If Altropane's prognostic indications were only that simple!
While I agree that ADHD is grossly over diagnosed, I really don't see how a dopamine-transporter (DAT) tag (i.e. Altropane) is going to alter the current level of cases. Altered DAT levels and/or activity is correlative to ADHD, not causative. Can ADHD occur without DAT alteration? For the foreseeable future, the initial/primary diagnosis of ADHD will be by psychiatrists and psychologists. These patients then may be referred to a clinical setting where their DAT levels (and probably many other things) are measured to evaluate if the correlation holds up. I don't envision a reversal of this sequence occurring for a VERY long time. And without the reversal, the number of cases in highly unlikely to decline.
In contrast to what BLSI may want you to believe, ADHD appears to present a multiple-neurotransmitter profile that refuses to be squeezed into an easy mold. Furthermore, alterations in DAT levels may be associated with other psychiatric (and non-psychiatric) conditions and it's unclear just how much variation there is in DAT levels across the population. Also note that the effects of cocaine, methamphetamine, and other drugs are mediated through alterations in DAT activity/levels; there is also the strong likelihood there are tightly regulated internal systems which can alter DAT expression and distribution. In other words, there's a decent possibility, in a broad population, Altropane may produce a large number of false positives and false negatives...if physicians rely solely on Altropane as 'an objective, biochemical basis for diagnosis of ADHD.'
Just as there are no magic bullets for the treatment of most neurological diseases, there are few easy diagnostic tools for complex behavioral syndromes such as ADHD. It also appears that BLSI is not alone in the field ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10793238&dopt=Abstract (an immediate question should be apparent: are there drugs that would produce the same change in the DAT readout...but would provide NO BENEFIT TOWARDS ADHD? If so then DAT-probes such as Altropane are, by definition, not broadly diagnostic of the condition) The abstract also presents the diagnostic sequence outlined above quite clearly.
Don't believe the hype put out by BLSI (and they certainly haven't cornered the market in biotech hype): a DAT marker will not, and should not, alter the number ADHD diagnoses. Since the condition remains poorly understood on a biological/biochemical level, a single diagnostic measure should never be granted unwarranted importance regardless of the loftiness of the goal.
JMVVVHO
(BTW, the use of Altropane towards Parkinson's disease may be the application to focus on. Now THAT could be a real winner...if BLSI gets there first.) |
