PBS Article Link: What, When & How of Taking Ritalin

Friday

Article: The What, When & How of Taking Ritalin
by: Dr. Lawrence Diller

"From a strictly physical standpoint, it appears Ritalin can be taken safely every day. On the other hand, one can cease taking it for a day, a month, or a year, and it should work pretty much the same as the last time it was taken. Some argue that Ritalin should be taken on a fixed dosage schedule, 7 days a week, 365 days a year--the frequently used analogy is to insulin for the diabetic. While I object to the Ritalin/insulin analogy on several grounds, one need only note that even daily insulin dosages are adjusted according to how much the patient eats and how active he is. It doesn't make sense to take a drug every day if it isn't needed. For individuals more severely affected by attention or behavioral problems, taking multiple daily doses of Ritalin seems reasonable. But for many children, problems manifest only in the school setting; they do quite well without medication on weekends, holidays, and vacations. For such children at such times, Ritalin seems unnecessary. ..."

In regard to the last line I say this: the diagnosis for ADD - ADHD requires that the symptoms be present in more than one setting. Therefore this doctor leaves me confused. If the problem only happens IN SCHOOL then that is not technically meeting the criterion for a diagnosis of ADD - ADHD and it signals instead, a problem with the SCHOOL.

I mean to say, if the student struggles in school but can do homework at home just fine (learning) without being medicated, and if the student acts hyper at school and nowhere else then the problem is school not the child.

excerpted from book:  Running on Ritalin: A Physician Reflects on Children, Society, and Performance in a Pill (Bantam, 1998). (pp. 253-6; 262-265) Copyright Lawrence Diller. Reprinted with permission.




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