Journal of Medical Sciences

Ritalin for ADHD: Uses, Dosage and Side Effects


Ritalin is helping millions of children (and their parents) face the problem of attention deficit hyperactivity disorder (ADHD), and it has been doing so for more than 75 years.

We use the term “helping” very loosely. Perhaps it would be more accurate to say that a drug like Ritalin helps counter the symptoms of Attention Deficit Hyperactivity Disorder (or ADHD, “H” standing for Hyperactive): a lack of concentration, the inability to wait, and panic attacks among others.

However, the science surrounding the issue is not even certain about what leads to ADHD. Neurologists acknowledge the fact that no single, specific cause has been identified. Doctors suspect that the condition could be caused by a range of different factors, including problems with neurotransmitters, toxins, and environmental circumstance.

In a situation like this, ADHD would most likely be an umbrella term used to describe that which is actually a number of associated disorders. Thus, the prescription of Ritalin, or its equivalent could be considered as only a relief for the symptoms of ADHD and not a cure.

Ritalin provides healing only on a superficial level, and does not necessarily treat the root-problem. Its effects last only for 3 to 4 hours, so it may have to be taken twice a day, and also over a person’s lifespan.

Ritalin’s ineffectiveness is further shown by studies beginning in the 1960s which showed that children who took stimulants for hyperactivity (the name for ADHD at the time) over several years did just as poorly in later life as the group of hyperactive children who took no medication. Compared to children without hyperactivity, both groups were less likely to have finished high school or to be employed, and more likely to have had trouble with the law or to have drug or alcohol problems.

Let’s talk about the side effects of Ritalin

These include appetite loss, anxiety, insomnia, headaches, stomach aches. Not to mention possible addiction. Perhaps this isn’t that surprising, considering that Ritalin is derived from the same family as cocaine.

There are withdrawal symptoms for Ritalin addiction, these would include insomnia, depression, over-activity and irritability, and worsening of ADHD-like symptoms. The fact that Ritalin was classified as a Class A drug in the U.S. in the 60s, and now as a Class II controlled substance (along with morphine and amphetamines) by the American military, should be an indication of the severity of the possible adverse long-term health effects of the drug.

Despite the widespread criticism from various sectors of the medical community about the excessive use of Ritalin and its equivalents, Cylert and Dexedrine, the growth of the drug’s prescription has been more acute in the last decade.

In the United States, the number of children and teens taking methylphenidate (brand name Ritalin) for ADHD jumped by 700% from 2000 to 2010. Although this seems to be mainly an American phenomenon, with the country producing and using 90% of all Ritalin.

Children are also being given Ritalin at a younger age. Typically, ADHD is identified at around age seven or eight, and medication at this time will be likely to continue for five to seven years. Now medication is commonly given to children as young as 3.

The problem with this is that brain-altering drugs can sometimes cause permanent harm, the effects of which may only be detected after a decade or more. This risk is increased in the case of psychotropic drug use in children, given that they are still undergoing mental development.

Signs of Ritalin addiction, use and abuse

One contributing factor could be the way in which ADHD is diagnosed in children. Children are brought to psychologists, school physicians, and pediatricians by teachers who see signs of problems with concentration or attentiveness, and by parents who feel that they are unable to control their kids.

However, doctors often do not have the time and resources to perform complete psychological analyses, often feeling pressured to prescribe the drug depending only on second-hand information provided (this problem is exacerbated by diagnostic standards that do not require physicians to witness the symptoms, but rely on the untrained judgement of school authorities and parents).

Recently, a study in the Archives of Pediatric and Adolescent Medicine found that almost half of the pediatricians surveyed spend an average of only half an hour diagnosing ADHD children. In Australia, there has been a call for more stringent guidelines regarding the administration of Ritalin.

However, the problem of Ritalin is not just a physiological one, but a mere slice of a larger, more insidious cultural phenomena . Prescribing Ritalin (or any other drug) to kids at a young age gets them used to the idea and into the habit of taking drugs. Be it Xenical for weight loss, Prozac for depression, or even multi-vitamins as dietary supplements, we are now living in a pill-popping society, where tablets are seen as quick fixes for problems that are caused by inadequate lifestyles.

Drugs do have their purpose in specific contexts. However, it is the indiscriminate prescription and self-prescription of drugs that is disturbing. When it masks a need to make fundamental improvements in one’s lifestyle (such as changes in dietary or sleeping patterns) to ensure mental well-being, health problems become camouflaged under the convenience of simply downing a fistful of tablets a day.

What would be more frightful is when using Ritalin is used as a tool for social engineering that substitutes proper parenting and schooling, when it becomes a moral equivalent of raising children with basic care and attention.

This is already happening in some parts of the US. Resource-challenged schools and parents with no one to turn to are increasingly turning to psychotropic drugs as a last-resort. In some elementary classrooms, as much as 40% can be on stimulant medication.

Looking at the situation on purely economic rationalistic terms, it is cheaper to pay for Ritalin than it is to spend money on parental counseling or smaller classroom sizes. But should this be standard practice? What would this say about society’s prevailing attitudes on youth and childhood? Are students to be treated simply as digits to be subdued by drugs when they prove too “difficult” for guardians and teachers to handle?

What we need then is a reassessment of society’s priorities and values. Yes, ADHD is a very real and serious issue. All the more precautions should be made for it not be to misdiagnosed or used as a scapegoat for the inability of care-givers to deal with behavioral “problems”.

NOTE: Ritalin should be used only as a short-term solution for crisis situations, and not a long-term cure, ideally administered as part of a more holistic program of psychotherapy, proper dietary and sleeping habits, and basic human attention. Otherwise, giving Ritalin indiscriminately to our children will only replace one problem with a much more severe one.

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