Study Probes Ritalin For Tots As Use Soars

Government Study Warns Of Side Effects, But Finds Benefits For Children With Severe ADHD

(AP)  The first long-term government study of preschoolers who take Ritalin, the popular attention deficit disorder drug, warns of side effects but also found benefits in children with severe problems.

The drug isn't approved for use in children under age 6, and the researchers said those youngsters need close monitoring. Preschoolers are more likely than older children to develop side effects, experts said.

The research was done because of concerns over reports that soaring numbers of very young children are being given psychiatric drugs, including Ritalin.

The study's message is, proceed with caution, said Dr. Thomas Insel, director of the National Institute of Mental Health.

“We're not talking about fidgety 3-year-olds,” said Insel, whose agency funded the study.

The research involved children with severe cases of attention deficit hyperactivity disorder — cases that included hanging from ceiling fans, jumping off slides or playing with fire. The researchers say the benefits of low-dose treatment outweigh the risks for these youngsters.

But critics disputed that.

“I hope publication of this does not lead to more overprescribing,” said Dr. Sidney Wolfe of the watchdog group Public Citizen. “The safety isn't adequately established, the efficacy even less.”

About 40 percent of children developed side effects and roughly 11 percent dropped out because of problems including irritability, weight loss, insomnia and slowed growth.

Preschoolers on methylphenidate, or generic Ritalin, grew about half an inch less and gained about 2 pounds less than expected during the 70-week study.

“This is a catastrophe. It just opens up the way for drugging the younger kids,” said Dr. Peter Breggin, a New York psychiatrist and longtime critic of psychiatric drug use in children.

Breggin said the research is part of a marketing push by the drug industry to expand drug use to the youngest children.

The study appears in the November edition of the Journal of the American Academy of Child and Adolescent Psychiatry. Several of the researchers have financial ties to makers of ADHD drugs, including Ritalin.

Lead author Dr. Laurence Greenhill, a psychiatrist with Columbia University and New York State Psychiatric Institute, has been a paid speaker for most companies that make the drugs.

Roughly 8 percent of U.S. children have ADHD, including around 3 percent of preschoolers.

Previous research found that about 1 in 100 preschoolers had been prescribed Ritalin, which has only been approved for use in children aged 6 and older. Use in younger children is considered “off-label” but is not illegal.

Dr. David Fassler, a psychiatry professor at the University of Vermont, said the study does a good job of outlining pros and cons of Ritalin treatment in preschoolers.

“This is exactly the kind of information we need to help parents make informed decisions about treatment options for young children with ADHD,” Fassler said.

The study included 10 weeks of behavioral treatment along with parent training and about one year of drug treatment. Nearly 300 families were enrolled, but many dropped out after the first phase, either because the behavior treatment worked or because they didn't want to put their children on drugs.

The drug phase started with 165 children, more than a dozen dropped out because of side effects.

Behavior improvements were seen in children taking 7.5 to 30 milligrams daily, but the optimal dose was 14 milligrams daily — less than half the usual Ritalin dose for older children, Greenhill said.

[mybrooks]

"cases that included hanging from ceiling fans, jumping off slides or playing with fire."
Isn't that what normal kids do? Ask anyone and they will probably tell you they either almost burned something down as a kid or played with fire and almost did, "jumped off a slide" be realistic, that's normal kids stuff, and sure if the parent does not discipline a child might hang from a ceiling fan but that is more of a parenting issue. God and nature did not intend our children to sit in a 20 x 20 room with 35 other children on a daily basis. Even the small one room school houses did not have the problems that the public schools have today. Children are truly meant to be taught one on one by their parents and family, not by strangers and 35 children that taunt and tease them on a daily basis. Not to mention only to go home to watch TV and play video games for hours or just arrive home without supervision because mom and dad are both at work. Just a mom concerned for our youth.

[ecuadoriana]

I absolutely agree with you, mybrooks. When I was a kid, back in the middle-ages of the 60's, my friends & I saw the lunar landing on television & became obsessed with the idea of building our own rocketship. All we needed was some scrap plywood, sheets of insulation & a gas can for fuel. All easy to obtain from anyone's garage. We built the rocket, tied the gas can to the side of it, climbed aboard, & dropped the match in the can. We suffered some burns, fortunately all lived to tell, & received punishment far worse than the humiliation of the failure to land on the moon- "Go to your room & stay there until I tell you to come out!" Yikes! The idea of not being allowed to play outside was a fate worse than death!

Of course this was all back in the day when kids were ALLOWED to use their imagination, play outside & learn from mistakes. By today's standards we would have all been dosed on Ritilin & ADHD would be the excuse attributed to our active imaginations, rather than actually learning the concept of "cause & effect". And today's punishment would be to have our violent, mind numbing video games taken away!

I'm a grown woman now & turned out really OK despite the scraped knees, falls out of trees, & spills off my bike (no helmets! imagine that!)! My imagination has served me well all these years in my never quenched thirst for knowledge.

I feel so sad for today's children who will become tomorrow's legally drug addicted adults.

[cantshutup]

When did parents stop parenting and instead became drug pushers? Did it have anything to do with the end of corporal punishment in schools? Or maybe because police and other authorities decided parents had no right to parent and used fear and humiliation to cause them to give up parenting to the authorities???

[savemart55]

Hmmm, psychiatrists sponsored by drug companies to find out if more drugs or less drugs should be sold to unsuspecting parents. But if this sounds weird to you, it's because you have "paranoid clinical suspicion disorder". But, not to worry. The new brain mapping study finished last week has found just the right little overly pinkish spot that causes this condition. Now be a good little boy and schedule your surgery as soon as possible.