American Academy of Pediatrics Guidelines for Treating
Disorders in Children with Ritalin Ignores Evidence of Cancer
Samuel S. Epstein, M.D.
following was released by Samuel S. Epstein, M.D., Chairman of the Cancer
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
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.
SOURCE: Cancer Prevention Coalition