit Hyperactivity Disorder) drugs! According to Data Monitor, the drug is likely to become the “drug of choice” for a significant part of the population; with revenues predicted to be $718 million in 2010. Amazing, isn’t it…

The Power of Advertising
Drug companies promote ADD/ADHD illnesses and drug remedies today as a means of profit maximization. In the case of Strattera, wonderful commercials about “Do you ever feel like the channel keeps changing in your mind… but you don’t have control of the remote?” “Do you get impatient standing in line?” And I want to say, “Why, no, I love standing in line. Every day I get up and say to myself… ‘Where can I go stand in line?’”

Then there’s the two advertisements I read in Newsweek (Sept. 22, 2003) this past week. One is advertising Adderall XR, the patient-friendly ADHD treatment, that shows a smiling six-year-old (baseball glove in hand) saying, “Already done with my homework, Dad!” The other is an advertisement for Concerta, showing a smiling son with smiling mother and the caption, “I see Jason. Not his ADHD. I see a big difference in my son — better test scores at school, more chores done at home — an independence I try to encourage; a smile I can always count on.”

Yeah, right. Flip the page on both advertisements, and you see a whole page of information talking about amphetamines’ adverse reactions, the fact that they are extensively abused, and that these drugs can lead to dependence (which is not exactly the independence the smiling “mom” is referring to.)

The intent of this marketing (in both magazines and TV) is simple — get your doctor to write you a prescription for their particular drug. This cuts the doctor’s recommendation out of the process and has been highly successful in selling drugs. Just ask your doctor how many people come in and tell them what kind of drug they want. Wake up America! Get your head out of the sand.

ADHD and Today’s Diet
It’s patently obvious that something is drastically wrong with the American diet when so many children, and now adults, are being diagnosed with ADD and ADHD. I guess the establishment would have just let us believe ADD/ADHD is some kind of spontaneous disorder without a cause, one that affects millions of children (and now adults) within the geographic boundaries of the U.S.

Does that mean it spreads like a virus? That it’s a result of poverty? Bad teachers? Bad parents? All of the above except diet? Come on, let’s get real. Use your common sense.

The quality of the food we eat (or lack thereof) has a profound effect on ADD/ADHD. For many people, nutrition alone can effectively work as an ADHD treatment. In recent years, many in the scientific community have devoted their research to documenting the relationship between nutrients and brain function, including Theil et al. in 2000, reporting on the value of nutrition-based intervention. Nutrients are required by the brain, as they are by every organ, so virtually any nutrient deficiency can impair brain function (Murray et al., 1998). Numerous studies also suggest that people with ADD/ADHD may be deficient in specific nutrients and that supplementation may improve some of the symptoms of the disorder.

Phospholipids and Amino Acids
A growing body of research has pointed to nutritional deficiencies, especially with phospholipids and amino acids, as a contributing factor to ADD and ADHD and learning difficulties

Phospholipids, like lecithin, make up 28 percent of brain matter. Dietary deficiency and the brain’s rapid use of lecithin may result in a slowdown of thought processes and occasional forgetfulness. Supplementing with lecithin may help to overcome these difficulties, as the brain does not make phospholipids like lecithin; they are only available through diet or supplementation. Phospholipids are molecules with an amino acid component and a fatty acid component which are found in every cell in our bodies. Phospholipids act as building blocks for cell membranes, hormones and neurotransmitters.

ADHD, dyslexia, dysproxia, and autism are now considered phospholipid disorders because phospholipids are so important in the natural history, symptoms and prevalence of these conditions, which aggregate with families (Richardson et al., 2000). These phospholipids are an excellent source of essential fatty acids (EFA’s).

In addition to phospholipid deficiency, numerous studies have also indicated, in comparison with other people, people with ADD may exhibit a deficiency in a wide range of amino acids (Bornstein et al. 1990). Researchers suggest that even subtle changes in diet can affect levels and therefore modulate neurochemistry function (Zersel et al, 1986).

One amino acid is 5 HTP, a natural mood enhancer, that helps to both enhance and normalize serotonin levels. A number of studies have shown 5 HTP to be as effective as antidepressant drugs in improving mood, and also to be better tolerated, with fewer and milder side effects. Certainly, it will not have the sexual side effect of drugs like Prozac, Zoloft, and Paxil (the last thing you need is to be depressed and impotent!)

It has been known for years that insufficient amounts of noradrenaline and dopamine play a role in ADD. These neurotransmitters are made from the nutrients in your diet and other essential co-factors. By taking in more of these nutrients in your diet, you can make sure your brain has plenty of the raw nutrients that you need.

Vitamins and Minerals
Behavior that is familiar as ADD/ADHD can also be a result of vitamin deficiencies. For example, deficiencies of vitamin A, vitamin E, B12, pantothenic acid, riboflavin, and minerals were linked to bad behavior. Improvement could not be expected to improve unless all deficiencies were corrected.

The B vitamins are extremely important for adequate neurotransmitter levels. B1, depleted by a high-sugar diet, was shown to produce irritability, nervousness, and even increased sensitivity to noise. In one study, researchers observed a significant increase in serotonin (important for mood and well-being) when B6 supplements were given (Bahaman et al., 1975). In other research, a study showed deficiencies of vitamin B6 and vitamin B12 play a primary role in emotional disorders (British Journal of Psychiatry, 1982).

Other studies have shown vitamin B3, folic acid, vitamin C, and vitamin B6 are the vitamins most commonly found to be low in individuals who responded well to nutritional supplements with measurable improvement.

Thanks in part to a report from the Food and Nutrition Board of the Institute for Medicine, choline is also fast becoming a part of a health conscious diet and an important nutrient for ADHD. Choline, a member of the B vitamin family, is a precursor for acetylcholine, and needed for proper mental functioning as well as for efficient breakdown of fats.

Final Words
Although there are three types of drugs used in the management of ADD/ADHD — stimulants, antidepressants, and antihypertensives — medicines are short term solutions, a Band-Aid® to the problem. There are many times that a Band-Aid® is needed and useful. (I have lots of them and have no problems using them.) But they don’t heal the cuts and scrapes they are placed over. They offer short-term solutions, but only the body provides the healing.

All of us have times in life when we feel we might need a little something extra. But don’t just stop there. Take a look at your diet, take a look at your lifestyle habits. It could be you are eating something or just not eating enough of something else that is contributing to the way you feel. It could be that you are not getting enough sleep. It could be you have fluctuating blood sugar levels. It could be that you have a lot of stress in your life or habits like smoking and/or drinking that are depleting your body’s store of the important nutrients it needs to manufacture valuable neurotransmitters.

Bottom line? Get a handle on your life! Go to the doctor, have a physical, get your blood work done. Pay attention to your “personal needs,” and above all else, don’t get sucked into the idea that you need to take some kind of prescription drug for everything that ails you. The Bible says we should be “people of purpose.” Why not start today and change your life — on purpose?

God Bless!

Cathy Oats

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