The Business of ADHD - ADHD expert

But the charge that the psychiatrists and the pharmaceuticals have joined together in a joint common mercenary interest is quite a charge. How can you say that?

I'm not the only one saying this. In the October, 1995, in the DEA background paper on methylphenidate, which is Ritalin, the DEA says that they have been contacted by the United Nations International Narcotics Control Board (INCB), that had expressed concern about the financial ties of Ciba-Geigy, then the manufacturer of Ritalin, to CHADD. They noted that CHADD had received over $775,000 from Ciba-Geigy, I think up through 1994, and eventually the figure went over $1 million. The INCB charged CHADD with being a vehicle for marketing a controlled substance directly to the public in violation of the Controlled Substances Act of 1971, and international statute by which all countries, all signatories, agreed. 

Ciba-Geigy confessed at that point that CHADD was their conduit to the public. CHADD personnel and NIMH personnel were regularly in-house at the Department of Education office of Special Education authoring ADHD materials. I think CHADD made a grant, I believe, of $700,000-some to the Office of Special Education to make a video about ADHD. Then when John Merrow, in his video production in about 1995 . . . pointed out the financial ties between the Ritalin manufacturer, Ciba-Geigy and CHADD, I think that money was then given back by the Department of Education, back to CHADD.

Peter Breggin

Psychiatrist and author of Talking Back to Ritalin: What Doctors Aren't Telling You About Stimulants and ADHD, Breggin founded the nonprofit Center for the Study of Psychiatry and Psychology. He has been a vocal opponent of the ADHD diagnosis and he strongly opposes prescribing psychiatric medications to children.

There are many, many reasons why we're giving more and more psychiatric drugs to children. Probably the most important reason is simple marketing. The drug companies, like the tobacco industry, like the alcohol industry, are highly competitive, and are always searching out new markets. The adult market has been saturated for anti-depressant drugs. How many millions and millions of people can take Prozac and Zoloft and all the other drugs? We have more adults taking anti-depressants than the National Institute of Mental Health estimates there are depressed people in the United States. The market is saturated, so the pressures move automatically to other markets. And the biggest next market is children. So you have drug company representatives, you have drug company-sponsored conferences examining this issue, or encouraging this issue of marketing to children. ...

What Ciba-Geigy, now a division of Novartis, has done is to fund a parents' group, CHADD, and the group has then gone and promoted Ritalin to the public. So that's one potential aspect to the situation.

How is it different than another pharmaceutical company supporting the American Diabetes Foundation or the American Cancer Society with funding? How is it different that Ciba-Geigy is providing some funding to CHADD?

One of the big differences in what Ciba-Geigy is doing, say, compared to a drug company who might give money for a diabetes drug to the AMA, is that Ritalin is a Schedule II--a highly addictive drug. And there are special controls put upon it by the US government. CHADD, in fact, has lobbied the US government to try to get Ritalin taken out of Schedule II. They couldn't do anything more valuable for the drug company, and more dangerous to the public, than that. Fortunately, they failed, and they failed in part because of our disclosures . . . about CHADD having so much money from the drug companies. . . .

What role did the pharmaceutical industry play in promoting Ritalin and Prozac to the country?

Even before Prozac was approved by the FDA, the drug company was sponsoring seminars for doctors throughout the country on the biochemical basis of depression, mentioning over and over again serotonin, which is the neurotransmitter that's affected by Prozac. They didn't happen to mention that there may be 200 neurotransmitters in the brain, and that connecting any one to depression is absolutely foolish speculation. The brain is an integrated organ, with probably thousands of substances participating in its function.

To label one, serotonin--which is, in fact, a widespread neurotransmitter that goes to every single lobe of the brain and affects everything from memory to coordination to cardiovascular function--imagine that that one happens to be the one that's out of balance, because Eli Lilly is selling Prozac.

But people are so eager nowadays for biological explanations. So physicians and the public grabbed on to what is essentially a PR campaign--perhaps the most successful one in the last 30 years in the Western industrialized nations--that if you have a mental disturbance, it's biochemical.

Harold Koplewicz

Vice chairman of psychiatry at New York University, Koplewicz believes that ADHD is a legitimate brain disorder. He wrote It's Nobody's Fault: New Hope and Help for Difficult Children and Their Parents. He is director for the New York University Child Study Center.

I think that we should look very carefully at who's funding science. I think you'll find that, overwhelmingly, the studies looking at treatment have been funded by the federal government. The National Institute of Mental Health has spent millions and millions of dollars looking at treatments. . . . When you looked at the medicines--all different kinds of medicines that basically have the same mechanism of action--they did work, and they were effective. And when you looked at behavioral therapy, you found that behavioral therapy wasn't effective unless they were taking medications. The federal government doesn't have a bias. They're not looking to support one treatment versus another. . . .

But yet there are pharmaceutical companies that do lobby politicians, and are out there and are pushing certain things and trying to get more funding for certain other things. And sales reps come around doctors' offices and invite doctors on cruises.