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Ask Dr. Z Your Own Question

Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 4898
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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Are there any qualified psychiatrists that deal with children

Resolved Question:

Are there any qualified psychiatrists that deal with children and Ritalin / Concerta that I can pose a few questions?
Submitted: 9 months ago.
Category: Mental Health
Expert:  Dr. Z replied 9 months ago.

Dr. Z :

Hello I believe I can help you with your question, I am a psychologist with extensive knowledge of psychopharmacology and I do have knowledge of these 2 medications if you would like to ask your questions

Dr. Z :

I see that you are online, so please feel free to ask any questions that you have

Customer:

Hi. Sorry, just composing my question. nearly finished

Dr. Z :

No worries, take your time :)

Customer:

Thanks. I have a 6 year old son going into grade 1 next year. He is bright but has ADHD which is severly hindering him and his confidence. I have seen a psychiatrist who has prescribed a trial period of 4 weeks with Ritalin. My son's mother refuses to accept is and will not listen to the psychiatrist, the OT, the speech therapist or the teacher. The mother believes that Ritalin will make Liam into a drug addict later on in life. She has being investigating Ritalin on the net. One of the things that she found is that if Liam is not ADHD but just showing symptoms of anxiety, it would be bad to treat it with Ritalin or Concerta. Is that true?

Dr. Z :

Well this is controversial actually. Ritalin has the ability to increase dopamine, which is helpful for people that have anxiety, but it can also increase norepinephrine as well which can increase anxiety. So some people who are prone to anxiety can have an increase in anxiety, but there are some studies that show Ritalin has had an anti-anxiety effect for children with anxiety. I would like to share this link with you describing some of what I have been saying here, but basically the results are mixed and Ritalin and other stimulant medications are not prescribed for anxiety on a typical basis

Dr. Z :

Now as for the "addiction" issue. Ritalin is an addictive substance, but if your son takes it as prescribed, then there is no risk for abuse or become a "drug addict"

Dr. Z :

Many effective medications have addictive qualities, but that does not mean it will lead to addiction if taken properly

Customer:

There are three issues that Kerry (the mother) has raised. Can I copy and paste it for your comments?

Dr. Z :

Of course I am happy to read them and comment on them

Customer:



1. They are telling you in advance that these drugs have not been fully tested- nor are they guaranteed not to cause complications in the future- nor do they even know fully about the mechanisms that causes the change in mental and behavioral effects in the user.

2. By the company's own admission - the drug has not been tested sufficiently -

3. The case echoes an earlier tragedy, in 2008, when 15-year-old Anthony Cole hanged himself in his bedroom after his Ritalin prescription was increased


4. Children on ADHD medication can be exposed to serious risks. Suicidal thoughts are among a battery of known side-effects of Ritalin-type drugs. Others include stress and anxiety, cardiovascular complaints, decreased appetite, stomach problems, dizziness, tics, skin problems and bruising. In 2009, the EU regulator, the European Medicines Agency, said all patients should be monitored for psychiatric symptoms during treatment. The agency added that, given the lack of information on the long-term effects of Ritalin, children should have treatment stopped once yearly to see if it is still needed.

Dr. Z :

Well Ritalin has been around since the late 1940's, so it has been extensively tested by the manufacturer and by thousands of independent studies and it is very safe. She is right that we do not fully understand how it works besides the dopamine and norepinephrine like I mentioned earlier, but that is because we do not fully understand the brain too.

Dr. Z :

The one case that your wife is citing in your Question number 3 is just that one case. It could have been caused by anything and there are literally millions of children and adults using Ritalin with no serious side effects at all

Dr. Z :

And here is a study briefly mentioning that the long term effects of this medication resolve in time and are not long lasting

Dr. Z :

So yes there are rare psychological side effect linked with this medication, as all medications have these side effects, but they occur in less than one percent of people in studies, so your son will be fine on the medication. Also this is why he will be carefully monitored by his psychiatrist to avoid any lasting impact if he develops those side effects.

