|
Ritalin is safe - and it works
Research dispels fears that drug hurts kids, and finds
that it actually helps brains grow
by Detroit News staff and wire reports
For more articles visit
www.bridges4kids.org.
NORTHVILLE -- For more than a generation, we've been
"drugging" our unruly children to calm them down. And in doing
so, we have risked damaging their young brains and setting
them up for long-term drug addiction -- or so we have been
warned.
But now, that mantra is being turned inside-out. The first
long-term results of what some have called a huge drug
experiment on our children shows what almost no one expected:
Not only do the stimulant drugs used to treat
"attention-deficit-hyperactive disorder" -- or ADHD as it is
known -- not damage the brain, they appear to enhance brain
growth, helping afflicted children catch up in brain size to
their more "normal" peers.
That blockbuster finding, printed recently in the Journal of
the American Medical Association, is finally easing the fears
of parents afraid of these drugs and is sending experts on a
mission to get the word out.
That's good news for parents such as Kathryn Peltier of
Northville. She reluctantly allowed her 9-year-old son to take
a cocktail of drugs, including Ritalin, after he became so
unruly he almost had to be pulled out of school.
"There's always a big trepidation about medicating your
child," Peltier said. "As a parent, I held off for as long as
I could, but when it comes to your child's well-being versus
the risk of medication, then the medication is worth it."
In Michigan, which ranks third in the nation for Ritalin
prescriptions, the treatments have generated controversy.
Michigan lawmakers this year debated a package of bills that
would have have banned teachers from recommending Ritalin or
similar psychotropic drugs to students. The bills died in the
Senate.
Michigan has consistently remained one of the nation's biggest
consumers of Ritalin. During the 1980s, Michigan ranked first
nationally in the use of Ritalin and all methamphetamines, but
numbers leveled through the 1990s.
Precise numbers weren't available Wednesday, but a 1999 study
by the U.S. Drug Enforcement Administration claimed Michigan
ranked third behind New Hampshire and Vermont. Nationwide,
about 6 million children -- one in eight -- take the
medication.
Study ends myths
The popularity of the drug has spurred debate and worry, but
West Bloomfield Township family physician Dr. David S.
Rosenberg blamed any stigma of Ritalin on drug abusers.
"Ritalin can be a godsend with the right patient, but it can
be a curse if it's abused or diverted," he said. "Most
diagnoses, though, are appropriate and most patients can see
real benefit from the drug."
The 10-year study released by the National Institute of Mental
Health seems to echo the sentiment.
Using brain-imaging technology, scientists scanned the brains
of some 150 children with attention-deficit-hyperactive
disorder while they grew through childhood, comparing them to
about the same number of children who didn't have the
disorder.
They found that those with the disorder start out with
significantly smaller brains -- by 3 percent to 4 percent --
than those without it. And the more severe the disorder, the
smaller the brain, the study showed.
But perhaps more crucial, those children who were treated for
years with psychostimulants such as Ritalin experienced more
brain growth over time than did untreated children, whose
brains remained "strikingly smaller" in certain areas.
"There is no evidence that medication harms the brain," said
Dr. Xavier Castellanos, the National Institute of Mental
Health child psychiatrist who led the study. "It is possible
that medication may promote brain maturation."
That likely explains why many students want to and can
successfully taper off the medication by the time they reach
high school, after years of using it. And that puts to lie
another myth -- that these prescribed stimulants set the stage
for later addictions to illegal stimulants.
Because these drugs are quickly secreted from the body, many
children have required at least three doses a day -- two of
them during school hours.
Controversy continues
But that odd phenomenon -- of dozens of kids lining up at the
school nurse's office to get their mind-altering drugs -- is
changing fast, with today's time-release stimulants. One pill
taken at home in the morning can sustain many children through
the day.
Not only is the safety of ADHD medications being proven in
valid, scientific studies, so also is the effectiveness of
them -- notably in yet another decade-long National Institute
of Mental Health study, this one comparing treatments in
nearly 600 ADHD children.
Just giving psychostimulant drugs alone -- under a doctor's
careful and consistent monitoring to achieve the right dose
and control side effects -- "normalized" almost twice as many
ADHD children, some 56 percent, than did intense behavioral
therapy without the drugs, the study found.
However, combining the medication with behavioral therapy
achieved the best results -- "normalizing" 68 percent of the
ADHD children.
Although these newly emerging studies are reassuring, they by
no means have ended the long-simmering nationwide controversy
over the medicating of our children.
But that controversy is moving away from dire threats about
harmful drugs to warnings that, no matter how good the drugs
may be, too many kids getting them don't need them.
Most of the symptoms of ADHD -- fidgeting, squirming, can't
stay seated, running around at inappropriate times, can't play
quietly, talks too much, won't take turns, can't complete
tasks, can't sustain attention or effort -- describe many
kids.
There is no doubt that attention-deficit-like symptoms often
emerge from other causes -- from child abuse, exposure to too
much violence, bipolar disorder, blood sugar imbalances, even
food allergies, studies have shown. On such children,
stimulant drugs can backfire dangerously, worsening the
behavior.
Detroit News Staff Writer Joel Kurth contributed to this
report.
Ritalin
facts
Children diagnosed with attention deficit disorder are usually
treated with Ritalin or an amphetamine (primarily Adderall).
Prescriptions for Ritalin and amphetamines have increased
five-fold since 1991.
Ritalin prescriptions skyrocketed in the early 1990s, but in
recent years have leveled off at 11 million annually.
Since 1996, amphetamine prescriptions have soared to nearly 6
million annually.
Michigan is said to rank average among the states in use of
amphetamine prescriptions. No state agency, however, tracks
Ritalin or amphetamine use among kids.
Source: Drug Enforcement Administration
|
