Anyone NOT for medicating ADD kids?

Parent Cafe
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<p>I am looking for feedback. My son is not hyperactive but he’s VERY inattentive. He forgets things, loses things, thinks he’s finished something but hasn’t, etc. Tests fine, so long as he has actually brought the book home and remembered there was a test the next day! IQ=gifted.</p>

<p>He is 14 and is going to be in 9th grade in the fall. He goes to a small and demanding school. Gets C’s without meds and he “hates” school.</p>

<p>I have heard lots of positives about the potential of really big focus changes with Ritalin, Adderall, etc. We have made an appointment with a neurologist in a month with an eye towards a trial of Ritalin. </p>

<p>But I have an “inner voice” that is worried and hesitant to put my kid on drugs. On the other hand, I do not want to rob him of important medicine that could really reduce his frustrations in school and help him be more engaged-- up to the level of his abilities.</p>

<p>Specifically: who has not chosen medication, and why? Did anyone try meds and stop? Anyone know about things like drug use later in life relating to Ritalin use, etc? Any students or adults ON Ritalin or similar medication, who can tell me about it “from the inside?”</p>

<p>My brother had raging ADD (never diagnosed) and I think his whole life was really hard for him; always a misfit in school (he did get into drugs as a teen and I have heard kids may do this to “self medicate.” I don’t want to wish this on my son. I also don’t need him to be a stright A student. I just want him to find a place where he is happy, engaged, and able to enjoy his own intelligence and intellectualism.</p>

<p>I would love more information.</p>

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<p>SB-
There is little evidence that any kid properly medicated on a psychostimulant abuses it. That’s not to say it never happens, or that they don’t give some to their friends, but it is not common for kids appropriatley medicated to misuse it. </p>

<p>By the way, it is a great idea to see a neurologist, but if you are considering requesting accomodations with collegeboard or ACT down the road, you will need a full psych/neuropsych to support the diagnosis.</p>

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<p>SBMom, I am pretty firmly in the “avoid medication for ADHD if at all possible” camp. However, I don’t want to post specifics here because as strongly as I feel about meds like Ritalin, I feel that this is a personal choice, and each family has to make their own decision… and I really don’t like the hurt feelings and antipathy that gets generated from the inevitable recitation of all of the worst possible side-effects of Ritalin vs. how much the meds have helped someone else’s kid. So I have sent you a PM with the details. Suffice it to say here that, especially with non-hyperactivity type ADHD, there are alternatives to medication (but they do take some effort, both on the part of the kid and at home). </p>

<p>I do also want to say that you might want to reevaluate whether the “small and demanding” school your son attends is the right environment for him. Your son may be the type of kid who needs “nurturing” and/or “flexible” rather than “demanding” academics, especially as he is high-IQ and may be chafing against requirements that he sees as busy work. His present school simply might require too many hours sitting still at a desk, too much sustained reading, writing, or listening, etc., for his very active mind. You said that you want him to be “happy, engaged, and able to enjoy his own intelligence and intellectualism” – the school he now attends may just be a bad fit. </p>

<p>I am not saying that the school is the cause of his ADHD - but I am saying that the school may be part of the problem because kids who have unorthodox learning styles often don’t do well in traditional or rigorous educational environments. Sometimes they need a combination of support and understanding, and a place where they can really explore or where learning is more self-directed. We talk so much about finding the right “fit” for college on these boards – I think we sometimes forget that “fit” is even more important in middle school and high school when our kids are so much more vulnerable.</p>

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<p>I will answer from the perspective of a teacher.</p>

<p>We see hundreds of students over the course of a career, and secondary teachers see thousands. An astute teacher is in a very good position to observe behaviors and to place those behaviors and the accompanying academic consequences on a continuum of behaviors seen in students.</p>

