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Clinical Practice Points on the Diagnosis, Assessment and Management of ADHD in Children and Adolescents submission

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To whom it may concern

The proposed ADHD Clinical Practice Points (CPPs) came to my attention today. I felt compelled to prepare and lodge a submission in response, as both a parent and concerned citizen.

I am particularly concerned about the following factors within the proposed CPPs:

  • pp 4, 12, 13 - The CPPs recommend stimulants as the first line treatment when pharmacological treatment is considered (pg 13). The CPPs do not identify the definitive causes for ADHD, stating that ADHD is a "description rather than an explanation" (pg 4) with no "specific treatment to 'cure' ADHD" (pg 12). I understand that the side effects of the commonly prescribed stimulants can include hallucinations, delusions, heart problems, high blood pressure and suicidal reactions. In this light, I consider symptomatic treatment by prescribed stimulants without assurance of the root cause(s) to be potentially ineffective and dangerous;
  • pp 16-17 - The CPPs appear to be skewed toward treatment strategies via stimulants in conjunction with behavioural therapies, effectively discounting alternative treatments for ADHD, including dietary change, exercise and chiropractic care. Many of these alternative treatments have documented scientific evidence and associated reports of success. 

    Harmful additives are still being allowed into our food products, some of which (eg. FD&C colours; additive 320 – common in peanut butter!) are known to cause hyperactivity in children (let alone cancer, respiratory problems and skin reactions). In his 1972 publication, <em>Nutrition and Your Mind: The Psychochemical Reponse</em>, Dr George Watson drew definitive links between diet and mental dysfunction. I do not understand how these can be discounted; and

  • pg 15 - The CPPs intimate that families may come under the scrutiny of child protection if they fail to observe treatment strategies - which are likely to involve treatment by stimulants. While such parents may be completely opposed to the use of stimulants, for they pose their own health risks, they may be open to the use of non-harmful alternative means of treatment that have proven successful for some, but are not recognised under the CPPs.

I am also concerned at these points of process from the Declarations of Interest document:

  • I understand that Chair of the CPPs Panel, Professor Bruce Tonge, is currently the Chief Investigator of a Melbourne clinical trial which includes giving antidepressants to 11-15 year-old children who refuse to go to school. As far as I was aware, truancy was not a mental illness and, with my limited knowledge of his ties to this study, I am concerned that Professor Tonge's views could be skewed toward the use of drugs where they may not be absolutely necessary;
  • Panel member, Professor Michael Khon, has numerous ties to stimulant manufacturers, acting on the Strattera (atomoxetine) Advisory Board for Eli Lilly and has been part of an Eli Lilly study on atomoxetine. In addition, he has received financial support from Eli Lilly and Janssen-Cilag (makers of Concerta the most commonly prescribed ADHD drug in Australia) to attend conferences. I feel that these connections could bias Professor Khon's views on the use of stimulants; and
  • I note that the Panel's Consumer Representative, Ms Margaret Vikingur, is the "President of Learning and Attentional Disorders (LADS), WA. LADS has received unrestricted grants from Eli Lilly, Novartis & Janssen Cilag for educational purposes" - and that these organisations manufacture three of the stimulants administered to treat ADHD. I am concerned at her ability to remain impartial because of these ties.

I appreciate your attention and consideration, and I look forward to the outcome of this review.

Yours faithfully,

Hannah Sforcina.

Page reviewed: 14 September, 2012