5/8/2000 – Secret files protect dangerous doctors

Secret files protect dangerous doctors

HARTFORD, Conn. (AP) _ A little-known government database
tracking malpractice suits and disciplinary action against
physicians remains unavailable to the general public, and at
least one congressman says dangerous doctors have hidden
behind that shield of secrecy long enough.

But standing in his way is the American Medical Association and
a powerful medical lobby, The Hartford Courant reported in
weekend editions.

The newspaper, using a public version of the database which
does not have names or other identifying information,
nevertheless deduced the names of several doctors who have
repeatedly faced malpractice charges but continue to practice.
One such surgeon was nicknamed “Eric the Red” because of
the way his patients bled.

The Courant said it identified the doctors by comparing the
anonymous data in the database with court records, regulatory
files and other public records.

U.S. Rep. Thomas J. Bliley Jr., R-Va., chairman of the House
Commerce Committee, unsuccessfully championed legislation
this year that would have opened the National Practitioner Data
Bank to the public.

“Now is the time to open the data bank,” Bliley told The Courant.
“It is unconscionable that consumers have more comparative
information about the used car they purchase or the snack foods
they eat than the doctors in whose care they entrust their health
and well-being.”

Federal law prohibits anyone other than hospitals, health
maintenance organizations and licensing boards from using the
complete database.

In its Sunday editions, The Courant reported the Fairfax,
Va.-based data bank lists malpractice payments of $25 billion
against more than 100,000 doctors, or one of every six
physicians in the country.

At the top of list, the newspaper said, is Dr. Eric Scheffey, a
Houston orthopedic surgeon. The data bank shows Scheffey
involved in 29 malpractice payments totaling $8 million.

After the 1985 death of a back surgery patient, Scheffey’s medical
license was put on probation, but he was allowed to keep
practicing. The 1994 death of another patient resulted in five
more years’ probation from the Texas State Board of Medical
Examiners. He can still practice but cannot perform operations
without another surgeon present.

Residents in a hospital where Scheffey worked gave him the
“Eric the Red” nickname, court records show.

Scheffey could not be reached for comment Sunday. Phone
messages from The Associated Press were left with his
answering service, where an operator said he was unavailable
until Monday. Calls to a private listing went unanswered. He also
did not respond to several attempts by the newspaper to contact
him.

The AMA has fought to keep the data bank closed to the public,
arguing that malpractice payments are an unfair measure of a
doctor’s abilities.

“Even some of our nation’s finest physicians who specialize
high-risk cases are involved in settlements,” said AMA President
Thomas Reardon.

He said the data bank was intended to allow only regulators and
hospitals to flag problem doctors who move from state to state,
and the general public could misinterpret or overreact to the raw
information.

But the patients who must live with their doctor’s mistakes say
access to the bank is a matter of public safety.

Christine Hachey, a Scottsdale, Ariz., travel agent, said she was
not aware of any complaints against the eye doctor accused of
botching her surgery. Dr. Gary Hall, of Phoenix, had accumulated
more than two dozen malpractice payments totaling $5.3 million
before his state medical board prohibited him from performing a
certain type of surgery.

It came too late for Hachey, who now needs a large magnifying
glass to read. “This really makes me angry,” she told The
Courant upon learning of the data bank. “I never knew any of
this. I can’t believe the system is so secretive. How are you
supposed to know whether your doctor is any good?”

In a letter to The Courant, Hall said his insurance company had
settled cases “without my consent” and noted he had performed
25,000 radial keratotomy operations.

“Therefore, though the number of entries in the National
Practitioner Data Bank appears high, it still represents a very
small percentage of the total number of cases I performed,” he
wrote.

Copyright 1999 Associated Press. All rights reserved. This
material may not be published, broadcast, rewritten, or
redistributed.

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5/7/2000 – Anti-depressants get into water system

One more of my worst fears has just been confirmed. This is
exactly why I have allowed nothing but distilled or reverse
osmosis processed water into my home for years. It is also why I
have great concern over cities where the water is fluoridated.
With Prozac being 18% fluoride and it being a main ingredient in
Paxil, Luvox, Phen-Fen, etc. I am concerned that there may
possibly be a synergistic effect from the water that could throw
patients on these drugs into toxic reactions. My concern is that
no one has looked at this possibility with fluoride or any other of
the chemicals put into our city water supplies.

