ADHD guidelines delayed by probe into conflict of interest

THE release of Australian draft guidelines for managing ADHD remains in limbo because a key US contributor is under investigation for conflict of interest.

Last week, the NHMRC divulged why the guidelines, developed by the Royal Australasian College of Physicians, have languished unpublished since being commissioned by the previous Federal Government.

“The NHMRC has subsequently become aware of a US investigation into an alleged conflict of interest involving a leading researcher in the area of ADHD, whose work is widely referenced in the draft guidelines,” a spokesman said.

The New York Times reported on 20 March, 2009, that the Harvard child psychiatrist, Professor Joseph Biederman, was under investigation by Harvard and the National Institutes of Health for violating research rules and allegedly failing to report consulting fees from drug manufacturers.

Professor Biederman is an author on a significant proportion of the 900 articles cited in the guidelines.

The delay has come to light after media reports sparked new concerns that ADHD treatments were causing psychosis in children. The TGA has argued adverse reaction reports had been conflated.   

To date, 330 adverse events have been reported for all ADHD medicines, and of those, 31 cases involved suicidal ideation but no completed suicides.

Dr Jon Jureidini, head of the department of psychological medicine at the Women’s and Children’s Hospital in Adelaide, said the new guidelines were a significant improvement and should be published immediately.

ADHD medications were being over-prescribed and should be restricted, he said.

“My concern is the evidence for the beneficial effects of ADHD drugs on anything but short-term symptomatic improvement is very poor, so you have to really question the harm/benefit ratio for those drugs.”