If I may, I think your making an assumption that those taking stimulants have ADD. Peter D. Kramer points out in his book LISTENING TO PROZAC that Depressive symptoms improve with stimulants- my brothers did, who has chronic depression (He latter was also put on an antidepressant). I agree medicine doesn't like our kind but It's because any mild mental illness is hard to improve upon with medicine even mild Depression. I feel confident that those children who get relief and greatly improve on stimulants are really a new generation of chronic Depressives; Their mothers and fathers (one or both with depression) also use the fictional term ADHD to keep from using the word depression. A very funny and enjoyable post. Sincerely,David

Not everyone has priority issues when it comes to personal values. I work with a young woman who has a hard time controlling her loud laugh and apparent need to jump out from behind filing cabinets and scare the crap out of people (far too early in the morning, for me anyway...) but I still love her. Maybe just because I have ADD and I know better. It took me a while, but I convinced my girlfriends she isn't a serial killer and may lack social etiquette but many serial killers DON'T and win people over because they often won't look much below the surface. And you're right. She has a very keen ability to see both sides of the coin.

This is the most blatant distortion of the facts that I've seen from an alleged "professional" -- not withstanding Peter Breggin. You have no shame, do you?

In a series of columns where you've said egregiously irresponsible things, you've really gone too far this time. It's quite obvious that you will put your own ego above children's welfare and parental concerns about doing the right thing for their children.

Someone really needs to pull the plug here.

Gina Pera, author
Is It You, Me, or Adult A.D.D.?

I find it not only laborious to read but also difficult to take seriously an article with such poor grammar and structure. I'll grant that it is very obvious you suffer from non-medicated or poorly medicated ADD.

I thought a PhD to be indicative of a certain level of scholarship. I am still trying to find the links to these studies and statistics you reference as I would expect such from a "renowned researcher". That would at least shed some light on the inferences you are attempting to make with your muddy rhetoric.

I'm also struggling to comprehend some of your terms. What precisely is a "clueless death"? Is that to indicate that the person killed had no idea what was happening, or that they died of an accident due to the lack of attentiveness often found in those with untreated ADD?

Let's just disregard all of that in the spirit of not "trying to bend us to a conformity that runs so many risks"; apparently, such as clearly presenting facts.

You state that "we aren't clearly diagnosed with anything better than a list of questions our teachers fill out". I'm sorry but I wasn't diagnosed until many years after my last stint in a classroom. I don't believe any teacher filling out a list had anything to do with my diagnosis. You address the world as if you are the chosen speaker for all who cope with ADD. You don't speak for me or many others I know. Speak for yourself, not us.

"Doesn't it say something in the Bible about loving your neighbor, even if he does have ADHD?" Does it also say that you must tie your financial future to someone unable to manage one? Does it say you must risk your life riding in his car as he fiddles with every knob in reach? Does it say you must sacrifice everything important to you while he whines that any sacrifice on his part is some sort of discrimination? (Note: Pronoun gender choice was yours.)

Don't you have to love yourself before you can love another? If you don't love yourself enough to protect yourself from the chaos, financial ruin, and other potential harm of someone that won't accept medical help then how can you love them? "It's better to be healthy alone than sick with someone else." --Dr. Phil McGraw (

"We don't (at least not unless we have a good reason) steal money, abuse little puppies, shoot guns at anyone (no record anyway)" Are you really willing to stand by that assertion? Due you truly believe that there isn't a single person in the world with ADD that has stolen something, fired a gun at someone or harmed an animal? Again you are presuming to speak for all with ADD and that you, in your omniscience, know every facet of every one of us and the complications of our lives.

Regardless, I suspect you really don't believe your own words, as you continue with "and I suspect if the truth was known". So you are saying the truth isn't known. Upon that, I think we can agree.

Putting yourself forward as the voice for all with ADD is very presumptuous and takes a grand kind of arrogance. To dismiss, with a wave of self-pity, the spouses who "fret about our responsibility commitments" is self-centered, reckless and bordering on abusive. You sound like a child bucking his mom's attempts to teach him how to join the adult world.

