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Ritalin: 10 Facts You Didn’t Know About The So-Called ‘Smart Drug’

The Huffington Post UK  |  By Charlotte Meredith

RitalinRitalin is hitting the headlines yet again, after new figures revealed the number of drugs being dished out to ADHD sufferers has increased by 56% in just six years – sparking fears students may be buying into a new ‘smart-drug’ craze.

    • Ritalin, also known as methylphenidate, is a central nervous system stimulant that affects chemicals in the brain and nerves that contribute to hyperactivity and impulse control
    • If it is snorted, swallowed in high quantities or injected, the drug can have a similar effect to using cocaine or amphetamines – and can be just as addictive.

 The use of methylphenidate drugs, including Ritalin, is on the rise 

    • In the United Kingdom, methylphenidate is a controlled ‘Class B’ substance. Possession without prescription carries with a sentence up to five years and/or an unlimited fine, and supplying it is 14 years and/or an unlimited fine
    • Street names for Ritalin include: Kibbles and bits, Kiddy cocaine, Skippy, Smarties, Vitamin R and Pineapple
    • The side-effects and misuse of methylphenidate have been associated with an increased risk of aggression, hostile behaviour and psychosis
    • The effects of long-term treatment on the developing brains of children with ADHD are ongoing, but there is limited data that suggests there are benefits to long-term use
    • The most common side common side effects are nervousness, drowsiness, bad vision and insomnia
    • More than one in 100 users can suffer from depression, hair loss and problems controlling muscle movement
    • Other users can suffer from anorexia, meaning some use it as an appetite suppressant
    • Some people who take the drug can subseuently suffer from Tourette’s syndrome.

Managing ADHD with Diet

By JANE COLLINGWOOD

In recent years there has been an increasing focus on the role of diet in attention deficit hyperactivity disorder (ADHD), both in children and adults.

balanced nutritionThe development of ADHD, along with many other mental illnesses, has been linked to nutrition. Research has shown that those with ADHD may be deficient in some vitamins, minerals, and omega-3 fatty acids.

Studies have found a reduction in symptoms when patients have taken daily vitamin and mineral supplements, but the evidence for a benefit is not fully established.

Scientists have reported that various aspects of a child’s diet–including food additives, refined sugars, food allergies and fatty acid metabolism–may have adverse effects on behavior. There is no definitive proof that any of these are responsible for ADHD symptoms, but there is some evidence for a role for omega-3 fatty acids, found in oily fish (such as salmon, herring, mackerel, anchovies and sardines), flaxseeds and linseeds.

Dr. Natalie Sinn of the University of South Australia in Adelaide says that “the current evidence supports nutritional and dietary influences on behavior and learning in children, with the strongest support to date reported for omega-3 fatty acids.”

Omega-3 fatty acids are converted to docosahexaneoic acid which is used mainly in the brain and eyes. A growing number of studies are investigating its relationship with ADHD. Taking supplements often leads to a small benefit compared with placebo. This has led to the suggestion that lack of omega-3 fatty acids affects brain function in such a way as to cause or worsen the symptoms of ADHD.

But in a recent 2010 review, experts from the Netherlands conclude, “There is a theoretical rationale for the effectiveness of fatty acids in the treatment of ADHD. At the moment, however, treatment of ADHD with omega-3 fatty acids is not recommended because it does not qualify as being evidence-based.”

Research has also been conducted on iron, zinc and food sensitivities. Iron deficiency is found in some children with ADHD. It is vital for brain function and individuals with iron-deficiency anemia can experience apathy, depression and fatigue, but tests of supplements are so far inconclusive. Zinc supplements “may be of great benefit” for ADHD, according to one study, but are not conventionally recommended.

A diet high in processed foods and soft drinks may lead to peaks and troughs in blood sugar, triggering periods of hyperactivity. While sugar intake has been linked with hyperactivity in a number of observational studies, more rigorous studies do not support a link.

The question of whether food additives such as preservatives, artificial flavorings, and artificial colorings trigger hyperactivity has been debated for more than 30 years. Research generally has not supported food additives as influencing traits linked to ADHD, but some studies have found small effects.

