Ritalin and Cancer?

American Academy of Pediatrics Guidelines for Treating Behavioral Disorders in Children with Ritalin Ignores Evidence of Cancer Risks warns Samuel S. Epstein, M.D.

Based on an industry-funded multi-university trial on 282 pre-teen children treated with Ritalin for attention deficit/hyperactivity disorders (ADHD), just published in Pediatrics, the American Academy of Pediatrics has endorsed the use of the drug. However, the Academy ignores clear evidence of the drug's cancer risks of which parents, teachers and school nurses, besides most pediatricians and psychiatrists, still remain uninformed and unaware.

Some 40 years after the drug was first marketed by Ciba Geigy, carcinogenicity tests were conducted at the tax payer's expense by the National Toxicology Program, the results of which were published in 1995.

Adult mice were fed Ritalin over a two-year period at dosages close to those prescribed to children. The mice developed a statistically significant incidence of liver abnormalities and tumors, including highly aggressive rare cancers known as hepatoblastomas. These findings are particularly disturbing as the tests were conducted on adult, rather than young mice which would be expected to be much more sensitive to carcinogenic effects.

The National Toxicology Program concluded that Ritalin is a "possible human carcinogen," and recommended the need for further research. While still insisting that the drug is safe, the Food and Drug Administration admitted that these findings signal "carcinogenic potential," and required a statement to this effect in the drug's package insert. However, these inserts are not seen by parents or nurses.

The Physicians' Desk Reference admits evidence on the carcinogenicity of Ritalin, now manufactured by Novartis, qualified by the statement that "the significance of these results is unknown," apparently not recognizing that this is more alarming than reassuring. Apart from cancer risks, there is also suggestive evidence that Ritalin induces genetic damage in blood cells of Ritalin-treated children.

Concerns on Ritalin's cancer risk are more acute in view of the millions of children treated annually with the drug and the escalating incidence of childhood cancer, by some 35% over the last few decades, quite apart from delayed risks of cancer in adult life.

These risks are compounded by the availability of alternative safe and effective procedures, notably behavior modification and biofeedback.

There is no justification for prescribing Ritalin, even by highly qualified pediatricians and psychiatrists, unless parents have been explicitly informed of the drug's cancer risks. Otherwise, prescribing Ritalin constitutes unarguable medical malpractice.

CONTACT: Cancer Prevention Coalition National Office: 2121 West Taylor Street, MC 922, Chicago, IL 60612, e-mail epstein@uic.edu.
www.preventcancer.com

Ritalin: What Every Citizen Should Know
by Phillip Day

In my recently released book, The Mind Game, we examine the abysmal Ritalin in some detail. Dr Epstein's research is also extremely timely, coming at a stage where Ritalin is prescribed to more of our young than ever since its infamous 1955 release onto the market.

RITALIN (methylphenidate)
Profile: An amphetamine similar to cocaine. Previously manufactured by CIBA Pharmaceutical Company, now made by Novartis. Primary treatment used in ADHD. Today used by millions of children in America alone. Side-effects published by the International Journal of the Addictions list over 105 adverse reactions to Ritalin, including anxiety, hair loss, convulsions, nausea, insomnia, headaches, stomach pains, weight loss, slowing of growth, and compulsive nervous behaviours. A 1975 study in the Canadian Medical Association Journal reported that "Findings suggest that children who take [Ritalin] even in moderate doses for several years may in some cases fail to grow at expected rates."

CIBA issued the following Ritalin advisory in 1985:

DRUG DEPENDENCE: Ritalin should be given cautiously to emotionally unstable patients, such as those with a history of drug dependence or alcoholism, because such patients may increase dosage on their own initiative. Chronically abusive use can lead to marked tolerance and physic dependence with varying degrees of abnormal behaviour. Frank psychotic episodes can occur, especially with parental abuse. Careful supervision is required during drug withdrawal, since severe depression as well as the effects of chronic over-activity can be unmasked.

Note that, by the admission of the manufacturers themselves, the purpose of Ritalin is to 'mask' the symptoms of 'over-activity', not cure them. And what is the definition of parental abuse in today's world? Apart from the obvious, can it also be when children and teenagers disagree with their parents? Suicide and suicidal tendencies have dogged withdrawal from Ritalin from its outset. Even psychiatry's bible, the DSM-III-R, states that "suicide is the major complication" of withdrawing from Ritalin and similar drugs. The tragic legacy these drugs have bequeathed to our children is discussed in Part 1 of my new book in the chapter entitled 'The Great Childhood Maddening'.

ENHANCES PERFORMANCE?
If Ritalin really worked to improve school performance, there should be abundant proof of this in the scientific literature. There isn't. The number of well-designed studies in which Ritalin has been shown to enhance long-term learning is a telling 'zero'. The litany of condemnation and negative reporting however is legion. A sampling of these is given below:

1.Breggin, Peter, "The Scapegoating of American Children", Wall Street Journal, 7th November 1989, p.1
2.Physicians Desk Reference (PDR)
3.Weiss, Gabrielle, et al, "Effect of Long-Term Treatment of Hyperactive Children with Methylphenidate", The Canadian Medical Association Journal, Vol.112, No.2, 25th January 1975, p.164
4.Kohn, Alfie, "Suffer The Restless Children", Atlantic Monthly, November 1989, p.98

"…all the conclusions converged: 'stimulant drugs have little, if any impact on… long-term academic outcome." (The Learning Mystique, 1987)

"…we again find no support for the assumption that 'learning' - in any general sense - improves as a consequence of drug treatment." (American Journal of Orthopsychiatry, 1976)

"The belief that long-term drug intervention will continue to be of value or produce better outcome in hyperactive children has not been substantiated by this or other studies." (Journal of Abnormal Child Psychology, 1981)

"The ideal dose for the suppression of conduct problems may actually impair cognitive effects which, theoretically, could negate any beneficial effect on academic achievement or even exacerbate the child's learning problems." (Journal of Learning Disabilities, 1983)

"The present results suggest that continued use of Ritalin and possibly other drugs to control hyperactivity may result in compliant but academically incompetent students…. The control of hyperactivity by medication, while effective, may be too costly to the child, in that it may retard his academic and social growth, a human cost that schools and society can ill afford." (Journal of Applied Behaviour Analysis, 1975)

Educator Larson has his own opinions after years of observing children on long-term Ritalin prescription: "…as near as I can tell, and this is completely unscientific, but by our work with them, they have got brain damage. The tragedy is deepened by the fact that the labelling of children with ADD is not because of a problem the kids have; it is because of a problem teachers who cannot tolerate active children have."

To neurologist Fred Baughman, the greatest tragedy is that, after being diagnosed, children believe they have something wrong with them that only a drug can fix. More poignantly, the child sees that his parents and schoolteachers believe this also.

For more information on this subject, or to purchase a copy of Phillip Day's book The Mind Game, please visit www.credence.org or call your national Credence office.