Consumer Reports on Vacuum Cleaners? Maybe. On ADHD Medications? Definitely Not!

Like me, you’ve probably consulted Consumer Reports when it comes to purchasing appliances. But would you trust them for advice on medically treating your ADHD? Given their latest press release, I certainly hope not!

It starts with this (and just gets worse):

“Parents should be skeptical if their doctors offer them free prescription drug samples, especially for the treatment of attention deficit hyperactivity disorder (ADHD). Free samples can hook consumers on high-priced brand name drugs that are not any better or safer than less expensive generic medicines.”

This is serious, folks — exactly the kind of issue that makes my heart pound when talk turns to cost-cutting and healthcare reform, that ADHD will end up on the cutting-room floor.

Consumer Reports medical advisor, John Santa (pictured right), apparently has made his career out of helping states to cut medical costs (for example, the Oregon Health Plan), and from this perspective, he’s decided that you that you don’t need expensive medications like Concerta, Adderall XR, and Strattera (you know, the medications that might have made all the difference in your world). You can do just as well with generic dexedrine and methylphenidate (you know, the medications that gave many of you the heebie-jeebies or other intolerable side effects). Does Santa have any experience treating ADHD? Did he talk to any ADHD scientific-medical experts? Does he have any clue as to the negative impact of this broadside? To me, it’s an obvious NO.

Maybe you’d need to have heard as many horrible-side-effects stories as I have to be simply outraged at Consumer Reports’ arrogant ignorance. For example, I receive e-mails from people with ADHD in foreign countries where nationalized health systems, for cost reasons alone, limit medications to those choices touted by CR. And they have the side effects to prove it, often to the point where they simply give up on medically treating ADHD and hope that one day their country will catch up to the U.S.

Now Santa and his Consumer Reports elves want to be the Grinches that Stole Clarity here in the U.S.? To save states some money? Do they realize the long-term costs they are risking in leaving ADHD untreated — or poorly treated? Moreoever, do they realize that the medications they recommend are those most likely to be abused (not typically by people with ADHD but others)? Can people with multiple advanced degrees truly be this bone-headed? Well, you know the answer, sorry to say.

If you do well with the short-acting stimulant medications, good for you! But know that many other people with ADHD don’t.  The start-stop, up-down nature of activation and deactivation can feel like a neurochemical roller coaster.  Then there’s the pesky matter of having to remember to take four or more short-acting pills daily. For children, this often involves trips to the nurse’s office and suffering stigma because of it.

Moreover, as any experienced physician can tell you, generics can wreak havoc with that narrow “therapeutic window” — the dose that works best with the least side effects. A few miligrams up or down can mean trouble, and the FDA allows a wide window of efficacy.  In the U.S., the FDA  requires the bioequivalence of the generic product to be between 80% and 125% of that of the original product. Bioequivalence, however, does not mean that generic drugs must be exactly the same (“pharmaceutical equivalent”) as their original product counterparts, as chemical differences may exist.

(For more information on the “therapeutic window” with ADHD medications, click here for Dr. Charles Parker’s post on that subject at Core Psych Blog.)

Moreover, branded drugs and their generics almost always contain different dyes, fill materials and binding — ingredients to which many people are allergic or have other adverse reactions. (And while I have no proof that it’s true, abundant anecdotal reports indicate that people with ADHD seem more prone to these sensitivities.) Imagine what happens when your pharmacy changes suppliers on a regular basis (and this happens at many pharmacies). Imagine when your physician has no clue that it’s the filler that’s the problem and not the medication — or some “unmasked” co-existing disorder, like bi-polar. Talk about neurochemical roller coasters! Consumer Reports tests cars, so you should trust them that this is a safe ride? Not on your life.

Some days, it’s hard to face the newspapers when it comes to ADHD-related issues. The ignorance is just overwhelming, matched only by the selfish grandiosity of some renegade researchers and grandstanding politicians (but I’ll save that for another day). Just when I think we’re making progress, some nincompoop threatens to set us back 50 years. Please fight back, however you can.

• Cancel your Consumer Reports subscription and tell them why.
• Write a comment below.
• Or send your comments to Consumer Reports and John Santa care of the contact person on the press release: Kristina Edmunson of Consumer Reports Health, +1-202-719-5923, kedmunson@consumer.org

Be sure to share any comment you send below, too!

Gina Pera