Getting Rid of Ritalin

32

rx2.jpgSusan (not her real name), a seven-year-old girl with severe Attention Deficit Hyperactivity Disorder (ADHD), was about to enter first grade. Her parents were concerned that schools would not accept their daughter due to her extreme hyperactivity and inability to concentrate.

Susan had been taking the widely used ADHD drug Ritalin for the last year but her parents had significant concerns. Side effects such as a loss of appetite and problems sleeping were coupled with a concern over possible cardiac risks associated with the drug. Furthermore, Susan’s parent saw no end in site with Ritalin temporarily helping the situation, but offering no long term solution. On top of all this, Susan simply didn’t feel herself when she was on the drug. She was far more subdued and in many respects, a different person.

However things changed when Susan’s parents met Dr. Amnon Gimpel, a Board Certified psychiatrist and neurologist, who has just published a book called Brain Exercises to Cure ADHD. As the title of his book suggests, Gimpel has created methods to treat ADHD at its core and empower parents to help their children overcome ADHD without the negative side effects of medication.

gimple.jpgGimpel teaches new techniques and strategies utilizing targeted mental and physical exercises that have been proven to reduce and even permanently eliminate the symptoms of ADHD in children, teenagers and adults. Through his counseling and seminars, and now with the publication of his new book, Gimpel gives parents the skills to coach their ADHD child to enhance memory, concentration and decision making, and to control hyperactivity and impulsivity.

In Susan’s case, it became apparent that she loved to jump rope. Applying Gimpel’s methodologies, it was suggested that Susan use this passion as an exercise to develop new brain cells, ultimately leading to significantly improved concentration and decreased hyperactivity.

With each new rope-jumping trick Susan learned and each new technique she mastered, her brain was forced to create new pathways to accomplish these challenging tasks. Simultaneously, her behavior improved immensely and she finished the school year at the top of her class, without any medication.

ADHD is one of the most common psychiatric disorders in school-aged children with over four million under-18s in the United States currently suffering.

To treat the condition, more than two million prescriptions for Ritalin–methylphenidate–are written each year, despite the myriad number of problems associated with the drug.

“The difficulty with this particular disorder is that, despite being recognized more easily by professionals in recent years, most physicians and therapists do not have a long-term solution to ADHD,” said Gimpel.

“Furthermore, medications, such as Ritalin, cannot solve the problems associated with ADHD alone, nor does it result in any permanent changes in the brain. As soon as Ritalin use is stopped, the symptoms of ADHD return.”

book.jpgIn his ground breaking book, Gimpel details mental and physical exercises to stimulate brain growth in precisely the areas where the ADHD brain is developmentally delayed, treating the cause of ADHD at its core. Through Brain Exercise Therapy, Collaborative Problem-Solving and other strategies, parents can take charge and correct the problem without interfering with the child’s personality, creativity or talents. Parents who are resistant, resentful or simply uncomfortable with continuously medicating their children can now find permanent solutions through mental and physical exercises that stimulate permanent brain growth and development for a calmer, more focused person, thereby diminishing or eliminating ADHD symptoms as well as the use of Ritalin and other ADHD medications.

“Gimpel has had extensive experience treating patients with ADHD and argues forcefully that parents can do more than just medicate their children.” said Dr. Isaiah Wexler, Associate Professor of Pediatrics and Head of Pediatric Endocrinology at the Hebrew University School of Medicine. “He provides parents with a variety of behavioral techniques, including brain exercise therapy, that are designed to empower both the child and parent, allowing them to control ADHD rather than vice versa.  This is a ‘must read’ book for families coping with ADHD and health professionals treating this complex and challenging disorder.”

32 COMMENTS

  1. Contrary to the impression this article leaves, Ritalin is not the only medication available. There are many options available and if the family takes the time to choose the proper medication and the proper dosage with their child’s neurologist who has experience with ADHD medications, then the drastic side effects mentioned in this article don’t have to be there.

    I hope that people don’t get the wrong impression from this article and take their child off of a medication which, if properly chosen and dosed, could make the difference between failing in school and a low self-esteem and succeeding in school and a high self esteem.

