This link ( was forwarded to me by a concerned parent, whose 9-year-old son is doing well on Ritalin. The article, entitled Side-effects of ADD medication, is actually an excerpt from a book by Dr Frank Lawlis, entltled The ADD Answer. It is disapppointing that a respected public figure such as Dr Phil would allow such an unbalanced diatribe on his website.

Whilst the article makes some valid comments, such as the importance of focusing on the family environment, it is spoilt by the obviously biased slant against medication, betraying a lack of knowledge of the substantial research at our disposal.

Here are five glaring errors which can’t go unchallenged:

1.          “…school counselors concede that such medication loses most of its effectiveness by the teenage years anyway, so medications are not a long-term solution for ADD

I would love to know who these school counselors are, and where they did their training. There is an abundance of evidence attesting to the effectiveness of both the stimulant and non-stimulant medications in adolescence. In fact, it is often in the high school years that treating ADD is most critical, as this is the stage of life when kids are expected to work more independently and draw on the organizational and planning skills which are so sorely lacking in this condition. Many children, especially girls, are often only diagnosed in adolescence as this is when the academic fallout is most noticeable. Please don’t tell me that they should be deprived of effective treatment at this crucial stage of their development.

2.        …only 50% of children with ADD can be helped through drug therapy, and the ones who respond to drug treatment face the following side-effects…”

 Try 70-80%. There are a host of well-conducted clinical trials which reveal at least a 70% response rate to ADD medications. This statement suggests an inevitability of developing side-effects. This is far from the case, and there is a silent majority for whom the medication is well-tolerated, such as the parent who contacted me about this article, and many others who I see in daily practice.

And his portrayal of the actual side-effects is, shall we say, imaginative:

3.        …can cause schizophrenic episodes”

Schizophrenia is a serious psychotic disorder associated with significant functional decline and lifelong impairment. The causes are complex, but they do not include Ritalin. Perhaps Dr Lawlis means that Ritalin can cause psychosis, which can certainly be the case in those children predisposed to such symptoms. Schizophrenia is one of a myriad of disorders in which psychotic symptoms can occur, but the two are not synonymous, and to conflate them as he does is both misleading and irresponsible.

4.        …anorexia (eating disorder)”

Anorexia nervosa is an eating disorder in which individuals experience a distorted body image and starve themselves to lose weight. Medications used for ADD often reduce the appetite, and this can be a troublesome side-effect, even leading to weight loss, but to implicate it as a cause for Anorexia is far-fetched in the extreme.

5.         “…boosts the activity of the heart and cardiovascular system so that they develop beyond what is considered normal.”

Perhaps it would be easier to respond to this statement if I could understand what it actually trying to say. Any suggestions? What is known about the ADD medications is that they can increase the pulse and blood pressure. We therefore monitor these parameters, and we would be very cautious about using such medications in child who has an underlying cardiac defect to start with. But there is no sinister effect on the cardiovascular system, as this statement seems to imply, and in a child with a normal healthy heart, there is no cause for alarm.

One would hope Dr Phil actually checked what was posted on his site; this one obviously slipped through the net!