Mood Swings

A Psychiatrist Surveys the Mind and the Wider World

Dr. Nassir Ghaemi, MD, MPH is director of the mood disorders and psychopharmacology programs in the department of psychiatry at Tufts Medical Center in Boston. See full bio

Comments on "Ritalin on first, Dexedrine on second..."

Ritalin on first, Dexedrine on second...

By Dr. Nassir Ghaemi on January 13, 2009 in Mood Swings

Apparently 8% of all baseball players have medical permission to take amphetamine stimulants, presumably for adult ADHD. Now this is something: perhaps psychiatric researchers on ADHD need remediation in the minor leagues, because nothing we thought we knew about ADHD would explain this report. Read More

ADD

Submitted by david Petropoulos on January 14, 2009 - 6:12pm.

I have ADD and do not believe in ADHD.I do believe one can have ADD along with depression.If your child needs a stimulant he has depression. People with ADD have only minor emotional anomalies. Problem children are future depressives. Sincerely,David

Ritalin on first and Dexedrine on second.

Submitted by Henry Mann, MD on September 2, 2009 - 5:54am.

Nassir Ghaemi is a world renowned expert on mood disorders and whatever he says on that topic should be seen as close to fact. Unfortunately he does not treat children and has little direct experience working with ADHD other than with hsi bipolarl patients. What he knows about ADHD he learns from sudies doen by others. He appears to have a mission to discredit the usage of ADHD medications, claiming that it is overdiagnosed in adults and college students. He cites studies which have suggested that individuals outgrow ADHD problems as they age. This could not be farther from teh truth. I have owrked with thousands of ADHD children and adults and find that no one outgrows it. Some learn to cope with the problems but most find themselves bedeviled by ADHD problems their entire lives. It is unfortunate that Dr. Ghaemi poses himself as an expert in a clincal area where it is clear that he has not had mcuh direct experience with patients. His conclusions are wrong and potentially damaging to adult ADHD patients who are attemtping to seek treatment for their disability.
His point about abuse is certainly correct; there can be no question that a certain number of patients receiving ADHD medications have an interest in abusing them. However most patients with ADHD would choose to abuse different medications or drugs as the effects of the stimulants on ADHD indiviuals is to calm them, not to get them "high". In my work with substance abusers I find that they are drawn to heroin, pain medications and benzodiazipines.
I have heard Dr. Ghaemi talk on bipoarl disorder several times and believe that he ia brilliant man; but in the area of ADHD he has far overstepped his area of expertise and is simpyl stirring up trouble for others with articles such as this.

reply

Submitted by Dr. Nassir Ghaemi on September 15, 2009 - 1:49pm.

I appreciate Dr. Mann's comments, which were generous and appropriately critical.

I will say that I became interested in adult ADHD because so many of my patients with bipolar disorder are being diagnosed with it. I then published a systematic review on the validity of the adult ADHD/bipolar disorder comorbidity in the Journal of Clinical Psychiatry, documenting its lack of evidence. I also then published in Psychopharmacology Bulletin the largest treatment study to date on adult ADHD/bipolar disorder, showing quite high manic switch rates. Thus, I have published scientific evidence on this topic, more than most supposed experts on adult ADHD, at least in relation to bipolar disorder. These studies are all MEDLINE accessible within the past two years.