    Another misimpression left by the article is that medication takes away a child’s personality, creativity, and vivaciousness. To the contrary, When a child is plagued by uncontrolled energy and an inability to focus on anything, the child can’t really accomplish very much intellectually and creatively because he or she won’t have the focus and zitzfleish to do anything creative or learn a new skill that they would have a talent in. But for children who need medication, and if it’s properly chosen and dosed, the medication will facilitate the child’s expression of their real personality, since it won’t be impeded by wild and unchanneled energy or the inability to focus on anything.

    While children who do not need medication should not be put on it unnecessarily, we also shouldn’t make our child suffer as the korbanos of our idealistic opposition to ADHD medication.

    -Benyomin

  2. What studies are there that this method works?This seems to be a paid advertisement.
    Drugs don’t change a child’s personality. It only controls his impulsiveness. Studies show that behavior modification together with medications is the best treatment for ADHD.

    Parents will often look for quick fixes and often try these snake oil remedies like the one mention in the article. People like Dr. Amnon Gimpel will often prey on peoples fear to make money. Speak to your child’s doctor before wasting your money on something new.

    Editors Response: This is NOT a paid advertisement.

  3. “The Myth of the ADD Child.” A must read. Written years ago by the well known educator, Thomas Armstrong. Contrary to what #1 writes, there are many non-medication methods for treating and perhaps curing ADD.

    It may, by-the-way, be a condition we really don’t want to rid the world of. It seems that many of our most successful individuals either have been or would be diagnosed with ADD or ADHD.

    Many would disagree, but I would think that the risks, which include kidney or liver failure for which function levels must be taken regularly, require a sh’ailah be asked if it is even permitted to take. Secondly, almost everyone reports the “different person” side-effect of these medications. Better behaved, yes. But also less driven, less sharp, less focused. Over all, less of a thinking, questioning, inquisitive person.

  4. If the teacher is boring, and the subject matter is inappropriate, the only answer to keeping a child from going nuts in the classroom is to drug him into submission.

  5. If we don’t want to use the oldest and best method, of teaching a little mussur and middos with our children, then there is another option available – and no prescription necessary – give them some shnops, it will calm them down till they will fall asleep.

  6. “we also shouldn’t make our child suffer as the korbanos of our idealistic opposition to ADHD medication.”

    the children dont suffer when they are kept off ritalin and other very similar Rx.
    it’s the teachers and administrators who suffer, who then make the parents suffer.
    they suffer because these are difficult children, and the staff prefers them drugged into complacency.

    the doctors will tell you they are treating a “chemical imbalance”
    ask any doctor, search the internet: see if you can find the name of this “chemical”, what tests they have to measure it, how exactly is it out of balance, what studies can be cited to indicate that there is a “chemical imbalance” you wont get any meaningful answers.

  7. There are many who believe that cancer can be cured without chemotherapy (healingcancernaturally.com is one example), would you take that risk if your child had cancer CH”V? The risks of Ritalin are relatively minor and some other ADHD drugs have even less risks and negative side effects.

    If your child is diagnosed with ADHD, do not let him/her coast through life without help, just as you wouldn’t read a book to cure his/her cancer. Children going through their school years with ADHD have to work for many years into adulthood to make up for it, if they ever do.

  8. Mark:

    “best answer parents can come up with”

    The sad thing about this comment is that it presumes that all children are the same? Fortunately, such a world is not the one we live in. Every child is different and there is no one-size-fits-all method that “parents can come up with.” It has to be based on the specific nature of the child. As I indicated in my earlier comment, one should not put their child on ADHD medication if the child doesn’t actually have ADHD merely because the child is energetic. On the other hand, withholding properly chosen and properly dosed medication from a child who will suffer intellectually and socially is also a detriment to the child.

    -Benyomin

  9. Without getting in to the issue of Ritalin or other medications being correctly prescribed and managed to alleviate the suffering of ADHD students, I suggest that you evaluate the source of these ideas.

    According to his website, Dr. Gimpel is the director of the Marriage and Counseling Clinic at Emory University in Atlanta.