Please, don't ever again assume the mantle of the self-proclaimed "Speaker for all With ADD" as we didn't elect you. Please, speak of your own experiences as your own experiences and refrain from improper generalizing and non sequitur declarations. Please, reference your sources so we may read, understand, and come to our own conclusions based on actual information instead of your vague, context-less jumble. Finally: Please realize that spell checking tools do not ensure you have used the correct word.

Thank you.

I find it quite disheartening that whenever there is a problem involving some medicine or another, everyone freaks out that it's "too dangerous" to be used, or to be on the market.

The problem is that as far as I'm aware, there's not one thing we put in out bodies that isn't potentially dangerous in some way or another. We assume that foods we buy at the grocer are "safe" because they're food. We assume that because medicines have been FDA certified, they are safe.

We as a society seem to forget that _everything_ has a risk, and that we need to manage _our_own_ heath care. That includes knowing all the risks and side effects of all meds that we take.

While I do have ADHD, the most dangerous medicine I take is not for the treatment of ADHD, it's a blood thinner to prevent blood clots.
It's also dangerous enough that it can kill someone. Also, because of that, I can't take anything for my arthritis except Celebrex, and we all know how dangerous that one is.

Peanuts, anyone?

You say, ungrammatically:
"...children with the ADD medication was 6 to 7 times more likely to die for unexplained reasons..."

I can explain. Accidents. Risks. Inattention. Distractibility. Impulsivity. Poor emotional control. Substance abuse.

Untreated AD/HD is a risk factor for all of those.

Can you think of anything funny about that?

It is quite interesting to me how purported 'experts' like yourself take a flier on limited information, a single piece of news completely out of perspective - out of real clinical context, and journalistically magnify that purported statistic into towel ringing, whining, hysteria, and, indeed, gossip.

Problems do exist with ADHD medications, of course, but why not take the responsible higher ground and identify the issues pharmacologically and medically rather than joining the reductionistic and anti-scientific, anti-pharmaceutical hysteria.

Your attitude regarding this limited information appears to be much more involved with your own self promotion [taking the easy path of joining the populist naysayers] than a serious look at ADHD and the remarkable progress that has taken place in the last 12+ years with the evolution of stimulant medications and the science of metabolism, careful adjustment of dosage, and the growing awareness of important drug interactions which still pervasively plague the treatment scene.

Painting this careless brush over correctable medical issues offers considerable fuel to the denial experts, and adds to the pain and suffering of those confused about what to do about their own ADHD - from the six year old child I saw in my office yesterday, to the business person from Paris who has suffered ADHD all his life and is suicidal in the context of potential failure with his new job responsibilities.

If you are an expert, and advise Dr Phil, please advise him not to read this superficial and remarkably incomplete article, and do ask him to consult with the several folks who have commented above, all with far more experience regarding the challenging problem of proper use of ADHD medications.

Abundant solutions are there for challenges with ADHD treatment, and they are uncommonly easy if you simply take a brief moment to consider these matters more deeply. If you want to have some fun take a look at my posts and review the new discoveries in the field of cellular physiology and neurotransmitter precursors.

Real answers take us all further down the path than gossip.

Your article does an excellent job of showing why people with untreated ADHD quite often do poorly in life. Did your editor go on vacation, or did you not have the sense to hire one?

Your comment about the look in your spouse's eyes matching the one you saw in your father's eyes should be a clue to you that you're doing something wrong. When one person thinks you have a problem, that's just an opinion. When more than one person thinks you have a problem, it's time to start checking to see if they're right. Guess what? They probably are.

Dr. Lawliss,

Aside from the fact that you can't write a sentence that really makes sense, this article is absolutely ludicrous. I have worked in the school system for five years, around hundreds of kids ages 5 to 18. I have seen ADD/ADHD in children, both undiagnosed and unmedicated, and those whose parents actually paid attention, read the facts, and elected to do the right thing for their child who was struggling.

Not all children with ADD need medication. Some have very mild forms, and can do well with lots of structure, one-on-one time, lists, etc. But those who, day after day, can't sit in the chair for more than a few seconds, constantly disrupt the class by running around, blurting out inappropriate things, spacing off looking out the window half the day, doing poorly on tests and assignments because they can't attend to the task, need something to quiet their mind, get them focused, and help them perform.

