Ritalin

[cgallery]

What are your takes on Ritalin?

I used to think that many of the kids that were on it just weren't properly disciplined at home.

I had no evidence other that what I observed with my own two eyes: Behavior that my parents would have never tolerated from me, nor that I would tolerate from my kids, was going uncorrected.

I also was surprised to hear of some kids taking the drug that I had previously thought were perfectly normal. No, they weren't 4.0 students. But they weren't wild, either. Well-behaved, not overly noisy, normal kids (I thought). So I kinda thought it was way over-prescribed.

But I have seen kids where I thought it might truly help, and parents that are reluctant to have it prescribed for a list of reasons (stigma, admission of failure to correct the behavior yourself, etc.).

What are your thoughts on this drug?

What would you tell a reluctant parent (friend) that was being pressured to stick their son/daughter on Ritalin when the kid was struggling and likely to have to attend summer school or even repeat a year of school?

And what about nutritional deficiencies? I have read that deficiencies in some minerals (magnesium, for example) can result in behavior issues. I only bring it up because I think a number of kids I see with behavior issues are really, really, thin. They're often very picky eaters and I wonder if they're getting all the vitamins and minerals they need.

[Ed62]

I'm sure there is a place for meds, but I think many of them are way overly prescribed. Kids, for the most part, seemed to make it OK without them for quite a long time. Sometimes I think the docs just think it's the "in thing", and if they don't prescribe something, and there is a problem, they might be sued. It's a shame we live in this kind of world.

Ed

[scmhogg]

My youngest was on Ritalin or dexedrine from age seven until 18. He has an very high IQ. But he was so disorganized in thought and manner he was having difficulty in school and at home.

The meds made a real significant difference. As a test, his pede told us to give him a cup of sweet coffee just before bed time, if he slept, we should go see the med shrink. It worked.

Ritalin and dexi's are appetite suppressants. Our, already, skinny kid had to gain weight or he would be taken off the meds. The doc said give him lots of "dirty calories".

Steve

[phi1l]

I though religious topics were off limits ....

I have seen a lot of positive & negative press on Ritalin. It can have some unacceptable side effect in some...


Actually, I think use of prescription meds. in kids should be a matter between the Dr. & parent. I suspect that in some cases the drug may be being used to remediate ineffective parenting. And also as mentioned, parental ego may be preventing use where it may be effective.

Parenting is way different today than when I grew up. Spanking is now not PC. I wonder what jail I might be in if that was the case back then

[Mr__Bill]

Lets replace ADHD with Diabetes. Now see if the arguments on not taking drugs to control things are still valid.

In the simplest of terms, ADD or ADHD is when the mind tries to process all the sensory input at the same time giving everything the same priorities and is unable to do so. Why is irrelevant at this point. Ritalin helps to provide the means for the individual to prioritize. How is irrelevant at this point. When the individual can prioritize the input they are able to put some input to the background and concentrate on just a few things. They are to the observer less distracted and able to focus.

Ritalin is only half of the solution, the other half is learning how to use the abilities that Ritalin gives the individual.

ADD is a sliding scale sort of thing. Unlike death where you either are or aren't. It's very hard to properly diagnose, ironically the easiest way is to prescribe Ritalin and watch the results, takes about 30 minutes.

The ADD individual is often described as a hunter in a farmers world. The epitome of ADD is a cat. Which brings us to another attribute of ADD, Hyper Focus. You may be able to sit and do your work and monitor what is going around you and give attention to things as necessary. Perhaps a baby crying, the phone ringing or juicy gossip from the next cubicle. The ADD person takes in everything and never gets the work done, unless they slip into a hyper focus mode where they blot out everything but what is in front of them. Thus the ADD person may not be aware of anything around them but that which they are focused on. Like the hunter who had gone from waiting and looking for prey to being focused on taking the kill. We see this as the kid lost in a video game, adsorbed in a book or the child who finely settled down in class but who is really miles away in his head focused on something else.

