Ritalin

The friendliest place on the web for anyone that follows U2.
If you have answers, please help by responding to the unanswered posts.
While a few may really need it, it's overused and a bad thing overall. It seems too many times teachers expect too much from little kids and just want them doped so they don't have to deal with them. Then you have families getting more welfare for a hyper kid so there's no hurry to get them off of it. IMO it leads to a life of drug dependancy and more natural approaches should be taken.
 
While a few may really need it, it's overused and a bad thing overall. It seems too many times teachers expect too much from little kids and just want them doped so they don't have to deal with them. Then you have families getting more welfare for a hyper kid so there's no hurry to get them off of it. IMO it leads to a life of drug dependancy and more natural approaches should be taken.

Being a clinical pharmacist with a focus on psychopharmacology I can honestly say amphetamines are overly prescribed, for the most part. Although, they do benefit a huge portion of the population and when there is a treatable population then they should be treated considering the overwhelming clinical research supporting their use. In some cases they could expose cardiovascular diseases (Arrhythmias) in many young adults causing death but does outweigh the benefit if youth can be tested and screened ahead of time? This is the reason Adderall was pulled off the Canadien market for a brief period of time.

Here is an article from The Economist I thought was interesing to try and explain the reason behind ADD and ADHD:

Evolution and genetics

The misfits
Jun 12th 2008
From The Economist print edition

The genetic legacy of nomadism may be an inability to settle


ABOUT one in 20 children (those under 18) have a group of symptoms that has come to be known as attention-deficit hyperactivity disorder (ADHD). About 60% of them carry those symptoms into adulthood. For what is, at root, a genetic phenomenon, that is a lot—yet many studies have shown that ADHD is indeed genetic and not, as was once suspected, the result of poor parenting. It is associated with particular variants of receptor molecules for neurotransmitters in the brain. A neurotransmitter is a chemical that carries messages between nerve cells and, in the case of ADHD, that chemical is often dopamine, which controls feelings of reward and pleasure. The suggestion is that people with ADHD are receiving positive neurological feedback for inappropriate behaviour. The surprise is that the variant receptors are still there. Natural selection might have been expected to purge them from the population unless they have some compensating benefit.

Of course, this analysis turns on the definition of “inappropriate”. The main symptom of ADHD is impulsiveness. Sufferers have trouble concentrating on any task unless they receive constant feedback, stimulation and reward. They thus tend to flit from activity to activity. Adults with ADHD tend to perform poorly in modern society and are prone to addictive and compulsive behaviour. But might such people do well in different circumstances?

One hypothesis is that the behaviour associated with ADHD helps people, such as hunter-gatherers and pastoral nomads, who lead a peripatetic life. Since today's sedentary city dwellers are recently descended from such people, natural selection may not have had time to purge the genes that cause it.

Dan Eisenberg, of Northwestern University in Illinois, and his colleagues decided to test this by studying the Ariaal, a group of pastoral nomads who live in Kenya. The receptor Mr Eisenberg looked at was the 7R variant of a protein called DRD4. Previous work has shown that this variant is associated with novelty-seeking, food- and drug-cravings, and ADHD.

The team looked for 7R in two groups of Ariaal. One was still pastoral and nomadic. The other had recently settled down. As they report in this week's BMC Evolutionary Biology, they found that about a fifth of the population of both groups had the 7R version of DRD4. However, the consequences of this were very different. Among the nomads, who wander around northern Kenya herding cattle, camels, sheep and goats, those with 7R were better nourished than those without. The opposite was true of their settled relations: those with 7R were worse nourished than those without it.

How 7R causes this is not yet known. It may stem from behavioural differences or it may be that different versions of DRD4 have different effects on the way the body processes food. Nevertheless, this discovery fits past findings that 7R and a set of similar variants of DRD4, known collectively as “long alleles”, are more common in migratory populations.

