ADHD: what made you decide to medicate?

[Anonymous]

Anonymous wrote:

If your child is only on task 20% of the time and many does learns nothing in school, how can you justify not trying the medications?

I thought the PP you are asking did a very good job of laying out her reasoning -- giving both anecdotal (her mom's results from spending years and years on psychotropic meds) and epidemiological evidence (the book referenced).

Fwiw, I have looked and looked and despite the fact that I am an above-average researcher, I have yet to find even 2 or 3 studies assessing actual, quantifiable, long-term effects of common stimulant (ADHD) drugs on the developing mind. I assume there never will be such studies because it is unethical to ask one group of children to reject meds and act as the control group for 25+ years.

Point being, I have never understood the parents who assert that the common ADHD meds have "been shown" to be "safe." What does that mean, beyond that the child does not quickly die of an embolism after a few months on, say, Ritalin? "Safe" for the brain 40 years down the line ... how, exactly? And compared to what group? I assert we don't actually know this.

I think you make my point regarding the original post I was addressing. These aren't psychotropic meds so making a decision based on a bad outcome for those is really apples and oranges. Plus, an educated decision isn't based on one person's experience. Secondly, the book she cites is ONE book, which clearly has an agenda, and is talking about a different class or meds -- so not epidemiologically applicable evidence. So it just seems that this reasoning doesn't hold up.

Everything has risks. I just don't see how being on task 20% of the time isn't also a pretty severe risk to a child's emotional wellbeing, academic future, and physical safety given the likelihood of self-medication once he's ild enough.

I'm not trying to pile on the PP -- we all make the decisions we feel are best. But I think so many times people think they've done research but they are not really applying reasonable principals to the evaluation of that research. For example, I have a friend that I love dearly who's son is on the autism spectrum. She has devoted her life to helping him, and I admire her greatly. She has become rabidly anti-meds and attributes everything to things like vaccines and food -- for which there really isn't any solid evidence -- and then at the same time has him undergo chelation, which is known to be toxic and highly risky, and which is not shown to help. It's very hard for me to understand.

[Anonymous]

Ack. Sorry for all the typos in the post above.

[Anonymous]

With all due respect for you, because I know you are doing what you feel is best for your child, I just don't understand this. If your child is only on task 20% of the time and many does learns nothing in school, how can you justify not trying the medications?

I think, contrary to what you say, that there are many many studies showing that the meds are safe and effective when properly prescribed and monitored. Can you direct us to the NY Times and PBS articles about this?


In answer to your question about why we're not trying the medications, it's because I'm weighing the benefits (potentially increased focus in school) against the costs (potential side effects, potential long-term effects that are unknown) and that right now he is still learning everything he needs to learn with me tutoring him a bit in the evening. He learns really well one on one. He's also happy even though he's not the most social kid and when he's engaged in activities he enjoys he doesn't have problems focusing. Also, I went and observed him in class in the fall, and in addition to observing him I also observe that what they were doing during the hour I was there was mindnumbingly dull, dull, dull. Maybe I wasn't there at the right time but still.

Regarding the articles, here is one link: http://www.nytimes.com/ref/health/troubled-children.html

THe PBS documentary is called "The Medicated Child". You can find it on their website.
Also, a fascinating article in the New Yorker about the genesis of DSM-IV once psychoanalysis was debunked: http://www.newyorker.com/archive/2005/01/03/050103fa_fact
I strongly recommend the Robert Whitaker book though, if you are curious.

[Anonymous]

Anonymous wrote:My nine year old saw how much the meds helped a friend and asked to try them. So far, so good.

OP, I understand what you mean about feeling like a crappy parent. I felt the same way. Logically I knew I couldn't "fix" my child, but emotionally I wanted to make it all right without putting my DC through any of that.