What's my take on Ritalin? To the child who needs and will benefit from it not giving it is the same as child abuse. Is it over prescribed? Yes.

Kids do not grow out of ADD. They learn to mask it. As adults the ADD individual can make use of Ritalin and often be a far happier person.

Down sides? Yup. Many, not the least of which is coming down from it at the end of the day. For the child it's really no different than you needing time to decompress at the end of the day. There is a period where the person feels control slipping away and frustration sets in. If you have a child on Ritalin you want this time to be between homework and bed, ah hour of video games will do wonder for everyone.

ADD seems to run in the family and it's not just a boy thing. If your child had been diagnosed with ADD or ADHD take a long look at yourself and your parents. Do you make it through the day on coffee? Caffeine is the poor mans Ritalin.

There are lots of positive things about ADD too but first the individual must be able to function in the non ADD world. While it's possible for some to do so without the benefits of Ritalin and similar drugs, withholding the drug from the vast majority of those dealing with ADD is just cruel. Imaging if everyone with diabetes was denied insulin because a lot of people can control it with diet modification, so you should be able to do so too.

bill
should have taken the meds first thing this morning....

[pierhogunn2]

I legally used the stuff well into my twenties, when, after a couple of formulation switches, I got very depressed and at one point, the point at which I took myself off of it, suicidal...

The ability to finish a task was great, and a welcome relief from the tedium of having mom or dad sit on me, quite literally in some cases, to finish my homework. The loss of a lunch time apetite made saving my lunch money up a nice bonus

the crippling mothly migraine wasn't a deterrent enough to keep me from taking it.

The pediatrician's test is a great idea

ritalin, et all has its place, but not to the degree it is used today to "control: our children. and it allows for lazy teachers and parents.

My aunt, a double masters in education, knows how to handle the ADHD among us and has even taylored some of her cirriculum to work for these kids... with amazing results

so I am not against it by any means, but believe it should be used with caution and planning

[germdoc]

Both of my sons were on Ritalin for over a year in their mid-teens.

For my older son it was like night and day when he was on it. He was able to focus and get his work done, the end of major behavioral issues. He on his own initiative weaned himself off it his senior year and actually wrote an essay about it for his college admissions application. He is now an engineering student at UW, still somewhat disorganized, but doing VERY well in school.

My younger son did see improvement as well, but he was on Concerta--a long-acting form--and had literally a psychotic reaction last year requiring hospitalization. In retrospect it seems to have been the cumulative effects of this medication, and lack of sleep--was sleeping only 2 hours a night for several weeks. He has been off for over a year, still has attention issues, but knows what he needs to do to focus and get his work done. He has to struggle more than my older son however. We discussed going on a different form of Ritalin and he did not want to do that.

Bottom line: as a parent or doctor I would consider Ritalin for any child (or adult) who met criteria for ADHD on a trial basis. Allow patient to participate in decision-making, keep going to cousellor or psychologist for behavioral issues, be aware of side effects--hallucinations, weight loss, etc. Also realize different forms act differently and can have different side effects. They're not all the same.

[Knottscott]

I have no doubt that ADD/ADHD are over diagnosed, and Ritalin is overprescribed, but there are some kids that truly have bio-chemical and psychological issues that go far beyond the environment the kids are raised in.

We have six kids, all raised in a loving practicing Christian home, by their stay at home biological mother and biological father...basically a fairly old fashion traditional, reasonably strict middle class American home. All six kids are bright healthy kids, but one of the six (possibly the brightest and most talented) was simply "out of bounds" for a good portion of his life. He suffered issues at school, behavioral problems, hyper-activity, depression, OCD, drug and alcohol abuse as he got older, and many other impulsive and detrimental behaviors that we largely unable to stop, discourage, or otherwise effectively discipline for. We tried everything we could possibly think of starting at around age 7, including several doctors and eventually medication. He was smart enough to smooth talk most of the doctors for several years before he finally started to realize that his problems were real and that the doctors were trying to help. It's hard to know how well the medication worked (Ritalin, Adderal, anti-depressants, mood stabilizers, etc), because by time he was old enough for medication, he was also old enough to find ways to self medicate with other substances, and he's never really given the medications a fair shake. To this day we still don't know exactly how to categorize the issue(s) he's faced, but he clearly had some problems that most kids don't face. He's off on his own now, at our request, trying to make a go of things, but I fear it could be years before he reaches his potential if he ever does.