A 2007 study suggested that the preservative sodium benzoate and several other commonly used artificial food colorings may exacerbate hyperactive behavior in young children. The researchers, from Southampton University, UK, say, “The outstanding feature of the results was the similar pattern of an adverse effect across three-year olds and eight- and nine-year-olds.”

The researchers do not claim that food additives cause ADHD, but the British Food Standards Agency now advises parents to consider eliminating the colorings used in the study from the diets of children who exhibit hyperactive behavior. Further studies are needed to find out whether different additives could have a similar effect, and whether they can also affect ADHD symptoms in adults.

Much of the dietary research on children with ADHD may be of interest to adults with the condition. For example, a 2005 study found that omega-3 supplements improved attention in healthy adults, probably due to their beneficial effect on the central nervous system. A trial of young adult prisoners also found a reduction in antisocial behavior with a supplement that included essential fatty acids.omega 3

A further review of research on adults found that “adequate levels of glucose in the blood facilitate attention control.” The researchers say, “Acts of self-control deplete relatively large amounts of glucose. Self-control failures are more likely when glucose is low. Restoring glucose to a sufficient level typically improves self-control.”

Blood glucose is controlled by hormones, but can be negatively affected by lack of food for extended periods, alcohol, very heavy exercise, “stress” hormones such as adrenaline, steroids and infections.

Proper medical diagnosis and a discussion of all possible treatment options should always be the first plan of action when treating ADHD. Psychiatrists need to be aware of the available nutritional therapies, appropriate doses, and possible side effects in order to provide alternative and complementary treatments for their patients.

But the decision on whether to alter diet or try nutritional supplements must be made by the patient or their parent, and as with any form of treatment, nutritional therapy should be supervised and doses should be adjusted as necessary to achieve the best results.


ADHD, Food Dyes, and Additives

By Stephanie Watson
WebMD Feature

Reviewed by Patricia Quinn, MD

You might have read that artificial food colorings can worsen ADHD symptoms such as inattentiveness and hyperactivity. And if you have a child with ADHD, you may have considered cutting out dyes and other additives from their diet.

Before you make any dietary changes, here are a few things you should know about the link between food colorings and ADHD.

What Does the Research Show?

The possible connection between ADHD symptoms and food dyes started with San Francisco pediatrician and allergist Benjamin Feingold. In the early 1970s, Feingold noted that hyperactive kids became calmer when they ate a diet free from artificial colors, flavors, and preservatives.

Since then, several studies have tried to confirm the link. What they’ve found is that, although dyes don’t cause ADHD, a small percentage of kids with ADHD do seem to be sensitive to the effects of food dyes and other additives.

After looking at 34 different studies, “We concluded that there is a small association of food dyes with ADHD,” says Joel Nigg, PhD, a professor of psychiatry and behavioral neuroscience at Oregon Health & Science University and author of What Causes ADHD?

In Nigg’s review, about 8% of children showed symptoms related to food dyes, and about 30% responded well to a dye-free diet.

Yet Nigg says there are still some open questions. The studies that have been done so far have mostly included small numbers of children: in some cases, just 10 or 20 kids. Plus, many of the children ate foods that had both dyes and other additives, making it hard to pinpoint the exact cause of their behaviors.

Researchers also aren’t sure exactly how artificial food colorings might impact ADHD symptoms. It could be that these substances affect children’s brains. Or, it’s possible that some kids are hypersensitive: They have a kind of allergic reaction when exposed to dyes and additives, Nigg says. Many of the kids who are sensitive to dyes are also sensitive to other foods, like milk, wheat, and eggs.

Limiting Food Dyes

In 2007 study linked six different food dyes to increased hyperactivity in children. After the study’s release, the European Union started requiring warning labels on foods containing the dyes tested in the study:

  • quinoline yellow (yellow #10)
  • ponceau 4R (not available in the U.S.)
  • allura red (red #40)
  • azorubine (not approved for food in the U.S.)
  • tartrazine (yellow #5)
  • sunset yellow  (yellow #6)

The U.S. didn’t set similar requirements. In 2011, an FDA Food Advisory Committee concluded there isn’t enough evidence to prove food dyes cause hyperactivity in children.

