Ritalin: Is It A Miracle Drug Or Are We Creating A Essay, Research Paper
Ritalin: Is it a miracle drug or are we creating a society of child junkies? Methylphenidate, more commonly known as Ritalin, is a stimulant drug used in the treatment of Attention Deficit/Hyperactivity Disorder (ADD/ADHD) in children. This disorder seems to be becoming more and more common, as is using Ritalin for its treatment. However, ADD/ADHD does not seem to be a biological disorder, so why is it being treated with a biological drug? Ritalin is being used to stunt activities that are considered disruptive and inappropriate, but are they due to an actual disorder or perhaps to high levels of creativity or to a lack of discipline? Ritalin is being overprescribed and helping to raise a generation of children that are dependent on drugs in order to function in society, while also lessening normal behaviors and creativity levels. According to the DSM-IV some of the symptoms of ADD/ADHD include fidgeting, difficulty playing quietly, trouble remaining seated, difficulty holding attention and following instructions, etc. Meeting any six out of the nine items on the list usually leads to a diagnoses of ADD/ADHD (Breggin, 57). Ritalin is commonly described to subdue these activities. However, do these activities really constitute a disorder? Many of these symptoms seem to represent normal childlike behaviors that can be curbed with either more adult attention or discipline. One study conducted by Alan Zametkin showed increased brain metabolism in PET Scans in adults that had had ADHD during childhood. However, when the studies were later separated it was shown that his results had been lumped together in a way to form these conclusions that were not completely accurate. After conducting other tests and experiments there does not seem to be a biological cause for ADD/ADHD. The neuroanatomy of the brains of children diagnosed with this disorder is normal (Breggin, 61). According to more recent studies, Ritalin effects all children the same, whether they exhibit the disorder or not. Any child that takes a dose of Ritalin will be able to focus more clearly, be more obedient, and be able to perform more mundane tasks. They become less focused on their own true feelings, which allows them to focus more on outside stimulants (Breggin, 62). If this is true, that a single dose of Ritalin can cause extreme concentration, then why the continuously high medication levels of Ritalin for children? They can actually cause more problems – hyperactivity, aggression, physical tics. Sometimes it can effect growth and also appetite and sleep schedules. There is also a risk of permanent brain damage due to long-term use of Ritalin (Breggin, 65). However, an experiment was conducted by Mark A. Stein et al. to evaluate the effectiveness and side effects of taking the general prescription of Ritalin – twice daily (b.i.d.) as compared to three times daily (t.i.d.). Placebo and titration samples were also used in the experiment. Twenty-five boys with ADHD, ages 6-12, participated in the experiment for five weeks. It was a triple blind study and results were based on weekly recordings by parents and teachers descriptions of the behavior and attention levels of the children, a child’s report of themselves, sleep logs and actigraphic recordings of sleep activity, as well as lab measures of attention (Stein, et al). The most common prescription of Ritalin is twice daily at 8:00 AM and noon. This type of prescription, however, does not help with after-school and nighttime activity. The experimenters wanted to test the side effects of higher doses of Ritalin. Each child was given three pills daily, whether or not they were a placebo depended on the dosing schedule per week. Different tests and rating scales were used to determine the following: ADHD symptoms and behavioral measures, stimulant side effects and sleep, cognitive and affective measures, and physical measures (Stein, et al). The results of this experiment revealed an improved level of behavior for children taking three doses daily, as observed by parents and teachers. The side effects for t.i.b. versus b.i.d. were not very different except for increased appetite suppression during t.i.b. and also increased time to fall asleep. When followed up, many of the children from the experiment were taking t.i.b. dosages of Ritalin with no apparent adverse effects (Stein, et al). However, these effects have not really become long-term yet. Yes, maybe higher dosages of Ritalin don’t have any outward harmful side effects while taking it, but will prolonged exposure cause irreversible brain damage? Is it worth the risk just to produce more docility in children for longer periods of time? Another risk in using Ritalin to create more docile children is that it is stunting creative activity which is something that our society usually tries to cultivate. In her article, “Attention-Deficit Hyperactivity Disorder and Creativity-What is the connection?”, Bonnie Cramond discusses how signs of high creativity levels may often be mistaken as signs of ADHD because their characteristics are very similar. Just as there are behavioral characteristics that must be met to diagnose ADHD, there are also behavioral characteristics that determine high levels of creativity in children. Strangely though, the characteristics of two very seemingly different conditions, are extremely similar. For example, often failing to finish things (ADHD) can be seen as having a lot of interests (creativity). Also excessive fidgeting, running, inability to remain seated (ADHD) can also be attributed to high energy levels (creativity). Daydreaming is also a characteristic on list for both of these conditions (Cramond, 197). These are only a few examples, however, most of the children that exhibit these behaviors are automatically diagnosed as having ADHD and most often put on Ritalin. Ritalin then suppresses the creative activities and allows children to concentrate on the more mundane parts of life that perhaps they didn’t have an interest in before.