[radhak]

Lets replace ADHD with Diabetes. Now see if the arguments on not taking drugs to control things are still valid...
....
....

Every once in a while, this forum shines through in offering perspectives that is not available anywhere else. This thread is one such.

Bill (and others) - thanks for putting your thoughts and experiences here. It helps ignorant goonks like me understand stuff like this better.

[pierhogunn2]

One more note, avoid Concerta like the plauge, even though the active ingredient, methylphenidate-hydrochloride is the same, the other bits and pieces that go along with it are put me in a state of mind where I was counting the steps to the top of the parking deck where I worked to test the theory of gravity in a very personal and final way...

good old ritalin is just fine, I don't know the effective half life of the drug in the system.

statera was also fine, different control mechanism, but still effective, just watch for strange genital discharge, you don't want to know really

but avoid concerta at all costs, if your doc sings it's praises, and you agree to take it, please watch your child closely, very closely...

[gsmittle]

One more note, avoid Concerta like the plauge, even though the active ingredient, methylphenidate-hydrochloride is the same, the other bits and pieces that go along with it are put me in a state of mind where I was counting the steps to the top of the parking deck where I worked to test the theory of gravity in a very personal and final way...

I wasn't diagnosed with ADD until my mid-forties. In school I was one of those "good kids" who didn't bounce off the walls. Instead, my mind was miles away practically all the time.

I started with Ritalin, but moved to Concerta. The problem with the Ritalin is its effects last about four hours, requiring me to take it three times a day to make it through a full school day. Concerta is once in the morning and I'm good to go for the next 14 hours or so. Coming off it is a bear, though.

I still hyperfocus from time to time. In fact, when I direct a play, my student director has standing orders to insist we take a break after 90 minutes. Otherwise I'll go for six or seven hours without noticing it.

Sometimes I'll start in my shop in the early morning and eventually wonder how it got dark so quickly. I didn't stop to eat or go to the bathroom, sometimes for twelve hours.

Sorry to hear about the urge to test gravity. I'll agree that all these meds can have different effects on different people; watching carefully for side effects is not just a good idea, it's necessary.

I know for my sons, Concerta has made the difference between straight-A students and being really, really frustrated.

Any drug should be a last resort, after all else (behavior mods, study skills, etc.) has failed.

Do I think it's over prescribed? Probably. Can I tell when some of my students have skipped their meds? Most definitely.

g.

[charliex]

Mr Bill and someone else mentioned coffee. Long story short.... 2 - 4 Lattes / cappuccinos a day plus on occasion an extra cup of Intense French coffee or triple espresso to bring things into focus. I can wake up at 2 AM have a latte and go back to bed and fall right asleep. When I was younger I would have been a poster child for Ritalin. If I didn't focus I was bouncing of walls. As I got older and learned focus I was able to accomplish a lot as I careened from one task to the other. On weekends and vacations my quick breakfast and then work til the extremely late dinner without break drove anyone I worked with nuts. On the job, one nice thing about focus is that the work day or in my case night went really fast. Now it's time in the shop. The only problem now is I don't have the energy.

Chas

[JSUPreston]

Man, this topic really hits home with my. We're going through this with both my boys.

The older (10 1/2) was obviously ADHD from the moment he was conceived. He ran marathons before birth. Once born, as soon as he had the motor skills, he would take anything and make straight lines out of it. We would find Hot Wheels/Matchbox car trains as long as he had cars, and they were almost always perfectly straight. He would know if you swapped the position of two cars. Was very OCD. Through a long, heartwrenching process we leaned that he is not only ADHD, but also had in effect childhood bipolar disorder, which he got from his mother (SWMBO). We learned of the bipolar after he threatened to hurt himself when he was 7 or 8 with a pair of scissors pointed at his heart. He is on meds for both the ADHD and the bipolar.