When it comes to drugs or chemicals and how they effect us and
our environment, society remains oblivious! We, like our
teenagers, tend to think we are invincible rather than human and
mortal.

Ann Blake-Tracy

Anti-depressants get into water system

May 7 2000 BRITAIN Roger Dobson

AN investigation is to be launched into the environmental effects
of pharmaceuticals amid new fears that tons of anti-
depressants and scores of other toxic drugs are polluting rivers,
threatening fish life and getting into drinking water.
Pharmaceutical companies are being given until the end of the
year to supply data on their drugs to the Environment Agency so
their impact can be researched.

Scientists in Europe have discovered that increasing numbers of
complex drugs – including heart medication, anti-depressants,
anti-epileptics, anti-cancer chemicals, cholesterol-lowering
medicines, sex hormones, antibiotics, hormone replacement,
aspirin, vitamins and ibuprofen – are surviving the human
digestive system, passing through sewage works and entering
rivers and the sea.

Dr Thomas Ternes, of Germany’s Institute for Water Research,
carried out sampling at one sewage works outfall and found 36
different drugs, plus five other compounds that had been
metabolised from them before they left the patient. Scientists are
blaming the drug pollution for some of the widespread and until
now unexplained mass deaths of tiny aquatic organisms. Some
drugs, especially anti-depressants, have also been found to
alter sperm levels and pawning patterns in aquatic life. Musks
and chemicals used in perfumes, and compounds from suntan
lotion, have been found to have accumulated in fish. Each year
in Britain about 600m prescription drugs and medicines are
dispensed.

Most of the research on environmental effects on drugs in rivers
has been done in Germany and Denmark; little has been carried
out in Britain. However, later this month at a world congress of
scientists in Brighton, the Environment Agency will lay down the
timetable for an investigation into the effects of the drugs. “We
have commissioned a review, which is due to be completed
within the next two weeks. There is limited data in Britain about
this issue and we don’t routinely monitor, said Dr Steve Killeen,
head of chemistry at the agency. “The report will make a series
of recommendations, including getting the pharmaceutical
industry to provide us with better information by the end of the
year. If we find that levels of drugs are causing environmental
damage, regulations are an option open to us.”

Stricter regulations could involve the need for more complex
sewage works to screen out the chemical compounds. A
conference to be held in America next month will also attempt to
quantify the problem for the first time. “Just about everything
people put into their mouth eventually gets into the water, said
Dr Christian Daughton, chief of environmental chemistry for the
US Environmental Protection Agency. “Serotonin, for example,
has been used to induce spawning in mollusks. Many
anti-depressants which are ending up in rivers are designed to
interfere with serotonin production in humans and may affect
spawning,” he said.

“Pharmaceuticals are perhaps also one of the reasons for
unexplained mass die-offs in some organisms that we see from
time to time.”

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5/7/2000 – Drugmaker: Breast Cancer Drug Linked to Death

Adverse Reaction
Drugmaker: Breast Cancer Drug Linked to Death

By Jessie Seyfer
The Associated Press

S A N F R A N C I S C O, May 5 — Pharmaceutical maker
Genentech Inc. has warned doctors that the breast cancer drug
Herceptin is linked to 15 deaths and 47 other adverse reactions
in patients.

In a letter to doctors sent Thursday, the company said the
adverse effects included allergic shock and extreme respiratory
distress.

“We sent the letter to oncologists to heighten their awareness
and educate them about infrequent adverse events that can
occur in certain patients,” Genentech spokesman Neil Cohen
said.

An estimated 23,000 patients have been treated with Herceptin.

Severe Reactions
Severe reactions to Herceptin had not occurred in clinical trials
before the drug gained Food and Drug Administration approval
in 1998, Cohen said.

But sometimes reactions can’t be foreseen in trials, he said.

“A lot of times you might see some safety issues once the drug
gets put into a larger patient population,” Cohen said.

Cohen said he didn’t know when the company first heard of the
deaths and reactions, but analysis had confirmed the link to
Herceptin.

Symptoms Seen Within 24 Hours
In nine of the 15 deaths, symptoms arose within 24 hours of the
time Herceptin was administered, according to the letter.

Genentech is working with the FDA to have the drug’s label
amended to reflect the new risks, Cohen said.

