On Sun, 3 Dec 2000, Mary wrote:

> Thank you for the suggestion, Todd. However, what are the side effects, have
> you read the insert, what are the long term effects of Ritalin???

Yes, I've read the insert, plus a mountain of other material on
Ritalin and similar drugs.  As you know, pharmaceutical companies
are required to list every reaction that *might* be an effect of
the drug, even if it is reported in only a small number of cases.

Anyway, the most common side effects are weight loss (resulting
from suppressed appetite), insomnia, and nervousness.  So far,
Dylan has experienced none of these.  He was never hyperactive,
but the drug has a somewhat calming effect.  His appetite appears
unaffected.  Like many 9 year-old kids, he is not thrilled to go
to bed when we tell him to, and usually spends some time fooling
around in his room before getting to sleep.  This hasn't changed.

In his case, the effects of not giving him Ritalin were much
worse.  Although he was able to learn readily, once we got him
focused on the task, getting him to that point was difficult.  He
had a TSS for years to help him with that, but began to resent
the intrusion, so that was causing difficulties too.

When we finally got the Ritalin, we gave him his first dose on a
Saturday morning, so we could observe the effects at home on a
non-school day.  He was watching cartoons.  About 15 minutes
later, my daughter (16) came upstairs and said, "Come downstairs.
There's something weird going on."  We went downstairs and Dylan
had turned off the TV and was sitting in the kitchen, reading
aloud from one of his Arthur chapter books.  Understand that
while Dylan was able to read this material before, it would only
happen when we insisted, and we would be lucky to get him to read
a paragraph before he became too distracted too continue.  Also,
he would get stuck on a word and would tend to have trouble
getting past it.  But on this morning he just guessed and kept
reading.

I asked him if he was okay.  He said, "Yes, I can concentrate now
so I can read instead of watching TV."  He continued reading, on
his own, for about an hour.  Then he worked on his drawings for
another hour before going outside to play.  These things just
didn't happen before.  Similarly, he now does his homework
independently, asking for help when he needs it but otherwise
preferring to do it himself.  Before, we had to hover over him to
get him to finish it.

On Monday, we sent a note to his teacher, explaining about the
medication.  Luckily, the note got lost, so she didn't know.  She
finally sent us a note asking about the sudden transformation.

I want to repeat that we didn't expect this at all.  We were very
prejudiced against Ritalin and the people who make it and use it.
We were, in short, very self-righteous.  It's too bad that our
son was the victim of our stubbornness.  Unlike many other
psychotropic medications, the effects of Ritalin are evident
within a half-hour, and are gone within 4 hours.  There is no
need to administer it for weeks to build up a blood level.  In
short, you can tell fairly quickly if it's going to help
(although it may take some time to get the dosage just right).
And any responsible physician will tell you there's no other way
to predict who will be helped and who won't.  You just have to
try it and see.

As a general thing, Ritalin has *not* been found to be helpful
for most kids on the autism spectrum, but that doesn't mean that
it helps none of them.

Todd Moody
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