Posted on 02/06/2005 1:22:18 PM PST by cinives
It is estimated that in the United States between 4 million and 8 million children are on Ritalin, the drug being used to change the behavior of children afflicted with a disease or condition called attention deficit disorder or attention deficit hyperactive disorder.
We already know that the long-term use of Ritalin can be fatal. In March of 2000, a 14-year-old ninth-grader, Matthew Smith, dropped dead of a heart attack while skateboarding. He had been on Ritalin since the first grade. And in 1994, the very popular singer and songwriter Kurt Cobain committed suicide at age 27. He was known as a "Ritalin child."
What parents are not being told by psychiatrists who prescribe the drug and the school nurses who give it to the kids is that taking Ritalin is like playing Russian roulette, simply because nobody can be sure what the side-effects will be.
Recently, I happened to come across a copy of the latest Physicians' Desk Reference on pharmaceuticals. It lists all of the drugs available to physicians and provides the drug's clinical pharmacology, indications and contraindications, warnings, precautions, adverse reactions, etc. So I looked up Ritalin. Its generic name is methylphenidate hydrochloride. It comes in two forms, a regular tablet and a time-release tablet. It was described as follows:
Ritalin is a mild central nervous system stimulant. The mode of action in man is not completely understood, but Ritalin presumably activates the brain stem arousal system and cortex to produce its stimulant effect. There is neither specific evidence which clearly establishes the mechanism whereby Ritalin produces its mental and behavioral effects in children, nor conclusive evidence regarding how these effects relate to the condition of the central nervous system.
So we really don't know exactly how the drug works in the brain, but the book warns:
Ritalin should not be used in children under 6 years, since safety and efficacy in this age group have not been established. Sufficient data on safety and efficacy of long-term use of Ritalin in children are not yet available. Although a causal relationship has not been established, suppression of growth (i.e., weight gain and/or height) has been reported with the long-term use of stimulants in children. … Clinical experience suggests that in psychotic children, administration of Ritalin may exacerbate symptoms of behavior disturbance and thought disorder.
Was the student killer at Columbine who took Ritalin psychotic? If so, he should not have been given the drug.
As for adverse reactions, otherwise known as side effects, this is what the Ritalin user may also experience: Nervousness, insomnia, skin rash, urticaria (itching, burning, stinging, smooth patches usually red), fever, arthralgia (pain in a joint), exfoliative (flaking) dermatitis, erythema (skin redness), multiforme with histopathological (microscopic changes in tissues), findings of necrotizing (death or decay of tissues), vasculitis (blood vessels) and thrombocytopenic purpura (purplish patches), anorexia, nausea, dizziness, palpitations, headache, dyskinesis (impairment of body movements), drowsiness, blood pressure and pulse changes both up and down, tachycardia (rapid heartbeat), angina, cardiac arrhythmia, abdominal pain, and weight loss during prolonged therapy. There have been rare reports of Tourette's syndrome (tics). Toxic psychosis has been reported.
If that isn't playing Russian roulette with a child's health, I don't know what is. Note the number of cardiac side effects, probably caused by the constriction of blood vessels. That's what probably caused the heart attack that killed Matthew Smith. We only hear about the worst tragedies. Skin rashes, headaches, dizziness, nausea and palpitations don't make the headlines; they just make the users miserable.
Why would anyone subject a child to a drug with so many possible harmful side effects simply to "cure" an attention problem? How about creating classrooms with more order and fewer distractions. The kind of chaos that now exists in American primary schools is a result of the new classroom configuration that creates attention problems.
You couldn't possibly have attention deficit disorder in the kind of classrooms that existed when I went to school back in the 1930s and '40s. In those days, the students sat at desks bolted to the floor arranged in straight rows. The walls were generally bare, with no distractions. The teacher was the focus of attention, and we were all taught the same thing. No individual education plans. And the teacher used the most rational and effective methods of instruction developed over the centuries. It was an education system that produced what Tom Brokaw called the greatest generation.
