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ADHD , Your Child and Medication
by Mike Cohen
TheSyndicatedNews columnist

ADHD, Your Child and Medication

Making the decision to put your child on medication for any problem is always a difficult and complex one – with ADHD it becomes even more difficult and complex. To begin with, ADHD is a newly defined illness and as such there is a wide divergence of opinions on the subject by parents, laymen, school officials, government officials and therapists. Behaviors that in the past were defined as bad children, non-conformists, wild children, etc are now lumped into the ADHD headline. In fact, even though the actual term ADD was not widely used until the late 1980’s, it has already morphed into ADHD, adding hyperactivity to the loosely defined mix. What was previously defined as an inability to focus has been widened to include all manner of behaviors previously outside the scope of the original label. With the identification of behaviors called ADHD constantly changing, how is a confused parent supposed to make an educated guess as to the right thing to do for the most precious asset one has – one’s children? And less personally, but more importantly, how are the powers that be, the people who quite often find themselves recommending treatment for “problem children”, supposed to be educated enough to the quickly changing psycho-therapeutic landscape to be suggesting the right course of action to parents who may make their decisions based solely on those recommendations? Unfortunately, it is my duty to inform you that, as I have learned through hard and painful experience, that the decision is yours to make, with the limited advice of your doctor or pediatrician.

Because of the newness and the vagueness of ADHD, after you’ve done the research and spoken with anybody and everybody you can possibly speak to about you’re situation, you’ll find out two very important things. The first is that ADHD unlike almost all other illnesses is difficult to diagnose and even more difficult to medicate. If you have something serious, like cancer, you’ll talk to the doctors, you’ll be given the choices to make in your situation and one way or another you’ll make them. You can always ask the doctor what he would do in your circumstances and he’ll give you the very best informed opinion he can. He’ll suggest surgery, or chemo or radiation given the type, size and spread of your cancer cells. But when it comes to ADHD, the best you’ll get from a doctor or a therapist are the different types of medication available on the market that your child, depending upon his weight and size, can take. Whether or not to medicate will be YOUR decision and your decision only. And while there might be pressure upon you from the school or from other parents, friends or family members, the ultimate decision whether or not to put your child on medication will be up to you – not them. Sadly, the second thing you’ll learn going through all this pain and confusion is that you know more about what’s going on with ADHD and your child’s life than anybody else. Now, that’s exactly the reverse of the usual medical situation. When you go to a cancer doctor to try to determine a course of action, how would you feel if you knew that you possessed more knowledge about cancer treatments than him? Scary, huh? You bet. But ADHD is so new and so vague AND so different from child to child that you will ALWAYS know more than the doctors you work with and unless some extreme medical breakthrough occurs in the near future, that sad situation will always be true. Even after you’ve made the decision about medicating your child’s illness, you’ll still be the one in charge. You will make the decision to increase, decrease, change or stop the medications – not your doctor. Your doctor becomes the one you call to discuss the situation, and to get a prescription after you’ve made a decision. He’s the one who will monitor your child’s physical progress under the drug – his heart rate, sedimentation rates, blood pressure and side effects. But assuming there are no extreme circumstances forcing you to heed his advice, you are the one who will make the decision about continuing the medication.

You have to do your homework. You have to read books, message boards and talk to anyone with experience to make the best decision possible. And don’t let scientologists, politicians, religious zealots or weirdos affect your decisions. All of them have an agenda of their own that has nothing to do with what’s best for your child. For some people medicine saves lives. For others it’s prayer. And for still others it’s a machine that measures your brainwaves. You know yourself and you know your child. Your job is to learn as much as you can, as quickly as you can to help your child by making the best decisions you can possibly make.