Our younger son (just turned 8) was recently diagnosed as Autistic (some of you guys have given very good advice on that thread I created just before Christmas). Before the Autism diagnosis, he too was diagnosed as ADD. He really tends to hyperfocus and is easily agitated when something breaks his train of thought. I have seen him so hyperfocused that he has wet his pants trying to stay on the task as long as possible. As someone else has said, he really tends to hyperfocus on computer/video games. He takes meds for the ADD, which does help him to level out a little.

SWMBO has ADHD and is bipolar. She takes meds for both conditions. I have often been told that I am ADD, and I do tend to hyperfocus and get very agitated when I have my train of thought broken. Sometimes a 5 minute break will result in hours of missed work for me, because it takes me so long to get back on the task I was working on. Like someone else said, I can get to work on something and not take a break for hours and will often miss meals and skip bathroom breaks for an extended amount of time.

Sounds like a trip to the doctor for me may be in order. As I get older, it's getting harder for me to focus on things, or I will try to do too many things at once. Right now, I am building virtual servers for an offsite DR project, reading the forum, checking e-mail accounts, researching new software for mainframe connectivity and looking at the owner's manual for my saw, while also thinking about the rummy game I will be joining in a few minutes during lunch. Oh year, I'm also visualizing what I need to do at home to finish out the doorway I replaced over the weekend.

In our situation, we actually waited longer than we should to put our first son on meds. My wife didn't want to have to put him on something because of some of her experiences. I was a little more open to the idea, but still skeptical. I did wind up having to just about force her to allow us to try the meds for ADHD for him. The improvement was almost instantaneous. We both were open to the other meds after the incident with the scissors. On our younger son, we knew something was right all along and were willing to try the ADD meds as soon as others told us he may need them. We were just frustrated that no one took us seriously about the Autism and that it took nearly 8 years to find someone willing to test him for it.

Thank you guys for all the insight on this topic. Now...off to lunch and that rummy game.

[dbhost]

When I was a child, what they now call ADHD was simply called "hyperactive", and LOTS of kids were "diagnosed" as hyperactive, myself included. Treatment was simple in concept, VERY difficult to actually do. Remove all processed sugars, white flour, and chemical additions from the diet.

As an adult we call that sensible eating, as a kid I seem to recall thinking of it as torture...

I bet if mom & dad would get the candy and soda out of the house (sugar and caffeine), and actually disciplined their kids then the kids would be better behaved.

I think the whole Ritalin thing is being pushed by parents unwilling or unable to deal with proper diet and discipline, schools too overburdened and looking for an easy fix, and drug companies more than happy to dope up little Johnny...

There ARE some kids mind you, that TRULY NEED some sort of help beyond common sense stuff. But that number is I am willing to wager, a FAR cry below what is out there with the whole ADHD thing... Either that or there is something HUGELY wrong going on with the gene pool and humanity is doomed.

[JSUPreston]

Db, I know where you're coming from. In our case, given genetics, restricting the sugars and junk foods and limiting the amount of carbonated beverages helped a little, but unfortunately wasn't enough for our boys. I do agree with you that a lot of times, it's just the parents wanting little Johnny to sit around and be the perfect, quiet angel all day and would rather medicate that discipline. Sometimes getting the kids involved in athletics helps with getting out some of the energy and lets the kids be kids. Both of ours are in karate (neither one would really make an organized sports team...no skills thanks to me) which does help. Cub Scouts really helps our autistic son, but we're not sure if the older son is going to continue Scouting now that he has his Arrow of Light.

The one thing I've learned from all of this is that you can't just look at the child to see what they might need. You've got to look at the entire family and figure out what is going on with them to be able to properly diagnose and help a child out.