    Should we be taking advice in chinuch from someone who spends his days doing this????????

  10. “the doctors will tell you they are treating a “chemical imbalance”
    ask any doctor, search the internet: see if you can find the name of this “chemical”, what tests they have to measure it, how exactly is it out of balance, what studies can be cited to indicate that there is a “chemical imbalance” you wont get any meaningful answers.”

    Feivel, before you insult the entire medical proffesion, I think you should understand what a neuroreceptor is. Neurologist spend their lives doing chesed, curing kids with chemical imbalances. There were years of work and tests put into identifying which ‘chemicals’ create which responses. You won’t get a meaningful response because you don’t know the physiology of the neurosystem. Don’t mean to be insulting. Just know b4 you criticize something.

  11. This article betrays not the slightest knowledge of brain neurochemistry. Why is this pablum the subject of a frum site? There must be some reason that thousands of qualified and caring professionals prescribe Ritalin.

  12. I know many children who are on Ritalin. For some of these children it has truly been a lifesaver, and for others I wonder if the parents are not just trying to keep their kid in control in an easier way. There is a definite truth that Ritalin makes the child ‘feel different’. A number of children have, over the past five years, told me that they do not like how it feels when they are under the drug. All parents and educators must use extreme caution when giving these drugs to children.

  13. I don’t have experience about ADD, however I do know someone who suffered years of OCD and didn’t want to take medication i.e. zoloft, Prozac. A few months ago his therapist suggested again that he should try medication. Suffering so long not having an other option he did go on medication. I can tell you all one thing the medication is amazing, it let’s you bring out the talents hidden in you that because of the OCD you couldn’t express them, your relationship with your wife is much better, your relationship with your children is much better IT ABSOLUTELY DOESN’T CHANGE YOUR PERSONALITY OR CHARACTER IT ENHANCES IT.

    PLEASE FOR ALL YOU SUFFERING FROM OCD TAKE THOSE PILLS IT CAN CHANGE YOUR LIFE!!!!!!

  14. the teachers and administrators who suffer FROM WHAT? so they should take ritalin to calm dowm and NOT act up with the ADHD they have (are)
    if they cant handle the job lets see if they can work as a truck driver or a warehouse job or even be a salesman HASHEM YRACHAM PLS DONT CALL THESE CHILDREN LOSSERS DONT CALL UP THE PARENTS AND TELL THEM YOUR CHILD HAS ADD-ADHD bring in the right people that understand AND HAVE A WARM HEART TO TEACH AND WORK WITH THESE CHILDREN IF NOT THEY WILL BE ON THE STREETS LIKE MANY HEART BROKEN PARENTS HAVE TO SEE THERE OWN CHILDREN IN THE STREETS BECAUSE THE MOSDOS CANT HANDLE THESE KIND OF CHILDREM\N
    “REMEMBER WHO ARE YOU WHO TOLD YOU THAT YOU ARE THE RIGHT PERSON TO BE IN CHINICH IF YOU CANT HANDLE IT GO OUT AND GET ANOTHER JOB YOU DONT HAVE TO BE A TEACHER A TEACHER IS A PERSON THAT WILL TEACH ALL KIND OF CHILDREN HOW TO REACH ITS GOAL IN TORAH LEARNING”

  15. Ritalin might have side effects, but most medications do, so you have to weigh the pros & cons – rather some minor side effects than some major ‘front’ effects that you have when not taking it.
    I have a relative who suffered from a.d.d. & some other issues, & medication helped wonders.
    It doesn’t cure but it really controls the symptoms.

  16. Guys, lighten up, will you? This is not a grand opportunity to start hating each other or various schools in medicine.

    If I may, my old maura d’asrau sh’l’y’t”a was a m’xanaech. He was at a staff meeting when ADD was first becoming “popular.” After much discussion, he opined that it was nothing new, but used to be called SFD. “What’s SFD?” asked the others. He replied: Sitz Fleisch Deficiency!

