Examining Drugs for ‘adhd’

which they really do not know yet what the effects are on growth. He states as well that stimulant medication IS addictive in adults, but says, “The results suggest that there is no increased risk for drug abuse associated with treatment, although -more research is needed to rule this out conclusively.-” Here again, if it is addictive to adults, I ask, why not children too, and he says that research is yet conclusive. With effects on the cardiovascular system, Barkley states, “studies have -not- specifically addressed this important issue.” So, they are prescribing something for which they are unsure of the effects on growth as well as the cardiovascular system.

Barkley states as well, “The side effect that should receive serious attention from clinicians is the possible increase in motor or vocal tics produced by stimulant medication.” He continues- “It still seems prudent to screen children with ADHD adequately for a personal or family history of tics or Tourette’s Syndrome.” I recall having a session with a child with the mother first and being informed that he was being treated with Ritalin, I later had subsequent time with the father, and he had visible tics, this really alarmed me in reading about the issue of tics and Tourette’s and I had to question not to the family but within myself if this was really the best option for the child faced with this risk. Barkley also states, “Isolated cases may arise in which parents note that a child is no longer ‘spontaneous’ or childlike in his or her behavior and appears -controlled- or -socially aloof-. This is concerning, and it appears that stimulants do have an affect in gaining control and conformity. Many of the stated results of the stimulant medication are too subjective, and Barkley states clearly that, “an improved ability to master increasingly difficult or higher-level academic material, such as that assessed in achievement tests, has -not- been demonstrated.

Here we have an example that it would not have been as a result of stimulant medication if we see academic progress. Barkley also says that ‘low and moderate doses of methylphenidate do reduce the frequency of aggression and noncompliance in groups of children but have no appreciate effect on either direction on prosocial or nonsocial behaviors.” So, I will acknowledge that stimulants can help with short-term behavioral inhibition, but what about long term? This is my main concern, with the side effects and without evidence of a long-term result and without knowledge of long-term results on growth and cardiovascular development, is this really the best option? Barkley states, ” Few studies employing rigorous methodology have evaluated the long term efficacy of stimulant medication. Those that have examined the issue have generally found little advantage of medication over no medication when evaluated over extended periods (Pelham, 1985, Weiss & Hechtman, 1993) Children who had been on drugs but were off at the time of follow-up were not found to differ in any important respect from those who had never received pharmacotherapy.”

Another concern is the effects in mood, I worked with one child who was already experiencing social withdrawal and was going through the trauma of losing a loved one. After receiving stimulant medication, this intensified. Wender states, “Instead of becoming high or excited, these drugs in general calm down ADHD children and sometimes they may even become somewhat sad.” Barkley states, “some children may evidence various mild negative moods or emotions in reaction to stimulants…Some children describe feeling ‘funny’, ‘different’ or dizzy as a function of medication.” What about self-esteem and confidence, Greenspan acknowledges that creativity can be affected, and Barkley states, ” some concern has been raised that diminished self-esteem could be a emanative effect of methylphenidate as children may attribute the source of their success while on medication to external rather than internal factors.”

Pages: 1 2 3