Starting ADHD Treatment with Ritalin in a 13 year-old?
anonymous Asks ...
My 13 year old daughter was just diagnosed with ADD. Because she is not hyper we missed the diagnosis for a long time but now that we have it it really explains a lot of her behaviors and her problems at school. The psychiatrist says she should take Ritalin. I would like to see her do better at school but she is managing OK in general. I am worried that if she gets hooked on the Ritalin she might move onto harder drugs as she gets a little bit older. Is she better off using the Ritalin or riding it out?
Dr. Richard Schultz Says ...
Hello and thank you very much for directing this question to me. I appreciate your concerns and admire your devotion to your child's well-being.
Of course, as a psychologist, I cannot only provide limited advice regarding medication for your daughter. That said, you do have some options here. First, if you want to take a conservative route, there are other ways to initiate treatment other than having your daughter start on a stimulant.
For example, you might first consult a child psychologist who can conduct more in-depth testing to refine/confirm the diagnosis and identify the areas of greatest weakness (all people with attentional problems are not created equally, as you probably know). In addition, the psychologist (and it should be one who has a specialization in working with learning and attention difficulties in adolescents) can begin to help your daughter learn behavioral and other strategies that might bring improvement in her symptoms. You can assess the benefit of this treatment (which, by the way, should really always accompany pharmacological intervention for ADHD) for, say 90 days, and then decide if you want to add the medicine to the regimen.
Further, there are non-stimulant medicines for the treatment of ADHD, such as Strattera, however, their benefit is not necessarily equivalent to that of stimulants. It really does tend to be a trial and error process.
As far as your concerns about your daughter getting "hooked" on Ritalin, or her use of it potentially paving the way for illicit substance use down the road, the overall risk of either outcome is marginal. This would remain be especially true if you closely monitor her use of the medication, and support her implementation of other strategies for improvement as suggested by the psychologist. Thus, the use of the stimulant may only be needed as a means of helping her to learn these other techniques, and its use can be discontinued or tapered once this occurs. The risk of substance abuse is actually higher among individuals with ADHD that go WITHOUT treatment than it is among those who receive it.
I do hope this information is of some use to you. I wish you and your daughter the best of luck with this and please feel free to write to me again if I can be of any further assistance.
Richard E. Schultz, Ph.D.