One suggestion is that long-distance migration selects for long alleles (see chart) because they reward exploratory behaviour. This might be an advantage in migratory societies because it encourages people to hunt down resources when they constantly move through unfamiliar surroundings.

As for the Ariaal, there remains the question of why 7R—although it is apparently beneficial to a nomadic way of life—is found in only a fifth of the population. One possibility is that its effects are beneficial only when they are not universal, and some sort of equilibrium between variants emerges. A second is that the advantage is gained when 7R exists along with another version of DRD4 (the genes for the two variants having come from different parents). Unfortunately, the way Mr Eisenberg collected the data does not allow these hypotheses to be tested.

Either way, his research raises the question of whether people suffering from ADHD and conditions related to it, such as addiction, are misfits coping with a genetic legacy that was useful in the evolutionary past, but is now damaging. As society continues to diverge from that evolutionary past, the economic and social consequences of being such a misfit may become increasingly important.
 
While a few may really need it, it's overused and a bad thing overall.

:up:

It seems too many times teachers expect too much from little kids and just want them doped so they don't have to deal with them.

:yes: specially where boys are concerned

Then you have families getting more welfare for a hyper kid so there's no hurry to get them off of it.

That sentence scared the hell out of me

IMO it leads to a life of drug dependancy and more natural approaches should be taken.

Not sure I agree that it leads to overall drug dependancy but it certainly normalises the use of drugs which is never a good thing - and agree absolutely that where possible other options should always be explored first


ps - gherman the article you posted was really interesting, thanks :)
 
Last edited:
This thread is so interesting. As a sophomore in college who is in a sorority, I can tell you that probably 80% of the girls in my sorority take ADHD medications (usually Adderall). Most people I know take it to study when they have tests and half of the older girls in my sorority take it so they won't eat. :| There is definitely a HUGE black market for this stuff on college campuses. I know people who got prescribed to it and they definitely do not have any kind of attention issues. It's really disgusting seeing girls waste away to 100 pounds because they went to a shrink and lied that they have an attention problem. Clearly it is prescribed wayyyyy too much.

But on another note, my brother is 15 and a junior in high school. He has always been a problem child, can't sit still, never got good grades, etc. My dad also definitely has some form of ADD but has never been medicated and he is very successful. He's very against medication. But knowing that my brother is such a smart kid but just can't pay attention was killing my parents, so they brought him to a psychiatrist. After weeks of testing for a million things they finally diagnosed him with ADHD and put him on Adderall. My dad is against it but my mom wanted to try so they did. Turns out instead of getting D's and F's in school he started getting A's and B's. But he HATES being on it. He says it makes him feel like a zombie and he hates not having an appetite. So my mom doesn't make him take it anymore but it just sucks because now he has half A's and half F's, which clearly is not normal. So I really think this stuff is great if it is used by someone who legitimately can benefit from it. But I don't think parents should MAKE their children take it. It's killing them that my brother is doing terribly in school, but what are they going to do? They don't want their kid to be miserable.
 
But on another note, my brother is 15 and a junior in high school. He has always been a problem child, can't sit still, never got good grades, etc. My dad also definitely has some form of ADD but has never been medicated and he is very successful. He's very against medication. But knowing that my brother is such a smart kid but just can't pay attention was killing my parents, so they brought him to a psychiatrist. After weeks of testing for a million things they finally diagnosed him with ADHD and put him on Adderall. My dad is against it but my mom wanted to try so they did. Turns out instead of getting D's and F's in school he started getting A's and B's. But he HATES being on it. He says it makes him feel like a zombie and he hates not having an appetite. So my mom doesn't make him take it anymore but it just sucks because now he has half A's and half F's, which clearly is not normal. So I really think this stuff is great if it is used by someone who legitimately can benefit from it. But I don't think parents should MAKE their children take it. It's killing them that my brother is doing terribly in school, but what are they going to do? They don't want their kid to be miserable.

