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MagazineDecember 1993 (Vol. 4 Issue 9)Ritalin

Ritalin (methylphenidate), taken by as many as a million American children to control hyperactivity and attention-deficit disorder (ADD), has been largely resisted by parents in Britain - until recently

Ritalin (methylphenidate), taken by as many as a million American children to control hyperactivity and attention-deficit disorder (ADD), has been largely resisted by parents in Britain - until recently. Lately, much media attention has been focused on Ritalin as a drug that can 'unlock' a child's potential compared with the supposed limitations of the dietary approach to hyperactivity.

The view espoused by Ritalin promoters is that the drug, an amphetamine, works by correcting biochemical imbalances in the brain. Not only is there no evidence to support that view, but there is no evidence that Ritalin makes any lasting change. As Ciba admits in the Physicians' Desk Reference, there are no long-term studies on safety and effectiveness. Furthermore, The American Textbook of Psychiatry shows a 75 per cent improvement with Ritalin compared with a 40 per cent response with a placebo, suggesting that half the response to Ritalin could be purely placebo.

What we do know is that it suppresses growth, makes a child more prone to seizures, and causes visual disturbances, nervousness, insomnia, anorexia and toxic psychosis. It's worth remembering that this drug is a class II category controlled substance, like barbiturates, morphine and others with a high potential for addiction or abuse. Uppers supposedly have a paradoxical effect on children, quieting them down, but often the effect is mixed. Children get subdued during the day, but stimulated at night, unable to sleep. The PDR entry for the drug carries a special box warning of drug dependence and psychotic episodes: 'Careful supervision is required during drug withdrawal since severe depression as well as the effects of chronic overactivity can be unmasked'. Numerous cases of suicide after drug withdrawal have been reported. One study (J Am Acad Child Adol Psych, 1987; 26,1: 56-64) showed that children treated only with stimulants (rather than drugs and counselling) had higher arrest records and were more likely to be institutionalized.

Peter Breggin, author of Toxic Psychiatry (HarperCollins, 1991), notes that long-term use causes irritability and hyperactivity - the very problems the drug is supposed to treat. One study showed evidence of brain atrophy in more than half of 24 adults treated with psychostimulants (Psychiatric Research, 1986: 245). In another study in Johannesburg (South Afr Med J, 17 Sept 1988), of 14 children, only two responded to the drug. One child showed significant deterioration, and another marked deterioration.

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