Small Study links Ritalin to increased cancer risk

“Health experts say the first human study linking Ritalin — the most popular drug used to treat attention-deficit problems — to a higher risk of cancer is raising alarms.

But they caution that more and larger studies should be conducted before pediatricians and therapists curtail prescribing Ritalin for the millions of children and adults in the United States who have benefited from its use for more than 50 years.

In a study to be published in Cancer Letters, Texas researchers found that after only three months, every one of a dozen children treated with Ritalin had a three-fold increase in chromosome abnormalities associated with increased risks of cancer.

‘This study doesn’t mean that these kids are going to get cancer, but it does mean they are exposed to an additional risk factor, assuming this study holds up,’ said Marvin Legator, an environmental toxicologist and principal investigator on the study by researchers at the University of Texas Medical Branch at Galveston and M.D. Anderson Cancer Center in Houston.” (Knight-Ridder)

I considered for a moment whether the study was funded by the makers of Adderall, the major competitor of Ritalin for the lucrative attentions of those prescribing for attention deficit disorder. I am being abit facetious but there is alot potentially at stake here, and I am not talking simply in financial terms. This finding ought to prompt a challenge to some of the conceptual assumptions and the intellectual laxness in mental health treatment.

The mental health field has gone rampant with the diagnosis of attention deficit hyperactivity disorder in both children and adults, with no discretion about the distinction between normal population variations in attentional style on the one hand and, on the other, disordered neural attentional mechanisms. I can’t tell you how many times, sitting in a discussion of a case, someone had the bright idea that, simply because the patient couldn’t concentrate or focus well, they ought to be considered for stimulants and diagnosed with an attention deficit disorder. People have decried the whole Diagnostic and Statistical Manual approach which dominates psychiatric diagnosis, but at least it requires a patient to meet stringent and well-defined criteria to be considered to have a given disorder. Certainly, in the DSM system the decision about what is a disorder and what is not is a work in progress but, especially as it is linked to the available data about biological abnormalities and treatment response in a given condition, it is certainly better than what I see throughout the field, which is diagnosing by got feeling. This is especially true when there is a distinction between a commonsense usage of a term and the technical sense in which it is used medically — for instance, “She’s been abused,” “He can’t pay attention,” “She appears anxious”, “He seems depressed” or “That’s crazy thinking.”

Yes, I am using commonsense usage when I say that classification based on the above kinds of observation is crazy; in other words, thoughtless diagnosis. Gregory Bateson said, “Information is a distinction that makes a difference.” Perhaps it should not be the case, but more thoughtful diagnostic distinction is needed when it makes a difference to treatment approach and the treatment is not benign. As a touchstone, consider the situation with antipsychotic medications. For forty years or more, the field has been cautious about diagnosing a psychotic condition because the earlier generation of antipsychotic medications had serious irreversible disfiguring neurological side effects (tardive dyskinesia) and other severe risks (neuroleptic malignant syndrome). Stringent legal protections were put into place before someone could be given these medications against their will or if they are not competent to make an informed decision with the ability to weigh the risks and benefits. Perhaps we will see some ramping down of the out-of-control rates of cavalier stimulant prescribing, particularly to children, if the cancer link is validated. IMHO, it ought not even to take that!