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When any diagnosis is made, the next step is always to identify the treatment options, choose one and implement it. Sometimes this decision is easy, but often it requires a little more thought and research. When it comes to a diagnosis of ADHD there seems to be a consensus among most teachers that some children need Ritalin. Many parents, however, feel that medication for ADHD is dangerous and should be avoided at all costs.
In order to gain a better understanding of how ADHD medications work, I visited Dr Shabeer Jeeva, a psychiatrist at the ADHD clinic in South Africa which has a patient base of over 10 000. Dr Jeeva is personally affected with ADHD, as are his two children.
Before delving too deeply into the different medications, it must be made very clear that there is a definite biological component to ADHD. In fact, at the end of September 2010 a study was completed by British researchers, which found that “children with ADHD were more likely to have missing or duplicated segments of DNA” (The Lancet). These DNA anomalies result in lowered levels of two neurotransmitters in the brain: dopamine and noradrenaline.
Importance of neurotransmitters
Dopamine’s function is primarily to focus our attention and help us identify signals in our environment, such as a disapproving glance from a parent when misbehaving. In addition, it is strongly connected with the pleasure centres of the brain. This means that when we are doing an activity we enjoy, dopamine is released, thereby keeping our attention focused. Noradrenaline’s function is to control our behaviour and limit impulsive outbursts. The levels to which these neurotransmitters are decreased vary from person to person and with the type of ADHD experienced: there is the inattentive type (lowered concentration), the hyperactive type and the combined type, which makes up 64% of the ADHD community.
The treatment for ADHD, therefore, is to increase the levels of the neurotransmitters, but unfortunately there are no natural remedies which can achieve this, barring exercise, which can temporarily boost dopamine levels for approximately two hours. There are a number of natural products and treatments available that improve the symptoms of ADHD, but they cannot increase dopamine and noradrenaline levels.
Three main medications
There are three main medications used to treat ADHD: Ritalin and Concerta are known as stimulants, as they stimulate the ability to focus attention. These medications work on dopamine and noradrenaline levels. Strattera only works on noradrenaline levels and is known as a non-stimulant. Ritalin has acquired the worst reputation of all these medications, with reported side effects of children withdrawing from their friends and family, moodiness and appetite suppression. Interestingly enough, Ritalin and Concerta share the identical active ingredient, with Ritalin’s effects lasting about four hours and Concerta about eight to 10 hours.
Ritalin’s quick release results in quick action, but is then followed by similarly quick “come off”. These rapid peaks and falls are responsible for the negative effects associated with Ritalin. Dr Jeeva therefore rarely prescribes Ritalin as the first port of call. Ritalin LA (long acting) is effective for approximately seven hours, but shares the peaks and dips of its short-acting counterpart. Concerta, which is longer-lasting, has a slower release and therefore a more gradual rise-and-fall effect.
According to Dr Jeeva, about 30% of all people who take any form of medication will experience side effects. He also explained that side effects are manageable, either by changing the dose or adding a supplement or medication to compensate. When a diagnosis of ADHD is first made and the treatment options around medication are discussed, there seems to be a belief that these three medicines are available and that the doctor just needs to pick one and prescribe a dosage based on the child’s weight. This is simply not the case: a rigorous and careful assessment is required before treatment is embarked upon.
Holistic action
22% of people with ADHD will not respond to stimulants and will require medical treatment of another kind, such as certain tricyclic antidepressants or mood stabilisers, to name only two. The unfortunate side to this is that the names of these medications are frightening and tend to have negative connotations. These are, however, only names and if the effects are positive, one should not be put off.
There have been articles written about the probability of people becoming addicted to drugs at a later stage if their ADHD is treated with medication. Dr Jeeva showed studies indicating that the use of stimulants in treating ADHD actually reduces the risk of taking drugs. Untreated, people with ADHD have a 75% risk of turning to drugs; treated, this percentage drops to 25%, which is fairly close to the 18% risk among the non-ADHD population. This makes sense when one considers the impulsive behaviours caused by a lowered sense of self esteem and lowered levels of noradrenaline.