Trying a Dye-Free Diet

Although the link between food dyes and ADHD symptoms is still not clear, some parents say they have seen an improvement after eliminating these and other additives from their children’s diet.

The eating plan Nigg found to have the greatest effect on ADHD symptoms is the one Feingold introduced decades ago, which removes all artificial colors, flavors, and preservatives (including BHA and BHT).

When Nigg looked at studies done on similar diets, “We saw a fairly large effect — about one-third to one-sixth the size of the medication effect,” he says. In other words, cutting out these additives worked one-third to one-sixth as well at curbing ADHD behaviors as taking medications.

Stripping your child’s diet of every processed food might be tough. “One of the challenges is getting kids to like the diet,” Nigg adds.

If you’re considering an elimination diet, he suggests enlisting the help of a nutritionist who understands ADHD. “Don’t try this on your own, because there are too many ways to miss key nutrients,” Nigg says.

Wait a few weeks to see if the diet has any effect. Then you can start adding foods back into your child’s diet, about one a week, to see which one restarts the symptoms. “In most cases, you could narrow it down to three or four things your child can’t eat,” Nigg says.

Colorings are added to many products, from coated candies to cough syrup. “What parents need to do is become label readers. They can start by looking at all the foods in their kitchen and not using the ones that contain any dye that has a number, like red #40 or yellow #5,” says Laura J. Stevens, research associate in Purdue University’s nutrition science department, and author of 12 Effective Ways to Help Your ADD/ADHD Child.

One benefit to avoiding artificial colors is that it can lift the overall health of your child’s diet. “Foods that contain artificial colors, it’s hard to find one that you would say has good nutrition,” Stevens says. Removing these colors should also limit excess sugar and other unhealthy ingredients.


Outdoor Activities for Kids with ADHD and Autism

Jul 03, 2013

Contributed by Dr. Robert Melillo

For children with ADHD, autism and other neurobehavioral issues (such as Tourette’s and dyslexia), it is crucial that parents take advantage of the summer break to help their kids continue to build upon the skills they developed during the school year.

Physical Activity for a Balanced Brain

According to the Centers for Disease Control and Prevention (CDC), 11 percent of school-age children have received a medical diagnosis of ADHD and one in every 50 kids has an autism spectrum disorder.

Instead of staying indoors, the warmer months provide families with the opportunity to do outdoor physical activities that are simultaneously skill-building and enjoyable. To help children build skills without feeling like they are doing work, the following are some examples of outdoor activities we recommend to parents in our Brain Balance Achievement Centers.

Build Things Together

Summertime is a great opportunity for families to work together in building something, such as a tree house. Working on physical projects is great for children with behavioral and learning disabilities because it helps develop cooperation and social engagement. Painting and playing with clay is great because it strengthens the abstract element of the right brain that needs developing.

Tap Into Your Musical Skills

In a group setting, have the kids create something original, whether it be a song, a rap, a dance or a story. Work together and build off of one another’s ideas. Children with ADHD are left brain heavy, which means they naturally rely on analytics and numbers rather than descriptors and abstract ideas. This will help broaden their imaginative scope.

Create a World of Water

If you visit the local pool, chances are you might hear kids chanting “Marco” and “Polo.” This game is perfect for children with behavioral and learning disabilities because it strengthens both spatial awareness and auditory skills while interacting with others. Other beneficial water activities include playing on a slip ‘n slide, waterskiing and surfing.

Pull Out the Chalk

Encourage children with behavioral and learning issues to create a hopscotch with the chalk. This sort of jumping, cardiovascular activity is great for building muscle tone, which most kids with ADHD lack, and is also typically social. Children can get their creative juices flowing by singing an original song together along the rhythm of the hops.

Be Creative at the Park

“Simon Says,” “Red Light, Green Light” — these types of mimicking games are great because they’re nonverbal, physically active, and require periodically inhibiting a response, which is an area of difficulty for children with behavioral and learning disabilities. This game entails paying close attention and draws on social cues, as well as concentration.

While we live in a society of technology, it is important for parents to use summertime as an opportunity to get their kids outdoors and away from technology, remembering that physical activity is vital to the support of a healthy, balanced brain.

