You'd think that after 30 years we might know something about how much of a problem tolerance is in the treatment of ADHD with methylphenidate (Ritalin), a stimulant medication. You'd think we'd have done to research to find out what happens when children take this medication for years.
You'd think. You'd be wrong.
One retrospective study done in 1989 on 108 boys with good responses, a highly selected group, seemed to show ongoing benefit without tolerance. It would have been interesting to see how well these children would have done with no medication at all. That's it.
On the other hand, the Google search on Ritalin and Tolerance had 190,000 hits today. Heck, some bored medical student could do a qualitative review of the Googleplex and compare it to the indexed literature. It could be exhibit A in the indictment of biomedicine. This is a topic of interest that is not being addressed by our research.
It boggles the mind. This is a scandal and a crime. All physicians and researchers ought to hang their heads in shame. Why aren't we screaming about this lack of work? (I mean, other than my screaming?)
I know the studies are terribly expensive and very hard to do. I suspect there's no tenure at the end of the tunnel. There's probably no NIH funding and no pharma money. I think I understand why we haven't done to the work. It's still a scandal. The way we do biomedicine is broken.