Far from insisting on medication as the only treatment, Dr Jeeva expressed the need for holistic action that includes effective parenting, diet, exercise, sleep patterns and quality, as well as natural supplements. For those who cannot take medication, daily intake of Omega 3, 6 and 9 fatty acids, together with a high protein diet, exercise and coaching is the route to follow.
Whichever avenue of treatment offers you the best results, education remains crucial: ADHD is still largely misunderstood, with many viewing the diagnosis as an excuse for children to misbehave, which, of course, is completely wrong.
For further information please visit www.adhdclinicjeeva.com.
(Delia A. Strondl, registered counsellor and Health24’s ADHD expert, February 2011)
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Your Comments
Ritalin
While I accept that Ritalin is helpful for children who need it, I also think that it is recommended far too quickly by teachers who are too lazy to do their jobs and want to drug children so they don't have to. In this highly competitive society we live in if a child battles academically then there must be something wrong which has to be fixed. People need to accept that some children are not as clever as others, but will always have something that they are good at.
ritalin
self indulgent crap.
@sceptical
I agree with you. Teachers are the first to jump on the ADHD bandwagon. If the child doesn't listen - then he must have ADD or ADHD. Me thinks the child hasn't been taught to listen in the first place!
@Melanie & Sceptical
Yes it is picked up quickly by the teacher because ADD/ADHD children battle the most whilst at school and confined to sitting still and learning for long periods at time etc. So if the teacher picks up a problem, ithen it should be up to the parent to have it looked into and diagnosed properly. 9 out of 10 times the teachers are correct and the kids that parents feel differently are the ones that suffer in the long run.
Really Now!
I'm raising a child with ADHD and believe me I would not recommend Retalin at all. Changing his diet and teaching him that every action has a consequence has helped. He still drives me crazy but he know he misbehaves he will get punished. if only I could get him to focus more...any ideas
@sceptical
hey i was an ADHD child, was just as clever as the rest, just couldnt keep concentration, which made it more difficult for me to study, i understood the work just as well as the others. Although i agree, it is prescribed to easily, or was in my day.
@JustMe - Really Now!
I have an idea for you - USE THE RITALIN. He is not misbehaving - he does not know he is because his brain is wired differently. You are NOT working on the problem of his attention - which means he cannot move forward in learning and schooling. So who are you doing any favours by not giving him the help he needs? You? The people commenting on your parenting? The school? The teachers? Because it is certainly not your child?
Ritalin
Concerta worked for our child - might not for everyone. ADHD is real and unless you have lived with an ADD or ADHD person, you should think carefully about your sceptical comments.
Interestingly, our son was diagnosed with ADD and then after an EEG discovered that it was primarily due to left temporal lobe epilepsy, symptoms of which coexist with ADD. This required epilepsy medication and now at age 19, he is off all medication and the EEG is clear.
@Adriaan
Sorry but it looks like you are a ADHD person, u thinking faster than you can type, quick wheres the Ritalin. Are teachers taught to teach, or have they under gone a 7 year study of the human anatomy to make a decision if the child has to be on a schedule 5 drug. My son has changed schools 3 times because the teacher did not know what to do with him, turns out he is a bit of a maths boffin, so he is now given Arithmatic and not a ritalin.
@Sean Teachers are drug pushers
Yup I had the same problem. Gifted children are bored and the teachers want to put them on Ritalin because they cannot engage the child and sometimes their IQ's are lower than the childs. I think in the majority of cases the teachers are the problem and the kids are actually OK. Teachers are NOT psych professionals.
Teachers
I have to come up for the teachers here.All of you who disses them are being unfair,they have to work with,or teach your child almost the whole day.You don’ t see what your child is doing.Yes they didn’ t study human anatomy for 7 years,but they know when your child is being a bit hyper.Then they just recommend it.Why don’ t you take your kid to a psychologist and find out what’ s really the issue,I mean common 3 schools same problem,there must be an issue.Don’ t be a hypocrite be a good parent!
Good article
As someone who has a medical background and has worked in ADHD, this article is surprisingly balanced and well written. I might add that some of those figures looks suspiciously like they've been pulled out of thin air without references to where they come from! And I'm not sure there is any evidence that changes to diet actually work - again, putting in references that back up such statements will be very helpful to the reader.
