Good morning,
My son was placed on Ritalin at the age of 8. It did help him focus more.
He mentioned a racing heart numerous times (from the first dose). He is
strongly attracted to addictive substances and feels that Ritalin played a
role in this. He has also been diagnosed (at age 14) as having heart
damage, and the arteries "of a 70 year old man" (physician's words).
IMO, pharmaceutical drugs can be helpful in life-threatening situations.
Beyond that, long term usage most usually results in damage to one or more
bodily systems.
Despite Ritalin being known as an addictive substance, FAQs like this one
below, abound. This is one of the things that makes me sick about
allopathic medicine and pharmaceutical drugs.
Siobhan
Ritalin and Related Stimulant Medications
[Back to ADHD page.]
Prepared by Pediatric Neurological Associates. [Click here for our home
page.]
What are stimulant medications?
Ritalin (methylphenidate), Dexedrine (dextroamphetamine), and Cylert
(pemoline) are sometimes called "stimulants". When prescribed for people who
have Attention Deficit Hyperactivity Disorder (ADHD), they stimulate parts
of the brain which are not filtering out distractions as well as they
should. They are not tranquilizers or sedatives. The children appear
"calmer" because they are more focused, not because they are sedated.
How can these medicines help?
They can improve attention span, decrease distractibility, increase ability
to finish tasks, improve ability to follow directions, decrease
hyperactivity, and improve ability to think before acting (decrease
impulsivity).
Legibility of handwriting and completion of school work and homework can
improve. Aggression and stubbornness may decrease in youngsters with ADHD.
Stimulant medication is not the only answer for ADHD! The medicine often
works best when used together with special help in school and behavior
modification procedures at home and school. Some youngsters and families
also benefit from individual, family, or group psychotherapy. If stimulant
medications do not help, or cause side effects that are a problem, you can
discuss other medications with the doctor.
How long does the medicine last?
Ritalin and Dexedrine last 3 - 4 hours. Sustained-release Ritalin (SR),
Dexedrine Spansules, and Cylert may last at least 6 - 8 hours.
How will the doctor monitor this medicine?
From time to time, the physician (or nurse) will check height, weight,
pulse, and blood pressure. When Cylert is used, blood is taken to check on
the liver function and blood count -- usually before starting the medicine,
and occasionally afterward. The doctor will ask for regular reports from
your child's teacher(s) to check on learning and behavior.
What side effects can this medicine have?
Any medication may have side effects, including allergy to the medication.
Because each patient is different, your doctor will work with you to get the
most positive effects and the fewest negative effects from the medication.
The list below may not include rare or unusual side effects. It is important
to note that except for a fraction of the children who experience mild
appetite or sleep problems, the vast majority of people have no significant
side effects from Ritalin.
Lack of appetite (Handle by encouraging a good breakfast, and afternoon and
evening snacks; give medicine after meals, rather than before. Problem
usually resolves.)
Trouble falling asleep, which usually improves over several weeks.
Headaches
Stomachaches
Irritability, crankiness, crying, or emotional sensitivity.
Rapid pulse or increased blood pressure.
Rarely, as the medicine wears off, hyperactivity or bad moods get worse
than before the medicine was started. This is called "rebound". The doctor
can make dosage adjustments to help this problem.
A few children may not grow quite as fast as usual. This is why the height
and weight are checked regularly. Growth catches up if the medicine is
stopped.
Occasionally, nervous habits (like picking at skin) or stuttering may
appear.
Muscle tics or twitches, jerking movements.
Sadness which lasts more than a few days.
Any behavior which is very unusual for your child.
Please talk to the doctor if you suspect the medicine is causing a problem.
What could happen if this medicine is stopped suddenly?
There are no medical problems in doing this. A few youths may experience
irritability, trouble sleeping, or increased hyperactivity for a day or two,
if they have been on daily medication for a long time, especially at above
average doses. Occasionally, it is better to stop the medication gradually,
over a week or so.
How long will this medicine be needed?
There is no way to know how long a person will need to take the medicine.
The parent, the doctor, and the school will work together to find out what
is right for each young person. Sometimes the medicine is needed for only a
few years, but some people may need help from medicine even as adults.
What else should I know about this medicine?
Many people have incorrect information about this medicine. If you hear
anything that worries you, please check with the doctor.
This medicine does not cause illegal drug use or addiction.
This medicine does not stop working at puberty.
Some young people take the medicine three or four times a day, every day.
Others only need to take it twice a day or once a day on school days. Your
doctor and you will work out what is best.
