I'd be interested in your thoughts about direct to consumer advertising by Pharma. Some argue that patients should not have to go through their MD's to get info about meds. Others, such as myself, think that these ads do more harm than good. I can see a patient-oriented position taking either side, which shows that the patient-centered view is not as black and white as some would like us to believe.

Uh, he's against it. Archives, man, meet the blogger!

I think the situation you've described is utterly Orwellian. Corporations telling parents how to raise kids is creepy beyond measure. No, normal kids don't dream about being on the board of directors--their selfish, clueless, narcissistic status-obsessed parents do, parents who feel the need to live through their children and end up destroying them in the process.

I feel bad for kids today. They can't simply be kids anymore and have a good time exploring their imaginations. No, they're stamped with a label from an early age, branded as consumers, and their own sense of healthy agency crumbled into dust as companies tell them what they want, whether it's Pokeman or a trophy.

There's also a cultish mentality that links ADHD to giftedness and sounds like this ad is just greedily feeding into parents' inflated views. No doubt some kids with ADHD are gifted and of course should be nurtured. But some kids are just hyper. Let 'em get into sports and burn off that energy.

When did we become such a nation of victims? Then again, I'm just an old-fashioned coot myself.

Well, I don't get it, Philip. I mean, what about being a pharmaceutical company doesn't leave you perfectly positioned to give parenting advice?

;)

RE: DTC literature and CD's, I came home with a boatload of it left by reps in the patient waiting area of a psychiatrist's office.DTC for the taking. Shire is leading the pack with adult ADHD target advertising, sealing the deal with medicating mom and child together! Pharma hasn't overstepped boundaries, they are intelligently manipulating parent with false hope via medications.

Take a look a who Carlat gave a cyber award to:
Biederman, of the Harvard Bipolar Child gang.

Look what Biederman is up to now: Carlat-Dialing for Dollars Award.

This is all connected, and the "thought leaders and experts" are leading the parents into thinking they cannot parent, rather medicate instead. Not missing a beat, they are making sure parents who might not have been dx, are getting that way too.

There was a piece on the CBS Sunday Morning show this past Sunday about direct to consumer advertising. It may have been a rerun, but there was coverage of an advertising agency working for a big pharma corp to rename a disease in order to better market it. The piece stayed away from psych meds, but made some good points. I like to think of the peddlers of cures from the 19th century with their elixirs that were really just booze when I fret over whether I have restless leg syndrome - which sounds to me like akathisia remarketed for profit.

To save Steve time digging through archives, here is an example of a DTC post from this site:

Behold Abilify Phone Booth Ad!!!

On the Atlanta Marta subway system, the leading advertisers are a Depression myth v. reality big pharma add - I forget which drug its pushing because I've avoided the train in the heat - and also recruitment ads for depression drug research places. And I wonder, if you are riding Marta and not depressed if you can possibly be sane, especially if it is your only mode of transportation. I'm lucky enough to have a car. Stephany, that Abilify ad is popular on bus stops here. Poor neighborhoods seem to be heavily targeted for big pharma ads, could poverty be related to mental distress? Could big pharma be in bed with medicaid making zillions pushing these drugs on the poor?

Sally, keep asking those questions because surely we already know the answers. Somehow, all of our voices need to get LOUD.

Medicaid has contracts with state hospitals and Zyprexa, for example in my state. So do some private hospitals.

Here's an article re: FDA and television ads:

FDA to study images' impact in drug ads

I just viewed that commercial ad for the first time this week. Kuh-ree-pee.

Real live kids aren't like those dreamy pharma portrayals, regardless of having ADHD or freckles or daily teeth brushing habits. They're just _not_.

Those commercial ad kids are Stepford children; they're actors playing creepy Stepford children, created purposefully to play upon the fears and worries of those parents of real life difficult to raise and hard to help kids; parents who'll swallow anything if there's a chance it'd help help them raise/control/help their child.

The sad fact I must admit is that if I was the desperate parent of a difficult to raise and hard to help kid I may very well nibble on the bait too. There but for the grace, and all that.

My wife has a subsciption to Cooking Light which I happened to be leafing through when I saw a 3 page print ad for Vyvanse. I couldn't believe what I was reading/seeing! The list of possible side effects for all patients was alarming-so much so that I got up and showed her the ad which of course she couldn't believe. If MAD magazine or The Onion had listed them they would have been hysterical but I wasn't reading a satirical newspaper or juvenile rag and the thought that parents would/could be subjecting their children to such a drug and that Shire is marketing so agressively is appalling. You must be a desperate parent (McBeth's words) to even consider this as an option and don't let the Vyvanse website fool you with those improved math scores-MFA!

