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American Academy of Pediatrics Guidelines
for Treating Behavioral Disorders in Children with Ritalin Ignores
Evidence of Cancer Risks warns Samuel S. Epstein, M.D.
Chicago, 10/04/01. Based on an industry-funded multi-university
trial on 282 pre-teen children treated with Ritalin for attention
deficit/hyperactivity disorders (ADHD), just published in Pediatrics,
the American Academy of Pediatrics has endorsed the use of the
drug. However, the Academy ignores clear evidence of the drug's
cancer risks of which parents, teachers and school nurses, besides
most pediatricians and psychiatrists, still remain uninformed and
unaware.
Some 40 years after the drug was first marketed by Ciba Geigy,
carcinogenicity tests were conducted at the taxpayers expense by
the National Toxicology Program, the results of which were published
in 1995. Adult mice were fed Ritalin over a two-year period at
dosages close to those prescribed to children. The mice developed
a statistically significant incidence of liver abnormalities and
tumors, including highly aggressive rare cancers known as hepatoblastomas.
These findings are particularly disturbing as the tests were conducted
on adult, rather than young mice which would be expected to be
much more sensitive to carcinogenic effects. The National Toxicology
Program concluded that Ritalin is a "possible human carcinogen," and
recommended the need for further research. While still insisting
that the drug is safe, the Food and Drug Administration admitted
that these findings signal "carcinogenic potential," and required
a statement to this effect in the drug's package insert. However,
these inserts are not seen by parents or nurses.
The Physicians' Desk Reference admits evidence on the carcinogenicity
of Ritalin, now manufactured by Novartis, qualified by the statement
that "the significance of these results is unknown," apparently
not recognizing that this is more alarming than reassuring. Apart
from cancer risks, there is also suggestive evidence that Ritalin
induces genetic damage in blood cells of Ritalin-treated children.
Concerns on Ritalin's cancer risk are more acute in view of the
millions of children treated annually with the drug and the escalating
incidence of childhood cancer, by some 35% over the last few decades,
quite apart from delayed risks of cancer in adult life. These risks
are compounded by the availability of alternative safe and effective
procedures, notably behavior modification and biofeedback.
There is no justification for prescribing Ritalin, even by highly
qualified pediatricians and psychiatrists, unless parents have
been explicitly informed of the drug's cancer risks. Otherwise,
prescribing Ritalin constitutes unarguable medical malpractice.
CONTACT: Samuel S. Epstein,
M.D.
Professor emeritus Environmental
& Occupational Medicine
Chairman, Cancer Prevention
Coalition
c/o University of Illinois
at Chicago
School of Public Health,
M/C 922
2121 W. Taylor Street
Chicago, IL 60612
phone 312-996-2297, fax
312-413-9898
email epstein@uic.edu
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