ADD
FYI
Ritalin
Parents need to start to accept these studies. This article is excellent. Moms tend to read or listen to anecdotal carpark mafia (ignorant moms) and then in turn spread absolute rubbish about Ritali so kids who can really benefit from this medication lose out on their entire school life. Agreed, some authorities may prescribe Ritalin unnecessarlily.. so Moms - try it for yourself and see how bad it is. It really works and kids can handle school better - concentrate, focus etc.
ritalin
My daughter was on ritalin and unfortunately her mother felt the same way as many of the people providing stupid comments over something they know little about. Without it everything went downhill and she became a complete delinquent. You take your child off ritalin at your own peril. Taking my child off ritalin was the greatest mistake we ever made. Be warned.
Ritalin
My daughter was in Grade 3 when her teacher suggested there was a problem. My first reaction was that it was the teacher that was the problem. However, I took her to a specialist paediatrican, and he diagnosed ADD. She has been on Ritalin (different dosages) ever since, and is now in Grade 7. The change was apparent within days, and none of us have ever looked back. Like ANY medication - it's not for everyone. Right child, right dosage, Ritalin is a life saver.
ADD
I am just new in this whole thing,as far as I know my daughter is a clever child but I was told by her teacher that she need to go and see docter she never concetrate in class.Last year she fail grade 1 and I took her for EEG now she is taking concerta, I feel guilty everyday about draging her. I don't believe in drags.
@ JustMe
Speake to me again when your child turns 14. We'll see whether you still feel the same way
Ritalin
I have a daughter who was diagnosed as ADD. For 18 months I resisted Ritalin. I took her to two pediatric psychologists and other therapists. I tired changes in diet, natural remedies and other therapies. They made very little difference. Eventually I put her on Ritalin after all trying every other alternative. Luckily she has had no side effects. Its a year later and the change in her is remarkable. She loves school, did so well last year plus put on 3kg. The doc left dosage the same 1 a day.
A never ending debate
Many of the arguments posted here are age-old ones and we are likely never to agree. As Mel said, it is not for everyone as Interloper mentioned, giftedness can be misdiagnosed as ADHD as many have said, teachers are not qualified to diagnose. However, if a trend is noted it is their duty to report it to parents-it is then the parents duty to do something constructive with the information. (To SM, your comments on references are duly noted.)
Ritalin
My daughter was diagnosed with ADD in grade 1 and was put on Ritalin. In her case a life saver !! From barely passing grade 1
to becoming one of the top students in her class in grade 2. She
passed matric and went on to obtain her degree , thanks to Ritalin. Used for the correct diagnosis Ritalin really works.
it works for some
Our son was on Ritalin and it worked very well for him. I agree with Mel and LInda - if it works, it enables your child to cope with long hours at school, saves him/her from being singled out for inattention by the teacher and ridiculed by the class you can take your child off medication during the holidays and on weekends and keep it for school hours. Our son came off Ritalin in high school and has done really well.
My Experience
Your child's teacher would be the first person to identify a behavioural problem because of the time spent with your child. It is your responsibility to explore the cause in consultation with your teacher. If it is ADD/ADHD, then it is your duty to consider the options. Ritalin has been brilliant for my son, he can now concentrate and complete tasks. He no longer feels like an underachiever and has much better self esteem. He felt inadequate and insecure before. We had tried diet b4 to no avail.
my side of the story
My sister's girl was identified by the teacher as having concertration problems. Never did the teacher say she had ADHD. She suggested Biostrath for a start then play therapy and finally a neurologist for an EEG. The EEG revealed some abnormalities with her sight on the left eye which could have been affecting him but concluded he did not have ADHD. So my thought is that a teacher would not diagnose a child with ADHD they would just point out the child's problems the rest is up to the parent.
The child comes first
I was VERY anti-Ritalin for many years, due to lending out my ears to unsubstantiated stories, and emotionally reacting to any form of " drug" . I am now the parent of a beautiful 10 year old, who, at the suggestion of the teacher, was thoroughly assessed by a highly qualified educational psychologists, later verified by a neurologist. My daughter is on low dosis Ritalin,has no negative side effects, has an incredibly strengthened self-image, writes better, learns better at school, enjoys life mor
Ritalin
I am a qualified teacher and the diffrence I have noticed with kids that werent on ritalin and then went on to ritalin is astounding. Some kids find ritalin doesnt work at all but then move to concerta and works perfectly so it depends on the individual child. For those that say ritalin is addictive load of rubbish we have never had a child that has been addicted to ritalin parents sometimes fight with their children to take it. Doctors sometimes get the dosage wrong and that mainly the problem.