In other words, they knew how to educate well. We really don't have to re-invent the wheel. But try telling that to today's educators, for whom the successes of the past simply don't exist.
Dr. Samuel L. Blumenfeld is the author of eight books on education, including: "Is Public Education Necessary?" "NEA: Trojan Horse in American Education," "The Whole Language/OBE Fraud" and "Homeschooling: A Parents Guide to Teaching Children." His books are available on Amazon.com. Back issues of his incisive newsletter, The Blumenfeld Education Letter, are available online.
And this is from what likewise source without an agenda - like, not having a practice making money from ADHD, not taking grant money from drug manufacturers, not having a career as a biopsychiatrist ?
Oh, and not paying for the FDA studies that "prove" rare side effects. We see how that has worked with Prozac and Vioxx.
thanks for letting me know you aren't calling me a liar.
why would i make this up?
All i know is what the interventional radiologist and the pediatric neuro-surgeon told us, at the New York Presbyterian-Columia Hosp. in New York City. As for the dr. who prescibed it, what was he supposed to do, have brain scans done every few months?
the side effects listed does mention -blood vessels-.
anyway, i was just sharing our experience. everyone are free to make their choices.
My son was diagnosis with having a brain chemical imbalance. A drug based solution helped him tremendously.
"So his point is, since there are other ways to manage the behaviors that make up the ADHD diagnosis, there is no need to give a drug with known negative side effects."
Yes there is a need for those that truly need it. But, it should not be considered the only solution.
"Also, you say this drug gives "enormous benefits" - I would like a copy of or reference to the study, peer reviewed and published, that shows these benefits over, say, 5-10 years of usage. To the best of my knowledge, the only studies in existence lasted only 14 weeks, and their conclusion was that the benefits did not endure after 14 weeks."
The problem with this study scenario is that a child should not take this medicine continually for more than 10 years. As they get older they learn to control their behavior, the medicine assists them with this learning.
"He has commented that ADHD is overdiagnosed and pushed by teachers looking for an easy behavioral out of discipline issues. You'd need to read more of his writings to get his overall message."
This is a problem that needs to be taken up with school boards.
"An additional point is that Ritalin has the same effect on people who have not been diagnosed as ADHD and who are just looking for a performance enhancement on tests, exams, etc - in other words, a time when you absolutely need to focus. Thus, if the effect is not confined to ADHD, it is considered just a drug for behavioral control. I don't know abut you, but the thought of that is really repulsive to me. "
Wrong! We kept our sons medicine in the same cabinet as the aspirin. One day I had a horrible headache and grabbed the Ritalin by mistake ~ keep in mind here, I very rarely get headaches and when I got medicine out of the cabinet it was normally to give my son his medicine. I took two tablets. I cannot remember if the headache went away, but I do remember that my house had never been so clean!
"I homeschool too - I just know too many people who use the diagnosis and drug as an excuse for bad behavior - it removes personal responsibility for an individual's actions."
This is where the drug gets its bad rap. We never excused any bad behavior and our son was never allowed to use his ADHD as an excuse for bad behavior. All medicines have some bad side effects. Does this mean we should stop medicating children that have an illness or medical problem?
"Don't be so offensive - if I've read this much about drugs and psychiatric diagnoses over the years, you think I've never encountered the term or looked it up or talked to anyone who has dealt with it ? Sheesh, you think you are the only one with a brain and sources ?
Cherland, E. and Fitzpatrick, R. (1999, October). Psychotic side effects of Psychostimulants: A 5-year review. Canadian Journal of Psychiatry, 44, 811-813."
