The Dangers of Ritalin

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Over the past hundred years, advances in medicine have greatly increased our ability to identify health defects. We have become experts in symptoms, able to link cause and effect like never before. As patients, these advances have meant several things for us - more comprehensive exams, more specific diagnoses, more treatment options, and more immediate treatment. However, these advances and their benefits have drawbacks as well.

Says Mr. Tom Bennett, a teacher at Raine's Foundation School in London,

"The advances of the 20th century have engendered an irrational faith in medicine as the solution to every ache and pain, not just life threatening emergencies."

Mr. Bennett is concerned about the students in his classroom being medicated with Ritalin - the most popular prescription treatment for the ever-climbing number of people diagnosed with ADD or ADHD.

Uncertain Cause and Effect

Eloquently put, but far from novel, Mr. Bennett's concern is one that many have voiced. There's an undeniably subjective nature to dis-ease, especially when it comes to mental ailments. At what point does behavior move from normal to abnormal? Are we getting a diagnosis too quickly? Is prescription treatment of ADHD really best for the recipient, even if it does produce better behavior?

Professor of sociology, Frank Furedi has his doubts:

"We still don't know to what extent we are disempowering kids when we turn to pharmaceutical solutions to solve our existential problems. If children do not learn how to contain their behaviour in a more nuanced way, we are storing up problems for the future"

Professor Furedi strongly believes there is more causing the trademarked impulsivity, hyperactivity and inattentiveness of attention deficit than just born traits. Indeed, attention deficit has been tied to a number of factors outside heredity - diet, environment, activity levels, TV-viewing, and parenting all seem to play a role. Furedi worries that by turning so quickly to medication, children are being robbed of valuable life lessons and personal responsibility for their actions.

Beyond this even, is a worry that attention deficit has become the go-to diagnosis for difficult children. It's concerning that even in true cases of impaired functioning, a diagnosis of attention deficit may not be correct. If this is the case, medication may hide symptoms that would allow a more accurate diagnosis to be made. The fact is, attention deficit shares symptoms with many other problems. Problems like depression, anxiety, bipolar disorder, malnourishment, problems at home or school, and normal personality differences can all produce symptoms of ADD/ADHD - and they are often misdiagnosed as such.

A Difficult Decision

Despite worries and uncertainties, most everyone can agree that when a problem is recognized, regardless of cause and regardless of the labeling - ADD, ADHD, anxiety, or personality quirk - when there's a problems, something should be done to help the child achieve their personal best. The solution however, is more difficult to agree on.

Ritalin can have extraordinary and almost immediate benefits for children and the adults responsible for them. You'll have no problem finding praise stories of the drug. There are countless parents, teachers and students with stories of complete turnarounds in performance - from hyperactive and disobedient to quiet and focused. Furthering its appeal, Ritalin, unlike the alternative of psychological therapy along with diet and lifestyle changes, requires almost no effort or time dedication.

Tim Bown, assistant head at Queens Park School puts it this way:

"Ideally, schools would prefer to offer intensive one-to-one support, but if the resources are limited - which they usually are - then we're pushed into a choice between medication or exclusion."

Help At What Price?

Leon Perry, a 13 year old former pupil of Mr. Bennett, is taking Ritalin. At age 6, Leon was a rambunctious and challenging child at home and at school. He had trouble with aggressive and disruptive behavior in class. Yet, it wasn't until his school gave his mother an ultimatum - find medication or get another school - that he was prescribed the drug.

Both Leon and his mother were reluctant to start treatment, but even Leon admits,

"I can get a bit hyperactive when I come off. I'll be honest - I can be violent. When I'm on my tablet, I think before I act, when I'm off, I think after. If teachers get on my nerves, I'll say what I want. When I'm on my tablet, I can't be bothered."

Said Mr. Bennett of his former student,

"His book was a disaster zone of scrawls and graffiti. Once medicated, his classes were undoubtedly saved from years of further disruption and his teachers spared a world of pain."

Shining testimonials of Ritalin's benefits, yet, neither student or teacher are sure the benefits outweigh the costs.

"I know it helps me in some ways, but I hate taking it, Leon explained, there are days when I deliberately avoid it. You just don't feel yourself. You feel so drained out. It makes you feel disgusted and down. Like you've got no soul or something."

Mr. Bennett noticed the same thing from his own perspective.

"He became a ghost of his former self and drifted around school and through lessons for years... He seemed to have lost the will to live....The only loser in the equation was the pupil, who seemed drugged into stupidity."

Unfortunately, this experience is one commonly noted by teachers and their students taking Ritalin. Ms. Sally Wright, an elementary school teacher, would like to see a change from prescription treatment to behavioral and psychological therapy.

"When they are given Ritalin, says Ms. Wright,"it either saps them of their personality and turns them into almost zombie- like children, or it has hardly any effect at all. In my experience, it is virtually impossible to generalize the impact it will have."

Beyond its strange zombifying effects, Ritalin can cause a number of problems.