 


The ADHD Food Fix: How to Fight ADHD Symptoms With Diet and Supplements

Studies show that a high-protein, low-sugar, no-additive diet combined with ADHD-friendly supplements like fish oil and zinc can drastically improve ADHD symptoms in children with no side effects. Here, an ADHD specialist tells you how to get started.

by Sandy Newmark, M.D.

Good nutrition can make a significant difference in the lives of children who have been diagnosed with attention deficit disorder (ADD/ADHD).

I have used nutritional interventions for hundreds of children with ADHD during the past 24 years. In many cases, dietary changes have not only improved the symptoms of hyperactivity, concentration, and impulsivity, but also have calmed oppositional behavior.

Many parents are eager to try foods and supplements to help their kids manage ADHD symptoms, but they often don’t know where to start. Below are several dietary changes — food to add to your child’s diet, things to eliminate — that, I have found, deliver the most symptom relief.

Stop Blood Sugar Spikes

Foods rich in protein — lean beef, pork, poultry, fish, eggs, beans, nuts, soy, and low-fat dairy products — may have beneficial effects on ADD symptoms.

Protein-rich foods are used by the brain to make neurotransmitters, the chemicals released by brain cells to communicate with each other. Protein can prevent surges in blood sugar, which increase hyperactivity. Giving your child protein for breakfast will help his body produce brain-awakening neurotransmitters.

Combining protein with complex carbs that are high in fiber and low in sugar will help your child manage ADHD symptoms better during the day, whether he’s taking medication or not. The single most important thing I recommend to parents is to decrease the amount of sugar in their ADHD child’s diet.

What many people don’t know is that eating simple processed carbohydrates, like white bread or waffles, is almost the same as feeding your child sugar! Your body digests these processed carbs into glucose (sugar) so quickly that the effect is virtually the same as eating sugar from a spoon.

A breakfast consisting of a Pop-Tart and a glass of juice, or a waffle with syrup, causes blood sugar to rise quickly. The body responds by producing insulin and other hormones that drive sugar down to too-low levels, causing the release of stress hormones. The result? By mid-morning, a child is hypoglycemic, irritable, and stressed out. This can worsen ADHD symptoms or make some non-ADHD children act like they have the condition. Having a simple-carb, low-protein lunch will cause the same symptoms in the afternoon.

Instead, try serving breakfasts and lunches high in protein, complex carbs, and fiber — like oatmeal and a glass of milk, or peanut butter on a piece of whole grain bread. The sugars from these carbohydrates are digested more slowly, because protein, fiber, and fat eaten together result in a more gradual and sustained blood sugar release. The result? A child can concentrate and behave better at school.

Go for the Fish Oil

Omega-3’s can improve several aspects of ADHD behavior: hyperactivity, impulsivity and concentration. As a result, I recommend that all children with ADHD take omega-3 fatty acids.

Omega-3s are essential fats important for normal brain function. They are called “essential” fats because the body must get them from diet; our bodies cannot make them. Research suggests that children with ADHD have lower blood levels of omega-3’s than kids without ADHD. So, unless your child is a dedicated fish eater, you’ll have to supplement, usually with fish oil, to achieve healthy levels.

A number of studies on omega-3s and ADHD have shown a positive effect. In a 2009 study, from Sweden, 25 percent of children who had daily doses of omega-3s had a significant decrease in symptoms after three months; by six months, almost 50 percent experienced better symptom management. This is an impressive result for a safe nutritional supplement with few side effects.

How much omega-3 should your child get and in what form? It’s a little complicated. The two main omega-3 fatty acids contained in supplements are eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). It appears that most benefits are derived from omega-3 products that contain more EPA than DHA. I recommend a total dose of 700 to 1,000 mg a day for younger children, and 1,500 to 2,000 mg for older children.

Omega-3s come in capsule, liquid, and chewable form. The gummies and chewables, unfortunately, don’t have much fish oil in them, so it is expensive and time-consuming to give your child the proper dose. Most kids who are too young to swallow capsules can take the liquid, although you’ll have to be creative about getting them to take it. It is OK to mix liquid omega-3s in just about anything. Orange juice and smoothies are a couple of favorites.