RITALIN
SCHEDULE 6 DRUG!!! SHAUN!!
RITALIN
RITALIN IS A SCHEDULE 6 DRUG FYI!
HUH?
What's this nonsense about teachers putting kids on Ritalin? A teacher can't! Only a doctor can. There's nothing wrong with a teach voicing their concern, which can then be followed up on by professionals. ADHD is a realy physical, chemical problem with a solution in the form of Ritalin. Misdiagnosis should be avoided but that's true with ALL diseases and problems.
...
Just to make myself clear, what I'm saying is that all these people complaining that teachers diagnose kids with ADHD and then give them Ritalin are talking crap! Not one teacher in the history of the world has written a script for Ritalin.
Ritalin
I sense a bit of ignorance in this article- 2 types of Ritalin/Concerta. These 2 drugs are precisely made up of the same ingredient i.e. Methylphenidate. Like all comodities on the market, each manufacturer has its own name and has modification to the drugs itself. Yes one is made in granule form in a capsule and the other in a hard casing that has a micro dot which releases certain amounts at certain times, hence a 12 hr effect. Straterra is actually an Antidepressant!
ALL DRUGS are not safe!
My story
I have been against Ritalin for years, fought with teachers, doctors and psychologists because you want only the best for your kid. We as parents are very quick to blame the teachers but if you think about it, they spend more time with our kids than what we do. My son is 8 yrs old now, he is going on his 2nd year of Ritalin & the difference is amazing. He is confident, relaxed and eventhough we have to force him to eat, we are greatful that teachers who cared enough to suggest " solutions" to us.
ADD Mom
I reiterate all comments of ADD/ADHD parents. My son is 9 and taking Ritalin for the past year has transformed his life. My question to you sceptics is, if your child was diagnosed with diabetes, would you give him insulin or would you rather go another route? Phumzile, don't feel guilty, you are doing a wonderful thing for your child.
Ritalin
Why does everyone have to be so judgemental! As long as you put the child first, that's all that matters. Ritalin has been great for my daughter, but I always say to people who ask, you need to make up your own mind, because it's not for every child. Do lots of investigation before you make a decision.
Thank you Ritalin
Ritalin changed/saved my life! I am 28 years old now and i can honestly say i would have not got to where i am now with out Ritalin. It got me through school and collage. I now live in the USA and earn over $100,000 a year. If your child has ADD please consider Ritalin. Most ADD children are intelligent, they just need a little help focusing all that brain power!
Ritalin - Make an informed decision
My son was diagnosed as ADHD last year at 15. The school mentioned that he found it difficult to focus and that he was consistently under-achieving but because of many other variables, ADHD was never mentioned by the schools.
I was very anti-Ritalin, but he was the one who asked me to allow him to give it a try. The difference is amazing.
As a team, child/parent/family/school psychologist we work together to find what was right for him. Diet also helped.Wish I'd known sooner
Drugs
And you wonder why at the later stage they are hooked on serious drugs..
William
Thanks for that point
Wrong link
Your link to Dr Jeeva is wrong, it should be: -|-//www.adhdclinicjeeva.com/
ritalin
The people making all these negative remarks are the one's with kids who dont need meds,
My son is living with adhd since 6 years old and he is 9 now, without meds he can not cope, he is on concerta 36mg and progressing at the moment, some parents are in denial and it can be a dangerous thing. My friend at work's son has the same problem no meds nothing and at the moment he is failing because she is in denial.
My sister in law' son failed grd 4 and she still wont listen or do anything .
