Is Ritalin safe?

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Parents need to adopt a healthy scepticism towards the introduction of any treatment for their child. They need to make an informed decision based upon the available evidence regarding the efficacy and side-effect profile of a medication or alternative treatment. They also need to consider the implications of not treating ADHD.

As a registered medication, Ritalin has been subjected to extensive scrutiny for over 40 years. Over a 155 clinical trials involving thousands of children attest to its efficacy and side-effect profile. There are children who experience no problems with the medication, others who have mild and transient effects and those who cannot tolerate the effects at all.

The most common effects are sleeplessness and nervousness, which may be dose-related and do abate in time. A loss of appetite is common but rarely a reason to stop the ADHD treatment as dietary adjustments can be made and long-term studies show no significant effects upon growth. Less frequently, children may complain of headaches, feel dizzy or drowsy, suffer vague abdominal pain, nausea , dry mouth or thirst.

They may feel dysphoric. Mood instability is an unpleasant side-effect and may be indicative of an associated mood disorder. Mild palpitations may be reported but there are no cardiac abnormalities. Caution must be exercised in children with pre-existing seizures, tics, depression, psychosis or hypertension.

Ritalin has a low abuse potential as it does not produce the euphoria characteristic of street drugs. Children with ADHD who go untreated are at a much higher risk of drug abuse than those effectively treated with medication.

If your child has ADHD, see a professional to discuss the diagnosis and treatment implications. Make an informed decision based upon the best available evidence. A comprehensive management plan embraces nutrition, effective parenting, educational strategies and medication, when appropriate.

This article was written Dr Lesley Carew, a child psychiatrist based in Cape Town, South Africa.

Peer reviewed by Dr A van der Walt, MMed (Paed) BSc Hon (Human Genetics), February 2015.

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