I do apologize for the snide remark. Ok, I have read this person's paper and even mentioned it. It does not meet the criteria I specified. First of all, the researcher was biased and HAD an agenda. Secondly, it is not authoritative (FDA, etc.). Also, it is the ONLY paper I have found that claims this large a number of pyschotic reactions. This is HAS NOT been reproduced by other researchers, and I would describe this person as a fringe element. Please realize, that if this was the normal reaction, 9% drug induced pyschosis, other physicians would have been clamoring to pull the drug. The FDA wouldn't allow such a high incidence of severe side effects. Other places I have read there have only been 30 documented cases of ritalin induced pychosis since its use started in 1955.
Short line - bad research that should not be embraced until reproduced by others without an agenda.
"why would i make this up?"
I never meant to imply you made anything up. I guess what I was saying was you were misinformed. However, you are correct that in rare cases there have been vascular complicatons.
The last thing I want to do is insult someone who has seen a loved one suffer. Please forgive me if that is what I have done.
"Oh, and not paying for the FDA studies that "prove" rare side effects. We see how that has worked with Prozac and Vioxx."
Sorry, just have to be nasty again. You are seriously distorting what happened. Since Prozac was released it was warned that suicidal behavior could surface in some users. This was never covered up. In the case of Viox, an NSAID pain reliever for arthritus, it was the manufacturer, not FDA, that covered up the heart problems side effect. Notice that the FDA had the drug pulled when this was discovered. Actually, I think the viox stuff is an ambulance chasing lawyer's dream. I hear advertisements on the radio daily where some law firm wants to find clients that have taken Vioxx.
Not to be a smart alec, but do you really go in for conspiracy theory stuff?
A most excellent response. Sounds like my wife and I could learn lessons for you.
I am really embarrassed that I used to rail against ritalin myself without any first hand experience on what a God send it is where needed.
I think there is one thing everyone here (for or against ritalin) can agree on. We love our children (and children in general) and we want them to get the best care possible.
"AAARGHHHHH! That really makes me angry..a teacher taking it upon him/herself to diagnose a child!!! Talk about overstepping boundaries...hope you had a few choice words for that teacher!"
I agree that teachers should NEVER attempt to diagnose ADHD. They should simply imform the parents, not coerice them. Only a qualified physician should be making diagnoses, and prescribing treatment. It is best if the parents, teacher, and physician work as a team. Of course, this isn't likely to happen; one can hope though.
I think that we need to hear from some children that at one time were on ritalin. I have two nephews that were on ritalin for a couple of years due to adhd. They are both older now and talk about how 'scattered' they felt and how frustrated they were when they couldn't concentrate long enough to complete a thought. The ritalin helped them focus on school work and different facets in their lives. So while this drug is often over prescribed, it does have its positive purposes.
When our son was diagnosed we went through four days of testing, with the doctors explaining everything along the way. When the physiatrist told us that treating with Dexedrine (the precursor to Ritalin) would help our son I called him insane. :-) He explained how it works opposite for those that have ADHD. We agreed, with much hesitation, to try it. Minutes after taking the medicine the three of us played 3 games of CandyLand, whereas before we never made it through setting up the game.
Bump for later
Based on what medical test ? And what reference point did the Dr used to determine there was an imbalance ?
Point here, all the ADHD Drs say this, but there are no studies and no tests proving this. They don't even know what a proper balance should be, for Pete's sake. All they have is speculation.
The problem with this study scenario is that a child should not take this medicine continually for more than 10 years.
Again, based on what medical study ? There are no studies that I have ever found that track the long-term effects of these drugs. There is no Dr I have ever met who has an answer to this, because the answer is, it's not been done to the best of my knowledge. If you have a reference to such a study, please pass it on.
Does this mean we should stop medicating children that have an illness or medical problem?
Again, ADHD is not a medical diagnosis, it's a behavioral diagnosis, so Ritalin and the other drugs used for ADHD control are not used in quite the same way as, say, insulin. Diabetes is a medically-diagnosible condition; ADHD is not. If your doctor says otherwise, I'd love to know what studies he bases that belief on, and what medical tests (and I don't mean behavioral checklists!) he uses to check the chemical composition of the brain, and what mix he considers normal. I guarantee you he has no answers. For diabetes, the patient must test his insulin level several times a day before taking his medication; do you do that with ADHD ? No, of course not. And how do the Drs know they have the Ritalin/Adderall et al dosage "correct" ? It's the point at which the person's behavior becomes "normal" or more appropriate to the situation. Gee, that's really scientific and medically defensible.
