to take Ritalin or not?

[Estherfromjerusalem]

My son phoned me this evening and told me that his almost six-year-old son (my grandson) has just been diagnosed as having ADD. He underwent thorough testing by a pediatric neurologist so I am sure the diagnosis is correct. Ritalin was recommended. My son and his wife wanted to hear my opinion about whether to give the child Ritalin or not. My daughter-in-law is a bit of a health freak, but not extreme. I told my son that one of my younger sons took Ritalin when he was about 10 years old, and it did help him in the classroom, but it caused knee shaking and it disturbed him so much that he stopped taking it. He was also very small and I understand that Ritalin suppresses appetite. Is that true?
On the other hand, my sister's son was diagnosed ADD when he was in his twenties, and started taking Ritalin then (he had to fight the medical insurance to get it, but he won in the end). And since then he has finished his first degree, done a second degree, held down a regular job, and started a relationship with a girl whom he is going to marry this summer (he is now 38 years old). So those are my two experiences of Ritalin.
I was wondering what your opinions are? If any of you have any interesting experience with Ritalin with a child around that age, I would be interested to hear it and grateful for your sharing. Just to fill in the picture a bit, this is a child who is NOT hyperactive. On the contrary, he doesn't really move enough and has to be encouraged to do physical activity. He is very talented artistically, drawing amazingly (his mother is an artist), and intellectually he is developing really well.
Love, Esther

 

[InsaneCdn]

I've taken Ritalin since the kids were small. No side effects, except that it's obvious when it wears off.
K1 started Ritalin at age 6. K2 started at age 5. Both are now on Concerta - same chemical family. Again... minimal side effects (slight impact on appetite for K1, but he's on a fairly high dose).

Ritalin has several advantages... one being that it doesn't accumulate in your system. So... you try it. It's out of your system in about 8 hours... and no matter what the dose, you don't have to taper off. It can also be fine-tuned in very small increments - big advantage when kids are small and 2.5mg makes a difference!

Biggest disadvantage was the rebound effect - you can really tell when it wears off! (Its part of why we moved to Concerta.)

 

[DaisyFace]

Esther--

I would say the parents should opt for the "lesser of two evils"...

If the child does well enough without medication, then no need to start just for he sake of a new diagnosis.

However, if the symptoms of the ADHD are interfering with the child's quality of life - then by all means, give it a try and see whether there is any improvement.

 

[InsaneCdn]

I agree with DF, with one caveat: It may not be obvious how much they need it, until you try the medication. K2 was an absolute angel at school - just had trouble completing her work. Reality? her brain was NEVER at school. Over-the top classical inattentive type. The Ritalin didn't change her personality at all, but the teacher was sure K2 had to have switched places with a double, somehow. It was THAT obvious, once we started medications.

 

[Estherfromjerusalem]

Thanks for your replies. I'll print this -- they are coming to stay with us over the weekend (Passover festival). What you have both said is interesting and is food for thought. I was really flattered that they wanted to "consult" me and talk about it with me. He's their oldest (they have three). I love my daughter-in-law, she is a lovely and loving mother, and also a good wife to my son. I must say, I'm not really worried about this grandson. Actually, he doesn't communicate with me very much, but he does with my husband. It's strange really, because all my grandchildren love me and want to come to me and be with me, and this one is reserved with me. Peculiar. Hmmmmm. Actually, it suits me because I think as I grow older (I'm 67) I want less and less to devote time to small grandchildren. I adore teeny new babies, up to about 6 months, and then when they become teenagers and older.

OK, enough about me. Love, Esther

 

[Giulia]

My two cents as someone with ADHD.

Side effects vary from a person to another. The only problem is... you never know what will be a medicine X side effect on a specific person until the person tries it.
The user's leaflet always warns about all potential side effects, even the most rare ones (even 1/10000000000 person).

Appetite suppression is a possible side effect. But it's not because it's a possible side effect that your grandson will have necessarily to live with this side effect.

Also, side effect can be present and severe the first few days, then wear off as the body gets used to the molecule.

Even Tylenol can have serious side effect.

