Nothing is more controversial in parenting circles than giving your child psychotropic meds. Parents are often confused by the advice they receive. Opinions are polarized. And no medication is more controversial than the well-known ADHD medication: Ritalin. Ritalin, the brand name for Methylphenidate is the medication most often prescribed to children. It is estimated that 75% of the prescriptions of Ritalin are written for children.

Other medications in the same “family” of stimulant treatments for ADHD include Concerta, Adderal, Focalin and the newly approved ADHD patch, Daytrana.

I’ll tell you upfront that I believe psychotropic medications have their place in parenting special needs children. The best analogy I can present is having a headache. If you have a headache, which in turn makes you feel lousy, become irritable and maybe not be able to think clearly, taking aspirin (Tylenol or ibuprophen) will often relieve the symptoms. Do those meds “cure” the underlying cause of your headache? No. They relieve the symptom. This is the view I have of psychotropic meds. The right ones will often relieve the symptoms of the chemical imbalances in a person’s brain in such a way that they are better able to function. But they don’t solve the underlying problem. So, I truly do believe in the necessity of other interventions, such as therapy, neurological and brain-based interventions, nutrition and supplements. These interventions seem to have more of a likelihood to help the brain “heal” – but our kids often need the relief the medications can bring.

Ritalin has its fans and definitely is reviled by many. If you search Ritalin in Google you will get a whole pile of articles on the evils of Ritalin, including how some teens abuse the drug to get a stimulant “high”. What may be harder to find is information that tells you that many children with ADHD are well-served by doses of this, or the related stimulant meds. That without it, the struggle to maintain attention, focus, and impulse control is much more difficult.

Stimulant medications treat ADHD in this manner. Children with ADHD have a pre-frontal cortex that is working too slow. This is hard to understand, because the child is bouncing around the room, so how can his brain be working too slowly. Well, the prefrontal cortex is the decision-making regulator of the brain. And if it is working too slowly, the person is impulsive and lacks attention and focus. Stimulant medications stimulate the prefrontal cortex to “come on line” and regulate behaviors and attention. Unfortunately, stimulant medications can stimulate other areas of the brain as well.

For many of our special needs adopted children – those who have co-existing conditions or abuse/trauma backgrounds – their aggressive behaviors do not make them a candidate for Ritalin. The problem is that while the stimulant meds treat the attention/focus symptoms of ADHD, they also can raise blood pressure (associated with increasing aggression and sometimes impulsivity). Ritalin is often the first medication a psychiatrist or pediatrician will prescribe when a child’s behavioral symptoms are a concern. And in the cases of many of our abused, neglected and neurologically disordered children…it may be the WRONG first choice.

There is a wise psychiatrist, Dr. John Alston, who has spent years working with children who have attachment disorder, PTSD, and histories of abuse, neglect and trauma. His conclusion, which I heard in a presentation he gave in 2003, is that the most dysregulated of our children see the biggest reduction of symptoms when a combination of atypical antipsychotics and mood stabilizers are used. These meds can be scary to parents (and doctors unfamiliar with them) because they are designed for people who have Bipolar disorder or Schizophrenia. But the calming effect they have on the brain chemistry can help reduce many of the agitation symptoms.

Prescription Treatments for ADHD.
About Prescription Treatments for ADHD
ADHD or Hyperarousal? Hyperactivity in Traumatised and Adopted Children

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