<p>In order to take advantage of this expertise, the doctor will likely give you observational questionairres. One will be an observational measure of your child’s behavior through your eyes and one will likely be given to teachers (since he is secondary age). May I suggest that you give the same form to teachers of classes that he does well in and also those he has more trouble with so that you can see the effect of interest, engagement in the subject, and the tolerance (or lack thereof) of the teacher. Sometimes it is not entirely the student, but rather a bad fit with a teacher who has very little tolerance for noise, movement, etc. that these students create in order to self-stimulate. (However, if you have experience with ADD and you have heard the same remarks from teachers throughout his school experience, he is probably on the ADD side of the continuum.) Only after completion and analysis of these observations do doctors generally begin to discuss medication. (Oh, and, from my experience with kids, Strattera has many fewer side effects and greater effectiveness without the huge swings throughout the day than Ritalin)</p>

<p>As to the manifestations you mentioned, it seems as though “behavioral modification” may also be effective for your son. While any program of medication for ADD should be supported with behavioral modification, it is frequently lost as a component. In my experience it is the most effective part and carries the most benefit through to adulthood because it emphasizes compensating behaviors and helps the student to try on different strategies with the support of the family. It is quite a lot of work, though, and requires planning, support in following through with tasks, and consequences for not completing what is started.</p>

<p>Frankly, I think that most teachers are ADD, or they would go crazy in a room with 25 kids.:wink: It is not a bad thing, and I believe that if teachers were more tolerant of kid behavior and more willing to tailor lessons to those with different learning styles we would all be better off. I must also say that I have seen meds practically perform miracles when properly dosed and with strong parent support and communication between home and school.</p>

<p>We all want students to do their best, and I am sure that the doctor will be happy to talk with you about the various approaches to ADD and whether he believes your son would benefit from these. Good Luck! I’m sure that with such a caring, well-informed mom he will find a method that will help him fulfill his potential. (Dang, that felt like writing a report card!).</p>

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<p>We have rampant ADD in our family. One member (at least!) has the H, too. His mother has been so confused over the medication thing she continually second guesses herself, and her S picks up on the confusion and mixed messages. It’s a mess. She gives in to pressure to do without meds, her S comes close to getting kicked out, he goes back on meds and they scramble to pick up the pieces. I am very, very worried about his future. He too is gifted. And yet he may not graduate. </p>

<p>I am a nurse, I worked in Mental Health for a few years, was a foster parent, and have seen much on both sides. My D was diagnosed many years ago (without the H, as many girls are) and we have done very well without meds. Written lists, removal of the TV, schedules, etc. have all helped. You would never guess she had any problem. Teachers have been much more willing to work with her than with some of the foster kids we’ve had who were also hyperactive. Sometimes those kids are so difficult to work with in class that “quick and easy” is heavily campaigned for.</p>

<p>I think it is valuable to “try” without meds. This takes time and knowledge. And patience and consistency. Getting a clear diagnosis, and not just a quick label from someone looking for an easy answer, is so important. There are so many other things that can come into play, that I can’t even begin to name them. (Sometimes meds in the short term can help even in those situations, while a long-term answer is being sorted out.)</p>

<p>I am glad you are seeking knowledgeable medical advice. There is so much information out there, much of it conflicting or controversial. You know your child the best, though. Get as much info as you can, then trust your instincts. Good luck!</p>

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<p>You might want to look into natural therapies too alone or as a compliment. My sister found her son had allergies that effected his behavior and also starting giving her son Omega 3 which a lot of children (and adults) are deficient in. Over a few of months, she noticed a big difference in his attention span. I also started to give it my S because he wasn’t a “fish” person and was always mild ADHD. It doesn’t help everyone but it is worth looking into. I heard about first from Dr. Weil, a doctor that uses natural and regular therapy on a TV program. I researched some other areas on the net and at the lilbrary and with my doctor. I was surprised at all the studies and information I found.</p>

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<p>I have ADD and I did fine without medication. But I would have to say that it depends on the individual.</p>

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<p>Calmom makes some very good points about the school and fit. Although I don’t know anyone who has actually been diagnosed with ADD, I suspect we all have a bit of ADD in us. </p>

<p>But… for what it’s worth, I think our entire society is over-medicated. Depressed? Take medication. Anxious? Take medication. ADD? Take medication. I barely know anyone who has not been prescribed some sort of medication to mask their feelings. As far as ADD, I never even heard that term until about 12 years ago. Once again, I agree with Calmom in considering a different type of school, before I’d turn to medication.</p>