Has your brother checked with the doctor? Maybe a lower dosage would work or a different prescription. The best answer would be if society would figure out a way to educate all types of kids instead of expecting them all to follow one method. If your kids doesn't work well with the current method, then they get F's. In a society where you really need a college degree to make a good income - kids need to be able to get through this. So, they are sort of forced to take meds to conform.
 
Has your brother checked with the doctor? Maybe a lower dosage would work or a different prescription. The best answer would be if society would figure out a way to educate all types of kids instead of expecting them all to follow one method. If your kids doesn't work well with the current method, then they get F's. In a society where you really need a college degree to make a good income - kids need to be able to get through this. So, they are sort of forced to take meds to conform.

Yeah, they just prescribed him a new thing called Focalin I think? They said it might not affect him as badly as the Adderall. I totally agree...my brother is a junior in high school and there is no way he is going to get into a decent college. And I KNOW he is a smart kid, I have seen him study hard and get A's. But half the time he even fails classwork assignments because he just can't sit there. Right now his grades are half A's and half F's which is obviously because some teachers accommodate him and some don't. I know it's not a public school teacher's job to take time out for kids with these kind of problems, but I wish there was some sort of solution or other kind of classes he can be in. For him to be educated in an environment that would work with him and have smaller classes (like a small private school) would cost my parents a small fortune!
 
Yeah, they just prescribed him a new thing called Focalin I think? They said it might not affect him as badly as the Adderall. I totally agree...my brother is a junior in high school and there is no way he is going to get into a decent college. And I KNOW he is a smart kid, I have seen him study hard and get A's. But half the time he even fails classwork assignments because he just can't sit there. Right now his grades are half A's and half F's which is obviously because some teachers accommodate him and some don't. I know it's not a public school teacher's job to take time out for kids with these kind of problems, but I wish there was some sort of solution or other kind of classes he can be in. For him to be educated in an environment that would work with him and have smaller classes (like a small private school) would cost my parents a small fortune!


Even if the public school teacher did take time out to teach, most of the kids would most likely not stick around. Getting through the regular school day is tough enough for them, they certainly don't want to put in extra.
 
What kinds of things are generally done at the high school level (besides medication) to help ADHD students? I realize it probably varies greatly from one school system to another, and even from one teacher to another, but just in general, what would be some examples of commonly offered assists? I know at the college level, many if not most colleges offer (usually through a disabled student services office) things like note-takers, audio textbooks, recorded lectures, extra time on exams etc. I've had quite a few ADHD students use those services over the years. I've never actually had to make any changes in the way I teach for them, and it's a little hard to imagine how I'd do that--a few times I've offered oral exams as an alternative, and sometimes those students avail themselves of my office hours more than others, but those things are no problem.

As far as the problem of Ritalin abuse on college campuses, I'm pretty sure I've seen figures recently estimating nationwide campus averages of 'illicit Ritalin use' (or however they put it) at 5-10%, with certain colleges having rates as high as 20%.
 
ADHD, Ritalin and all it's me-too drugs got a 20 year head-start but Bipolar disorder is making up ground. In the last 10 years, diagnoses are up 300% in adolescents and 400% amongst children.

The reasons are much the same as for increases in ADHD diagnoses:
1) Softening of diagnosis criteria resulting in rising misdiagnosis
2) Aggressive marketing by drug companies
3) Upcoding the diagnosis of behavioral problems to the more severe, in this case, diagnosis of bipolar disorder just to receive greater compensation from insurance companies or Medicaid.

Some people, including children, really do have chemical imbalances or other organic mental illness that shouldn't be stigmatized or treated any less aggressively than physical illness. But four year old manic-depressives? Give me a break.
 
ADHD, Ritalin and all it's me-too drugs got a 20 year head-start but Bipolar disorder is making up ground. In the last 10 years, diagnoses are up 300% in adolescents and 400% amongst children.

...

Some people, including children, really do have chemical imbalances or other organic mental illness that shouldn't be stigmatized or treated any less aggressively than physical illness. But four year old manic-depressives? Give me a break.

