Editorial del New York Times sobre el desorbitado crecimiento de diagnósticos TDA/H en niños y adultos
December 18, 2013
An Epidemic of Attention Deficit Disorder
By THE EDITORIAL BOARD
The hard-sell campaign by drug companies to drive up diagnoses of attention deficit hyperactivity
disorder, or A.D.H.D., and sales of drugs to treat it is disturbing. The campaign focused initially on
children but is now turning toward adults, who provide a potentially larger market.
There is no doubt that a small percentage of children, perhaps 5 percent, have the disorder and
that medication can alleviate the symptoms, such as inability to concentrate, that can impede
success in school or in life. Some studies have shown that medications helped elementary
schoolchildren who had been carefully evaluated for A.D.H.D. improve their concentration and
their scores on reading and math tests.
Recent data from the Centers for Disease Control and Prevention showed that 15 percent of
high-school-age children had been diagnosed with the disorder and that the number of children
taking medication for it had soared to 3.5 million, up from 600,000 in 1990. Many of these
children, it appears, had been diagnosed by unskilled doctors based on dubious symptoms.
A two-decade campaign by pharmaceutical companies promoting the pills to doctors, educators
and parents was described by Alan Schwarz in The Times on Sunday. The tactics were brazen, often
misleading and sometimes deceitful. Shire, an Irish company that makes Adderall and other
A.D.H.D. medications, recently subsidized 50,000 copies of a comic book in which superheroes tell
children that “Medicines may make it easier to pay attention and control your behavior!”
Advertising on television and in popular magazines has sought to persuade mothers that Adderall
cannot only unleash a child’s innate intelligence but make the child more amenable to chores like
taking out the garbage.
The potential dangers should not be ignored. The drugs can lead to addiction, and, in rare cases,
psychosis, suicidal thoughts and hallucinations, as well as anxiety, difficulty sleeping and loss of
appetite. On Tuesday, the Food and Drug Administration warned that some A.D.H.D. medications,
including Ritalin, Concerta, and Strattera, may, in rare instances, cause prolonged and sometimes
painful erections known as priapism in males of any age, including children, teens and adults.
So many medical professionals benefit from overprescribing that it is difficult to find a neutral
source of information. Prominent doctors get paid by drug companies to deliver upbeat messages
to their colleagues at forums where they typically exaggerate the effectiveness of the drugs and
downplay their side effects. Organizations that advocate on behalf of patients often do so with
money supplied by drug companies, including the makers of A.D.H.D. stimulants. Medical
An Epidemic of Attention Deficit Disorder – NYTimes.com http://www.nytimes.com/2013/12/19/opinion/an-epidemic…
1 of 2 12/19/2013 05:52 AM
researchers paid by drug companies have published studies on the benefits of the drugs, and
medical journals in a position to question their findings profit greatly from advertising of A.D.H.D.
The F.D.A. has cited every major A.D.H.D. drug, including the stimulants Adderall, Concerta,
Focalin and Vyvanse, for false and misleading advertising since 2000, some of them multiple
times. The companies, when challenged, typically stop those misleading claims, but the overall
impact appears marginal. The number of prescriptions for A.D.H.D. drugs for adults ages 20 to 39
nearly tripled between 2007 and 2012, and sales of stimulant medications in 2012 were more than
five times higher than a decade earlier.
Curbing the upsurge in diagnoses and unwarranted drug treatments will require more aggressive
action by the F.D.A. and the Federal Trade Commission, which share duties in this area. It will also
require that doctors and patients recognize that the pills have downsides and should not be
prescribed or used routinely to alleviate every case of carelessness, poor grades in school or
An Epidemic of Attention Deficit Disorder – NYTimes.com http://www.nytimes.com/2013/12/19/opinion/an-epidemic-of-attention-deficit-disorder.html?_r=0
2 of 2 12/19/2013 05:52 AM