That's an honest and very interesting perspective. For us, we'd rather our child be able to function well with medication than go through the self-esteem, behavioral and learning issues that kids with ADHD face without medication

[Anonymous]

I'm having such a bad time with my son and he is only 2 1/2 and his doctor said that I shouldn't give him meds until he gets 7..
Do you know anything to help him on his age?
Thank you

[Anonymous]

I think you make my point regarding the original post I was addressing. These aren't psychotropic meds so making a decision based on a bad outcome for those is really apples and oranges. Plus, an educated decision isn't based on one person's experience. Secondly, the book she cites is ONE book, which clearly has an agenda, and is talking about a different class or meds -- so not epidemiologically applicable evidence. So it just seems that this reasoning doesn't hold up.

Everything has risks. I just don't see how being on task 20% of the time isn't also a pretty severe risk to a child's emotional wellbeing, academic future, and physical safety given the likelihood of self-medication once he's ild enough.

Well, I see your point and I'm acutely aware of the self-medication issue since I have an untreated ADHD brother who does that with alcohol. I'm not making light of that. We know the risk of remaining completely untreated.

What we don't know is the risks of taking psychotropic medications for ~15 years as a brain develops.

There is one that looks at Ritalin from the 1980s onward but it doesn't ask the right questions, IMO and it's not at all rigorous. They don't (and can't) use the gold standard control group. It's available through the NIH website, in partial. And that's it. That's the longitudnal research on the psychotropic-assisted child brain with ADHD

And by the way, Adderall, Concerta, Ritalin and some others are absolutely classified as psychotropic drugs, by the Nat'l Alliance of Mental Illness and the feds.

[Anonymous]

11:45 here. In my post, I did not mean to sound anti-medication. I know many parents who have found that the ADHD drugs are critical for their children, and we would consider medication again now that our child is older (age 8). One thing I will say, try to find an excellent pediatric psychiatrist to get the dose right (it's hard to find one taking new patients in NoVa) and NOT a general pediatrician (we did the pediatrician with our 4 yr 10 mo old, and there was little support/expertise provided). For the person who asked about CogMed, this has been the single biggest factor for our daughter. It costs about $2,000 and requires a significant time commitment from a parent for a 5-week period, but honestly I feel this therapy pulled my daughter from the edge of the abyss. The doctor we used for this (relatively new) therapy was Dr. Moshe Shtuhl of Family Compass in Reston. It is a computer-based training program that your child completes at home (with a telephone "coach" provided by the doctor). You can do a search on line (just type in CogMed Working Memory Training) to find out more and see if you think it might help your child. Warm thoughts to all struggling with the ADHD issues!

[Anonymous]

Anonymous wrote:

With all due respect for you, because I know you are doing what you feel is best for your child, I just don't understand this. If your child is only on task 20% of the time and many does learns nothing in school, how can you justify not trying the medications?

I think, contrary to what you say, that there are many many studies showing that the meds are safe and effective when properly prescribed and monitored. Can you direct us to the NY Times and PBS articles about this?


In answer to your question about why we're not trying the medications, it's because I'm weighing the benefits (potentially increased focus in school) against the costs (potential side effects, potential long-term effects that are unknown) and that right now he is still learning everything he needs to learn with me tutoring him a bit in the evening. He learns really well one on one. He's also happy even though he's not the most social kid and when he's engaged in activities he enjoys he doesn't have problems focusing. Also, I went and observed him in class in the fall, and in addition to observing him I also observe that what they were doing during the hour I was there was mindnumbingly dull, dull, dull. Maybe I wasn't there at the right time but still.

Thanks for that info, PP. I will check those citations out!

Regarding the articles, here is one link: http://www.nytimes.com/ref/health/troubled-children.html

THe PBS documentary is called "The Medicated Child". You can find it on their website.
Also, a fascinating article in the New Yorker about the genesis of DSM-IV once psychoanalysis was debunked: http://www.newyorker.com/archive/2005/01/03/050103fa_fact
I strongly recommend the Robert Whitaker book though, if you are curious.