One of particular concern is the way it inhibits growth. According to recent research, children taking Ritalin for just 3 years are, on average, one inch shorter and six pounds lighter than other children. To correct this, doctors will often recommend drug vacations or an extended break from the prescription. Unfortunately, these recommendations are often ignored by caretakers who have become used to their child's behavior on Ritalin. Doctors also warn parents to remain conscious of Ritalin's more common mild side effects and to seek medical attention if Ritalin's more rare serious side effects occur.

Other side effects listed as "mild" include:

• Digestive Problems. Loss of Appetite, Stomach Pain, Nausea and Vomiting
• Nervous System Problems. Insomnia, Dizziness, Headache, Numbness, Tingling, Cold Feeling in Hands and Feet
• Vision Problems.
• General Health Problems. Sweating, Skin Rash, Weight Loss, Fatigue (after the Ritalin has worn off)
• Mental Health Problems. Depression and Anxiety.

Side effects listed as serious include:

• Heart Problems -  Fast, Pounding, Uneven Heartbeat; Dangerously High Blood Pressure (Buzzing in Ears, Shortness of Breath, Uneven Heartbeats, Chest Pain, Severe Headache, Confusion, Anxiety, Blurred Vision, Seizure)
• Purple Spots on the Skin, Easy Bruising
• Headache, Fever and Sore Throat with Severely Blistered, Peeling, Red Skin
• Mental Health Problems. Aggression, Restlessness, Hallucinations, Strange Behavior, Motor Tics and Twitching
• Feeling Like You Might Pass Out And/Or Passing Out

Great Expectations

And if Ritalin's side effects weren't enough to make you rethink a prescription, the results of a new study from the University of Buffalo might be. The shocking new study has shown that even some of Ritalin's benefits may just be all in our heads!

In their study, pediatric psychologists prescribed a medication for children whose parents suspected attention deficit. What these parents didn't know however, was that the medication their child was receiving was actually a sugar pill.

At the beginning and end of the test period, parents were asked to rate their child's behavior, their expectations of them and their relationship with them. The remarkable results showed that, despite their child receiving no actual medication throughout the test period, parents viewed their children more favorably and had more positive relationships with them after the study was completed!

"The act of administering medication, or thinking a child has received medication, may induce positive expectancies in parents and teachers about the effects of that medication, which may, in turn, influence how parents and teachers evaluate and behave toward children with ADHD. We speculate that the perception that a child is receiving ADHD medication may bring about a shift in attitude in a teacher or caregiver. They may have a more positive view of the child, which could create a better relationship. They may praise the child more, which may induce better behavior," speculates lead author of the research, Dr. Daniel A Waschbusch.

A Better Way?

You may be wondering what other options are out there.

"I don't want to risk the side effects of Ritalin, but my child's success is important to me. If I choose not to medicate my child, is there anything else I can do to help them with their impulsivity, hyperactivity and inattentiveness?"

The short answer? 

YES! You can ABSOLUTELY help your child be as successful without prescription drugs!

Just don't expect results overnight.

Doctors are beginning to better understand the roots causes of attention deficit symptoms, and as their understanding increases, the number of treatment options and the effectiveness of those options do as well. Natural therapy takes time and effort, but those who have gone through it feel the benefits (and lack of side effects!) are well worth it. Alternative care will most likely start with behavioral/psychological therapy for the child AND the parent. Sessions will help teach the child valuable coping skills and help parents more effectively help their children.

There will most likely be some lifestyle changes recommended.

• Expect to reduce screen time:
  • TV
  • Movies
  • Video Games
  • Computer Games
  • Internet

• Expect diet changes as well:
  • Avoiding sugars
  • Avoiding caffeine
  • Adding nutrient supplements

If your child attends school, your therapist will provide you with support to help them succeed there and help you discuss treatment with their teacher. Already some schools are catching on and adopting a new drug-free approach to attention deficit. Different behavioral strategies like on-the-spot rewarding, for example has been shown in studies at Nottingham University to produce a response similar to medication in attention-deficit children! In fact, there are multiple studies that show a positive impact when a classroom-based intervention occurs.

Unfortunately, the number of teachers being trained for attention deficit is still very low, and with the suggested 30 hours of in-service training required, few schools will pursue this. Schools have a limited budget, and without parental push for training, they're unlikely to spend the necessary money for it. A real shame, especially considering just how many students the training would positively affect! While most teachers would be willing to work with you to support the needs of your child, you can do even more when you let your school know how important the success of your child and this training is for you.

Sources:

http://www.guardian.co.uk/education/2010/may/11/ritalin-adhd-drugs

http://www.tes.co.uk/article.aspx?storycode=6043074

http://3stepsadd.com/premium/addadhd-drugs-and-the-placebo-effect-shocking-new-research/

http://www.wrongdiagnosis.com/a/attention_deficit_hyperactivity_disorder/misdiag.htm

http://www.drugs.com/ritalin.html

http://en.wikipedia.org/wiki/Methylphenidate