In 1992 Shaw conducted a study examining the relationship of the two conditions. He compared a group of ADHD children to a group of normal children. They were matched according to age, sex, and IQ. Their responses to certain psychological tests and tasks were measured. “The ADHD group showed greater left laterality of function, greater perception of tacit relationships on a matching task, more crossed eye-hand dominance, less time spent on unsolved anagrams, higher figural creativity, a higher score on the stimulation seeking measure, greater incidental memory, more use of imagery in problem solving, and greater use of peripheral information to solve anagrams” (Cramond, 199). Many of these results are commonly used to describe creative individuals, however, in this case they also describe the ADHD group. Cramond has also done some case studies of children who may be taken for either creative or ADHD. Eleven-year-old Benjamin was thought by his parents to have ADD because of his short attention span and distractibility. According to individual intelligence tests he is above average, and his achievement test scores are especially high in math. Also, his score on the creativity test was in the 99th percentile, still though, he was diagnosed with ADD because he showed at least eight of the 14 characteristics used to characterize it (Cramond, 202). Philip is a 15-year-old who was sent for psychological evaluation when he was three because he didn’t stay quiet and in his seat during preschool. At age five, he was put on Ritalin. Later tests showed that he had average intellectual functioning, and above average functioning in math. He scored in the 87th percentile on the creativity measurement despite his medication, which usually decreases right hemisphere activity, reaction time, curiosity, etc (Cramond, 203). These are just a couple of cases that illustrate the difficulty of deciphering between the two conditions. Unfortunately, many children that are simply displaying creative tendencies will be incorrectly diagnosed as having ADHD, medicated, and lose their creative abilities. Ritalin seems as if it effects many different areas of the brain. If it has an effect on sleep and appetite it is effecting the medulla somehow. The way that it suppresses activity seems to be working through the limbic system and also through the hypothalamus in relation to the regulation of hormones. However, there still isn’t really any evidence indicating a physical manifestation behind ADD/ADHD. I think that more tests, such as PET scans, etc. should be done, especially during times of ADD arousal to see if any brain areas are showing more stimulation. A potentially harmful biological drug is being used to treat a disorder that does not show a biological basis. ADD/ADHD is a disorder that is over-diagnosed and as a result Ritalin is a drug that is over-prescribed. So many activities that were once considered to be normal childhood curiosity and playfulness are now seen as problematic. Why weren’t these methods needed even 30 years ago? Children are not miniature adults. They have shorter attention spans than those of adults. In reference to Philip, how many three-year-olds actually remain seated for an extended amount of time? Does this mean that they must all be medicated to produce the docile effects that make the lives of parents and teachers easier? There are some children that really do need Ritalin, however, not the extremely high numbers that receive it. A generation of children id growing up on a drug that they believe is necessary for them to function in society. With this belief, is there really any hope for them to ever even try to function normally on their own? Many parents seem to be looking for an excuse for why their children are acting out of control. Perhaps they should look to themselves, but instead they seek a diagnoses of disorder and opt for the quickest remedy, Ritalin.
Journal-of-College-Student Psychotherapy. 1995: Haworth Press, NY. “The hazards of treating “ADD/ADHD” with methylphenidate.” Peter R. Breggin; Ginger Ross Breggin. Journal-of-Creative-Behavior. 1994: Creative Education Foundation, Buffalo. “Attention-deficit hyperactivity disorder and creativity: What is the connection?” Bonnie Cramond. Pediatrics. 1996: American Academy of Pediatrics. “Methylphenidate Dosing: Twice Daily Versus Three Times Daily”. Mark A. Stein, PhD; Thomas A. Blondis, MD; Eugene R.Schnitzler, MD; Tara O’Brien; Julie Fishkin; Brad Blackwell, MS, RPh; Emily Szumowski, PhD; and Nancy J. Roizen, MD.