Parents with children who’ve been diagnosed with ADD or ADHD have a difficult choice to face: should we medicate?

Therapy in combination with medication is widely believed to produce the best results in terms of behavior and academic achievement. Side effects can be an issue, though, and many parents dislike the idea of putting their child on a psychiatric medication.

Now a larger question looms: do the medications currently used to treat ADHD even work?

The New York Times this weekend ran a major article critiquing the use of medication for ADHD in kids. It’s an opinion piece, but one written from the vantage point of considerable authority by a therapist who has been researching children with ADHD for 40 years.

His assessment of the current state of ADHD treatments is frightening. Especially if, like me, you take Ritalin every day to manage your own attention problems.

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Will my daughter need medication for attention deficit disorder?

When my daughter was just two years old, her Montessori teacher told my husband and I that something was going on. She wasn’t sure what it was, but based on her decades of teaching she could see that my sweet girl wasn’t interacting in the classroom the way other 2-year-olds did. Rather than getting her hands into everything, making a mess, touching and manipulating things, she’d head off to the far corner of the room and bury her face in a book.

It’s hard to know exactly what is going on with a two-year-old girl who isn’t quite able to express her frustrations or feelings. What we did know was that Madden had always had trouble sleeping, was fairly restrictive with her eating, and avoided doing anything that required fine motor work. She wasn’t interested in scribbling or using utensils or anything of the sort.  At first I thought she was just quirky, but when her teacher shared her concerns, it was time to find out more.

We took Madden to see an expert developmental psychiatrist who spent time observing her and said she did not have autism or Asperger’s, but that it was likely she did have sensory processing disorder. The psychiatrist said that our daughter needed occupational therapy, and that we would have to wait until she grew older to see if there were any other issues we’d need to pay attention to. Continue reading »

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Ritalin is being prescribed to kids as young as 4

All four-year-olds are pretty active. Jumping around, flitting from story-time to play-time to a tantrum, spacing out, it’s all part of the preschooler territory. Is it ever appropriate to medicate kids that young for attention deficit disorder?

Some doctors think so, while others don’t.

In the U.K., a growing number of very young children are being given Ritalin and other ADHD medications in defiance of NHS guidelines. The Guardian ran a piece on this over the weekend.

U.K. guidelines are that behavioral and family therapies should be the first treatment for ADHD, with medications used as a last resort and only for children over 6. Why do doctors defy those guidelines?

In part because the medications work. They get a fast, clear response that can take years of behavioral therapy to match. Still, given side effects like stunted growth and loss of appetite, one wonders if they’re ever appropriate for very little kids.

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Ritalin gave me back a huge part of my mind

I sat down to work. I got up to get a glass of water. I remembered an important bill I needed to pay, and logged into my bank’s website to pay it. Before I’d finished that task, I’d gotten distracted by a book I’ve been meaning to review, sitting on my desk. Less than a chapter into the book, I IM’d a friend with a question about plans for this weekend.

And so it went, until I remembered a key detail: I’d forgotten to take my Ritalin this morning.

Now I’ve taken that little pill, and my workday has run smoothly since. Is it really so simple? Sometimes, yes. Drugs can be the answer. Or at least part of the answer.

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Many of our kids are off at camp for the summer. Some have even taken the plunge and gone to sleepaway camp.

Found Magazine shows off stuff that they, you know, find. Hence the title. Someone found a letter that a camper wrote to her parents. It’s quite something. Continue reading »

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Some disturbing new evidence is coming to light about the stimulant drugs, such as Ritalin, used to treat kids with ADHD. In a small number of children, the drugs have caused sudden death; in fact, kids treated with these drugs are seven times more likely to die suddenly than kids who are not.

Madelyn Gould, a professor of clinical epidemiology at Columbia University/NewYork State Psychiatric Institute, was asked by the FDA to look at the safety of ADHD drugs after some reports of deaths started coming in. She examined the death records of 1,128 children from 1985 to 1996 and found those taking stimulants drugs were much more likely to die.

However, Gould herself doesn’t recommend taking children off the drugs; instead, she suggests that parents make sure their pediatricians thoroughly screen their children for  cardiovascular abnormalities before putting them on the drugs. Doctors should take a full family history and do additional screening if the child has risk factors for heart disease. They should also be monitored regularly to check for any alarming increases in blood pressure.

Even if the risk is small, it’s pretty scary. But as someone who’s lived with untreated ADD, it really affected my performance in school and can make even day to day life as an adult more difficult than it has to be. It’s just another tough choice we have to weigh as parents – don’t treat something that can very negatively affect our kids, or treat it but worry about the higher risk. Parents of kids with ADD or ADHD, what do you think? Are there other things you’ve tried that work or don’t work as well?

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