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Thoughts on ADD/ADHD Medications
Note: All of the "Thoughts on..." pages represent Safer Child opinion and/or advocacy efforts. Remember: we aren't psychologists, psychiatrists or social workers. Our thoughts come from experience, observation, feedback and research. If you aren't interested in our opinion or advocacy efforts (and we aren't offended if you aren't), you can still obtain the information you're looking for from the other pages. If you would like to comment on anything we've said, please do so. We'd love to hear from you and learn from you, and we thank you for visiting our site. This article, and all other articles posted on our Web site, are protected by copyright and may not be reprinted or distributed without express permission from Safer Child, Inc.
Silence in the ranks -- To Safer Child, one of the most striking things we've discovered about Ritalin (and other ADD/ADHD medications) is that public debate about it among child health or advocacy organizations has been muted or even non-existent. We feel that -- whether or not these organizations have concluded that there is a problem -- they should still be notifying parents, educators and especially doctors about the questions being raised. Perhaps we aren't looking in the right places. Perhaps seeking information on their Web sites isn't the best way to get it from them. Perhaps some organizations are reluctant to weigh in on this issue until all the dust is settled. Perhaps they have chosen a view and now decline to discuss the matter further. Perhaps a debate is raging that isn't being made public. We aren't sure why the information isn't easily accessible, but we're deeply troubled by the "no comment"s we've been getting. Debate is necessary -- Safer Child feels a public debate on these drugs is timely and worthwhile. We accept professional opinion that ADD and ADHD are real conditions that sometimes require real medication, and we accept professional opinion that Ritalin and other drugs like it offer relief to families who've exhausted all other avenues. It's entirely possible that the truth is somewhere in the middle, causing people on all sides of the issue to believe that everyone else is confused. Perhaps the drugs are both under and overprescribed. Perhaps controls are both too tight and too loose. Perhaps the drugs are both helpful and harmful. We just don't know. But we would like to see more talking about it. It's important to know of the view of Ritalin taken by the U.S. Drug Enforcement Administration, Department of Justice. On its Web site, the DEA lists Methylphenidate (Ritalin) as a "Drug of Concern" and says this about it: "Methylphenidate, which is manufactured under the brand name Ritalin, is a Schedule II stimulant that produces pharmacological effects similar to those of cocaine and amphetamine...A growing number of incidents of abuse have been associated with adolescents and young adults who are using MPH for its stimulant effects: appetite suppression, wakefulness, and increased focus/attentiveness (for long nights of studying), and euphoria...MPH also produces dose-related increases in heart rate and blood pressure and is capable of producing severe psychological dependence." See our Expert Voices page for information from the DEA on ADHD and Stimulant Abuse in School-Age Children. Fortunately, we are beginning to see articles about ADHD and medications in popular literature, such as magazines and newspapers. People are beginning to wonder, to ask questions, to press for answers. In October 2001, the American Academy of Pediatrics issued a new policy on Ritalin and on how to diagnose attention deficit/hyperactivity disorder (ADHD). Ritalin is approved by the AAP for treatment of ADHD as long as the treatment goals are clear and the children are properly monitored. The AAP already had issued recommendations for doctors to diagnose ADHD only by using the American Psychiatric Association's "Diagnostic and Statistical Manual," Fourth Edition (DSM-IV). Meanwhile, Safer Child encourages you to make sure that before you accept a diagnosis of ADHD and especially before you fill a prescription for medication, your child has undergone a complete physical exam to rule out other any other possible causes of the behavior (such as hearing or vision problems, insufficient sleep, chronic dehydration, snoring or sleep apnea, lead poisoning, giftedness, sexual abuse, poor discipline, etc.). According to the experts: ADHD should not be diagnosed in a 15-minute visit. If your doctor doesn't want to do a complete exam, consider finding another doctor. Symptoms should be present for at least 6 months BEFORE diagnosis. It is not recommended that children younger than 6 years old take stimulant medications such as Ritalin or Adderall, since their safety and efficacy in young children has not been determined. And, if medication isn't working, or if it's making your child's behavior worse, consider obtaining a second opinion. Besides the fact that ADHD medications can have a negative effect on children who don't need them, it's also possible for medications to conflict with each other or for medications to improve one symptom while worsening another. If you have anything you'd like to pass on to us, we'd be very pleased to hear from you.
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Safer Child, Inc. is a 501(c)(3) charitable organization with federal tax-exempt status. Please note: 1) External organizations listed herein do not necessarily endorse Safer Child positions, nor do we necessarily endorse theirs. We list them as a courtesy and aren't responsible for their accuracy, completeness or content. 2) We recommend you maintain a healthy skepticism when reviewing information on the Internet; it might appear to be reliable -- yet actually be false, misleading, incomplete, out-of-date and/or intentionally harmful. 3) There might be material on the Internet that you disagree with or find objectionable; preview all sites before viewing them with your child. 4) We are not responsible for external addresses/phone numbers changing without our knowledge. 5) The information and commentary on this site are not substitutes for professional advice from your doctor, lawyer, or mental health professional. 6) Requests for permission to republish, copy and/or distribute any material found on this Web site should be directed to Safer Child, Inc.
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