ADHD Treatment

The Best Treatment for Attention-Deficit/Hyperactivity Disorder

Psychology 2 / Mr. Terrell

Attention-Deficit/Hyperactivity Disorder (ADHD) is a behavioral syndrome characterized by inattention and distractibility, restlessness, inability to sit still and difficulty concentration on one thing for any period of time states Lotha (2006). She also explains the numbers of the diagnoses are increasing annually and according to the Issues & Controversies Database (2005), “Most experts estimate that the disorder affects between 3% and 5% of American schoolchildren, although some say that the figure may be as high as 11% or higher.” This diagnosis was started to be viewed as an official condition until the 1950’s and scientists labeled
it attention deficit disorder (ADD) in the year 1980. Branching out the conditions in 1987, researchers discovered ADHD is an independent attention disorder that related to ADD (2006). Study on this diagnosis continues along with the study of its treatments bringing a label of controversy to the name of ADHD and its solutions.
Scientists think ADHD occurs in part because certain receptors in the brain involved in focusing attention and reining in impulsiveness fail to respond to the brain's natural chemicals, dopamine and norepinephrine.
The interactions between the chemicals and the receptors help most of us stick with tedious chores like balancing the checkbook (they also prevent most of us from blurting out spontaneous observations about the boss's ideas). Medications like Ritalin are thought to increase those chemicals and to stimulate the inhibitory receptors, producing the odd result of a stimulant drug's acting to increase inhibition. Brink explains the drugs enter the body quickly and leave just as quickly, curing nothing but letting a child focus on the important work of learning (1998). Ritalin, which has a calming effect on people with ADHD, is given to students in the hopes that the drug will help them better focus on their schoolwork and other tasks. Receiving treatment, including medication, helps children function better and allows them to lead normal, well-adjusted lives. (Issues and Controversies Database 2005). The medical term of Ritalin is called
methylphenidate.
Methylphenidate is in a class of medications called central nervous system stimulants. It works by changing the amounts of certain natural substances in the brain. (PupMed 2011) Ritalin is a central nervous system stimulant. It affects chemicals in the brain and nerves that contribute to hyperactivity and impulse control.
Pup Med states the names of the medications include Concerta, Metadate, Methylin, and Ritalin (2011). The regular tablets (Ritalin, Methylin), chewable tablets (Methylin), and solution (Methylin) are usually taken two to three times a day by adults and twice a day by children. With regular dosage the condition should improve during your treatment (Pub Med 2011). A long-awaited study by the National Institute of Mental Health shows that drugs like Ritalin calm kids down even better than previously thought--as long as the children continue taking them (Brink 1998). A panel of experts convened by the National Institutes of Health in November 1998 concluded that Ritalin and similar medications, if closely monitored, are the most effective known treatment for the disorder (Issues and Controversies Database 2005). Another medication used to treat ADHD is Adderall. Aderall, similar to Ritalin, is the combination of dextroamphetamine and amphetamine. It is in a class of medications called central nervous system stimulants. Like Ritalin, it works by changing the amounts of certain natural substances in the brain (Pub Med 2011). Extended-release Adderall (XR) is indicated for treatment of ADHD only in adults and in children ages six and older. (Pub Med 2010). Experts say the medications are safe and highly effective at alleviating the symptoms of the disorder (Issues and Controversies Database 2005).
Along with the pros for medicating the kids there are cons and alternatives for treatment. The increase in the use of psychotropic drugs among toddlers troubles doctors because the brains of children at these ages are still undergoing rapid and important biological development. Mind-altering drugs, they say, can impede or transform this development (sK2000). “In my work, I witness firsthand the detrimental effects of medication on a child’s development. Everything from day-to-day moods to physical development and self-esteem are adversely affected, an oftentimes the side effects are heart breaking to watch” states Gordon who is a pediatrician (p.5) (2008). Critics point out that Ritalin can have damaging side effects, and can cause insomnia, decreased appetite and nervous tics. In addition, Ritalin can slow children's growth rates. The researchers noted that there are no clinical trials showing that these mind-altering drugs are safe or effective for children so young (Souped-up Kids 2000).
Breggin argues that Ritalin and similar drugs actually create symptoms similar to those found in obsessive-compulsive disorder, a syndrome marked by persistent unwelcome thoughts and irresistible urges. "They cut back on children's spontaneity, their curiosity, their sense of exploration. Their vitality is suppressed", said Breggin (2005). Denise Luper, a mother of an ADHD child that consumed Ritalin for many years stated, "She's just a zombie sometimes. She's there in body, focused, but it's not her. I'm used to this happy-go-lucky person." (Lim 2007). Many experts express anger that Ritalin and similar medications are being so heavily and commonly prescribed. Rather than allow children to be rowdy, playful and childlike, they say, parents and educators are increasingly demanding that children only sit still and get good grades. Many of the children taking stimulants, however, continued to show symptoms of ADHD, suggesting problems with the doses or with how they were taking the medication according to Lim (2007). Doctors are also concerned about the long-term safety of psychotropic medications, especially because when toddlers start using these drugs, they can stay on them for a long period of time (Souped-up Kids 2000).
The lack of long-term data on the safety and effectiveness of the drugs makes it unethical to prescribe them to large numbers of children (Issues and Controversies Database 2005).
Critics argue that parents and teachers push doctors to prescribe Ritalin in order to help students excel in school by increasing their ability to focus on schoolwork (Issues and Controversies Database 2005). On the contrary experts are concerned that those drugs seem to have little effect on children's academic achievement or social adjustment. 25% of parents whose children have been diagnosed with ADHD refuse to medicate their children. In addition, some doctors are reluctant to prescribe those drugs and instead advocate behavioral therapy for the child. Psychosocial treatment typically involves teaching parents and educators how to better control the behavior of children with ADHD. For example, parents are advised to punish inappropriate behavior consistently and reward actions they wish to encourage, such as completing a homework assignment. The Issues and Controversies Database states parents and teachers learn the most effective ways to respond to ADHD children and learn how to create environments that are best suited for keeping such children disciplined. (2005). Pediatrician Gordon states, “In fact, they can be accustomed to completing most tasks with determination and efficiency when they perceive that there is a clear structure to an
activity.”(p.23)(2008)
The question of whether to medicate the children isn’t just a yes and no. One prominent psychiatrist, Coyle, noted that psychotropic drugs should only be used in extremely unusual cases in children between the ages of two and four. (Souped-up Kids 2000). Most experts agree that medication can help, but it isn't the only solution - parents and teachers need to learn new ways (through rewards and consequences, for example) to teach their kids how to follow rules and sit still according to Brink. (1998) Studies show children with ADHD are more likely than other children to be held back a grade or drop out of school. In addition, they are more likely to have problems with substance abuse later in life and are more likely to spend time in prison. It’s critical to deal with ADHD and I believe Cyole said it best when he said, “…that psychotropic drugs should only be used in extremely unusual case.”(2000) Bleeding both medicine and psychosocial treatment is best.