Just saw that ADHD Shire Roadmap television ad on Oxygen cable channel[geared toward women], during the day--the ad only shows little boys that the mother's are "worried" about. It shows one little guy on a baseball team saying not only does he want to play baseball, but one day own the team. And Shire is going to help him reach that goal! Now mom goes to the psych office and finds DTC paperwork and story books for the kid left by a pharma rep and is convinced that this is indeed what her little boy needs[medication].I'm pretty sure that little boy in the commercial could play ball and own the team without medications on board by age 10.Just my opinion. Here's a sample of DTC stuff I found in the psych magazine rack: Shire ADHD DTC.
The timing of the DTC literature and the television advertising is planned purposely with the beginning of the school year. THAT's wrong.But THAT'S PHARMA.

As the mother of a child with ADHD and a website administrator for LDs and ADHD (I get no money for that) and one of the parents who was involved in the roundtable which worked on the roadmap kit, I have to reply to this.

ADHD is a real, identifiable neurological disability. When your child has ADHD, it is way beyond being a "spoiled brat who needs discipline". Ordinary family discipline does nothing but frustrate the kids and makes it even harder for them to learn in spite of average to above average IQs.

Shire put a great deal into researching things which work with kids with ADHD. They are offering us hope for the future. Many kids with ADHD do grow up to be innovators, enterpreneurs, successful people. They tend to be very creative in their thinking.

They do not learn the same way "normal" kids do. I say that sarcastically as they are normal kids, they have the same feelings and dreams that other kids have but have the inability to learn the way other kids do.

No parent who loves their child chooses to classify him or her with a disability or to medicate them unless all other options fail. Some kids with ADHD can make it without meds and the people at Shire I have talked with know that. The roadmap program is designed to help everyone, including those who choose not to medicate.

BTW, I do not medicate my son and am not employed by Shire so I have nothing to gain by posting in their defense.

We parents of ADHDers see Shire as a company which has put out major money and effort to help our kids and offer us hope. I have met them. They genuinely care.

An example of an ADHDer who has made it big- Ty Pennington of Extreme Makeover, home edition. His mother was studying psychology and was given permission to watch the worst kid in school for a day and guess who they had her watch?

1999- 2007: OCD: ADHD: Childhood Bipolar Disorder: The Evolution of a Diagnosis ; part 11-Soulful Sepulcher.

There is an example of DTC literature I picked up on the coffee table at the psych office. Oprah has the ADHD Roadmap Shire in advertising on her "O" network. [which runs after the show off-camera talks with the audience regarding the days show, for instance the recent bipolar mother murdered child show].

The concern is children being MIS diagnosed and medicated without reason. Of course medication is there to help those who need it.

It's the group of kids, like mine who were medicated for wrong dx and with wrong meds and might end up dead or brain damaged.

Kudos to Ty. He made it to DTC [Direct to Consumer] advertising in psych offices. Right where Shire wants mothers to see his face.

This is all my opinion, I'm a mother, unpaid in any job at the moment with a daughter in a psych ward hoping a medication brings her "back" to me.

BUT to understand Shire, and the research and doctors behind that Ty advertisement--a person must understand how this all works. On my blog for instance on the "CME" tag-- you can see how I myself am learning via psychiatrists and professionals who blog--why we need to be critical of what often "looks good and caring" to the public. [Carlat and CL Psych are linked at the sidebar on Furious Seasons].
It is not about who needs medications, it is about who doesn't.

I'm sorry you had a bad experience like that. Nightmare experiences like yours make me so angry. It shouldn't have happened.

We always suggest you go to a psych or neuropsych who is very experienced with diagnosing and treating neurological disorders. An MD or family psych without experience is more likely to misdiagnose.

A misdiagnosis can result in the wrong meds causing major problems. A child with bipolar given stimulants before the bipolar is under control can easily be thrown into a manic phase.

Also, please never allow a dr to give your child any med for ADHD even if it isn't a stimulant, until he has done a complete cardio workup on your child. A child with a hidden heart problem can be severely damaged or even die from them. You can be much more confident once you have done everything to make sure its as safe as possible.

Keed in mind that a person can also die from aspirin if they are taking it wrong or have a sensitivity to it, so any med should be only given with care. The mortality rate for stims taken properly isn't as high as you would think from all you hear in the media. There is always something else going on that caused it. A case I am thinking of now was parents who kept upping their 4 yr old's meds to subdue her and make her sleep. She od'd but that wasn't made a major issue when it was reported. It was mentioned and thats about it.