Herceptin is used to treat breast cancer patients that have too
many copies of the HER2 gene. A healthy version of this gene
produces a protein that signals cells to grow and multiply
normally. But in women with too much HER2, the breast cells
reproduce out of control and spread throughout the body.
Herceptin, an antibody, blocks excess HER2, shrinking and
eliminating tumors.

Copyright 2000 The Associated Press. All rights reserved. This
material may not be published, broadcast, rewritten or
redistributed.

http://www.abcnews.go.com/sections/living/DailyNews/breastca
ncer_drug0505.html

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5/1/2000 – PA Suit blames Prozac for suicide try

Suit blames Prozac for suicide try

By Jeff Swiatek

The Indianapolis Star

Last updated 11:58 PM, EST, Monday, May 01, 2000

A Pennsylvania woman and her husband have sued Eli Lilly and Co., charging
that Prozac caused the woman to attempt suicide in 1997.

The lawsuit, filed Friday in federal court in Pittsburgh, says Diane V.
Cassidy was prescribed Prozac by her family doctor in July of 1997 for weight
loss.

Three weeks later, Cassidy checked into a motel, slit her wrists and took an
overdose of a drug that damaged her brain, the lawsuit says.

Cassidy, 47, survived, but is brain-damaged and requires constant care, the
lawsuit says.

A co-plaintiff is Cassidy’s husband of 29 years, Melvin J. Cassidy. They live
in Monroeville, Pa.

Lilly spokesman Edward A. West said, “Prozac had nothing do with this woman’s
situation.” He added, “There is a real serious question about whether there
was a suicide attempt or not.”

The 23-page initial complaint asks for $4.84 million to cover medical
expenses, lost wages and life-care needs. Intangible damages also are sought.

The lawsuit accuses the Indianapolis drugmaker of negligence for not warning
doctors that Prozac can cause suicidal behavior in some patients.

Prozac, the nation’s top-selling antidepressant, is not federally approved as
a weight-loss drug, but the lawsuit says Lilly “has either actively or
tacitly encouraged doctors to prescribe Prozac for weight loss.”

The lawsuit joins a dwindling number of fewer than 10 product-liability
claims over Prozac. Five years ago, there were more than 150 claims. Most
have been dismissed, dropped or settled.

Handling the Pittsburgh lawsuit are Greensburg, Pa., attorney Lawrence D.
Kerr and Houston attorney Andy Vickery, who has three other Prozac lawsuits
pending against Lilly.

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4/30/2000 – Gumble’s Interview with MI Medical Examiner re: Ritalin

From Ann Blake-Tracy….

We sent you the news last week that Oakland County Medical
Examiner Dr. Ljubisa Dragovic in Pontiac, MI attributed a ten year
span of Ritalin use to the heart failure death of 14 year old
Matthew Smith.

Apparently for years the school had threatened to turn the family
in for neglect if the boy was not kept on Ritalin – a problem facing
far too many families today in a country that has been given
warnings by the United Nations because the United States uses
90% of the world’s Ritalin supply. This is going on in schools
that deceive us all by posting signs that read “Drug Free Zone.”
It would be far more appropriate to post signs that read “Drug
Zone.” I have always said it is so ironic that the police could
probably confiscate more “meth” raiding a school for
methylphenidate (Ritalin) than they would in shutting down a
meth lab.

Matthew’s chest pains and racing heart had been ignored as
warning signs that the small blood vessels that supply the heart
were being shut off by the Ritalin because, “You just don’t see
this in the younger population.”

On April 17, 2000 Bryant Gumbel interviewed Dr. Dragovic and a
psychiatrist who was attempting to defend psychiatry’s use of
Ritalin. Some very interesting points were made by Dr. Dragovic
in the interview that we would like to share with you. Some of the
most important points I have highlighted.

Ann Blake-Tracy
___________________________

GUMBEL: Matthew’s cause of death was officially listed as heart
attack. Why do you blame Ritalin?

Dr. DRAGOVIC: Well, because we found, at autopsy, changes
that were of significance, and these changes were particularly in
small blood vessels that supply the heart muscle. These
chronic changes, these are the changes that result from
long-term type of exposure to a stimulant like this.

GUMBEL: Could–could there possibly be no other cause for a
heart attack in a 14-year-old? No family history of heart trouble,
no–no possibility of drug use?

