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Joelle Mugisha ENG 105 09/20/2020 Tenielle FeldBush Positive and negative sides of Ritalin debate as an issue in treating ADHD Attention-deficit hyperactivity disorder is a common diagnosis in children and young adults. Stimulant medication such as Ritalin are the most frequent treatment for Attention-Deficit Hyperactivity Disorder (ADHD) in both children and adults. Ritalin is a Novartis’ brand name for methylphenidate hydrochloride, a drug used in ADHD treatment. To treat the condition, more than two million prescriptions for Ritalin, methylphenidate are written each year. “In up to 90 percent of cases, stimulant medication helps children improve their approach to schoolwork, get more focused and organized, think before acting, get along better with others and break fewer rules. They often seem happier, too” (APA,2020, para. 1). With a rise in ADHD diagnosis the number of stimulant medications prescriptions are rising as well (CHADD, 2020). Despite these benefits, some concerns remain. Parents are worried that their children are being misdiagnosed and given Ritalin unnecessary which may increase drug addiction, create severe recurrent pancreatitis but others observe the effectiveness of the treatment. Addiction on drug substances is one of the concern people have that may occur due to Ritalin consumption. Recently, the media has reported that Ritalin is a possible gateway drug to other stimulants, a conclusion that stems from research by Nadine Lambert, PhD, director of the school psychology program at the University of California at Berkeley. According to Lambert, there is a relationship between ADHD and the use of stimulants in childhood, dependence on

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tobacco and other stimulants as adults. In her study, she found that half of the youth who took Ritalin had become regular smokers by age 17 (APA, 2020, para.2). In Lambert’s study, only 30% of those never treated became regular smokers, 36% of adult smokers treated with Ritalin as children, while 2% who never smoked or took prescription stimulants became dependent on cocaine as adults (APA, 2020). There are growing concerns amongst the parents that push them to make the decision to medicate or not ADHD. ADHD stimulant medication such as Ritalin modifies the dopamine’s level, which is a chemical in the brain. Changes of dopamine’s level enhance changes in brain functioning while on the medication (Miller, 2020). The real concern is if the patient stop taking the medication, the brain seeks where to draw the same level of dopamine hence a possible addiction. However, Studies from the Child Mind Institute have displayed that there is no interrelationship between ADHD medication treatment and the high risk of addiction as this has big chances to occur when these stimulants are abused or not taken as prescribed (Miller, 2020). Addiction is not the only concern; some disease may also be a result of Ritalin consumption. Severe recurrent pancreatitis is another effect that may be caused by the consumption of Ritalin (Artul, Artul, Habib, Nseir, Bisharat, et al., 2014). A case of a 10-year-old boy has been presented with severe relapsing pancreatitis. Three weeks after starting the Ritalin treatment, the little boy with Attention Deficit Hyperactivity Disorder (ADHD) got the severe pancreatitis three times in two months (Artul, et al., 2014). They are no prior publications on pancreatitis due to the use of (methylphenidate) Ritalin and physician’s attention is trying to be caught concerning this possible complication. Every patient with abdominal pain who is on Ritalin treatment should be screened and monitored for a possible complication. However, very limited cases like this have been published and there is not enough evidence that would show that the severe pancreatitis is

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caused by the Ritalin. Many have encountered the importance of the treatment as they have seen considerable improvements in their lifestyle abilities. Even though there are concerns about the Ritalin, many people have been helped and witnessed its effectiveness. The goal of the study that has been conducted was to analyze neurofeedback with and without Ritalin in treating children with ADHD (Fatemeh, Fatemeh, Fakhri, & Jabalkandi, 2018). Some treatment for Attention Deficit Hyperactivity Disorder similar to the neurofeedback (NF) exist but having pharmacological approach accompanying them is necessary. “Participants were children aged 5--10 years with ADHD seven participants were in neurofeedback group with Ritalin and seven in neurofeedback without Ritalin group according to random split and parent's conformation” (Fatemeh P., Fatemeh I., Fakhri T., & Jabalkandi S. A., 2018, para. 3). According to Fatemeh P. et al., the neurofeedback is efficient in ameliorating some of the behavioral conducts caused by ADHD in children whose parents did not want medical treatment. However, the combination of Ritalin and neurofeedback increase the efficiency of the outcome. So, the combination approach is strongly recommended for ADHD treatment. Debates on ADHD medication, especially Ritalin, are observed and one can see that people are worried about possible addiction on drug substance, creation of severe recurrent pancreatitis for patient taking Ritalin as treatment for ADHD but others recognize its effectiveness in improving the patient’s quality of life. No evidence has been shown to affirm the correlation between consuming Ritalin in children and the substance drug addiction in adults. Even if there is no direct link between addiction of stimulants and ADHD, it is important to always monitor medications and the effects. Some other diseases are also said being a result of Ritalin consumption such as severe pancreatitis but only few cases have been published and there

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is no attestation that the two are associated. Although there are many debates and concerns about ADHD medications especially Ritalin, many people have seen its efficiency. Lives are improved every day especially when Ritalin is combined with neurofeedback which is why multimodal approach is strongly recommended for ADHD treatment.

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References American Psychiatric Association (2020). Retrieved from https://www.apa.org/monitor/jun01/ritalin CHADD Publications, (2020). Retrieved from https://chadd.org/about-adhd/general-prevalence/. Miller, Caroline. (2020). Child Mind Institute, Will ADHD Medication Change My Child’s Brain? What we know about the long-term effects of stimulants taken for ADHD. Retrieved from https://childmind.org/article/will-adhd-medication-change-my-childsbrain/#:~:text=Stimulant%20medications%20have%20been%20shown,a%20positive %20effect%20on%20symptoms. Suheil Artul, Faozi Artoul, George Habib, William Nseir, Bishara Bisharat, & Yousif Nijim. (2014). Severe Recurrent Pancreatitis in a Child with ADHD after Starting Treatment with Methylphenidate (Ritalin). Case Reports in Gastrointestinal Medicine, 2014. https://doiorg.lopes.idm.oclc.org/10.1155/2014/319162 Pakdaman Fatemeh, Irani Fatemeh Tajikzadeh Fakhri, & Jabalkandi Samaneh Amani (2018). The efficacy of Ritalin in ADHD children under neurofeedback training. Neurological Sciences, 12, 2071. https://doi-org.lopes.idm.oclc.org/10.1007/s10072-018-3539-3...