I'm sorry. I didn't mean to write a book and take over the blog. I do want anyone considering whether their child has ADHD to know the safest way to get a correct dx and treatment. I also suggest you do a search for adhd support sites and read up on what they have to say. Most of them have great information.

I think that parents these days aren't really sure what to do because there is so much stuff coming at them from everywhere telling them what they can and can't do with their kids and how to do whatever and if your kid isn't this perfect little person that sits in their desk the whole day at school and is perfectly respectful and knows exactly what to say when like a grown person and is social at the right times and does all their work all the time and gets perfect grades, then something is wrong with them and the school will stay on you and on you until you finally cave because they are focusing solely on how well they are not doing.

With regard to my daughter's story, hers started at age 11, in 1999. Little information was available, and the research I did the last 8 yrs was on my own, never coming from a psych. She saw neurologists, [2],and 9+ psychiatrists, several with 30+ years experience at prominent hospitals. It certainly would be a shame if parents were being given meds for their children w/out proper dx and good care. I don't know how many more psychiatrists/neuro-docs a person could see. They all medicated her. The only thing that changed over the years were the diagnoses and the medications according to the latest and most pharma-repped out ones. I'm sure she won't be the last kid to be medicated without reason, especially now. The medications are getting approval for all uses, and ones that failed in some categories are being used for others. For instance--Strattera was touted for bipolar in kids years ago, and now it's being marketed toward Adults with ADHD. I've got that Lilly CD sitting right here. Piles of take-home DTC literature from Pharma companies. What happens when a person who has not researched or lived with a young growing teen and watch the nightmare unfold, they listen to the doctors as the doc calls it "the illness" or changes the dx and the rx. Live and learn, and that's what is alarming, the market is being flooded with meds for kid use now and the medications have death as side effects, black box warnings etc.

Although I agree with the comment that companies should not cross the boundaries into parenting, I found the other comments offensive and uninformed. Your doubts that a five year old could draw those pictures or have grand ideas would be completely removed if you spent a few hours with my niece. She suffers from ADHD. She is the brightest child with a wild imagination, one that keeps her awake at night, but is constantly struggling to be a successful student. Her mother has had endless problems from her teachers not "understanding" my niece's special needs. It is very easily confused by many as a lack of parenting and discipline. Even I sometimes lose perspective and feel that a visit from the "Nanny" would solve everything, but it won't. Parenting, teaching, living with a child with ADHD is heartbreaking.

This advertisment is serving a very important purpose....awareness. If there is a small booklet that a parent of an ADHD child can obtain and share with the child's teacher, open up channels of communication between the parent and teacher, what is the harm?

I wish that your comments had not reached down low by discounting the portrayals of the children. These children are special and will in fact contribute more to society than you. Next time, please think and research more before you insult.

Most of the negative comments here are from people who have no knowledge of what ADD/ADHD is. I'm in my 50's and have struggled with this condition ALL MY LIFE. ADD is not an excuse, it is a reason. It is not a ''current'' disorder, it wasn't just ''discovered'' last year or even ten years ago.
If your children wear glasses I could say that the eyeglass manufactures are just feeding into a parents ''clueless, status-obsessed'' life style.
Just because you don't understand something (Does anyone remember Tom Cruise & his cluelessness about Depression ?) doesn't mean it's not real, doesn't affect thousands of people whether they be high-schoolers, college age, middle age, or 13 year old not being able to understand and follow along with direction from their English teacher.
If you don't understand someones medical condition there are several ways you can find information about it.
1. On your computer you can go to a place called ''Google''.
2. After youv'e gone their type in ''Ask''. IF you have an open mind that might keep you busy for a few minutes researching about ADD.
3. If you want more/other information see step 1. and enter ADHD.

The only thing worse then Over DX is Under Dx.

My son is ADHD. I cry when I think of what he goes through. he is smart funny, and so loving. He tries so hard but it is difficult for him to process things the way other children are able to do. He is involed in sports and other activities that so many people think that is all they need to "get the hyperness out." People don't understand. I ordered the roadmap kit. I can't wait for it to get here. I know my son. I know how to parent my son. BUT I am also ALWAYS open to new ideas. I don't work for any of these companies. I run a daycare in my home. So it's not that I can't handle kids. It's that I am willing to listen to ANY person who can help me help my son. People that blast ADHD and blast those trying to help the parents of these kids just make me so hurt. If it was your child that seemed lost you would be right here in the trenches with us...

I also have a daughter with ADHD and she was diagnosed at three and I just went the the roadmap website and I am very thankful for the kit that they are going to send me. I think people whom do not have a clue what this disorder entails should become educated before they form such strong opinions.