Medication. Time and again, I hear kids on meds saying that it's the first time in their lives their mind wasn't running at a thousand miles and hour and they could pay attention. I see confidence soar, as their grades improve, interaction with peers becomes easier, and they feel, well, "normal".

I have also seen undiagnosed, unmedicated child ADD blossom into adult ADD. I was married to it for 13 years. I say "was." He left, deciding he didn't have any problems at all, and that it was just me. All the money he wasted, the jobs he lost, the rages, the inability to remember crucial things like picking our children up from school, paying bills, and always blaming me. By the time he was an adult, the blaming and excuses to cover his own failings were so engrained in him since childhood that he couldn't see straight. He did better on meds. Didn't like them, so he quit. Said he didn't need them.

If ADD/ADHD is not properly diagnosed in children and properly treated, it becomes out of control adult ADD, accompanied by huge problems that affect a lot more people - in jobs, at home with spouses and kids, in communities. I do not have room here to enumerate the number of serious issues that arise because of undiagnosed/unmedicated ADD. It's naive to think that we ought to just sit back and enjoy the "creative" side of kids or adults with ADD, and let the rest go, or compensate for it ourselves, over and over and over.

Your words are exactly the kinds of things I would expect a person with ADD to say about your own disorder. People with ADD are notorious for being oblivious to the affect their disorder has on other people, and try really hard to throw "red herrings" around, trying to turn other people into villains. I hope parents out there who have kids struggling with ADD/ADHD aren't deterred by your words. You may be a "doctor", but it doesn't make you an expert.

I wish Psychology Today would find "real" ADHD experts for their ADHD blogs. Let me share the response by esteemed researcher, Dr. Russell Barkley, to the above study:

"...Even if we concede that the study suffered no serious methodological flaws, the fact remains that it provides evidence purely of a correlation association and not of causation. Other factors may be creating this association and not MPH use. This fact alone should lead to some skepticism about the conclusion that stimulants may cause an increase in risk for sudden death. Yet even if we assume that the association is in fact true, what then is the risk of sudden death in children on stimulants? It is most assuredly not the 1.8% found in the USD group here. This would mean that one out of every 55 stimulant treated children would have died of unexplained sudden death, which is patently false. To reach the actual risk we must calculate the likelihood of a child dying suddenly of unexplained causes (approximately 1-4 per 100,000 per year, or .00001-.00004) and multiply this by the likelihood that they were taking MPH in this study (0.18), and that comes to .0000018-.0000072) which is 1.4-7.2 cases of unexplained deaths per million children treated with MPH per year.

If this is a true signal of a relationship between MPH use and sudden death, it is of such an extraordinarily low relationship as to make it nearly impossible to detect against the background rate of sudden unexplained deaths in the general population of children, which is about 10 per million cases per year at a minimum. In other words, the original expert panel reviews by the FDA and Health Canada conducted in 2007 probably got the conclusion right when they did their evaluation of this issue correctly. They examined the frequency of sudden death among stimulant treated children compared to the background rates for sudden death in the general population. They concluded that sudden death was not higher than the background and may well have been lower. The reason for the latter finding might well be attributed to the fact that children going on stimulants get medical evaluations that may detect risks for cardiac or circulatory disease or death and such cases do not typically progress on to stimulant treatment. This was also the conclusion of the analysis of Winterstein et al. (2007) in examining all Florida Medicaid claims in a 10 year period in which they reported no significantly elevated rates of sudden death in stimulant treated children.

In science, it is best to examine the totality of available evidence and not just that produced by a single study. Given previous studies, albeit also correlational in nature, that children taking stimulants did not demonstrate a greater likelihood of sudden death than children in the general population, we are faced with a pool of somewhat contradictory evidence – at least three analyses done correctly find no such association while the Gould et al. analysis done inversely found an exceptionally weak signal. This alone should lead us to be cautious about our conclusions until more research becomes available on this issue and not to issue sweeping conclusions much less hold press conferences on this issue."

Terry Matlen, ACSW
Author, "Survival Tips for Women with ADHD"
http://www.MomsWithADD.com