Dr. Z :

But if your wife is concerned about this medication, there is also a non-stimulant medication approved for the treatment of ADHD called Strattera, but it is not as effective as the stimulant medications

Dr. Z :

Do you have any questions or concerns so far?

Dr. Z :

Are you still there?

Customer:

Hi. are you back?


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 

Dr. Z :

Yes I am here, did you see what I wrote?

Dr. Z :

For some reason the chat scrolled all the way to the bottom though

Customer:

I seemed to have lost connection with you for a moment. Did you get my last question?

Dr. Z :

This was the last question I received " Children on ADHD medication can be exposed to serious risks. Suicidal thoughts are among a battery of known side-effects of Ritalin-type drugs. Others include stress and anxiety, cardiovascular complaints, decreased appetite, stomach problems, dizziness, tics, skin problems and bruising. In 2009, the EU regulator, the European Medicines Agency, said all patients should be monitored for psychiatric symptoms during treatment. The agency added that, given the lack of information on the long-term effects of Ritalin, children should have treatment stopped once yearly to see if it is still needed."

Customer:

Last question: can you comment on these statements:

Customer:

1. They are telling you in advance that these drugs have not been fully tested- nor are they


guaranteed not to cause complications in the future- nor do they even know fully about the


mechanisms that causes the change in mental and behavioral effects in the user.


2. By the company's own admission - the drug has not been tested sufficiently -


3. The case echoes an earlier tragedy, in 2008, when 15-year-old Anthony Cole hanged himself in


his bedroom after his Ritalin prescription was increased



4. Children on ADHD medication can be exposed to serious risks. Suicidal thoughts are among a


battery of known side-effects of Ritalin-type drugs. Others include stress and anxiety,


cardiovascular complaints, decreased appetite, stomach problems, dizziness, tics, skin problems


and bruising. In 2009, the EU regulator, the European Medicines Agency, said all patients


should be monitored for psychiatric symptoms during treatment. The agency added that, given the


lack of information on the long-term effects of Ritalin, children should have treatment stopped


once yearly to see if it is still needed

Dr. Z :

Sure, give me a second to look it over

Customer:

Thanks a mill

Dr. Z :

Oh those I already answered, let me paste what I wrote earlier about this.

Dr. Z :

It must have got lost on your end when you had connection issues

Dr. Z :

Well Ritalin has been around since the late 1940's, so it has been extensively tested by the manufacturer and by thousands of independent studies and it is very safe. She is right that we do not fully understand how it works besides the dopamine and norepinephrine like I mentioned earlier, but that is because we do not fully understand the brain too.

Dr. Z :

The one case that your wife is citing in your Question number 3 is just that one case. It could have been caused by anything and there are literally millions of children and adults using Ritalin with no serious side effects at all

Dr. Z :

And here is a study briefly mentioning that the long term effects of this medication resolve in time and are not long lasting

Dr. Z :

So yes there are rare psychological side effect linked with this medication, as all medications have these side effects, but they occur in less than one percent of people in studies, so your son will be fine on the medication. Also this is why he will be carefully monitored by his psychiatrist to avoid any lasting impact if he develops those side effects.

Dr. Z :


But if your wife is concerned about this medication, there is also a non-stimulant medication approved for the treatment of ADHD called Strattera, but it is not as effective as the stimulant medications


Dr. Z :

Here is also another study about the long-term risks of Ritalin, but even the researchers state that it is safe when properly used. And the study was not fully complete either

Customer:

Thanks. That helps. Is there a way that I can save this chat?

Dr. Z :

Actually when you finish rating me, this chat will be sent as a link to your email, if it has not already, so you can always use it for future reference. In addition, this chat will be saved in your JA account under My Questions so you can always go back to it when you need to

Dr. Z :

This medication is very safe to use and is very short acting, so it does leave the body fast.

Dr. Z :

Is there anything else I can assist you with?

Customer:

Thanks a lot. You've been a good help.

Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 4898
Experience: Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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