Tuesday, June 9, 2009

Medicating children for behaviors; a harsh new reality

(This entry is #2 in a series of posts regarding medicating children for behaviors)
In the 1970s and 80s, children who were deemed "attention deficit" or "attention deficit hyperactive" were started on a new wonder drug, Ritalin. This stimulant medication is thought to have a calming effect on children diagnosed with ADD or ADHD by increasing activity in the brain thereby improving attention. Long term affect on the brain is still unknown as it has been used only for the time span of one generation. It remains unapproved for children under the age of 6. This was the medication that I was handing out to the school children in the 1980s (see post from June 1, 2009).

Today, Ritalin, Adderal and Concerta are the medications most commonly prescribed for ADD/ADHD. They are available in a long acting dose, initially intended to be given in the morning and providing therapeutic calming for the entire day. What I have found to be a frightening new trend is the long acting forms of these medications are now being prescribed for both morning and lunchtime administration. So as the long acting morning medication is continuing to release its prescribed dosage, a second dose is now being started at lunchtime; in effect, two long-acting dosages are being released into the body at the same time, overlapping each other. The child is then receiving more than the prescribed dose during the overlap time.

General side effects of stimulants such as these are loss of appetite, growth retardation, weight loss, heart palpitations, and headache. When the long-acting forms are prescribed for both morning and lunchtime, these side effects are even more pronounced. Keep in mind these are stimulants, medications often sold on the black market, stronger than the caffeine in coffee or today's energy drinks. The child becomes nervous, agitated, refuses to eat lunch, shows mood swings and often becomes explosive (similar to our response when we have had too much coffee on an empty stomach). When this response occurs, the parents seek additional medical help; too often, the youngster is then diagnosed "Bipolar".

With the secondary diagnosis of Bipolar, the current method of treatment now seems to be prescribing psychotropic medications. These are the medications I discussed yesterday:
Abilify, Seroquel, Risperdal are antipsychotics (intended for schizophrenia but used "off label" for bipolar disorder); Trasodone, Tofranil, Zoloft, Prozac and Remeron are antidepressants; Clonidine and Tenex are blood pressure medications (used here to treat the insomnia brought on by the stimulants); and Tegretol, Trileptal, Depakote, Topamax and Lamictal are seizure medications (used here to treat mood instability or "explosiveness" brought on by stimulants). Each of these medications have powerful and permanent side effects. They all have warnings against use in children less than age 6; many have "black box warnings", citing extreme caution if using. I will discuss those in my next post.

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