ADHD debate: medication – the hidden dangers

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My experiences as a parent and ADD consultant

Charlotte was a happy, lively, curious child who always looked forward to every new day, including going to school. But now I was watching my six year old daughter cry uncontrollably each afternoon on her return from school as the drug wore off. It was unbearable for me to watch, especially when she would exclaim through her tears, “I can’t stop crying mummy”.
Charlotte was experiencing one of the side-effects of the stimulant drug methylphenidate, commonly prescribed to children displaying so-called “hyperactive” behaviour and labelled as having attention deficit hyperactive disorder (ADHD). Many people will know methylphenidate by its most commonly prescribed brand name, Ritalin.

Fortunately for Charlotte, she only had to endure the traumatic side effects of methylphenidate for five days. By the fifth day she had developed a nasty red rash down the inside of her legs and around her genital area, so I immediately stopped the medication. I had been warned by the doctor of the known side effects of methylphenidate (uncontrollable crying, loss of appetite, difficulty sleeping and angry outbursts) but the rash was perhaps more worrying, as it arrived without warning.

Since working as an attention deficit disorder (ADD) consultant, I have learnt that not all parents are informed of the numerous side effects of methylphenidate. Parents are often influenced by today’s frustrated teachers, many of whom believe an uncooperative, energetic child must have a neurological disorder which requires medical intervention (despite the lack of a diagnostic test to prove that ADHD has a biological basis). The problem is that the vast majority of doctors and teachers are not fully informed themselves of the potential dangers of methylphenidate use. Meanwhile, many doctors are still happily writing out prescriptions for the pills to pacify distraught parents. Indeed, methylphenidate continues to be the most commonly prescribed drug for children with an ADHD diagnosis.

There have been many claims  made by teachers that methylphenidate makes an ADD child improve academically, but there is no conclusive evidence to prove this assertion. Indeed, a five year study by R. Weiss and colleagues of two groups of hyperactive children, one group on methylphenidate and the other group not on drugs, reported that there was “no differences between the drugged and non-drugged children in terms of school marks, grades failed, amount of hyperactivity or anti-social behaviour.”

In 1999 I attended a seminar by an Australian doctor, Anthony Underwood, who concluded from his own research that methylphenidate did not improve a child’s school work long-term. He stated that, in the first year of drug use, there was often an initial apparent improvement reported by teachers and parents, but after that a plateau effect occurred, as the child’s body adjusted to the regular drug use, and there was no further progress.

Professor Leon Eisenberg, of Harvard Medical School, states “This whole trend towards giving pills to children as a solution to everything, particularly in the absence of evidence that they work, is fundamentally unethical.” He explains further that we should be concerned about a child with disciplinary and emotional problems, “but it’s no reason to diagnose and to drug the child.”

Most children prescribed methylphenidate have been identified for treatment by teachers. What is most concerning is the power that schools have to make parents believe that they have a “damaged” child who can only be “fixed” by the use of drug treatment. Parents should also question why it is that these children only need to be “medicated” during school time and not after school or at weekends. Methylphenidate has unfortunately become the quick and easy fix for many parents and teachers.

When I was told that Charlotte had “behaviour problems” in the classroom, it was suggested that I would be seen as an irresponsible parent if I did not put her on methylphenidate. Indeed, the paediatrician, who diagnosed Charlotte as having ADHD, advised me to be a responsible parent and use the drugs available. After researching the ADHD drugs being recommended for my child, I agreed to trial the drugs, but on the understanding that, if I did not believe the drugs were helping Charlotte, I could stop the treatment at any time.

Charlotte’s sensitive body did not tolerate any of the four drugs we trialled and I was particularly shocked by her allergic reaction to one of them. Yet when I rang the paediatrician to report the severe skin rash, the advice I was given was even more horrifying. The doctor said “Don’t worry that is just a side effect [of the drug]. I will write you a script for Prozac for her to take in the evenings, and that should fix it.” Thankfully for parents, not all doctors have such a narrow focus on the treatment of the ADD condition, and now there are many alternative treatments available offering drug-free options.

We must look at the causal issues of ADD and ADHD. Methylphenidate is a band-aid solution to a complex set of problems that our children are suffering from in today’s toxic society. Parents and teachers should be educated about ADHD as a behavioural problem. Experiences, such as coming from a broken family, being left alone for long periods, playing violent video games, being a victim of bullying, sitting through dull, mind-numbing school lessons, and living on a diet of highly processed foods, are more likely to be contributing to the development of the non-compliant, hyperactive behaviour of a child.

Research has shown that much of the ADD child’s hyperactive behaviour is a direct result of the types of food he/she eats on a daily basis. Therefore, a child’s diet should be the first consideration when putting together a drug-free treatment programme. The most significant improvements in behaviour, in my experience, will be observed once the necessary dietary changes are adhered to.

Correct diagnosis of ADD and ADHD by teachers and doctors is  also essential. As a consultant, I often receive calls from parents who have been told by a teacher that they have an ADHD child, when their child’s behaviour issues actually suggest an autistic spectrum disorder (ASD), such as Asperger’s syndrome. Unfortunately, methylphenidate can also be prescribed unnecessarily for ASD.

So often, children are misdiagnosed by uninformed teachers, whilst doctors and parents are quick to turn to harmful medication. Sadly, I still hear some misguided parents confidently announce “…but it is easier now because he can ‘self-medicate’ without me having to remind him.”

Jennifer Gilmour

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