It's interesting that we've got two primary symptoms, inattentiveness and mood instability, that are also addressed in Omega-3 fatty acids, which the Western diet is generally very low in, but is supposed to be found in high levels in the brain and is considered necessary for normal fetal development and growth. I also believe there's been studies have that shown that it has had a beneficial effect on both bipolar disorder and ADHD. Considering how many children eat the equivalent of junk food on a daily basis around the country, which is inevitably low in Omega-3s, along with any number of necessary nutrients, coupled with living in a high stress society, where the few nutrients you get are quickly depleted, is it any wonder we have a rash of mental illness diagnoses amongst children?
 
^

The whole impact of diet on behaviour is absolutely fascinating - I know its not going to work for everyone as some kids really do have issues that need to be treated medically but I have tons of friends who have noticed changes in their kids behaviour depending on diet . . . This isn't based on anything scientific - just a mum observing the behavioural changes - one of my boys is 'Mr Fidget' - he listens in class and gets pretty good grades but he CAN NOT sit still to save himself - nervous energy by the bucketload which noticeably lessens when we increase the amount of fish in our diets . . . took me & the teachers a while to figure it out . . . but even something as small as a tuna salad at lunch seems to help - its not a guarantee of course but it really seems to impact.

The 'over diagnosis' of ADHD, bipolar etc makes me crazy cuz it just really seems like such a lazy way out and it lessens the amount of attention / care that kids who are genuinely in need of help get.

Great thread by the way - really really interesting :)
 
It's interesting that we've got two primary symptoms, inattentiveness and mood instability, that are also addressed in Omega-3 fatty acids, which the Western diet is generally very low in, but is supposed to be found in high levels in the brain and is considered necessary for normal fetal development and growth. I also believe there's been studies have that shown that it has had a beneficial effect on both bipolar disorder and ADHD. Considering how many children eat the equivalent of junk food on a daily basis around the country, which is inevitably low in Omega-3s, along with any number of necessary nutrients, coupled with living in a high stress society, where the few nutrients you get are quickly depleted, is it any wonder we have a rash of mental illness diagnoses amongst children?

OK, I'm going to buy some Omega-3 supplement. Any recommendations to a brand or what should I look for on the bottle? Anything to stay away from?
 
Maybe pediatricians will cut down on the amount of ritalin that is distributed to the male children in this society. I would like that.


I have not read this entire thread yet, but I agree.

I teach 7th grade Language Arts and I have seen the abuse of ritalin and other drugs used on students. What is shocking is how parents and some teachers are so quick to recommend drugs as a solution.
 
Tough Choices for Tough Children

by Judith Warner (columnist)
New York Times, Nov. 20



It was disturbing to read in The Times this week that the “atypical” antipsychotic Risperdal, a tranquilizing whopper of a drug with serious, sometimes deadly side effects, is now being widely prescribed to children with attention deficit hyperactivity disorder. This despite the fact that Risperdal, which is used in children mostly to treat bipolar disorder, isn’t approved for ADHD, and apparently doesn’t work for treating it at all.

So why, according to new Food and Drug Administration data on doctors’ prescribing practices, were 16% of the pediatric users of Risperdal over the past three years children with ADHD? The simple answer is to point fingers at the drug companies, whose aggressive efforts to promote off-label use of this problematic new class of drugs have resulted in a spate of lawsuits, including one recently filed by the Arkansas attorney general that accuses Risperdal’s manufacturer, Johnson & Johnson, of having “engaged in a direct, illegal, nationwide program of promotion of the use of Risperdal for non-medically necessary uses”—like the treatment of ADHD.

