Ritalin overdiagnosis and misuse in children with behavioral disorders

Ritalin: Good or Bad?

Ritalin is a tradename for Methylphenidate hydrochloride, an antidepressant stimulant. It was created to stimulate the central nervous system and is used to treat increased compulsion to sleep and hyperactivity disorders in children.

According to University of Miami pediatric psychologist Dr. F. Daniel Armstrong, despite recent bad press regarding Ritalin, sometimes children need the drug to keep them safe and healthy. "Sometimes it is the safest way, especially if the children are at risk to themselves or others," said Armstrong (The Miami Herald).

However, a recent article in USA Today magazine points out that physicians are too quick to diagnose attention deficit disorders and dispense stimulants to children who exhibit normal activity levels. "The difficulties in finding a panacea for entrenched, maladaptive behavior in children do not provide sufficient justification for plunging into a nationwide pharmacopoeia for solutions." (USA Today)

THESIS

While many physicians and researchers tout Ritalin for its helpful effects on children with DD or ADHD, it should not be used as a first or only step in helping children with behavioral probes. Parents, educators, and family doctors should first rule out other causes for behavioral problems at school or at home.

In many cases, problems that look like ADHD are hiding other issues, suh as language or memory difficulties, learning disabilities, emotional disorders, or even hearing and vision problems. This can result in children being misdiagnosed with ADHD and prescribed Ritalin, which can be dangerous to them. Before prescribing Ritalin so freely, researchers need to produce evidence that Ritalin is not harmful to small children.

EVALUATION

This article proves that the increase in the number of users among children and young people should be regarded with caution. There are too many questions unanswered. For example, there are no proven results for long-term studies.

Current efforts to fully understand how Ritalin works in the brains of hyperactive children still have a long way to go. Until then, it should not be used on innocent children.

SUMMARY #2

The Miami Herald article argues that Ritalin may be a good thing. According to Dr. Lawrence A. Schachner, the university's director of pediatric dermatology, pediatricians want to hear about" Ritalin and other stimulants because there is a high demand for them.

Ritalin proponents say that the drugs are helping children combat mental illnesses and enabling them to enjoy a normal childhood. Still, the drug is enabling society to ignore other problems contributing to children being hyperactive or having problems concentrating.

EVALUATION

Whether or not doctors and parents accept ADHD as a neurobiological disorder influences the question of how, or when, to treat it. It has become increasingly common to treat ADHD by prescribing Ritalin to children.

Supporters of Ritalin argue that there is a clear connection between abnormal brain chemistry and symptoms of ADD and ADHD. Studies show that ADHD victims have less of the neurotransmitter dopamine in their brains. This chemical messenger is believed to cause the brain to be more aware and more focused. With ADHD victims, it seems that the brain has more difficulty maintaining dopamine levels and a harder time keeping focus.

According to Ritalin proponents, Ritalin works to maintain dopamine levels. However, the long-term risk to children who take Ritalin to manage ADHD is unknown. Therefore, it is too dangerous a drug to be administered so freely.

CONCLUSION

After months of controversial headlines regarding Ritalin, the American Academy of Pediatrics released its first recommendations for diagnosing ADHD in young children. The academy claimed that up to 12% of all children might suffer from ADHD. The academy reported that 80% of children on stimulants, including Ritalin, had been helped.

However, it also admitted that existing diagnostic tests were ineffective, including lead screening, tests for generalized resistance to thyroid hormone, and brain image studies. Some of the criteria for diagnosing ADD and ADHD include "inattention" and "hyperactivity-impulsivity," such as the following: "often does not seem to listen when spoken to directly"; "often has difficulty organizing tasks and activities"; "often has difficulty playing or engaging in leisure activities quietly"; and "often talks excessively." These "symptoms" basically describe the majority of schoolchildren at one time or another. (USA Today)

The Food and Drug Administration has promised to design studies to provide safe and accurate pediatric dosage information for labeling on all drugs that are used for children, including Ritalin. However, the New York Times published an article in 2000 that argued that these efforts would not adequately address the problems of indiscriminate diagnosing and treatment of ADD and ADHD in young children.

Julie Zito, associate professor of pharmacy and medicine at the University of Maryland, says that the JAMA study is important because it "seems to support the anecdotes that more children are receiving a diagnosis and treatment for attention deficit hyperactivity disorder in the late 1990s than ever before." (USA Today)