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Attention Deficit Disorder in Adults

A new drug could help people who have trouble focusing. But it's likely to sharpen the debate on the prevalence of the disorder and how it's diagnosed.

February 10, 2003|Valerie Reitman | Times Staff Writer

DIFFICULTY concentrating? Getting along with your spouse? Weaning yourself from the Internet or that computer game to get your work done? Or thinking about all those things you have to do instead of focusing on what you're reading right now?

Pharmaceutical giant Eli Lilly & Co. thinks its new blue, gold and white pills might help.

The Indianapolis drug maker has been heavily marketing the drug Strattera, also known as atomoxetine, for attention deficit/hyperactivity disorder. It's the first drug approved for ADHD in adults as well as children, and a surprising number of adults -- including doctors, lawyers and chief executives -- may benefit.

For The Record
Los Angeles Times Friday March 07, 2003 Home Edition Main News Part A Page 2 National Desk 1 inches; 39 words Type of Material: Correction
Psychologist's name -- In a Feb. 10 Health section article on a new drug for attention deficit disorder, the first name of psychologist Robert J. Resnick was left out. He runs a clinic at Randolph-Macon College in Ashland, Va.
For The Record
Los Angeles Times Monday March 10, 2003 Home Edition Health Part F Page 8 Features Desk 1 inches; 37 words Type of Material: Correction
Psychologist's name -- In a Feb. 10 story on a new drug for attention deficit disorder, the first name of psychologist Robert J. Resnick was left out. He runs a clinic at Randolph-Macon College in Ashland, Va.

The roll-out includes Lilly-sponsored informational sessions with psychiatrists and physicians nationwide to educate them about the condition and, of course, encourage them to prescribe the drug. And it promises to draw attention to a syndrome that is largely undiagnosed, but possibly endemic, in adults. In fact, the drug could do for ADHD what Prozac, another Lilly drug introduced in the late 1980s, did to highlight an epidemic of low-grade depression across the country.

The new spotlight on ADHD, however, also promises to dredge up skepticism about whether such a syndrome actually exists and whether society -- which has come to expect chemical relief for everything from anxiety to sexual dysfunction -- is simply looking for a quick fix to smooth out personality quirks and discipline problems and improve concentration.

Critics charge that society has tilted too far toward helping people who say they have ADHD. Patients under treatment can get extra time to take their college entrance and professional boards and win protection from being fired -- even if they're disorganized or can't complete projects on time -- under the Americans With Disabilities Act.

Meanwhile, Lilly and many psychiatrists claim that as many as 4% of American adults -- about 8 million people in the U.S. -- suffer from ADHD.

Adults whom psychiatrists say have ADHD might charitably be described as "organizationally challenged." They have lightning-short attention spans and perhaps a propensity to engage their mouths before their brains. They might fidget and daydream much of the day and find boring and passive activities particularly challenging. Few people like to balance their checkbooks, but those with ADHD just can't seem to make themselves do it.

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Equal-opportunity disability

Though they might be good at conceptualizing ideas and adept at socializing, when it comes to the details, they often just can't execute until the last minute, if at all, says Dr. David Feifel, director of the Adult ADHD Clinic at UC San Diego School of Medicine.

Though there are many criminals and chronic job-hoppers who are said to suffer from it, ADHD is an equal-opportunity disability, according to several psychiatrists interviewed for this article. Patients include every sex, race, age and socioeconomic status, and surprisingly many successful professionals, such as chief executives, doctors and lawyers. (Despite its name, it doesn't necessarily involve hyperactivity, a symptom often seen in young boys with the diagnosis, but that often isn't present in girls or adults.)

"They are people who ... have the No. 1 qualifying factor: underachievement," says Dr. David Comings, director of medical genetics at City of Hope National Medical Center in Duarte. "They are not as successful as their motivation, efforts, intellects and abilities would seem to indicate."

Some people compensate by gravitating toward professions that are less detail-oriented, provide constant variety, and require short bursts of attention rather than sustained day-in-and-day-out concentration and organization. For instance, if they become doctors, they might choose to work in an emergency room -- where constant activity provides plenty of stimulation and isn't boring -- rather than doing cancer research. Others cope by surrounding themselves with efficient secretaries, assistants and spouses, or simply work or study longer to compensate for their lack of concentration.

Lew Mills, a San Francisco psychotherapist who works with ADHD patients, says he was 40 when he realized he'd had the disorder since childhood. He might have three projects going on a certain day, he says, and might do one and forget the other two. "It feels like there are always a lot of balls in the air and I'm trying to catch as many as I can."

But the ADHD diagnosis in both children and adults itself is controversial. After all, couldn't most of us be more successful? Don't we all have personality traits that make some of us more detail-oriented and organized and others perhaps more gregarious and better at envisioning the big picture?

With life becoming so much more complex, with so many distractions, many people feel more overwhelmed than ever and may be prone to seeking chemical relief.

Some doctors dismiss ADHD as a concoction of drug makers out to make money.

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