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Isn’t it counter-intuitive that if a child is ‘hyperactive’, you can ‘treat’ this with a stimulant drug (Ritalin, amphetamines, etc.)?

By on November 27, 2017

If someone is already ‘hyped-up’, why give him or her an ‘upper’?

Ah, you see, stimulant drugs, when given to ‘hyperactive’ children, have a ‘paradoxical’ effect compared to that in adults, and actually calm such children down!

But is this true? It is now realised that the actions of stimulant drugs are the same in adults and children: In small doses, they help concentration and alertness, but in large doses can cause hyperactivity.

In the 1940s and ‘50s, stimulants were commonly used to treat depression and as appetite suppressants. ADHD was originally known simply as childhood hyperactivity disorder and was thought to be rare until the 1980s.  At that time, according to a publication known as DSM III (Diagnostic and Statistical Manual of Mental Disorders, third edition) ‘impaired attention’ was added as a feature of the disorder. Hence, many more children were included in its diagnostic scope and treated with stimulant drugs.  One recent study showed 8% of children aged 4 to 17 years had been diagnosed as having ADHD in the US. Can it really be true that so many children are psychiatrically ill in this way? And 56% of these were under medication.  Did they really need it? Is the net being cast too wide?  

It’s easy to ‘medicalise’ boisterous or disruptive behaviour in children and for paediatricians to reach for a quick fix and prescribe psychoactive drugs. No one knows how these drugs work. The idea that they normalise a ‘chemical imbalance’ or are in some way specific to treating the condition does not stand up to critical examination; it is pure speculation.

Often, hyperactivity and other disturbed behaviours in children are due to emotional conflicts or relationship difficulties at home or school, and what is needed is for a concerned physician or therapist to work with the family to try to sort out the underlying problems. This takes time and trouble but is ultimately more rewarding than just giving medicines. Medicines do not solve the problem, and at best control or ameliorate symptoms. Though this may be helpful in certain circumstances, it seems to me that some doctors may be over-ready to treat childhood behavioural difficulties with drugs. It is always wise to be cautious in treating children with drugs, because of the ever-present risk of side-effects. These include growth impairment, increased pulse rate and blood pressure, blunting of spontaneity and emotional responsiveness, depression, anxiety, insomnia, and addiction.

 

About Dr. Gabriel Symonds

Dr. Gabriel Symonds was the director of the Tokyo British Clinic. The clinic closed down in May 2014 after serving the expatriate community for 20+ years. Dr. Symonds has retired and the Tokyo British Clinic is now closed. Dr Symonds will continue to live in Tokyo and may be contacted by e-mail over any questions concerning medical records or related matters: symonds@tokyobritishclinic.com He will be available from another address for: smoking cessation psychotherapy/counselling circumcision information Tel: (03) 5458-6099 www.tokyobritishclinic.com