What is the Role of Medication for Persons with ADHD?
Medication has become the most common method of treating children with ADHD. And the use of medication for adults with ADHD is also on the rise. Psycho stimulants are by far the most frequently used type of medication for persons with ADHD. Psychostimulants stimulate or activate neurological functioning; the most common type of psycho stimulant used for ADHD is Ritalin, or methylphenidate. Although it may seem counterintuitive that stimulants would be used for persons who exhibit inattention and/or hyperactivity, what actually happens is that Ritalin stimulates those parts of the brain responsible for inhibition. Ritalin helps in the release of the neurotransmitter dopamine, thus enabling the brain's executive functions to operate more normally (Solanto, 2002).
For most persons, it takes about one hour for Ritalin to take effect, with the optimal effect occurring at about two hours and the effects wearing off after about four hours. However, the effects can vary from one person to another, so it is important that the physician, teacher, parents, and child work together to arrive at the proper dose and timing of the medication.
Another psycho stimulant that is gaining in popularity is Adderall. Researchers have found Adderall to be at least as effective as Ritalin, and its effects are longer lasting, meaning that it does not have to be administered as often (Faraone, Pliszka, Olvera, Skolnik, & Biederman, 2001; Manos, Short, & Findling, 1999; Pliszka, Browne, Olvera, & Wynne, 2000).
Side effects are relatively common with psychostimulants. However, most side effects are not serious and can be dealt with without too much trouble. The most common side effects are insomnia and diminished appetite. These can usually be controlled if one is careful with respect to when the doses are administered (e.g., not too close to mealtimes or bed times). Less common side effects are abdominal pain, headaches, and irritability. There is also speculative evidence that in a very small number of cases, Ritalin may heighten one's susceptibility to have tics or increase their intensity in those already having a tic disorder, such as Tourette's syndrome.
Negative Publicity Regarding Ritalin
Ritalin has had more than its share of negative publicity in the popular media. For example, several critics of its use have appeared on high-profile TV shows, such as "Oprah," "Geraldo," and "20/20." Many of the critics have claimed that parents and teachers are too intolerant of behavioral deviations and turn to drugs to make children more docile and compliant. Many have also claimed that prescribing Ritalin for children in the early years somehow teaches them or encourages them to turn to illicit drugs, such as marijuana or cocaine, in the teenage years. Although there is a higher incidence of illicit drug use among teenagers with ADHD, there is no evidence that this is the result of using Ritalin (Barkley, 1998). In fact, there is some evidence suggesting that just the opposite is true—those who take Ritalin are less likely to abuse other drugs later (Biederman, Wilens, Mick, Spencer, & Faraone, 1999).
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