Dr. DRAGOVIC: Well, we did all the toxicological workup. The
only medication he was on was actually Ritalin, which is
methylphenidate. We certainly excluded all other disease
processes in his body. There was nothing wrong with the
14-year-old, other than the fact that he had some significant
changes, long-term changes in the small vessels that supply
his heart muscle. And I’m not talking about large coronary
arteries. I’m talking about arterioles. These are the smaller
vessels that, over a period of time, get really primed up by-by the
effect of this type of medication.

GUMBEL: I want to bring in our guest here. Psychiatrist Bill Koch
has prescribed Ritalin to thousands of patients. You’ve
characterized Dr. Dragovic’s views on Matthew Smith’s death as
a wild claim. How come?

Dr. KOCH: Unfortunately, with all due respect to the doctor, there
is absolutely no evidence that Ritalin causes vascular disease.
This medication has been around for almost 50 years. It’s been
used in millions of children, and there’s no evidence that it
causes heart disease. In fact, it has been cleared by the
American Heart Association as being very safe. They don’t
require even any monitoring, unless there is somebody who
already has heart disease. Among the patients that I see, I even
give it to people who have heart disease. I mean, obviously, if
they have heart disease pre-existing, they’re very carefully
monitored. But there is no evidence. In fact, one of the nice
things about Ritalin is that it has very little effect on the heart,
as
do some of the other stimulant medications.

GUMBEL: …Dr. Dragovic is there something you’re not looking
at?

Dr. DRAGOVIC: Well, I would like to remind my esteemed
colleague over there that in pathology, and particularly in forensic
pathology, we don’t come to a conclusion through a democratic
process of arguing the points. It’s the findings that dictate the
diagnosis, and they are there. We didn’t put them there. If there
is a better explanation I will certainly take it. To exclude the
possibility of effect on the heart of a known adrenergic agonist is
really a far-fetched type of expression. Unfortunately, we learn
through our mistakes, and the analogy can be found in Seldane,
or the cases of which I have deaths related to Seldane I have
investigated, cases of deaths of Parlodel, Bromocriptine and
things like that–we are just learning through the unfortunate
experiences, and…

GUMBEL: Let me ask you something. Where Ritalin is
concerned, will you have any pause about prescribing it from
here on?

Dr. KOCH: Absolutely not.

GUMBEL: And Dr. Dragovic?

Dr. DRAGOVIC: I’m not a psychiatrist. I’m a forensic pathologist
and a unipathologist. I’m a basic scientist. I have seven children.
I would never suggest or allow my kids to take it or anyone who I
know would I advise to take it.

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4/30/2000 – FDA Warns of Fatal Risks Linked to TriCitrasol

WASHINGTON, Apr 19 (Reuters Health) – The US Food and
Drug Administration (FDA) is warning US hospital pharmacies
and dialysis centers of at least one case of fatal cardiac arrest
linked to the unapproved injectable drug triCitrasol.

The agency issued its warning after learning of the fatality, in
which a patient went into cardiac arrest after receiving a 46.7%
concentration of the sodium citrate anticoagulant, which was
introduced into a hemodialysis permanent blood access
catheter. The catheter was implanted into the patient
immediately prior to the incident.

Rapid or excessive infusion of triCitrasol has been blamed for a
host of serious reactions, including fatal heart rhythm disorders,
seizures or bleeding due to loss of blood calcium.

The FDA is warning against the use of the drug with blood
access catheters. The agency said that it is currently reviewing a
number of additional cases that might be associated with
triCitrasol infusion when performing hemodialysis. The drug’s
manufacturer and its distributor are collaborating on the recall
effort.

Cytosol Laboratories, of Braintree, Massachusetts, markets the
drug in individual sterile, 30 mL glass vials and in catheter “kits.”
Medcomp, of Harleysville, Pennsylvania, distributes the kits
under the trade name Ash Split Catheter II, as well as the
individual vials. Medcomp is handling the recall of only those kits
and separate vials marketed before November 1, 1999.

“We have every single [catheter] kit tracked,” a Medcomp
spokeswoman told Reuters Health, noting that recall of the kits
began on April 9, followed by recall of the separate vials on April
14. The FDA claims that about 3,000 Cytosol catheter kits are
sold nationwide, although Todd Polk, Medcomp’s head of
regulatory affairs, would not confirm those numbers to Reuters
Health. Polk declined to speculate when the recall might be
brought to a close.