I’ve seen some children improve within a few days, while others didn’t show improvement for a few months. My advice to parents is always to be patient, and not to give up on an omega-3 regimen too soon.

Maintain Iron Levels

Many parents and professionals are unaware of the important role iron plays in controlling ADHD symptoms.

A study done in 2004 showed that the average iron level of children with ADHD (measured as ferritin) was 22, compared with 44 in non-ADHD children. Another study showed that increasing ADHD children’s iron levels improved their symptoms almost as much as taking a stimulant. The children in these studies were not anemic. The fact that your child has a normal “blood count” does not mean that his ferritin levels are normal. Because too much iron is dangerous, I do not recommend giving iron without first checking the ferritin level. Ask your pediatrician to test it.

If iron levels are low, below 35, say, talk with your doctor about starting your child on an iron supplement and/or increasing consumption of iron-rich foods, which include lean red meat, turkey and chicken, shellfish, and beans. The ferritin level should be rechecked in a few months.

Check Zinc and Magnesium Levels

Zinc and magnesium are two other minerals that may play an important role in controlling ADHD symptoms. Both are essential to normal health, and a surprising number of children, with and without ADHD, don’t get enough of them. Zinc regulates the neurotransmitter dopamine, and it may make methylphenidate more effective by improving the brain’s response to dopamine.

Magnesium is also used to make neurotransmitters involved in attention and concentration, and it has a calming effect on the brain. Have your doctor check your child’s magnesium and zinc levels when you test ferritin levels. I find that at least 25 percent of the children I see are low in zinc.

While studies have been done on both minerals’ effects on ADHD, the results are not as clear-cut as in studies done on omega-3’s and iron.

Cut Back on Chemicals

Several studies suggest that artificial additives make non-ADHD children more hyperactive, and make hyperactive children worse. The European Union requires a warning label on food packaging that contains additives: “This food may have an adverse effect on activity and attention in children.” Gatorade, cheese puffs, and candy are typical examples of foods containing artificial colors and preservatives, but additives and colors can be found in other foods.

The first step in avoiding additives is to read food ingredient labels until you’ve found a wide range of foods that are additive-free. In most cases, fresh, unprocessed foods are your best bet, as they contain few additives.

However, these days you can find bread, cereal, cookies, pizza, and just about anything else made without additives. Avoid colorful cereals, like Fruit Loops and Lucky Charms. Cheerios are better, and lower in sugar. Substitute 100-percent fruit juice for soft drinks and fruit punches, most of which are artificially colored and flavored.

Watch for Food Sensitivities

A number of research studies have shown that many children with ADHD are sensitive to certain common foods in the diet. These sensitivities make their ADHD symptoms significantly worse. In one recent study 50 children were placed on a restricted diet for five weeks, and 78 percent of them had significant improvements in ADHD symptoms!

In my practice, I have seen improvements in many children when they stopped eating foods they were sensitive to. The most common culprits are dairy, wheat, and soy.

It’s important to know that ADHD children do not necessarily have “food allergies” in the strict, medical sense. Results when testing for food allergies are usually negative in these kids. The only way to know whether food sensitivities affect your child is to remove certain foods from his diet and observe his reaction. A child might have food sensitivities if he displays allergy symptoms, like hayfever, asthma, eczema, or GI problems. But I have seen children with none of these problems respond well to a change in diet.

If there are one or two foods you suspect might be exacerbating your child’s ADHD symptoms, eliminate one for two or three weeks. Observe your child’s ADHD symptoms during that time. If you are thinking about starting a restrictive diet, find a professional to guide you. I know dietary changes are tough to engineer in a child with ADHD, but many families have done it successfully and are happy with the results.

Try Helpful Herbs

Several herbs have been recommended for managing ADHD symptoms, including ginkgo, St. John’s Wort, rhodiola, and ginseng. Most have been poorly researched, with two exceptions.

In a large European study on hyperactivity and sleep problems, a combination of valerian and lemon balm helped to relax children with ADHD by reducing anxiety. I use these herbs regularly for kids who deal with these problems. Consult a naturopathic doctor to find the appropriate dose for your child.

