I Shrunk the Shrink and They Liked It

When I first began planning a personal/professional yearlong sabbatical in Melbourne, Australia I never expected that my experience with web-based telepsychiatry would profoundly change the way I treat children and their families.

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When Will We Be Able To Just Say No? America's Love Affair with Legal Amphetamine/USA Today Print Op-ED, May 13th, 2015

I've decided to create a new psychiatric disorder. Why not? Drug companies do it all the time.

Shire, which makes Adderall, won approval recently from the Food and Drug Administration to market its amphetamine drug, Vyvanse, for the treatment of BED. You haven't heard of it? Neither had many people, until Shire funded studies to get the binge eating disorder into the DSM-5 — America's official psychiatric bible of common life dilemmas translated into mental disorders. My disorder is called achievement anxiety disorder (AAD), and it explains the increasing reports of prescription amphetamine misuse most often in the form of Adderall abuse.

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Matthias, a seven year old patient of mine, had his fifteen minutes of fame (though some may describe it as infamy) when he was featured in a front page New York Times article called “One Drug or Two: Parents See Risk and Hope” on November 14, 2015.


I had been working with the Times reporter, Alan Schwarz, for over a year on different articles he had published in the New York Times on ADHD and medication. I felt I knew Alan well when he approached me asking for deep background for another long article. He was contemplating a piece to highlight the lack of scientific data supporting the common practice of using more than one psychiatric drug in children. Because we have virtually no evidence pro or con, in essence we “experiment” with our children when doctors add a second drug. In the course of our discussion I mentioned to Alan that at that very moment I was reluctantly considering prescribing two drugs to two of my patients. Matthias was one of them.

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