Saturday 23 August 2008

ADHD, Ritalin and Michael Phelps

Miranda Devine in the SMH.

2 comments:

The Pook said...

I get very annoyed when people with no knowlege or expertise in the area, like judges, politicians, journalists and radio shock jocks make these kind of comments. This is an issue that the mass media like to dredge up and sensationalize every few months.

Even the ultra-simplistic Miranda Devine admits "It would be absurd to suggest that every child diagnosed with ADHD would be an Olympic star without medication; and of course there are responsible doctors prescribing Ritalin." But this last clause still gives the impression that a large number, perhaps even a majority, are not responsible. Nothing could be further from the truth. I'd be pretty certain that practically every paediatrician (and they are paediatricians, not GPs), who prescribes ritalin or dexamphetamine is doing so in a responsible and controlled way.

The case of Michael Phelps cannot be used to argue that kids are typically misdiagnosed or that everyone is able to move off medication. The syndrome varies in intensity, symptoms and comorbid conditions from person to person. Perhaps Phelps was one of the 40% or so of people who do not retain the condition in adulthood. Many people are able to go off medication at about the age that Phelps did. Many are not.

Medication is actually one of the surest ways to diagnose the condition. If you have it, there will be an immediate and significant change in behaviour when medicated. Sometimes, literally, overnight! If you have been misdiagnosed, there will be no effect and the paediatrician will look to some other diagnosis and stop medication.

Here are some facts to counter the hysterical myths put about by the mass media and trendy organic herbal people:

1. ADD and ADHD are real. It is a physical ailment caused by defects in the brain's ability to use dopamine. It is no less a clinical condition than depression, bi-polar disease, schizophrenia, or other problem caused by brain chemistry. And just as with these other conditions, ADD/ADHD runs in the family. Often siblings, cousins, parents, or other close relatives will have it. It has a real genetic basis.

2. There is little or no evidence that any regime of treatment is effective unless it includes medication. So called 'natural' or psychological or behavioural modification programs alone simply do not work. Though, those things will help if done as well as medication. If you feed your kids red food colouring, give them a poor diet, and treat them socially the wrong way, they will be worse, as would any kid. But diet and discipline alone will not make them better.

3. Kids on ritalin or dexamphetamine are NOT more likely to become drug addicts. The opposite is probably true. Someone with ADHD who is not medicated is more likely to "self-medicate" with illegal drugs. Or for that matter, with tobacco, since nicotine also helps ADHD, and these people are more likely to smoke.

4. Kids on medication do NOT sell their drugs to their classmates. For a start, if they stopped taking them to sell them, their parents and teachers would immediately notice. And second, the dosage is so low that it would have zero effect on a normal person.

5. In many cases of ADHD, comorbid conditions exist. It is usually the worst of these conditions and not ADD itself,that are behind a child's appearance on Today Tonight or in the courtroom of judges like the one who made the comments in the article. People with ADHD have a higher incidence of things like Oppositional Defiance Disorder, Conduct Disorder, Autism, Depression, Bi-polar, Anxiety disorders, OCD, etc. Some of these comorbid conditions result in extreme anti-social behaviour. So it would not be surprising that a judge should come across lots of people on Ritalin. Without realising it, he probably also comes across lots of people with ADHD who are not on Ritalin too. It has nothing to do with the medication.

As you may have noticed, the misinformation regarding this disorder is one of my pet peeves!

Anonymous said...

My name is Nathan Finch and i would like to show you my personal experience with Ritalin.

I am 32 years old. Have been on Ritalin for 2 years now. This drug has saved my life. I have seen drastic differences between times in my life when I was taking it and when I was not. I failed out of one school and graduated top of my class in the next. Floated from job to job and then became very successful. I don't like the way I feel when I am taking it (I'm boring -- no personality) so, I time my doses to help me in the office or when I have to focus on mundane task's at home like paying bills, taxes etc. and then go without it when I'm recreating.

I have experienced some of these side effects-
Initially some apatite suppression, insomnia and slight gitters. This was corrected by reducing my afternoon dose.

I hope this information will be useful to others,
Nathan Finch