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Attention Deficit Disorder Creates Dilemma

Posting Date: 10/10/2005

When a child is diagnosed with attention-deficit hyperactivity disorder, a parent is put in a terrible bind. On the one hand, teachers may push for medications like Ritalin or Strattera. That?s because kids with ADHD can be inattentive, disruptive and have a hard time getting schoolwork done in an orderly fashion.

On the other hand, parents hear that such drugs may have serious side effects. Ritalin makes some children nervous and may cause insomnia. Other children get stomachaches, headaches, heart palpitations or muscle tics. Many lose their appetites.

The drug Strattera now carries a black box warning about irritability and suicidal thoughts or behaviors. Such a caution can?t help but worry concerned parents.

The dilemma of dealing with ADHD is no longer of mere academic interest. An estimated four million U.S. children have ADHD. More than half have taken medication to help them pay attention in class and control their impulses.

Many parents feel torn between their desire to help a child perform well in school and their fear of doing harm:

?Our daughter has ADD but I am scared of the meds. Ritalin gave her tics and antidepressants made her sleepy and depressed. She took Cylert for about a year until we learned that it could harm the liver. Our daughter has been on no medications for almost five years. She is a senior in high school but it?s a daily struggle.?

Not all parents are able to help their child manage school without medication: ?My grandson has had ADHD for years. (It was noticed when he was 2 years old.) He's now 13, and has been on Ritalin for about 8 years. The school won't allow him in if he doesn't have his medication; they administer it in the office.?

Many parents feel coerced by this type of school policy. They want their children to do well, but are concerned about potential side effects. They would like to believe that medicines such as Adderall, Concerta, Ritalin and Strattera are safe and that long-term consequences have been well studied. But there are relatively few clinical trials that run more than several months or a few years. Some children are prescribed stimulant medicines for decades, even after they grow up.