 

[buddy]

my son has taken medications since very young. There was no question it was needed so a little easier to decide, though it is still a hard decision, of course no one wants to medicate in that way if they dont need to. One thing I have found from people in my life who have tried it with their children, it at least is a medication that if it does not work, you can stop it pretty easily. Not as much the kind that needs to build up and then to slowly be withdrawn if things dont work out.

Let us know how it goes.... nice to hear from you!

ps have a wonderful Passover!

 

[Estherfromjerusalem]

Thanks Buddy. And thank you all for your input. It is very good to know from your experience that it can be stopped immediately and without withdrawal problems, and I shall recommend to them to give it a try, since it can be stopped at any time.

Buddy, thanks for the Passover wishes. At the moment I am still like a drunkard dizzy from all the cleaning, shopping and preparations. I keep forgetting that I am older and can't do what I used to do. Oh well.

Love, Esther

 

[Malika]

Hello Esther. Echoing wishes for a happy Passover.
Your son and daughter-in-law will obviously take the decision that feels right to them, in the light of the knowledge they obtain. My own feeling about this is that I would not give Ritalin to a young child, whose brain is still developing, until it was clearly needed and in a sense inevitable. I would not give it, myself, just to try or even just on a doctor's recommendation. I have heard the testimony of parents who have found Ritalin a wonderful thing that has given their child some real quality of life back, and I respect their experience. At the same time, I can see no justification for giving it to a child who is "intellectually developing really well", to quote your words, unless there is some pressing problem with attention deficit that warrants it.

 

[Giulia]

Malika, sorry to partly disagree with you.
But if your child had asthma, diabetes, epilepsy... would you refuse to give medicine because "he does well" ?

The key point is that it's not because the child seems to do well that he truly does well. Appearances can be very deceitful, even with ADHD (and my experience is that appearances deceit more with ADHD than with other illnesses. Only my experience, so it worthes what it worthes).
I was at the same point, and while stepmother said that "I was too intelligent not to pretend to suffer", whereas I was struggling with all the mix I had. And no, it was beyond my abilities to "pretend to suffer" like my stepmother said so often.

Of course we don't give medicines just to confirm or infirm a diagnosis.
But it's not because the child seems to do well that he truly does well. We don't have to leave a child to struggle with ADHD only because "we don't medicate a developing brain, he can overcome the ADHD".
It's the best road to let a child self medicate for his symptoms when symptoms become too impairing.
If we give a medicine rather than letting a child self medicate, we can avoid many substance abuse problems (not all, but many of them). Contrary to what many people may say.

If he really does well, and if he has really minimal impairment, it's ok not to medicate.
But it's not because a child seems to do well that he truly does well. We have to be careful with deceitful appearances, like he looks like ok whereas he is not ok.




Esther, the best advice I can give you as someone with ADHD is letting the parents make their own decision about it, and support them whatever the decision they make.

Assure them your support whatever the decision they make for their child with ADHD. If they want to medicate but feel guilty about medicating, tell them that if their child had a physical illness like diabetes, asthma, epilepsy.... what would they do ? I can swear you that comparing ADHD to a physical illness helps with alleviating guilty feelings. Praise them for how well they support their child, praise for any of your grandson's success....
Ask them if they have ways to discipline that work better for your grandson than others. Even if you know the matter, what applies to one may not apply to another.
I know that it's not specific to your question and it goes somehow beyond.
I know it's more general, but whatever your decision, show them that you are there no matter what. It may seem obvious for you, but it may not be obvious for them.

I can be sure from what I've read that you are a terrific grandmother So don't beat up yourself, you know too well how to beat yourself up (like everyone).

I echo the happy Passover (I'll make this holiday with my mom. Yup, she is Jewish too, and I feel strongly my Jewish identity too)

 

[Estherfromjerusalem]

Malika and Giulia,
I truly appreciate your input, it is truly food for thought and deliberation. And everyone else's input too. I am now going to print out this whole thread and on Saturday when we have some quiet time together I will give it to my son and daughter-in-law and let them digest all that you have written, and then we will discuss it. All my children know that they have my complete support in their raising of their children. I know from my own experience that every parent wants the best for his/her child, but that doesn't stop every parent from making a wrong decision sometimes.
Thanks, everyone.
Love, Esther