If
you wish to return to the 'Ask Dr. Dunc.' mainpage, please click
here
If
you wish to visit the 'Ask Dr. Dunc.' question archives, please
click here
Question
102: Good Morning. This past Thursday ....I heard you speak
about your life history as well as your thoughts about Tourrette,
ADHD etc....To me, it sounded like you were not a fan of medicine.
I have sat on the fence about the medicine issue for a long time.
I have seem the effects of meds on students. Some being visably positive,
some not. Personally, I have a son who is 10 and for many reasons,
I beleive he could be ADHD/PI. His behaviour is not an issue at all
but focusing is. He required the quiet space to accomplish alot. I
also don't believe that he is at Grade level and this concernes me
as the years go on. To have the assessment done, there is a 2 year
waiting list. I am afraid to make the decision of meds. I beleive
that Ritalin is a methenfedamine (I am sure that that is spelt wrong)
and therefore am concerned about giving it to him but on the other
hand, am I not being a good mom if I don't try? Sometimes these decisions
seem easier as a teacher... Any thoughts? Thank you so very much.
C.M., ON, Canada.
Good morning
to you, C.M. Oh, dear -- I certainly didn't want to give THAT impression.
My apologies. Please allow me to clarify:
While I PERSONALLY have chosen not to take medications (and this certainly
would have come through in the presentation you heard, as I was asked
to talk about my own story as an individual with a difference), this
does not mean that I discourage them PROFESSIONALLY. To thrust my own
choice onto others would not be particularly responsible of me.
What I
am NOT a fan of, is knee-jerking into ANY solution (medications OR psychological
treatments). People need to make an informed and INDIVIDUAL choice based
on their own preferences and life factors. There are many physicians
who can and do present on the medication side of things. In my presentations
I tend to spend more times discussing other options for two reasons:
these non-medicinal treatments are what I'M trained in, and it is important
for SOMEONE to be letting people know that there is more than one route
of treatment for them to explore.
To medicate or not is a big topic C.M. -- one that you should cover
with your own health professional who knows your situation. There are
a couple of things worth mentioning for you to think about though:
-don't confuse the question of "should I medicate or not",
with "should I TREAT or not". These are separate issues which
people can sometimes confuse
-of all psychotropic medications, psychostimulants (often used for ADHD
-- methylphenidate is known as Ritalin, and is one
of these) seem to have the fewest side effects (most commonly dysphoria,
insomnia, appetite loss, and increased heart rate and blood pressure).
-these
medications are "in and out" (i.e. they begin to work immediately,
and their half-life is only a matter of hours). Therefore, occasional
use (discussed with and approved by your physician) can be ok without
worrying about the need for a slow buildup into, or removal from, the
system that some other medications require in order to be effective
and safe. It does work best when used continuously though.
-some
people claim that taking psychostimulant medications like Ritalin will
lead to later substance abuse -- actually the data suggest the opposite
(i.e. taking this medication will PREVENT later drug abuse in an attempt
to 'self-medicate'). There also haven't been concerns about growth suppression;
while there is evidence that this can occur in the short-term, the effect
is temporary (i.e. adult height and weight is unaffected).
-of the two subdivisions of ADHD (Inattentive, Hyperactive-Impulsive)
recent research suggests that psychostimulant medications are most effective
for the second type; if psychostimulants are used for the inattentive
type, low dosages are more optimal than high dosages.
-finally, realize that, in their desperation to help their children,
many parents make the unfortunate mistake of stopping a medication too
quickly, or believing that the medication is ineffective, when really
it is their haste to see improvement or their confusion over exactly
what the medication is designed to DO that misleads them into discontinuing
a medication that CAN help. Medications for ADHD may help a child to
better attend, but this will not magically mean that the student is
suddenly 'caught up' in academics or social skills, or that self-esteem
or negative patterns of interaction that have been learned over years
will be suddenly erased. This is work that still needs to be accomplished
in addition to the drug; medications give you the 'solid ground' on
which to have success in accomplishing these tasks though. This is why
the research tells us that the combination of both medications and psychological
treatments usually works the best -- better, in fact, than the sum of
both parts.
I hope this helps, and clarifies my position for you. Again, realize
that this is not a comprehensive review of all the issues you need to
consider, nor an opinion for you one way or another. It is simply food
for thought to help guide your thinking. I do encourage you to discuss
this with your health professional.