But I think the truth is more complicated than that. I think that what’s happening is that children with big problems are being given big, bad drugs because no one really knows what to do with them. The biggest controversy in the controversial field of psychiatry these days (“the only field where the doctors are more stigmatized than the illness,” as Thomas R. Insel, the director of the National Institute of Mental Health, described it to me last week) is the issue of pediatric bipolar disorder, which many child psychiatrists now say is being grossly overdiagnosed, with a spike in incidence that dovetails suspiciously well with the introduction of atypical antipsychotics in the early and mid-1990s. At the heart of that controversy—the human heart, you might say—is a group of children who are really difficult: chronically irritable, extremely aggressive, prone to explosive outbursts and out-of-control rages.

Many doctors, influenced by the work of Dr. Joseph Biederman at Harvard Medical School (whose ties to industry were detailed in The Times in June), say these symptoms are signs of mania, and call these children bipolar. Others label them with “extreme ADHD” or Oppositional Defiant Disorder or “severe mood dysregulation,” a diagnosis that’s been proposed by Dr. Ellen Leibenluft, chief of the section on Bipolar Spectrum Disorders in the Mood and Anxiety Disorders Program at the National Institute of Mental Health. For the past five years, Dr. Leibenluft has been tracking 100 children she believes have severe mood dysregulation, studying the course of their illness and the outcome of their treatment. 60% percent of these children were diagnosed with bipolar disorder—mistakenly, she believes—before she met them. 90% percent of them meet the criteria for diagnoses of ADHD or ODD 60% suffer from serious anxiety. 25% had an episode of major depression before they turned 12. “The severely mood dysregulated children are as sick as the bipolar children. They’re severely impaired,” she told me this week. “You can see easily why people would feel you need to use medication. But what medication? We don’t have the data to see what medication because we don’t yet know how to think about these children diagnostically.”

It may well be these kinds of children—these diagnostic orphans — who, at least in part, are showing up now as the “ADHD” patients being treated with Risperdal. The issue of what to call these children is a hot one and will heat up further in the near future as discussions take place over whether a new or changed diagnostic category for them should be put in the DSM-V, the long-awaited updated version of the American Psychiatric Association’s diagnostic manual. And it isn’t just a matter of semantics. Category change could mean treatment change. Children who are diagnosed as bipolar, even if they have attention issues, anxiety or depression, often aren’t treated with stimulants (the first-line treatment for ADHD) or antidepressants, because some prominent child psychiatrists have argued that they make bipolar children much worse. So physicians who suspect children are bipolar instead try the much more powerful atypicals, which have much more serious side effects. But severe mood dysregulated children wouldn’t necessarily have to go the atypical route. And there is also data to indicate a real role for non-drug therapy. In other words, thinking hard about these kids—instead of merely moralizing about them and their psychotropic drug use—may well lead to a situation in which atypical use can be greatly reduced.

This will not satisfy the critics of today’s biological psychiatry for whom no drug use is good drug use, nor the critics of today’s culture of parenting who are sure that all the aggression, irritability and out-of-control behavior that psychiatrists call mental illness is actually nothing more than a state of “toddlerhood in perpetuity” caused by ineffective parenting practices, as the conservative family psychologist and writer John Rosemond and his coauthor have asserted in his new book, The Diseasing of America’s Children. It won’t solve the problem of the drug companies’ predatory marketing practices, or of thought leaders in psychiatry renting out their minds for the sake of fancy vacations and top-flight meals. But the fact that efforts are being made, in a concerted way, to figure out what lies behind the scary-sounding statistics about drugs like Risperdal argues, I think, for hope. After a period in which drug companies have had way too much power in determining how children with psychiatric issues are treated, the pendulum may be swinging back.



--------------------------------------------------------------------
(Incidentally, Risperdal, like Ritalin, is in the opinion of many doctors also routinely overprescribed to elderly people in nursing homes, to keep them "cooperative." I've gone back and forth with my mother's social worker and psychiatrist--who's never even seen her; she just 'diagnoses' over the phone with input from nurses--about this and other medications they keep putting her on, altering her dose of etc., without even notifying me. :| )
 
Back
Top Bottom