Once you’ve made the decision to try medication you’ll have your first choice to make between the two kinds of drugs available – amphetamines (speed) and non-amphetamines. I don’t want to go into the brand names or the chemical classifications of the two types – you can find all that information out for yourselves. I’m more interested in discussing the human nature of the people and the drugs involved. They say that speed works for ADHD kids because it has the opposite effect on kids than it does on adults. Adults take amphetamines as diet pills or for extra energy. Shortly after taking them the adult mind begins to race, blood pressure increases and their appetite disappears. Side effects of speed taking by adults include but are not limited to the following: rapid weight loss, rapid heart beat, difficulty sleeping, an inability to focus on one thought, slurred speech, itchy skin and a marked decrease of appetite. With the exception of an inability to focus, all of the adult side effects from taking speed can be present in your child to one degree or another. These effects are what you are now on high alert to spot in your child. Your doctor will have recommended a dosage for your child depending upon his or her age, height and weight. Your job, once the drugs are being taken, is to look out for any immediate negative side effect. You know your child – a big eater who turns into a non-eater is not a good thing. An active kid who sits lethargically and stares out into space is not a good thing. A good sleeper who turns into a terrible one is not good. A talker who becomes silent, a non-complainer who suddenly has a non-stop array of aches and pains is not good. Stomach problems, headaches, irritability – all of these things have to be watched for once the medication starts. Here again, each child is different, each child will react differently to any medicine and you and you alone are there to determine if there’s anything drastically different about your child once he starts taking medication.

There’s one more thing to be aware of with the speed medications. They come in two types – the pills that have their immediate affects taken once, twice or several times throughout the day and the time release capsules that are more or less taken once in the morning and release their dosage slowly over a period of time. The time release capsules have the advantage of releasing the medicine over a long period of time so it doesn’t hit them like a sledgehammer. The drawback is that by nightfall, when it’s time to eat dinner, relax and go to sleep, it could still be releasing medicine into their bodies and causing problems. Once again, after a short time for adjustment to the new medicine, it will be you who calls the doctor, reports on your child’s progress and makes the decision about whether or not the dosage is too high or too low, whether or not to stay on the medicine and whether or not to try something else. Your doctor will give you the choices based upon your child’s experiences but you will make the decision. Remember, there’s very little to measure here. With cancer, there are blood markers, tumor sizes, spreads to monitor and check frequently to make new decisions about the course of treatment. With ADHD, there are only extreme side effects and your determination of your child’s progress that will be the deciding factors. The doctor is only there to give you the choices available, the appropriate dosages and a prescription. The rest is up to you. My personal experience with these drugs and my child is that the bad effects outweighed the good ones and in a short period of time I took him off them. For other kids, there were no bad effects, only good ones and they lived healthy productive lives taking daily doses of one of another of these drugs with only positive benefit. Your experience with them will differ from anyone else’s. The best thing you can do is to be aware of your child and watch him like a hawk while he’s taking these medications.

Finally, there are the non-speed drugs or rather the non-speed drug. The only one available right now is a drug called Strattera and I mention the name because it is the only non-amphetamine medicine available for treating ADHD. I’m not recommending it, I’m just describing it. What this drug does is it slows down the brain. It simply filters the electrical impulses in the brain and slows them down rather like swimming through thick water. It has the same effect on anyone and everyone who takes it which means it’s not used on children because it has a unique effect on them. It is used by children and adults alike for ADHD in dosage levels appropriate for their age and size. It also comes with an array of possible side effects just like any other medicine and your child needs to be monitored for these side effects in the same manner as you would for any new drug. My son has always done wonderfully well on Strattera and remains on it to this very day. He has a healthy appetite and sleeps well and while the medicine doesn’t control his impulsive behavior as effectively as the speed drugs did, the trade off is well worth it to us. His behavior is controlled enough to be acceptable to the school he’s in and to the kids he’s around which is all I wanted to accomplish. If I chose to I could drug him into total submission because like I tell you, I’m in control. I could ask for a higher dose of the medicine, the highest dose allowed by the doctor but I don’t. I’d rather trade some impulsive, cantankerous behavior for acceptability in school, a growing social circle of friends, and a growing understanding of right and wrong for a smaller dose of medicine. Like all parents I hope my son one day can live a productive life without Strattera, but for right now it works, it has very little side effects and he’s definitely on an upward spiral. He’s not the easiest kid to parent, in fact he’s definitely a handful. But he’s doing well on the medicine with little or no side effects and that’s where we wanted him to be. And that’s what any parent wishes for a child with an illness.

Published: Jul 19,2008 12:03
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