To Medicate or not to Medicate?

To Medicate or not to Medicate?
A brief guide to support sound decision making on a complex topic

What’s best for this child, in this situation, at this time?

This article attempts, very briefly, to lay out the key considerations for making a choice regarding whether or not to provide prescription stimulants such as Ritalin for a child for the treatment of ADHD. For good reason, there is no quick answer. However, with careful consideration, you can make a sound decision based on what is most likely to support the quality of life and education of your child, in their particular learning situation at this time. The question of giving psycho-pharmaceuticals to children is likely to evoke strong emotions but it’s important, for the sake of your child, to look at the decision with a somewhat scientific approach. What exactly is going on with your child and what are the realities of the situation?

Does Ritalin work and is it safe?

Your first question is likely to be do stimulants like Ritalin work for lessening ADHD symptoms and are they safe? Statistically, the answer is yes to both questions. Studies have been done on the effectiveness and safety of Ritalin and other ADHD medications for decades and consistently they are shone to be effective in 80% of cases and not harmful in the long term. But your child isn’t a statistic and you want to know if it will be effective and safe for your child.

The effects of Ritalin and other drugs for ADHD both intended and unintended varies widely. The hard fact is that each individual taking the drug will be a bit like their own Guinee pig. For some the effects are nearly miraculous and all involved may wish they had started taking medication sooner. For others, it will be a case of trying different formulations, adjusting doses, and times for taking the medication in order to find an optimal balance. For a few, medication doesn’t work or at least not well enough to merit continuation. For all individuals taking medication for ADHD there is a balance that has be struck between the benefits of the medication and the sometimes stressful presence of side effects.

What problem are you trying to fix?

What’s brought you to having to make this decision? You love your child and want what is best for him or her so it’s vital to take stock of exactly what you are hoping to achieve by giving your child medication. Ask yourself, how important are the issues at stake at this time? If the issues are behavioural, how much of the behaviour has to do with ADHD or something else? Are there developmental stages of a temporary nature that have to do with kids being kids, or are the issues keeping your child from being able to be the kid he or she wants to be? Take care not to judge what kind of adult your child will be some day based on the behaviour of your child today. A child’s behaviour can and does change dramatically with maturity.

A good rule of thumb is this: medication is useful in situations where an individual is struggling to be the person he or she wants to be.

Make your decision based on your child

This may sound obvious but, ask yourself if you are balancing this decision on not only on your principles but also careful consideration of the facts at hand. Educate yourself. Listen to both side of the issue whether for or against medication. Importantly, don’t try to make a decision based on the opinions of those who may be unqualified to speak knowledgably on the topic such as talk radio host, other parents or community members. You can make a sound decision grounded in information from respected sources such as those written by knowledgeable and unbiased experts on ADHD. *

What if you choose not to provide medication?

Whatever the situation that brought you to having to make this choice, how will that be effected by not supplying medication? Are you aware of the alternatives that are available to address situations complicated by ADHD? It’s true that pills don’t teach skills. All children with ADHD whether medicated or not, may need additional therapy, support or coaching to learn how to manage daily tasks. Finally, ask yourself what is potentially lost or gained by not going the medication route?

If you do choose to provide medication

Be honest with yourself in terms of who stands to benefit the most from your child taking medication. The answer needs to be: your child. Children grow up so quickly and whatever the issues, it’s important to acknowledge for whose sake the medication is being given? How you know will be by noticing who stands to gain the greater quality of life by this choice. Again, the answer needs to be, your child. Whatever you decide, remember that you can always change your mind if the situation changes.

Who gets the finally say in this decision?

So far in the article, I’ve talked about the decision you as a parent will make. Ultimately however, it is the person who stands to be the most effected by the decision who needs to have the final say.

Present the information you have gathered to your child in an age appropriate way and get feedback from your child regarding what he or she thinks about taking medication to support their safety, quality of life and learning.

Keep in mind that whatever you decide, your child can always pause or cease taking the medication as called for.

A few last tips

• If you do decided to provide medication for your child, be sure you are working with a healthcare profession who really understand ADHD. Not all do. A knowledgeable provider will know that on-going communication between you and the provider regarding the medication and its effects is vitally important.
• Pills don’t teach skills so look into getting extra help for your child to support understanding of ADHD and the strategies to make it more manageable.
• It’s easy to get caught up in the emotions of this kind of decision. Try to be objective.
• Keep your child in the loop in an age appropriate way. Communication will be key to setting the child on a life-time path of seeing himself in a positive, able to be successful, way.
• If a child is not able to be the person he or she wants to be due to inattention, then perhaps the kindest thing to do is to provide the medication at least for a trial period.

What’s going to provide the best quality of life for this child, in his/her situation, at this time?

By Brett Harrington ADHD Sorted

*Below are a few recommended sources of information regarding use of ADHD medication
On line:
www.additudemag.com
http://www.helpforadd.com/medical-treatment/
http://www.consumerreports.org/cro/2013/01/the-pros-and-cons-of-treating-adhd-with-drugs/index.htm

Books by highly knowledgeable experts on ADHD such as Dr. Russel Barclay or Dr. Ned Hallowell