Reference Page
Brink, S. (1998). Doing Ritalin Right. Sure, it works--but there are big flaws in the way it's being given. Retrieved from http://health.usnews.com/usnews/health/articles/981123/archive_005259.htm
Gordon, J. and Chang, J. (2008). The ADD and ADHD Cure: The Natural Way to Treat Hyperactivity and Refocus Your Child. Hoboken, New Jersey:John Wiley& Sons Inc.
Issues and Controversies Database (2005). Attention Deficit/Hyperactivity Disorder. Issues & Controversies database, p.1. Retrieved from http://www.2facts.com/article/i0400830
Issues and Controversies Database (2000). Souped-up Kids. Issues & Controversies database. Retrieved http://www.2facts.com.ezproxy.scccd.edu/article/s0801940
Lim, P. (2007). Study Asks How ADHD Teens Retrieved from http://sks.sirs.com.ezproxy.scccd.edu/cgi-bin/hst-article-display?id=SCA2758H-0-8049&artno=0000262084&type=ART&shfilter=U&key=Ritalin&title=Study%20Asks%20How%20ADHD%20Teens%20Cope&res=Y&ren=N&gov=N&lnk=N&ic=N
Lotha, G. (2006). What is ADHD. In The New Encyclopedia Britannica. Chicago, IL: Encyclopedia Britannica.