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<p>And I just wanted to add that for many kids (and this may not be so with your child), they watch way too much TV. With TV’s quick editing and super fast pace, it’s no wonder kids get bored with a real person who stands up and lectures at normal speed. Remember Bill Nye the Science Guy? How would you like to be a science teacher competing with that. So if you have a TV, I’d suggest getting rid of it. Seriously.</p>

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<p>I am just giving you my personal opinion on medicating ADD kids. If the ADD is picked up early enough, sometime might be invested in using some behaviour modification, natural methods and see if any improvement is made. If not, I would go to the meds and see if that makes a difference and also pair it with therapy and behaviour modification. I would put the kid on meds for about two years. I would want the kid off meds by the middle of highschool and performing on his own, and would try to taper the meds that way. There are some professions and opportunities closed to those who have taken these meds within a period of time (4 years, I think). If possible, I would like to keep those opportunities open. Also by mid highschool and college, many kids start experimenting with other substances and mixing them with ADD meds can be dicey. I do not know any technique successful in keeping kids away from alcohol and drugs in a social setting, and it seems to me that the kids who are on ADD types of meds seem particularly at risk–just an observation, not a stat. It’s better to have a clean system when you are dealing with the complexities that young adulthood begins, unless it is very clear the meds are needed. That too can happen, and if you can get the kid on the meds and see the results for a few years, take him off and see the consequence that can figure in the equation.</p>

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<p>Thank you all for your advice.</p>

<p>Alexandre: what helped you?</p>

<p>To clarify-- the past semester has been spent on behavior modification approaches. He dropped his foriegn language, got a study period with the learning specialist; we make lists of homework, teachers email me, etc. It resulted in improvements (up to B- level at 3rd quarter) but the improvements fell apart the moment we let up on the hand-holding (4th qarter, at the school’s request). </p>

<p>As for school fit-- this is a very good point. We knew public jr high would be too much of a zoo. My son was admitted to two small private jr highs-- rigorous & alternative-- & he picked the traditional school he’s in. He had visited both schools for a day and said the other one did not have enough structure for him. (This was <em>before</em> ADD diagnosis-- just his own instinct about himself.) In a way, this school probably “flushed out” the ADD… the other might not have. All in all, I am glad to have found out about the neurological basis for the “space cadet” quality we have seen since he was 6 years old. My anger over the chronic disorganization is 90% less now that I know much of it is beyond his control.</p>

<p>My choices in town are 3 massive public HSs, a couple of smaller rigorous privates, a Catholic HS, homeschooling, or private tutoring. I think my son could attend CC in conjunction with any or all of the above. The alternative school in this area is more geared towards juvenile delinquents and would not be a good environment.</p>

<p>I am exploring a few ideas right now. I am thinking of a year of foriegn service/language study which could function as a “Gap year” for my son and let him have less academic pressure while doing something worthwhile. He’d delay 9th grade by a year (which is the only bummer of this approach, not being with other friends upon return.) This experience would play to his strengths (very socially confident and great “ear” for languages/music.) He is willing to consider this option and thinks it could be fun. </p>

<p>I suppose I want to see whether or not medication is of great help to my son, then decide whether or not to go for meds/school or to have him take time off anyhow. If the medication is not effective, I would probably have him take time off or a study with a private tutor.</p>

<p>My son does not watch tv generally-- though he loves to make films and I do have to limit the time he spends in front of his computer editing on Final Cut. </p>

<p>Jamimom, you and I are on the same page. I can envision your plan.</p>

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<p>My 15 year old son has gone from being depressed and anxious, getting C’s and D’s, having few friends, having teachers dislike him and being unable to complete the simplest tasks and chores, to getting all A’s and B+'s, having teachers engage him in intellectual discussions outside of class and recruit him for clubs, being helpful around the house and feeling immensely more confident socially. He is very health conscious, in great shape and involved heavily in HS sports.I am thankful that there are medication, therapy, and parenting techniques to help him. He was not diagnosed until jr. high, and just completed his 1st year of high school. He takes Strattera, which is a different class of drug, not a stimulant.</p>