I am truly sorry for the parents here whose kids have been stigmatized and labelled with an ADD/ADHD diagnosis. And yes, I have very strong opinions on this issue, because whatever developmental and emotional issues are troubling your children the last thing you should be doing is giving them stimulants. I have spent a long time studying these medications and even submitted a report to the FDA when they were reviewing cardiac and neuropsychiatric effects. These drugs permanently alter the brain as well as have other very serious phsycial effects. It is a violation of your children's rights to be giving them these medications. There are many other ways to address the behavioral and emotional issues that are troubling your children. Stimulants "work" if you can call it that just like steroids work for athletes. That doesn't mean they are good for your kids. In fact they are a segue into the use of other psychotropic drugs (all of which are neurotoxic) because they lead to depression and even mania and psychosis. When they were first discovered they were often called "math pills". Don't kid yourselves that you are "healing" any "deficiency in your children. Go to www.breggin.com and read his excellent article on their long term effects.

I'm really surprised to see ADHD believers confidently asserting here that it's a neurological disease. There's no evidence of any such neurobiological disorder.

ADHD is diagnosed the same way any mental illness is: the clinical impression of the doctor judging the patient's behaviour. There is no scan or other test to prove or disprove any psychiatric diagnosis, nor do I believe there ever will be.

I can't believe almost an entire generation of parents fell for this one. Good luck in your kids' teen years, when Ritalin often gets augmented with crystal meth or other addictive substances. This ADHD craze and rush to medicate is true insanity.

The reason this discussion is regarding DTC, is because it is a drug industry motivated by making $$ without regard to the child/or adult. Many people benefit from medications, but it's the one's who may be medicated without reason[mostly kids with growing brains],that's a concern for many. Here's an article about DTC , USA vs. Europe.

The Wall Street Journal- DTC out of control in USA not happening in Europe

"“I don’t see DTC advertising coming to the major markets of Europe,” David Brennan, CEO of London-based AstraZeneca, told Dow Jones Newswires in a recent interview. “The U.S. is a market-driven model and most of the European model is a government-payer model.”

just passing along an interesting depression support community www.depressiontribe.com

I have a wonderful, smart, seven year old who is terrific at home and very well behaved. Put him in a classroom (or court or field with a coach), however, and he cannot be still or pay attention for two seconds. I never dreamed he was ADHD until his teacher and counselor asked me if they could test him. I agreed and their test showed him to be ADHD. Now I am looking for a doctor who will treat him! My only hope is that he will be able to learn better and improve his grades and reading skills. I don't think discipline is his problem at all.

Lynn,

This is a problem within the school system [I work in one]teachers by law not allowed to dx a child, or offer a test on the premise of their diagnoses. By law parents and children have rights, and the first thing I would recommend is telling the school admin the teacher dx your child; second request and start an IEP or 504 plan process.[Legal school documents]. Because, if in fact your child needs any accomodation, such as more time reading, writing or taking tests this is the document that will ensure that, and not just the medications. If a child cannot focus, and is on medications the teacher is not obligated to accomodate your child without that/those documents in place.Which places more pressure on your now medicated child, to perform according to classroom cookie-cutter protocol; and while trialing medication and possible side effects on top of it all; at age 7 that is a lot to ask from a child. [just my opinion].

Trust me once your child who I assume is about 1st or 2nd grade will be labeled for his entire school career and once medication is brought into the picture the school demands the child takes it. How do they? you will get phone calls when you child is still wiggly and not paying attention: but now they will ask "Has he taken his medication today?"

I would not discuss any diagnosis with them or medication again, until you find an experienced psychologist to work on therapeutic intervention before entering the medication arena.

As a parent and a person who works in the schools, I guarantee this is not going to be pleasant for you or your child; I also recommend starting the process by googling PBS Frontline "The Medicated Child" and watching it online.

You might think differently after watching that program.

Good luck.

Here is the link to the PBS Frontline "The Medicated Child". Just click on "watch the full program online".

The Medicated Child PBS.

I read part of your remarks ref the commercial and how you seriously doubt this and that about what children think and are capable of. I have ADHD and it's been a life struggle. I survived my life because I had wonderful parents and the best help possible in every area of my life to deal with the ADHD and dyslexia. When I saw that commercial it made me smile and cry a bit. It was a relief. It was a pat on my back that someone DOES know how I felt as a child and have felt all my life. I LOVE that commercial. The expressions on faces of those children in the commercial are even right on. Like the child with the baseball cards at the end. If you don't live the life you can only hope to understand what it's like to live in our heads and bodies.

