I’ve always promised myself that this column would never get “academic,” but I see no choice with respect to the issue at hand, so here goes ... as simple as I can make it.
Fractional anisotropy (FA) is a measure of connectivity in the brain. As such, it’s a reflection of cognitive aging as determined by the deterioration of white matter. The more white matter, the “younger” the brain, and vice versa.
For as long as methylphenidates (Ritalin, Concerta, et. al.) have been given to children who are diagnosed with ADHD, pharmaceutical companies, physicians, and mental health professionals have maintained these drugs are safe. Are they?
Methylphenidates (MPH) affect brain function. They are stimulants, classified by the Drug Enforcement Administration as Schedule 2 narcotics, the same classification given to cocaine, morphine and amphetamines.
How does “safe” equate to cocaine and speed? It doesn’t. When confronted with this inconvenient truth, the purveyors in question claim, usually, that MPH is prescribed in low dosages that pose no hazard. But cocaine in low dosages is not safe. It is still cocaine. As a recent scientific study establishes, the same is true of MPH.
A 2019 study published online in Neuroradiology found that after 16 weeks of MPH “treatment,” the brains of pre-teen boys (ages 10-12) showed statistically significant cognitive aging as determined by measures of FA. Mind you, every single one of the boys taking MPH showed cognitive aging. A placebo group of boys showed no cognitive aging; neither did adult males who exhibited ADHD characteristics and were given equivalent doses of MPH.
In other words, the damage to the brain (it’s called “compromised white matter integrity”) done by MPH was exclusive to the pre-teen group, comprised of kids whose brains are still in development. Boys are much more likely than girls to be diagnosed with ADHD and given MPH, so what we have here is a problem — white matter deterioration — that is going to affect boys, primarily, in ways not yet determined. Now, intact WM is critical to executive function, sustained attention, problem solving, and impulse control being three primary components thereof.
The symptoms of ADHD describe problems with executive function: short attention span, inability to sustain concentration and finish tasks, problem-solving difficulty, impulse control deficiency, low tolerance for frustration. So the standard treatment for ADHD — methylphenidate — is, in the long run, making matters worse.
Online at Harvard Health Publishing (Harvard Medical School), a psychologist claims that the only risks of MPH are “nonserious” and names decreased appetite and sleep problems. In all fairness, her commentary is dated 2016, three years prior to the study in Neuroradiology. Nonetheless, I have to wonder how many parents are now going to be told, by prescribing physicians and psychologists, that taking MPH poses not just short-term, nonserious adverse effects, but potentially very serious, permanent dangers to their children. How many parents are going to be told that WM damage may be irreversible?
What sensible parents, hearing that warning, is going to let MPH damage their child’s brain? Bear in mind that the study in question found the cognitive aging effect of MPH to be significant after only 16 weeks of administration. Most of the ADHD-diagnosed kids I run across have been taking MPH for years. Consider that the full effect of MPH prescription may not show up until the kids in question are well into their middle years.
Scary is a word that pops to mind. So does immoral.
Rosemond is a family psychologist in North Carolina. Readers may send him email at firstname.lastname@example.org.