Ian Goddard (Ian@goddard.net)
Wed, 08 Dec 1999 05:42:53 -0500




(c) 12/8/99 Ian Williams Goddard

The New York Times (12/7/99) [1] reports that a possible new psychiatric diagnostic agenda for children may be to identify "early warning signs" of schizophrenia that are to be treated with antipsychotic drugs. Research funded in part by the drug company Eli Lilly is attempting to see if antipsychotic drugs can reduce the incidence of full-blown schizophrenia if given to "high-risk" subjects while they are still children. With the ability to cause permanent brain damage and disfiguring conditions such as tardive dyskinesia, antipsychotic drugs, also known as neuroleptics, are the most harmful psychiatric drugs. [2]

Also of concern regarding an "early schizophrenic" focus in childhood diagnosis is that the drug Ritalin, which is being prescribed to millions of children, is known to produce symptoms that mimic schizophrenia. [3] One drug study even found that Ritalin "induces a psychopathology that seems to mimic schizophrenic psychosis more closely than that induced by amphetamines and cocaine." [4] About the ability of psychostimulants such as Ritalin to mimic symptoms of schizophrenia, Peter Breggin, M.D., states:

"All of the stimulants, including Cylert, can cause psychoses that mimic schizophrenia... These druginduced psychoses look so much like schizophrenia that a strong argument has been made that stimulant abuse sometimes causes 'chronic schizophrenia.'(43)" [5]

Since doctors often prescribe multiple drugs (polypharmacy), and since an illness treated by one drug may be caused by another (iatrogenic polypharmacy), the potential exists that Ritalin-induced schizophrenia might be treated with even more dangerous mind-altering drugs. As Breggin observes: "Because Ritalin is promoted as relatively free of adverse effects, the development of a severe mental disturbance can be mistaken for the surfacing of further 'mental illness.'" [6]

The potential for iatrogenic polypharmacy could arise as a result of any "early schizophrenia treatment" agenda unless all doctors are aware of all adverse effects of stimulants and are willing to take a child off them to see if symptoms subside before they risk prescribing potentially braindamaging neuroleptics, and yet psychosis has been reported during withdrawal from long-term Ritalin use. [7] Chances are some doctors will drug first and ask questions later.

Quoted below are excerpts from a study that found Ritalin produced a dose-dependent dysfunction in nonschizophrenics that "'mimics' schizophrenic psychopathology." The range of doses in the study intersects Ritalin's therapeutic range. The study used Ritalin to test a hypothesis about the nature of an on-set schizophrenic dysfunction. The fact that Ritalin
(methylphenidate) was chosen reflects the fact that it is a
drug of choice for modeling schizophrenic psychopathology.

Here then are important excerpts from that study:

Archives of General Psychiatry (1988;45(9):827-32)
     Methylphenidate-Induced Information Processing
     Dysfunction in Nonschizophrenic Patients

     David L. Braff, MD, Leighton Huey, MD 

     Department of Psychiatry, University 
     of California, San Diego, La Jolla 92093. 

     "Schizophrenic patients have significant deficits 
     in a wide range of attentional and information 
     processing tasks. It is hypothesized that
     catecholamine (eg, dopamine) overactivity may 
     induce and that antipsychotic medications may 
     reverse these attentional deficits." ...

     "This experiment was designed to test whether 
     systemic administration of the dopamine agonist 
     methylphenidate hydrochloride [Ritalin], in 
     nonschizophrenic patients, would induce an 
     information processing dysfunction similar to 
     the dysfunction typically seen in schizophrenic 
     patients in the visual backward masking task."[8]

     "These results show that methylphenidate, which 
     increases central catecholaminergic activity, 
     induces dose-dependent deficits in information 
     processing similar to those seen in schizophrenic 
     patients. ...this experiment used a combination 
     of psychophysical tasks and pharmacological 
     probes and is a novel illustration of how 
     stimulant challenges can induce the type of 
     information processing dysfunction seen in 
     schizophrenic spectrum patients." ...

     "...the higher dose of methylphenidate induced
     significantly more information processing 
     disruption, indicating a dose-dependant effect 
     that needs further investigation." [IAN: The 
     low dose in this study was 0.5 mg/kg, the high 
     dose was 1 mg/kg, oral. Typical therapeutic 
     doses of Ritalin range from .3 to .7 mg/kg [9]]

     "...we assume that normal humans operate at 
     a highly efficient threshold level for many 
     attentional operations, so that even modest 
     impairments of these critical functions can 
     result in cognitive or symptomatic impairment. 
     ... In this context, our drug treatment effect 
     represents a striking, methylphenidate-induced 
     impairment of the normal mechanisms by which 
     information is processed in humans." ...

     "[M]ethylphenidate, possibly through its aminergic-
     enhancing properties, 'mimics' schizophrenic 
     psychopathology by inducing specific, time-
     linked backward visual masking abnormalities."

STUDY ABSTRACT: http://www.ncbi.nlm.nih.gov/htbinpost /Entrez/query?uid=2901251&form=6&db=m&Dopt=b

[1] The New York Times: Doctors Try a Bold Move Against Schizophrenia. By Erica Goode, December 7, 1999. http://nytimes.com/library/national/science/health/120799hth-behavior-

[2] Should the use of neuroleptics be severely limited? Peter Breggin, MD: http://breggin.com/neuroleptics.html

[3] Studies cited showing Ritalin can mimic and increase schizophrenia: http://www.erols.com/igoddard/conyers.htm

[4] Journal of Pharmacology and Experiment Therapeutics: Inhibition of methylphenidate-induced behaviors in rats: differences among neuroleptics. Koek W, Colpaert FC 1993 Oct;267(1):181-91.

[5] Talking Back To Ritalin. By Peter R. Breggin, MD. page 18. The reference cited in the Breggin quote is: Flaum M., & Schultz S. K. (1996) When does amphetamineinduced psychosis become schizophrenia? American Journal of Psychiatry. 153(6), 812-5.

[6] Ibid., page 17. http://www.breggin.com/prbbooks.html

[7] American Journal of Psychiatry: Depression and psychotic regression following prolonged methylphenidate use and withdrawal: case report. Rosenfeld AA. 1979 Feb;136(2):226-8.

[8] On Visual Backwards Masking Paradigm Tasking: http://www.sci.sdsu.edu/CAL/cab.html#BackMask On Visual Masking Deficits In Schizophrenic Patients: http://www.appi.org/ajp/dec96/ajp12toc.html#AJPdec96-9

[9] Typical Starting Dosage...of Some ADHD Medications http://lib-sh.lsumc.edu/fammed/intern/adhdmeds.html

(Web posted: http://www.erols.com/igoddard/polyrisk.htm)

GODDARD'S JOURNAL: http://users.erols.com/igoddard/journal.htm