Manufacturer, psychiatric group accused of overdiagnosing to sell Ritalin

Manufacturer, psychiatric group accused of overdiagnosing to sell Ritalin

By AMY WESTFELDT, Associated Press

NEWARK, N.J. (September 15, 2000 11:22 p.m. EDT http://www.nandotimes.com) - The American Psychiatric Association and the makers of the drug Ritalin are encouraging overdiagnosis of behavioral problems in children to boost sales of the drug, according to two lawsuits filed this week.

Novartis Pharmaceutical Corp. and the psychiatric association promoted the belief that a large number of children need to take Ritalin for attention deficit disorder or attention deficit hyperactivity disorder, the suits filed in New Jersey and California allege.

A similar suit against the East Hanover, N.J.-based maker of the drug and the association was filed earlier this year in Texas. The latest suits were filed Wednesday in state Superior Court in Hackensack and in San Diego federal court by some of the same attorneys who filed huge lawsuits against gun makers and the tobacco industry.

Novartis and Ciba-Geigy Corp., which produced Ritalin before the two companies merged in 1996, also donated hundreds of thousands of dollars to an organization of members with attention deficit or hyperactivity disorder, the lawsuits say.

They also charge that the companies worked with the psychiatric association to include the diagnosis of the two disorders and list it in the Diagnostic and Statistical Manual of Mental Disorders in 1980, creating a huge market for the drug.

The companies released misleading sales literature about Ritalin's effectiveness "without ever advising ... that Ritalin usage would not stimulate or improve academic performance and/or have any long-term effect on the symptoms associated with ADD or and/or ADHD," the California suit says.

Novartis released a statement Friday calling the charges "unfounded and preposterous" and noted that attention deficit/hyperactivity disorder has been recognized by medical experts worldwide.

The American Psychiatric Association also denied the allegations.

"The APA will defend itself vigorously by presenting a mountain of scientific evidence to refute these meritless allegations and we are confident that we will prevail," the association said in a statement.

Between 4 percent and 12 percent of school-age children - about 3 million, mostly boys - are believed to have attention deficit/hyperactivity disorder. The symptoms of short attention span, impulsive behavior and difficulty sitting still are also associated with youthful rambunctiousness, which has raised questions of whether youngsters are being overmedicated.

Congressional hearings recently examined whether Ritalin, a brand name for the stimulant methylphenidate, is overprescribed for the disorders. The American Academy of Pediatrics issued its first guidelines earlier this year for diagnosing the disorders, stating that a child must show symptoms in two settings for at least six months.

The lawsuits, filed on behalf of children who took the drug in both New Jersey and California, say that Ciba-Geigy Corp. began a conspiracy to boost the Ritalin market in the mid-1950s, leading to the creation of the ADD diagnosis in the Diagnostic Statistical Manual. In 1987, the diagnosis was expanded to attention deficit/hyperactivity disorder.

The lawsuits say that the drug's makers gave $748,000 to the California advocacy group Children and Adults with Attention-Deficit/Hyperactivity Disorder between 1991 and 1994 to help promote Ritalin sales.

Eye Disorder Linked to ADHD in Children

NEW YORK, Apr 14, 2000 (Reuters Health) -- An eye disorder appears to be linked to attention-deficit/hyperactivity disorder (ADHD) in children, according to University of California, San Diego researchers.

The eye problem, called convergence insufficiency, is a physical problem of the eye that makes it difficult to keep both eyes focused on a near target. The disorder affects less than 5% of children -- but the research team found that it is three times more common in children with ADHD than in other children.

``This is the first report on the potential connection of these two disorders,'' Dr. David B. Granet said this week during the American Academy of Pediatric Ophthalmology and Strabismus meeting in San Diego.

Granet and colleagues reviewed the records of 266 children identified as having an inability to keep both eyes focused on a close target. The investigators found that 26 children (9.8%) also had a diagnosis of ADHD. ``Twenty of these patients were on medication for ADHD when diagnosed with convergence insufficiency,'' Granet told Reuters Health.

When the researchers reviewed their institution's records of 1,700 children diagnosed with ADHD, they discovered that about 176 also had eye exams, Granet said. ``Of these, almost 16% or 28 children also had convergence insufficiency,'' he added.

This analysis shows that ``children with ADHD had three times the incidence of convergence insufficiency than what was expected in children walking in off the street,'' Granet said.

Convergence insufficiency ``makes it more difficult to concentrate on reading, which is also one of the ways doctors diagnose ADHD,'' Granet commented.

``Convergence insufficiency may not be well known outside the field of eye care specialists,'' Granet told Reuters Health. ``We don't know if children are being misdiagnosed with ADHD when they truly have convergence insufficiency or vice versa,'' he said. ``We also don't know if one causes the other or if medications used for ADHD cause convergence insufficiency,'' he added.

``More study needs to be completed to confirm the connection and to answer these questions,'' Granet said.

Granet also noted that convergence insufficiency responds to eye exercises that can be done at home.

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