If a dose is missed, just pick up with the regular dose at the next
scheduled time. Do not double up the next dose.
It is important not to chew Ritalin Sustained Release tablets or Dexedrine
Spansules, because this releases too much medicine all at once.
If the medicine seems to stop working, it may be because it is not being
given regularly (especially at school), because your child has gained weight
and needs a higher dose, or because something at school or at home, or in
the neighborhood, is upsetting your child. Please discuss your concerns with
the doctor.
© Pediatric Neurological Associates
Dying on Ritalin
A teenager's fatal heart attack raises troubling questions about the safety
of a drug whose popularity is exploding.
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By Lawrence H. Diller, M.D.
April 27, 2000 | Ritalin is once more in the news. In just the past two
months, a survey found large increases in the use of the stimulant drug --
prescribed most commonly to treat hyperactivity and depression -- for
toddler misbehavior. What's more, newspapers reported the widespread
recreational use of Ritalin on college campuses and by adults. And now, a
medical examiner in Pontiac, Mich., has released findings strongly linking
long-term use of Ritalin to the death of a 14-year-old boy.
The teen died at home while playing on his skateboard. Initially, it was
thought that he had injured himself in a fall, but the medical examiner
found the cause of death to be cardiac arrest secondary to blockage of
coronary arteries that supplied blood to his heart. Such changes in the
blood vessels are not ordinarily found in children so young, but are typical
of the damage seen in adults who chronically abuse stimulants. The boy had
been taking Ritalin for attention-deficit hyperactivity disorder under a
doctor's prescription for 10 years. The medical examiner believed that no
other reason could account for the changes in the child's heart. At least
two other children who were taking Ritalin have recently died, in Texas and
Ohio. These cases will now be investigated further.
What does this report mean for the approximately 4 million children taking
stimulants for ADHD in America today? Amphetamines like Dexedrine and
Adderall -- as well as Ritalin, a closely related stimulant -- have been
used to treat hyperactive children for decades. It stands to reason that if
heart attacks were a common risk associated with these drugs, we should have
discovered the link long ago. When taken properly -- orally and in low
doses -- these drugs have always been believed to be quite safe, one
justification for their use in otherwise healthy children. Nearly 40 years
of experience using Ritalin in children has reassured parents and doctors
about the relative safety of this drug.
Nevertheless, aspects of the Michigan case, if confirmed, are troubling.
Ritalin, amphetamine and cocaine are closely related in pharmacological
structure and action. All three can be abused and lead to addiction, though
children who do not self-medicate virtually never become addicted. It's well
known that amphetamine and cocaine affect the coronary blood vessels and the
heart itself; heart attacks and sudden death in stimulant abusers occur with
enough frequency to have generated a body of medical literature. The
Michigan autopsy found pathological changes in the boy that match those of
unfortunate amphetamine and cocaine abusers.
While we've used Ritalin with kids for years, until the 1990s treatment
typically ended at puberty -- when childhood hyperactivity usually
diminishes. And treatment for more than five years was unusual. But now that
many behavior experts are recommending lifetime stimulant treatment for ADHD
and more and more children are taking Ritalin into adolescence, the Michigan
case demands further investigation, with other pathologists reviewing the
medical examiner's findings before firm conclusions are drawn. In addition,
a study of teens who have taken the drug for a decade or more should be
mounted quickly to determine if their heart function is being affected -- if
only to reassure an anxious public shaken by this news.
Given the ongoing controversies surrounding Ritalin use, this report further
complicates the difficult choices facing parents and children taking or
considering taking the drug. To the families of the children whom I treat, I
am recommending no changes at this time. However, any teens complaining of
heart symptoms should be assessed by their doctor and possibly referred to a
cardiologist for a more complete exam and a stress electrocardiogram.
Unfortunately, chest pain and fatiguing easily -- two cardinal signs of
heart disease -- are also common complaints of slightly anxious but healthy
adolescents.
Whether it turns out to be a tragic coincidence or the first inkling of a
catastrophic side effect of Ritalin, the death of this child reminds me as a
doctor of my Hippocratic oath: Primum non nocere -- first do no harm. Until
I learn of further evidence exonerating Ritalin's association with sudden
death, I know I'll be just a bit more careful in deciding which child does
or doesn't take this medication. I know parents will be, too.
salon.com | April 27, 2000
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About the writer
Lawrence H. Diller practices behavioral pediatrics in Walnut Creek, Calif.
He is the author of "Running on Ritalin: A Physician Reflects on Children,
Society, and Performance in a Pill."
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