[Anonymous]

Back to the OP's question:

My 1st grade DD came home from school crying, saying she is "different from everyone." She described how the other kids have no trouble keeping their hands to themselves, but that she has to think about it all the time. She said, "I can't even listen to what the teacher is saying!" Why am I so different? What is wrong with my brain? I am the worst kid in the whole class. (Of course, we have never referred to her as different, having problems with her brain, etc. She came up with it on her own)
That's when we decided to medicate.

[Anonymous]

I think you make my point regarding the original post I was addressing. These aren't psychotropic meds so making a decision based on a bad outcome for those is really apples and oranges. Plus, an educated decision isn't based on one person's experience. Secondly, the book she cites is ONE book, which clearly has an agenda, and is talking about a different class or meds -- so not epidemiologically applicable evidence. So it just seems that this reasoning doesn't hold up.

12:29 here. I appreciate your comments. I did say that these books and articles confirm my own biases.
Just two more things:
ADHD drugs are psychotropic drugs. Psychotropic means "affecting your mental state".
Also, I did approach the Whitaker book wondering what the guy's agenda was. At the end of the day, I would love to know what the truth is about these issues--and I'm not claiming I do, but I'm highly skeptical of the accepted wisdom In it he does explain in the preface (if I remember correctly) that he started researching these issues for something completely unrelated, and then started stumbling across studies that did not bolster the pharmaceutical industry's claims about these drugs. So with regards to his agenda, at the end of the day, the guy is a journalist, and the most he can gain as a result of going against a powerful industry is a reputation as a sensationalist crackpot. Contrast that with the agenda of the myriad researchers who receive astronomical consulting fees from the pharmaceutical industry for studies that shed a favorable light on their products. Who has more to gain?
He does address drugs for ADHD in the book, and the studies he looked at are all on his website. Here is the link to the studies on childhood mental disorders.
http://www.robertwhitaker.org/robertwhitaker.org/Children.html

[Anonymous]

OP here. I just wanted to thank each of you for providing such thoughtful answers to my question, and for making me feel a little less alone.

[Anonymous]

Another good book to check out is Judith Warner's We've Got Issues.

She's also a respected journalist, and she started out to write a book exposing the irresponsible use of psychotropic (thanks for the correction on that term!) drugs for kids.

Her conclusions ended up exactly the opposite -- that child psychiatry is actually a success story and if anything, not enough kids have access to the drugs they need to improve their lives.

So worth checking out for a contrary opinion.

[Anonymous]

Another great book is The Way of Boys. Highly recommend it.

[Anonymous]

11:45 here again for OP. A few years back, when I was really feeling low about my daughter and my ability to help her, I read a great book called "Positively ADD" (don't remember the author) that profiled 14-15 famous people, all with ADHD, who went on to become profoundly successful in their lives (the first profile was about James Carville). Each one described the hardships of dealing with the disorder as children (most didn't even have diagnoses back then, let alone parental support of their differences), and how they came to view their differences as assets later in life. It made me realize that, however hard it is to raise and help a severely ADHD kid, these kids often have special gifts that, if found and nurtured, can lead to extraordinary accomplishments. I try to remind myself that my mission is to find and nurture my daughter's talents, and not just focus on her challenges. "Teach to the strengths, while accomodating the weaknesses." Good luck, and hang in there. You know your child best and your mommy instincts will tell you what's right regarding the meds.

[Anonymous]

Gosh, this is such a timely thread, thanks for posting the question -- we currently had been resisting trying medication for our 8 yr old son who has ADHD and now have a consultation appointment next month to go over a treatment plan with his pediatrician. He has been going to weekly therapy, has an IEP in school, etc and it just seems to me that his attention is getting worse and worse - so much so that it is difficult to even communicate with him at times. It's frustrating for us and for him. My husband was very resistant but I think he can see now how much it is impairing our son's ability to be successful so we shall see how it goes...