The Ritalin Riddle
Making a decision like using medication such as Ritalin can be a hard one. Usually families have been struggling, looking for answers regarding their child's learning problem, frustrated, wanting a solution. Medication should never be used as a way of escape. Christian's don't pop pain killers just to see how they like them. Neither do we even take Tylenol unless there is a good reason. We feel, even when we have a headache, it is best to try natural measures before resorting to Tylenol. Perhaps looking at Ritalin the same way can help you. Good physicians should attempt to help their patients find simple measures to cure simple problems, working up to medications as actually needed .
The term "medication" or even "Ritalin" carries with it a stigma of "failure" within some social groups.
Unfortunately the chasm between those who homeschool and use medication, and those who homeschool and are violently opposed to Ritalin, is getting wider every week. Presenting both views within the NATHHAN NEWS has its drawbacks. We receive fire from both sides instead of one!
When we, as a family, have a hard decision to make, we sit down with paper and pencil and write out the yea's and nay's separately and then compare them. So this is what we are attempting to do on this page. As parents we need to be informed. The information here is provided as a summary of the letters pro and against using medication we have received. Please forgive us if your reasons are not stated here. As always, the final decision rests with parents under the council of their child's doctor.
1. Will help our child to learn in a more calm manner.
2. Good habits, under the influence of medication may carry over into the other times of the day and make life run more smoothly.
3. Will help our child to "sit still" during class time, control their impulsivity, distractibility, short attention span, hyperactivity, and emotional lability
4. May help with behavior problems
while our child is on it. Will be easier to manage in a group setting.
Ritalin, when combined with other remedial measures (psychological, educational and social) can have a stabilizing effect on develop- mentally inappropriate symptoms.
5. If homeschooling, some of the stress will be off of Mom during the day while child is on the medication.
6. Child may feel better about themselves when they succeed in school work or other projects.
7. Our family will be at peace again, without the distracting, hyper-energetic frenzy associated with life with our child. "Social discrimination" from friends is a small price to pay for harmony in our home.
8. Medication can be withdrawn usually by puberty.
Thoughts on not using medication
1. With patience we can train our child to control himself. We can better direct our child's environment via homeschooling, with lots of physical exercise, a quiet room to learn and shorter sit-down time.
2. We will work harder at finding ways to help our child remember his chores, not be distracted and to stick to the task. This will take a lot of trial and error.
3. We are afraid of "masking" behavior problems that won't go away unless we teach, train and reprove. We will have to avoid group settings until our child has proved themselves capable of handling the social distractibility.
4. Dad and Mom may need to find other ways to relieve stress, such as taking breaks in the evening, getting rid of the problems as they arise and staying on top of them. This may takes an inordinate amount of diligence.
5. Medication may cause our child symptoms that make them or us uncomfortable. (see below). Seeing the fruit of using natural methods may not be apparent for some time, but the fact that we are not using a controversial medicine makes us feel better.
From the Physicians Desk Reference 1994 edition. Page 835 and 836
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 behavior effects in children, not conclusive evidence regarding how these effects relate to the condition of the central nervous system.
Warnings: Should not be used in children under 6 years of age since safety and efficacy in this age group has not been established. Sufficient data on safety and efficacy of long-term use of Ritalin in children are not yet available. May lower the convulsive threshold in patients with prior history of seizures, abnormal EEG's and very rarely those with no prior history of seizures of abnormal EEG's. Ritalin should be used cautiously with those patients with hypertension. Symptoms of visual disturbances such as blurring and difficulties with accommodation have been encountered in rare cases. Adverse Reactions: Nervousness and insomnia are the most common adverse reactions but are usually controlled by reducing dosage and omitting the drug in the afternoon and evening. Other reactions include: hypersensitivity (skin rashes, fever........) anorexia, nausea, dizziness, palpitations, headache, dyskinesia, drowsiness, blood pressure and pulse changes both up and down, tachycardia, angina, cardiac arrhythmia, abdominal pain, weight loss during prolonged therapy. There have been rare reports of Tourette's syndrome. Toxic psychosis has been reported. Although a definite casual relationship has not been established, the following have been reported in patients taking this drug: leukopenia and or anemia; transient depressed mood, a few instances of scalp hair loss. In children, loss of appetite, abdominal pain, weight loss during prolonged therapy, insomnia, and tachycardia may occur more frequently; however, any of the other adverse reactions listed above may occur.
Ritalin should be initiated in small doses, with gradual weekly increments. If improvement is not observed after appropriate dosage adjustment over a one-month period, the drug should be discontinued.
Ritalin should be periodically discontinued to assess the child's condition.
Families who need to read this article in entirety should check out this book at their library with a medical dictionary in hand.