With anticipated widespread acceptance of revised diagnostic criteria in DSM-5, the bible of psychiatric diagnoses, researchers are now keen to examine the efficacy of treatment for prenatal attention deficit disorder (ADD-PN).
“We’ve already got the drugs. This will allow us to study the incidence and treatment of ADD in the womb (ADD-PN) using only the highest ethical standards in medical research,” said Dr. Erma Kidd, a psychopharmacologist on staff at Slamdunk Medical College and Hospital, one of the few remaining medical institutions in the country not underwritten by the pharmaceutical industry.
Researchers have known for decades that ADD (or ADHD, as it is sometimes called) carries a genetic predisposition. “We’ve been able to track this malady through generations of families. The trouble was that we had no good clinical criteria for prenatal diagnosis of the disease,” Dr. Kidd explained in a recent e-mail. “Publication of DSM-5 changes all of that. Now we can diagnose ADD-PN in the womb. And if we can diagnose it, treatment options are just around the corner.”
This late-breaking news comes on the heels of recent announcements that child psychiatrists, general practitioners, pediatricians and maintenance personnel working in their offices have been given the green light to treat preschoolers with powerful stimulant medications in an effort to improve quality of life—for them and for their parents.
Off the record, preliminary studies examining the efficacy of prenatal pharmacologic treatment for ADD-PN have been underway since last year. “It’s been exciting, but extremely tough on our research team,” Dr. Kidd wrote. “After devising modalities to administer methylphenidate-like drugs to a cohort of fetuses, we were forced to wait until the babies were born before we could adequately study their behavior and development.”
Nevertheless, preliminary data is promising. “Mothers who had methylphenidate infused into their amniotic fluid reported considerably less fetal movement during the third trimester of gestation,” Dr. Kidd said. “Indirectly, we infer that the drug was helping these fetuses to calm down, to become less impulsive and more focused in the womb.”
Subsequently, some of the subjects have been born; and the data so far is impressive. Developmentalists report that when compared with their peers, many infants in the research cohort seem to be able to rest comfortably in feeding chairs in front of daytime television game shows for longer periods of time. They also exhibit less interrupted sleep, and coo and babble only when prompted.
“Imagine, babies genetically destined to suffer from ADD throughout their lifetimes, who now at only 2 months of age show less impulsivity when vocalizing with their parents. They wait to be recognized before speaking; and even then, their remarks seem to be much more age appropriate.”
The future looks bright for these children. “No more food fights at the dinner table, no more negative behavior at bedtime,” Dr. Kidd added. “We’re working hard to make it a better world for parents, for all of us.”
Still, some clinicians exercise a word of caution. “When it comes to the grey matter of the human brain, nothing is black and white,” one researcher commented. “In these clinical trials, nothing is a slam-dunk.”
Apart from stock options which she has yet to exercise, Dr. Kidd has disclosed no contractual relationships with any of the major pharmaceutical companies who market methylphenidate in their product lines.
Brian T Maurer's Weblog 