As to the question of whether Medcomp knew of the Cytosol
product’s status as an unapproved drug, Polk responded,
“obviously not.” The FDA said that alternative 4% citrate solutions
remain available for use in hospital pharmacies, hemodialysis
and other medical settings. The agency said that it is working
with Cytosol on a limited access plan, as the drug is still needed
in some cases to prepare white cells for transfusion.

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4/21/2000 – More Prozac Backlash

Here is a commentary that defends Dr. Joseph Glenmullen’s
book, Prozac Backlash, by Nicholas Regush, a medical features
writer for ABCNEWS. Mark

It appears today on the ABC News site:

More Prozac Backlash
Drug Firm Attacks Prozac Book, But Lacks Long-Term Data

Commentary
By Nicholas Regush

Prozac Nightmare. This is what I would have called Dr. Joseph
Glenmullen’s book on the vastly over-prescribed, so-called
miracle happiness pill and its cousins such as Zoloft and Paxil.
He was actually much too kind in dubbing it Prozac Backlash.

Glenmullen, who has a private practice in Cambridge, Mass.,
claims far too many people, including 28 million Americans,
have taken the new antidepressants that boost serotonin in the
brain. He claims that their numerous side effects, including loss
of sex drive and self-destructive and violent feelings, are poorly
tracked and long-term safety data sorely lacking.

He is also concerned these drugs can cause some brain
damage and cites effects such as loss of motor control and
grotesque facial and whole body tics.

Glenmullen emphasizes, however, that individuals who have
moderate to severe illness might benefit from these drugs.
Those with mild depression or the “worried well” should avoid
the potentially harmful effects of these drugs and seek
alternatives such as talk therapy, he says.

Company Denounces Book
But Eli Lilly and Company, makers of Prozac, have denounced
Glenmullen’s book as loaded with “omissions,” “half-truths,” and
“anecdotes.”

A call to Lilly provided me with an official company statement
about the book that pointed out Prozac “is one of the most
studied medicines in the world and often the first choice of
doctors.” Lilly, however, omitted the nagging fact that very little
is
known about their product’s long-term side effects.

Lilly’s statement goes on to say that Glenmullen discredits the
work of the Food and Drug Administration. But what does it
mean to discredit a government agency that does a pathetic job
of tracking drug side effects once a new drug gets on the
market? By the FDA’s own estimates, only some 1 percent to 10
percent of all drug side effects are reported to its surveillance
system.

The “anecdotes” or case reports that Lilly denounces in
Glenmullen’s book can be a tip-off of what might be happening
to many more patients. It seems to me that it is better to have
case reports that point to potential problems than rely on the FDA
to process a tiny fraction of harmful events caused by the new
antidepressant drugs.
The company also writes that Glenmullen attacks the work of
research scientists, academic medical institutions and doctors.
In his indictment of the health care system, he apparently finds
collusion, conspiracy and ineptitude around every corner.

Valid Criticisms
Having read Glenmullen’s book, I can’t recall any conspiracy
theories. He does, however, do a very fine job of pointing out how
inept the drug approval and drug tracking systems are in this
country and that medical researchers financed by the drug
industry are on FDA advisory boards and sometimes even vote
on drugs that they helped to research.

Which brings me to Lilly’s suggestion that I contact several
doctors “who are available for comment on the book.” The first
one I reached was Dr. Jerrold Rosenbaum, director of outpatient
psychiatry at Massachusetts General Hospital, in Boston.
But wait, did he read Glenmullen’s book? Oh, only about 60 to 70
of the 386 pages, he said. (He “thumbed through” some other
parts of it). “There’s nothing new in this book,” he said. “There
are gross exaggerations.”

Rosenbaum also objected to Glenmullen’s suggestion that St.
John’s Wort might serve as an alternative for some patients who
are mildly depressed. True, this herbal approach to depression
needs more science behind it — but then so does Prozac. Did
Rosenbaum see anything of value in the small parts of the book
he read and thumbed through? Yes, Glenmullen offers some
ideas in the book “that are reasonable for fair debate.” For
example, maybe Glenmullen is correct in writing that the
managed care system gets too many people on
antidepressants because that’s often the cheaper approach.
Talk therapy, for example, can cost a bundle.

