Ritalin and ADHD

Removing the Riddles

Fewer medications have been so widely praised and misunderstood as Ritalin. There seem to be many misconceptions and myths about its benefits and risks for treating ADHD. So just what is the truth behind Ritalin?

The clinical name of Ritalin is methylphenidate ('meth–ill–'feni-date). Although Ritalin is usually prescribed for children who have been diagnosed with attention–deficit/hyper–activity disorder (ADHD), it can be prescribed to other individuals who have an abnormally high level of activity.

The National Institute of Health (NIH) estimates that up to 5% of all children — or about 2 million — have ADHD. Two–to–three times more boys than girls are affected. An average of at least one child in every classroom in the U.S. needs some help for this disorder. Left undiagnosed or untreated, ADHD can continue into adolescence and adulthood, leading to a lifetime of emotional problems.

Ritalin is one of many medications that can be prescribed to treat ADHD. Others include the lesser–known medications such as Dexedrine, Dextrostat, Adderall, and Cylert. These latter medications, unlike Ritalin, are dextroamphetamines, not methylphenidates.

How Does Ritalin Work? Like many medications, Ritalin stimulates the central nervous system. Although its effects are much stronger, they have been compared to caffeine or less potent amphetamines. Ritalin amplifies the release of dopamine in the brain. This improves the ability of those whose dopamine signals are weak to focus and be more attentive. Ritalin has a significant calming effect on hyperactive children and helps them focus on the task at hand.

Ritalin comes in short–term tablets (whose effects last about three–to–four hours) and sustained release tablets (whose effects last up to eight hours). These are more practical for children, since they may need medication only during the school day, special events, or other situations such as exams that may require medication.

Are There Any Negative Side Effects? When taken as prescribed, Ritalin is usually a very safe and effective medication. Research shows that show with ADHD don’t become addicted to stimulants when Ritalin is taken in the medically prescribed form and dosages.

One study indicates that boys with ADHD who are treated with medications like Ritalin are less likely to abuse drugs or alcohol when they are older than those boys with ADHD who aren’t medicated with Ritalin.

On the other hand, another study conducted on laboratory mice seems to indicate that using Ritalin or Ecstasy may increase future sensitivity to cocaine. This seems to come from the effects that Ritalin has on the part of the brain associated with reward, according to the researchers. It should be noted, however, that relatively high doses of Ritalin were used for this study, making the finding more relevant to people who abuse Ritalin than for those who take it as prescribed. Some myths that persist about Ritalin are just that — myths. These includes the following, adapted from the National Institute of Mental Health (NIMH):

• Myth: Stimulants such as Ritalin lead to drug addiction in later life.
• FACT: Stimulants help many children focus and be more successful at school,home,and play.Avoiding negative experiences now may actually help prevent addictions other emotional problems later in life.

• Myth: If a person responds well to Ritalin, it proves the person has ADHD.
• FACT: Ritalin allows many people to focus better and improve their attentiveness, whether they have ADHD or not. The improvement is just more noticeable in those with ADHD.

• Myth: Medication should be stopped when the child reaches adolescence.
• FACT: About 80% of those who need medication as children still need it as teenagers, and 50% will need medication as adults.

Is Ritalin Abused? Those to whom it hasn’t been prescribed are the ones who most often abuse Ritalin. Most use it for its stimulant effects to suppress the appetite, bolster wakefulness, enhance focus and attentiveness, and increase feelings of euphoria. When Ritalin is abused, the tablets are usually crushed and taken orally or nasally ("snorted"). Some abusers have been known to dissolve the tablets in water and inject it; this is especially dangerous for the abuser since fillers in the tablets are not water–soluble and can block small blood vessels.

Because of its potential for abuse, the Drug Enforcement Administration (DEA) has placed strict controls on the manufacture, distribution, and prescription of Ritalin — as well as on other stimulant medicines. Not only does the DEA require special licenses and restrictions for these activities, states can enforce additional restrictions, including limiting the number of dosages per prescription.

Is Ritalin Over-prescribed? Some have questioned the increase in the use of Ritalin for children with ADHD. Because Ritalin has been advertised directly to parents by it manufacturer,some feel they have been misled into thinking Ritalin can solve all of the children’s behavioral problems; even school personnel have pressured parents of problem children into using Ritalin. High–profile efforts to under–cut Ritalin through lawsuits (which have been dismissed) have given rise to a lot of misconceptions about how ADHD is diagnosed and treated.

The most important step in diagnosing ADHD is to have a medical or behavioral health professional trained in such a diagnosis to provide it. This minimizes the chance of an incorrect diagnosis and can help identify non–ADHD conditions that parents or school personnel might not be aware of. For example, allergic reactions or low blood–sugar conditions can cause symptoms that an untrained professional can mistake as ADHD.

When a trained professional diagnoses ADHD and a subsequent prescription is provided, it’s likely that Ritalin will help not hinder the child. Despite the effectiveness of Ritalin regarding ADHD, it isn’t a magic pill by itself: additional efforts to modify behavioral problems — such as behavioral therapy — play a crucial role as well.

It’s natural that you as a parent should be concerned about any medication your children are taking. Understanding the benefits and potential risks of any medication is an absolute necessity.

Remember that you can learn more by calling your EAP 24–hours a day, 7–days a week, with any other questions or concerns. You’ll have our undivided attention.