Friday, August 31, 2012

My Take on Meds

The key word being "my."

A couple of months ago, a woman that I know casually told me that her son was having problems in school and she was having him evaluated for ADHD.  This woman told me that she couldn't wait for the evaluation (done by psychologists and certified by psychiatrists) and was hoping that her child would be put on Ritalin because she knew lots of other kids in her son's school that had similar problems, they went on Ritalin and everything was great.

We also discussed Maya a little and she asked me out of genuine concern what Maya's issues were.  To her, Maya seemed like a normal kid and while she did notice that Maya sometimes had trouble understanding things, she thought that socially Maya was like any other kid her age, with her own foibles and quirks, but to her, Maya seemed as mainstream as any other kid.

Without wanting to go into too much detail, I told her that Maya's biggest problems right now stemmed from her cognitive issues.  Learning was a slow and arduous process and while she was making progress, it was slow going and that the gap between her and her peers was widening and that her (in)ability to focus was a big barrier.

Then came the inevitable question of whether Maya was on meds?  I said that she wasn't.  And a look of genuine surprise came over this woman's face, why would I not consider putting her on Ritalin when it was so effective?

I explained that Ritalin was a drug for the treatment of ADHD and Maya does not have ADHD.  We had her evaluated for it and she did not meet the diagnostic criteria.  I then explained that my opinion, after having spent 4 years dealing with psychologists, psychiatrist and therapists that no one ever suggested we medicate Maya and that my opinion was that they were not so quick in the Netherlands to put children on meds unless there was a clear diagnosis and unless the child was not adequately impacted by therapy.

This whole exchange got me thinking about my own views on Medication?

Before anyone gets all huffy, know that my views are mine alone, by writing this blog entry I am not telling anyone else what they should do with their own child, or making any judgment whatsoever on parents who have decided to medicate their child or not medicate their child.   Each family has to decide what is best for their own situation.  Just to be clear here I am only talking about drugs geared at behavioral type issues which come with conditions like Autism, ADHD, ODD, etc.

Just wanted to get all that out of the way.

I am neither pro- nor anti- meds.  I think there are situations which warrant medication, where medication can improve health and the quality of life. I do think though that meds are certainly over prescribed and they are often used as a first resort rather than a last resort type of intervention.

Why do I feel this way?

Because these are powerful drugs and they are often not tested on children before they are prescribed to children.

We don't know the long term effects these drugs will have on kids' developing brains.  The brain is not fully developed until age 25 and putting your kids on meds for 5, 10 or more years just seems scary to me.

I've read time and again accounts from parents about the side effects of the drugs used for autism, ADHD and other behavioral issues.  They can be horrifying and sometimes even worse than the thing they are supposed to help and a lot of times they don't help.  And even if they do it can take a long time before you get the dosage or the combination right. The side effects of Ritalin include:  Addiction (in bold), nervousness including anxiety and irritability, lack of appetite, headache, stomach ache, dizziness, heart palpitations, stunted growth, blurred vision, seizures.  And the side effects of anti depressants and anti psychotics (often prescribed for autism) are even scarrier

Because even if they do work, sometimes they mysteriously stop working.

Because meds are a slippery slope, once you go on them, it's tough to go off, the solution when a med doesn't work seems to be another med and your kid can easily turn into a chemistry experiment.

I do think there are situations within autism and other disorders where meds are absolutely necessary like I said I am not anti-meds.  But I do think meds should be the last resort, after therapeutic interventions don't work at all, only if the behavior is so severe it impacts the child's safety or the safety of those around him or her or where the child's quality of life is at risk.

My experience here in the Netherlands is that psychologists and psychiatrists do not medicate as a first resort, although I only have our own experiences to lean on for that opinion.  No one has ever suggested that we medicate Maya and she has been helped through therapy.  Her quality of life is not severely impacted by her autism and she is not threatening to anyone (unless morning breath counts).

What do you think?


  1. Jumping in a little late here, but I can't ignore the potential for discussion here.
    I used to be very anti meds for children, especially at young ages. However, dealing with my dd who has severe ODD, to the point where she was going to get kicked out of school in first grade for attacking a teacher, helped change my mind.
    While I'm not thrilled she's on meds, they have made a huge difference. The first week I excitedly told my husband, "it's like 80% of her anger is GONE", which is a HUGE step for my daughter. But it is a slippery slope. We now have her on a combination of two low dose meds. The first one, and most important to all of our well being is only "on label" for pediatric use for autistic rage. Apparently works well for all rage, however.
    From personal experience, I am certain that almost anyone's performance can be enhanced by some of the Ritalin type drugs. That doesn't mean everyone should use them. I've heard that as many as 60% of the children in our neighborhood take meds at some point. On the plus side, without the meds, I doubt my daughter would have been able to continue into second grade in a normal classroom. While she still has some social challenges, she's much more accepted and is much happier than she was before the meds. What finally made me give in to meds was when she told me, "Mommy, I don't want to be like this".

  2. Lita, I know a little of what you have gone through and I know going to meds was not an instantaneous or easy decision for you. You took time, you weighed the pros and cons and made a careful decision. As I said in the post I do think meds can help in lots of situations, but I think parents have to go into it with their eyes open. No judgment here!