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<p>Clearly, there are some kids/adults that need to be on meds. It can make the difference between a functioning and non functioning person. The meds can be lifesavers in such a case. Determining where a young adult falls in the spectrum of ADD is a whole different story. A lot of things come into the equation when the kids become independent and are exposed to the world at large, and internally, this is the time other mental issues rise to the surface as well.</p>

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<p>SBmom, I had to shcedule my time differently than most students. I could not allocate a pre-determined time in a day to study. To ADDers like myself, studying is a state of mind! I had to study whenever I felt the inclination. I also accepted the fact that I could not usually just sit down for 5 straight hours and get it done. I would usually study for 15-30 minutes and then, relax and do something else for 15-30 minutes and then return to studying for another 15 or 30 minutes. Sometimes, I could study for 3 or 4 straight hours, but I would alternate between subjects every 30 minutes or so. The key is to know when tyo alternate from studying to relaxation or from subject to subject. </p>

<p>Another important ingredient to my relative success is my parents. They never believed I had to settle for second best simply because I had a learning disability. They were understanding, but at the same time, they pushed me and insisted on good results. It is important for the parents to strike that delicate balance.</p>

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<p>First I would try diet ( common allergens are wheat, corn, soy, dairy)
Bilateral focused exercise also helps with improving concentration- rock climbing especially.
Some people have found good results with homeopathic remedies.
Also important no matter what way you go is to support the nervous system by extra B vitamins.
All that said-I think medication can be a very important part of a health plan. Medication can allow therapy or behavior modification to work, whether the disorder is ADD, depression, anxiety etc.
My oldest daughter has learning disabilties as well as ADD. She managed through sheer intellect and extra time to get by till high school. But in high school the amount of work was so much more intense that it was obvious her normal coping strategies weren’t helping anymore. While it took a great deal of time to find the right medication,she is having relatively good results with Straterra a new SNRI.
I really hate medication. My father killed himself with an overdose of antidepressants. My mother spent much of the past 30 years heavily medicated, and I have been on various medications for depression with varying results, although I haven’t been on any for about 8 years.
However, the only thing that made me feel even halfway normal is Adderal a stimulant that is used for ADD. I laugh when people worry about getting addicted. I never could remember to take it, which is why I had an extended version, and I never did refill my last prescription, and my insurance no longer covers my doctor.
Medication can be very useful and as long as we remember it is not a panacea, and as long as we don’t paint those who need medication as taking the “easy way out”, it is invaluable</p>

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<p>EK That is helpful to me.</p>

<p>I think I have ADD-like brain as well only the opposite. I become totally focused on one thing to the exclusion of other things. Attention Surfeit(?sp) Disorder?</p>

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<p>SBMom- I think you posted on my a thread some time ago ( my first post on CC) about an ADD antidote. I just want to reccomend a book for you called “Bright Minds,Poor Grades” by Michael D. Wheatley,Ph.D. It is by far the best written aid that I have come across. Mostly it helped ME be more accepting of my son and his ADD. My son hated school in junior high as well. His first year of HS was soooooo different. Part of this was getting away from the whole jr.hi. scene and part of it was teachers who recognized and appreciated the fact that he is gifted and contributes to his daily classes in a major way- but they didn’t belittle him for grades that are far below where he should be performing. He is still making C’s in most classes because he doesn’t turn in work. He got an A on every single mid-term and final though. If school was only about taking tests, he would be fine. </p>

<p>In HS son lost every single text book, didn’t ever go to locker, didn’t keep a date minder (always lost). But if you asked him, he loved high school and felt that all of his teachers really liked him. This was a huge difference from jr. hi. - where I think kids are overguided and scrutinized heavily. After two years of me policing his work in jr hi, I just let him go- and the grades are not much different, but man is my kid happy. Now he realizes that if he wants to make better grades he will need some kind of help staying organized. His chem. teacher this year was acutely aware of this and gave him a lot of extra chances/reminders to get work turned in. He did well in that particular class. </p>