To improve attention, a new herbal product, called Nurture & Clarity, was developed, and carefully tested, by a team of practitioners in Israel. The children taking it demonstrated significant improvement, as measured by their performance on the Test of Variables Attention, a computerized measurement of attention. I would not make definitive recommendations based on one study, but this product is worth looking into. You can read about it at adhd-clarity.com.

Finally, pycnogenol, an extract made from French maritime pine bark, has been shown to improve ADHD symptoms in a limited amount of research. I have found that the herb helps improve concentration in some children.

One last thought: Herbal products vary greatly in quality, and some contain contaminants. You should find a knowledgeable professional to help you identify reliable sources of pure, standardized herbs.


The Upside of ADHD

Attention deficit hyperactivity disorder (ADHD) hasn’t changed, but how experts view the disorder is evolving in a new direction. Instead of only focusing on the difficulties posed by ADHD, today, the upsides are likely to be noted, too: the quick-wittedness, the speedy grasp of the big picture and the great enthusiasm for nearly everything. These traits make ADHDers endearing and simultaneously exasperating.

This change may sound like just a new way of describing the same old thing, but to those with ADHD, the difference is profound. An estimated two percent to four percent of American adults and three percent to seven percent of children have the brain-based disorder. For them, it’s the difference between seeing themselves as broken and thinking of themselves as having advantages, even if they have to cope with being fidgety, distractible or easily bored.

 In Praise of ADHD

 JetBlue Airways CEO and founder David Neeleman is famously frank about his ADHD. He was diagnosed in 2001, seven years after he realized he had it. By then, he’d already founded and then sold Morris Air. He had done so well in his own eccentric way that he felt he was doing fine without medication. Still, Neeleman says he’s not anti-meds: “I have talked to a lot of people who swear by the medication.”

Neeleman credits ADHD with his creativity and “out-of-the-box thinking”—it led him to invent e-tickets while at Morris, for example. “One of the weird things about the type of [ADHD] I have is, if you have something you are really, really passionate about, then you are really, really good about focusing on that thing. It’s kind of bizarre that you can’t pay the bills and do mundane tasks, but you can do your hyper-focus area.” He spends “all my waking hours” obsessing about JetBlue. The rest of his life, Neeleman says, would be a “disaster” if not for his wife, who manages their home and children; his accountant, who pays the bills and tracks his finances; and his personal assistant, who sends him his schedule every day and steers him from appointment to appointment, keeping him on track.

Ken Melotte, 43, of Green Bay, Wis., is quick to credit ADHD for his successes, too. “I have ideas immediately,” says Melotte, who’s on the management team of a national trucking firm. “I instantly start working on solutions, seeing different ways to do things.”

Yet, ADHD has been a struggle for him. Melotte doesn’t care for medication. The disorder vexes him most at work, as a project manager, when he had “a terrible struggle” keeping track of all the details. On the other hand, he believes that ADHD traits like empathy, intuition and the ability to motivate and inspire others made him a successful manager.

A “Context Disorder”

ADHD is considered a “context disorder,” Thom Hartmann says. Hartmann, an expert on the disorder, is one of the few who saw the positive side of ADHD before it was fashionable.

“If a left-handed person has a job cutting origami with right-handed scissors, that doesn’t mean they have a disability; they have a context disorder,” Hartmann explains. “Short people trying to play basketball have a context disorder.”

People with ADHD “may instead be our most creative individuals, our most extraordinary thinkers, our most brilliant inventors and pioneers,” writes Hartmann in his 2003 book The Edison Gene: ADHD and the Gift of the Hunter Child (Park Street Press, 2003). He posits that the people with ADHD may carry genetically coded abilities that once were, and may still be, necessary for human survival and that contribute richness to the culture.

A spate of books has come out that echoes Hartmann’s positive spin, including Delivered From Distraction: Getting the Most Out of Life with Attention Deficit Disorder (Ballantine, 2005), by Drs. Edward Hallowell and John Ratey, and The Gift of ADHD (New Harbinger, 2005) by Lara Honos-Webb.

To Hartmann, “Any kind of difference, even those differences that may make life more difficult or be viewed by some as pathologies, have to have some sort of upside, outside of pure disease processes. Otherwise they wouldn’t survive in the gene pool.”

by Marilyn Lewis for MSN Health and Fitness