as a very concerned parent of an ADD child and actually having it myself I feel the more support we can get the better. Why wouldn't you want to hear more from the company who makes the drug you take? When you sign up for shire they track you progress with the drug diagnosed and with yourb permission cordnated that info with the doctor. So instead of the doc giving you some scrip and sending you on your marry way they actually keep communication with everyone in the situation. I feel we need more support for children and parents that actually have to stuggle with this. It is a true heartbreaking event to see your child struggle with this and to see the frustration they do really have. The commercial is about the best explanation I have ever seen to describe ADD/ADHD. If you do your reasearch on this you'll find that majority of these children are brighter it just take more patience from those who don't suffer from it. it is very easy to judge when you don't have to deal with it. Also the company who came out with SHINE did so because of a new drug they released in 2007 that has to be digested to work which inhibits it to be used as a street drug. Who do people think they are to give advice about a disorder (not illness) who has not had to live it or been clinically educate about it. There are many disorders that have no diagnostic way to prove them exept by symptoms. The contradictions in preveios comments just dumbfounds me. You put SHINE down and the lack of proof of a clinical diagnosis but obviously you didn't comprehend the purpose of SHINE or the treatment for ADD/ADHD.

As a former special ed teacher I can tell you that 90% of the problems kids with ADHD have is because the school system teaches children in very limited ways. I had one kid who was a genius (off the charts, literally) in spatial perception--a skill rarely tapped by the traditional school system. He had trouble with visual tracking. He could read, but no one knew it because they only gave him timed tests. Turns out it took him 2.5 times the average to read something, but he understood what he read very well. So he grew up thinking he was "lazy" and "dumb". Far from it. He's a successful carpenter now, building homes for millionaires and raising a family in a modest--but well built--home. All of my special ed students were referred to me with two labels, "lazy" and "s/he can do it when s/he wants to" (as if they're not entitled to the same "off" days as the rest of us).

The solution to a school system run by academics (because the people running the schools are people who succeeded in them in their current format) is to change the school system, to advocate vigorously (hire a lawyer if you have to) for the proper accomodations or, better yet, special schooling. This requires a LOT of effort and you need to be a real pain in the butt. Don't think being nice is going to get what your child needs in a traditional format.

Medication--in other words, changing your child's brain--is really not a good solution. When you do that you are buying into the notion that your kid's brain is defective. That's a pretty terrible message to give a growing child. Given what a bizarre society in which we live, it's far more likely the culture in which you're raising your child needs alteration.

Think about childhood a hundred years ago. Kids had many more physical outlets then, and far less pressure to "succeed" in the narrowly defined, academically or business oriented path of today's USA. An agrarian society values spatial and mechanical skills much more than the academic society in which we now live. If ADHD exists now, you can bet it existed then. Yet somehow people managed to do without brain-altering medications.

By the way, my niece works in a Very Famous psych hospital. She's been getting the Ritalin generation for some time now and they are strikingly different from previous generations of psych patients. These young adults are used to being labelled, used to being "treated", used to taking pills, used to being a "problem". They are sitting ducks for heavy medication and a lifetime of negative diagnoses intended to "fix" them. They are most definitely NOT going to be owning any baseball teams or sitting on any corporate boards, at least in part due to the effects of long-term medication combined with a lifetime of being treated as if they're the problem.

Her daughter was the ONLY child in her third grade class who was NOT on ritalin, because my niece refused to bow to the pressure (my niece is very, very stubborn).

The thing I found incredibly creepy about this ad is the extreme points of view. Surely there is something between being a "problem child" and owning an entire team, isn't there? What ever happened to the middle? Isn't it okay to simply be a kid who grows up to hold a job, have a stable marriage, raise some kids in a reasonably nice home? Shouldn't that be enough of an achievement? What's up with this grandiose Captain of Industry stuff? It sounds almost vengeful, actually. And to hear it coming from the lips of children is pretty disturbing.

I've seen kids with ADHD walking on the ceiling, driving their teachers and parents crazy. And I knew they could be managed with structure, CBT and physical outlets they simply weren't getting. And were never going to get in a traditional school. Just co-ordinating a simple IEP to track whether or not a kid's done his/her homework is nearly impossible. I know it is possible for adults to create a system that enables these kids to use their creative talents instead of being pushed into a narrow academic definition of "success".

But it's not going to happen in the traditional school system. And it will require more attention and structure at home, which means maybe the parents won't be able to do everything their peers do because there's only so many resources in any given system. The kid may remain an ongoing challenge. But give rewards other, more traditional, kids don't. Because they're unique.

Filing down the square edges of your little peg to enable him/her to fit into that round hole is only a temporary solution. But that's what we do with kids in our society. This situation is only one manifestation of this phenomenon.

Best wishes to all who struggle with figuring out what's right for their kid.