No Long-term Data
Dr. Anthony Rothschild, a psychiatrist affiliated with University of
Massachusetts Memorial Health Care, in Worcester, Mass.,
didn’t much care for the book either. He says he read most of it.

“The book ignores years of experience of the safety and efficacy”
of the serotonin boosters, he says. Really? I thought the book
included the strong argument that it would be really neat to have
long-term safety and efficacy data so that we can have some real
experience with these antidepressants.

Whose years of experience is Rothschild referencing here,
anyway? Considering that large numbers of users of these
drugs take them for more than a year, let’s not get too huffy and
puffy about people questioning their safety, particularly over the
longer term.

Yes, Glenmullen’s book may at times seem too insistent on the
value of case reports (often from his own patients), and, yes, his
interpretations of some of the scientific literature might differ
from those who strongly support the use of these
antidepressants.

But in the end, he raises important questions that will become
increasingly difficult for Lilly and its doctor pals to duck.

Perhaps the federal government needs to do long-term studies
on the impacts of these drugs as the pharmaceutical companies
have little incentive at this point to do it because the drugs have
been on the market for several years.

Someone has to care about the long-term effects.

http://www.abcnews.go.com/sections/living/SecondOpinion/seco
ndopinion.html

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4/17/2000 – Heat deaths related to medication raised

The inability to handle heat has been a common report from
patients for years with the serotonergic medications. Many
patients also find that it continues after coming off the
medication. Now the Dallas Morning News brings us some
insight into the dangers of that reaction.

Ann Blake-Tracy
————————

Heat deaths related to medication raised
Dallas Morning News (April 17, 2000).

DAYTON, Ohio – Findings from health authorities have doubled
the number of deaths related to psychiatric medications taken by
the mentally ill during last summer’s fierce Midwestern heat
wave.

New figures from the U.S. Centers for Disease Control and
Prevention in Atlanta and the Cook County medical examiner’s
office in Chicago show that at least 23 of the estimated 300 dead
were mentally ill people who took medicines that made them
especially vulnerable to death from intense summer heat.

The total could be higher because not all coroners where heat
deaths occurred performed toxicology tests. The medications
interfere with the body’s thermo-regulatory system, hazards
known to physicians but seldom publicized.

Common drugs included Mellaril, Elavil, Prozac and Zoloft.

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4/17/2000 – Ritalin May Have Led to Boy’s Death

Medical Examiner: Ritalin May Have Led to Boy’s Death
Monday, April 17, 2000

THE ASSOCIATED PRESS

PONTIAC, Mich. — A medical examiner says long-term use of
Ritalin, a drug used to treat hyperactive children, may have led to
a 14-year-old boy’s death.

Matthew Smith collapsed at his home on March 21 while playing
with a skateboard and was pronounced dead at a hospital a
short time later. Oakland County Medical Examiner Ljubisa
Dragovic concluded that the boy died of a heart attack the likely
cause of which was 10 years of taking Ritalin for attention deficit
hyperactivity disorder.

“This was a gradual development,” Dragovic said Sunday in The
Oakland Press. “There were changes that occurred in the small
blood vessels that supply the heart muscle.

Smith’s family told Dragovic the teen-ager occasionally
complained of chest discomfort and racing heart, signs that
something was wrong, the medical examiner said. “This is not a
heart condition, which could have been diagnosed just like that,”
Dragovic said. “You just don’t see this in the younger population.”

But Dragovic’s naming of Ritalin as a suspect in the boy’s death
is being questioned by some experts who say the drug has been
shown to be extremely safe. Ritalin is a popular brand name for
the stimulant methylphenidate, believed to increase a child’s
alertness by stimulating the central nervous system.

Joseph Biederman, professor of psychology at Harvard
University and a longtime researcher of stimulants, said
Dragovic’s conclusion was unfounded.

“It is a free country and people can have whatever opinion they
want,” Biederman said. “But Ritalin has a long history of safety
unparalleled by any other drug.”

Cardiac side effects to Ritalin are rare and don’t include death,
said David Rosenberg, a child psychiatrist with Children’s
Hospital of Michigan in Detroit.

“There have been reported increases in blood pressure and
pulse that aren’t clinically significant,” Rosenberg said. “But I
would want to avoid it in someone with an underlying heart
condition.”

Biederman, who also is chief of pediatric pharmacology at
Massachusetts General Hospital in Boston said it is not unusual
for people to take Ritalin their entire lives.

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