ADHD
My son was diagnosed with ADHD at 4 years old. He's 9 now and doing extremely well on Ritalin. Without it we fear for our lives, he's agressive, has no self-esteem and is defiant and disrespectful. A lot of people blame the parents when you say your child has ADHD as they say you're too lazy to discipline. If you haven't ever lived with an ADHD person you have no right to comment. It's sheer hell from morning to night but to see your ADHD child achieve something - it's pure heaven.
ritalin
My daughter and stepson are both on ritalin for ADD. The difference it has made to their school work and self confidence is unbelievable. My daughter was 7 weeks prem at birth and jaundice both which have an effect on learning ability. only side affects were a lack of appetite at break time. This was solved by using a protien shake instead of a sandwich. We did our research and didn't listen to uneducated parents who spread negative stories without having used the product
Don't judge to soon
From my first day of school I struggled to concentrate. I was not the Hyper-active ADHD, I was sluggish. Everyone said it was because I was lazy. My mother had me at remedial and extra lessons. Nothing worked and finally after failing Std 6 they said I had Dyslexia. Nobody ever said to my mom that it could be ADD. Life was tough and I really believed I was dumb.
At the age 28 (no matric) and many failed jobs later, I am on Concerta and for the first time in my life I am clever!
Thanx Doc!
Drugs
-|-//www.cchrint.org/
Not for my family
If a doctor prescribes Ritalin, I wont let him diagnose me, or any member of my family.
The Myth of Mental Illness
-|-//en.wikipedia.org/wiki/The_Myth_of_Mental_Illness
Ritalin
Parents must understand, that a dopamine and noradrenaline imbalance also causes psychological suffering. Would they deny themselves a painkiller for a lifelong headache? Would they be able to sit all day on a seat of sharp stones and be productive? I know. I've been there. Children cannot articulate their discomfort. But Ritalin gave me a fighting chance. Ritalin is an angel - the real horror story is with 'wholesome' foods + ignorance. There is nothing else to 'cure' besides the latter.
Diagnoses??
If you are healthy, get diagnosed first, or one of their the healthy siblings, and see what crap they are prescribed, then you'll see that they'll give any healthy person a mental illness diagnoses.
Selftest??
I have done the self test on " Dr. Shabeer Jeeva's" site. My conclusion is that it only shows you are in need of project management skills. And the " skype" consultations he offers is a real classic. How can people fall for this.
Concerta
If you don't have a child who is professionally diagnosed with ADD/ADHD, you really don't know what u're talking about. Basically, Ritalin assists the neuro pathways so that later he can operate without it as it forms a 'memory' in the brain. those of you denying this to your child, are only making it harder for them. We didn't wish this on our children. If you have a headache, do you suffer for days or do you take a pill? hypocrites. my child is now doing fantastic on concerta.
Ritalin
I cannot believe some of the comments from parents who deny their children the help of Ritalin! Being a sufferer of ADD, I don't have the attention span to read such rubbish. If you have never experienced the problems that go with ADD or ADHD yourself then you have no right to comment. I was slapped around the head almost daily at school and told I was stupid. If some teacher had suggested I went on Ritalin, things would have been a whole lot easier for me. My son now in Cont...
Ritalin Cont...
My son now in Grade 4 has struggled since grade 1 with school. I realised that he was experiencing the same problems at school I did. The inability to concentrate for even short periods of time and not stupidity as was suspected in my day. I mentioned it to every teacher, but seen as he's a quiet child they wouldn't hear of it. 3/4 through grade 3 his teacher suggested an assesment - ADD! Instantly a different child on Ritalin LA 20. He now loves school and is flying through his work!!
Ratalin
Forgot to add he almost failed each year. He went to Occupational Therapy from the second term in grade one, right up until two weeks after he started the Ritalin. Suddenly he no longer needed therapy. He started Ritalin in October last year and managed to pass well by the end of the year, they had threatened to fail him. He doesn't take it on weekend or holidays and it makes no difference to his behaviour - so where is the problem? I'm ADD with a touch of H - hence the talking too much -)
chemical imbalance
Impossibility Number 1: No one measure a chemical imbalance in the brain. Impossibility Number 2: No one determine micro-amounts of dosage required to correct such imbalance if it existed. Our diets already contain more preservatives than our bodies can deal with.
Ritalin
My son uses Ritalin and he is a much happier child. He can do a great job at school and he can control his emotions much better.
Ritalin - I still stick with Never Ever
-|-//www.cchrint.org/videos/disorders/psychiatry-labeling-kids-with-bogus-mental-disorders/
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