<p>S is on Adderal. I diagnosed him with ADD in 2nd grade but the school would not go there with me. I put him in music lessons at that point, trying to help him develop a work ethic and enjoy a challenge of something that he didn’t already know about. I pleaded yearly with each teacher about getting him diagnosed and each year was met with “he is the brightest student in this class, he can’t have ADD.” And so in jr hi he hit the wall. I gave up on the schools and went to 2 different doctors to get a diagnosis. I regret to this day listening to the schools. I even went back to his 5th grade teacher after his diagnosis and asked her if she really believed that S was not ADD. She told me that teachers in our district are “coached” to avoid diagnosing kids with ADD and especially those who are making all A’s, which at the time he was able to pull off. When I told her how poorly he was doing in jr. hi. she was tearful and knew that a mistake had been made. My point I guess is the school may have its’ own agenda too- don’t always assume they are right. I did ask for a 504 plan this year and was shot down- I am sure it would cost our $$struggling district some money. Next year I plan to meet with teachers and ask for some cooperation and I am going to meet with Ss doc soon to discuss whether to push the 504. It is hard to know what to do. I will tell you that my son is much better on his meds than off. He will tell you that any day he does not remember to take them, which is rare- is a really bad day…</p>

<p>I don’t know that a trial of meds would hurt a thing and it could help tremendously. I know of many “night and day” anecdotes from parents like us who finally decided to give meds a try. I am personally against medicating kids for ADD if other alternatives have not been exhausted. The question is, what is the goal of meds? Is it straight As? or is it a child who says that his days are much better on meds than off- a child who can focus much better with meds (per history and my observation) but is still making all Bs and Cs. Good luck with your son- he sounds very much like mine.</p>

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<p>"A blue-ribbon National Institute of Mental Health Consensus Panel was convened by the National Institutes of Health in 1998 to end the controversy regarding the use of Ritalin in the treatment of Attention Deficit Hyperactivity Disorder (ADHD). The 13-member expert panel – including psychiatrists, pediatricians, neurologists, epidemiologists, and educators, and thought to be favorably disposed toward the use of psychostimulants – found, “After years of clinical research and experience with ADHD, our knowledge about the cause or causes of ADHD remains largely speculative.” They also found, based on hundreds of peer-reviewed studies, that, after 20 years, Ritalin has no proven positive long-term effects. In the short-term clinical trials that have been undertaken (three months or less), the Consensus Panel reports there is “demonstrated ineffectiveness of current treatments in enhancing academic achievement”, and “little improvement” in social skills. For the full report, see <a href=“http://odp.od.nih.gov/consensus/cons/110/110[/url]”>http://odp.od.nih.gov/consensus/cons/110/110&lt;/a&gt; "</p>

<p>I have much more to say on this subject, but I agree this is a matter of personal choice. I just think folks should know what the consensus opinion has been. You should know that these drugs were banned in Sweden as early as 1968, and reviewed regularly, and they have found no reason to lift the ban. In England, drugs are used, but ADD/ADHD are diagnosed at a rate approximately 2-4% of the rate in the U.S. A new consensus is beginning to emerge that the majority of U.S. “ADD” cases are in fact some form of undifferentiated PTSD (often caused by schools and school environments - removed from schools, symptomology often disappears.)</p>

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<p>I agree with Calmom and mini. Stay away from the drug intervention if you possibly can. Are there afflicted male role models available to you who can advise (if they can recall) how they gradually learned to deal with the same issues?</p>

<p>By the way, hyperfocusing on details for a period of time often occurs with ADD, which is one reason why many ADD kids get excellent standardized test scores. That was my situation in school too.</p>

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<p>Ritalin does leave the body fairly quickly, so some students go off of it summers or even weekends.
I found that the generic Ritalin was much less effective and more irritating than the brand name Ritalin. It often is the first drug used as it has been tested extensively and because it leaves the body so quickly.
( The reason why Sweden banned Ritalin was because of wide spread abuse, not because it is ineffective- ever spent a winter in Sweden?)
<a href=“Attention-Deficit/Hyperactivity Disorder - National Institute of Mental Health (NIMH)”>Attention-Deficit/Hyperactivity Disorder - National Institute of Mental Health (NIMH);