Question: My 28-year-old nephew has taken Ritalin since he was about 8. I have heard bad things about Ritalin and long-term usage. Should he try to stop taking this medication?
Dr. Hibberd's Answer:
Ritalin (an amphetamine) therapy for adults has always been contentious. While attention-deficit hyperactive disorder is described in adults, there are newer options available (such as Strattera, a norepinephrine reuptake inhibitor specifically indicated for ADHD) that are probably safer options than Ritalin for use in adults.
Bear in mind that other disorders can also present with hyperactivity, especially in adults, and proper evaluation is necessary to avoid mistreating these and other disorders (such as bipolar disorder etc.).
Attention-deficit hyperactive disorder (commonly referred to as "hyperactivity" and several other names for the same condition) was noted prominently in school-age children and postulated as reflecting minimal brain dysfunction in the maturing brain.
It was believed that children grew out of this condition as their brains matured into adolescence. In truth, many patients probably learned to compensate for this condition in other ways with the passage of time. Drug therapy, although effective, is by no means the only available treatment for ADHD.
Early conventional reports indicated Ritalin as effective drug therapy in children without prominent amphetamine effects. On the other hand, treatment of adults with Ritalin resulted in a pronounced amphetamine effects.
There are adults who do respond to Ritalin treatment; however, they require regular monitoring and periodic re-assessment for both their condition and for amphetamine-related side effects. When discontinued, Ritalin withdrawal should be supervised by your physician.
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