And who would qualify as "not biased" ? As far as I can tell, you think anyone against the use of drugs is biased.
I'd still like to see the source you said you had proving that Ritalin is safe and efficacious after 14 months.
In my book, not biased means peer reviewed and replicable. Most research on Ritalin that I've had the chance to see has used subjects who have already been on psychotropic drugs, hardly a good way to study another psychotropic drug.
No one is clamoring to pull these drugs because there is an entire industry worth billions of dollars built up around ADHD and depression, and there is so much false information passed to patients. Look at the entire issue about brain chemical imbalances or ADHD being like diabetes, comments many doctors make to parents. Are these factual statements ? No at the moment they are not. Will they ever find the "normal" chemical balance of the brain ? Maybe ? Do we know it now enough to mess around with it ? In my opinion, no, especially if doctors feel they have to lie to parents to get them to give their kids these drugs. Ritalin like insulin ? Puhleese, I'm not that much of a sucker, altho a lot of parents take that at face value and never look further. After all, if you cannot trust your doctor, why go to them ?
As far as the FDA being unbiased - ha! They use research paid for by the drug companies producing the drugs, their own researchers accept grants from drug companies, and their oversight is notoriously poor. Just look at the latest flap over Vioxx as just one example. They also do a very poor job of correcting side effect information when it is reported to them after the drugs are on the market. They take years to accumulate this data. I don't really fault the FDA - my point is, they are not without problems either.
I don't think drug manufacturers hiding negative results, or the FDA not taking the time to study the side effects over time is not a conspiracy theory.
Yes, suicidal behavior was listed in the initial side effects for Prozac but it was downplayed by the FDA and the namufacturer. It was also not recommended/tested on children under 18, yet that became one of the largest categories of users. Only after there were an increasing number of suicides were the warnings made more severe. However, those you deride as being biased were way ahead of the FDA in warning about these adverse affects. So - who was biased ?
IMO, you take the party line ladled out by the drug companies. You said I think that you were a biochemist ? So, in the interests of full disclosure, who do you work for ? FDA, drug company, research center doing what kind of research, or university who takes grants from what companies ? For myself, I am a computer scientist.
Yes and thank you for that. It's easy for people to believe that placing a child on ritalin is what lasy parents do, but it's just not that way, in many cases.
My child is far from comatose while taking ritalin. There was never a night and day difference, either. His personality is not changed nor is he any less energetic. All ritalin(concerta) had sone for his is help him to focus on his school work, and focus him enough to act less impulsive. Meaning, he no longer gets frustrated and attempts to hurt himself, his brothers or other children.
EEG, MRI, observation.
Again, based on what medical study ?
Personal experience.
It's the point at which the person's behavior becomes "normal" or more appropriate to the situation. Gee, that's really scientific and medically defensible.
Here is your problem, I think. You believe all the hype that Ritalin is used to "control" children that are not robots. You have not experienced life with a child that has ADHD. You do not understand the frustration that they go through.
If a study was done on all the children that truly need Ritalin, it would find that the parents were reluctant to medicated their children.
I will say this once again – if a child does not need Ritalin it will not help to “control behavior”. That child will be bouncing off the walls.
Would you folks care to participate in a mini non scientific study?
Okay.
No, I did NOT want to medicate my child, and put up a stink about it. I still do not want my child on concerta, and would like him off it as soon as possible.
My nephews parents spent a lot of time and money seeking ANY alternative to the medication route. Counseling, tutoring, changes at home and at school, medical testing, psych testing,etc... then the decision to use the medication was made.
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