  17. #13

    i have been a physician {MD)for 32 years. i know well the arrogance and absolute certainty with which the profession as a whole conducts itself. Your impression of the wisdon behind ritalin use is completely incorrect. It has been promulgated for use purely on an empirical basis, the criteria being manageability, and not for the benefit of the child (except perhaps incidentally).

    it is not a drug somehow “designed” to treat AHD (which is an imaginary entity, to which anyone with certain disruptive behaviors is thrown into)
    it is a dangerous powerful chemical, which has effects worse than its side effects.
    IF, IF, there are “chemical imbalances”, no one can name those chemicals or say what their “balance” should be.
    it is a sham, like so many before it, being cleverly thrust upon these poor, trusting, unknowledgable parents.

  18. As a mother of 2 ADD children, one out of control. I have had both my children tell me that the medication helps them and they feel good about their actions, mouth and relating to others in a “normal” fashion. There are so many medications out there to try, hopefully one of them should not make them feel “ughy”. It takes a lot of trial and error but in the end it makes the child succeed in everyday life and not feel like a failure or different. There are exercises to be learned and for some that is enough, but there are those that require medication. In the end you want to do what is the best for the child!

  19. “There must be some reason that thousands of qualified and caring professionals prescribe Ritalin.”

    yes, the same reason millions of hysterectomies were routinely performed, the same reason x-rays were used to treat acne, the same reason tonsils were brutally cut out from millions of children who had a cold……arrogance, ignorance, foolishness, and money, not necessarily in that order.

  20. Shuali & others:

    To repeat, if parents or teachers just want medication to make their lives easier, then that’s not a good reason and it shouldn’t be done. But is a grave mistake to believe that this is always the case. It is, in fact, a detriment to *the child* to withhold properly chosen and dosed medication for the ADHD condition. Without the benefit of such medication, the child will have very limited ability to channel their energy and focus. The result of this is often failure in school, discouragement and further acting out to avoid school-work since it feels like a source of failure rather than success.

    Again, if our child would benefit from properly chosen and dosed medication to minimize or eliminate personality or other side effects, it would be to the child’s detriment to withhold it.

  21. Story from a Psychologist friend:

    She was counseling a child with ADHD whose parents and neurologist perscribed an ADHD medication. After a couple of weeks on the medication, our friend asked the child, “Do you feel different in any way because of the medicine?” The child answered, “No. I feel the same. But it sure seems to have helped my parents and teachers. The teacher started giving easier work and my parents don’t yell at me as much. So it sure is working on them!”

    🙂

  22. i keep seeing people here posting about ritalins mild and few side effects

    the following is from epocrates online a well respected physicians resource:

    Serious Reactions
    * dependency, abuse
    * psychosis
    * mania
    * aggressive behavior
    * Tourette’s syndrome (rare)
    * arrhythmia
    * MI (myocardial infarction)
    * stroke
    * sudden death
    * seizures
    * growth suppression (long-term use)
    * hypersensitivity rxn
    * exfoliative dermatitis
    * erythema multiforme
    * thrombocytopenic purpura
    * leukopenia
    * neuroleptic malignant syndrome (rare)
    * cerebral arteritis (rare)
    * hepatic coma

    Common Reactions

    * nervousness
    * insomnia
    * anorexia
    * abdominal pain
    * weight loss (long-term use)
    * tachycardia
    * nausea
    * motor tics
    * headache
    * palpitations
    * dizziness
    * fever
    * rash
    * urticaria
    * depression, transient
    * drowsiness
    * dyskinesia
    * angina
    * Blood Pressure changes
    * visual disturbances
    * elevated liver transaminases

    in addition ritalin carries the dreaded “Black Box warning” mandated by the fda for particularly severe problems that require special monitoring:

    caution if drug dependence or alcoholism hx; chronic abuse can lead to marked tolerance and psychological dependence w/ varying degrees abnormal behavior; frank psychotic episodes can occur, especially w/ parenteral abuse; careful supervision during withdrawal, severe depression may occur; withdrawal after chronic use may unmask underlying disorder sx requiring follow-up

  23. as an adult who takes ritalin i can personally testify that it is a lifesaving drug. the quality of my life, and learning in particular is incomparable now to what it used to be. halevai that i would have started taking it as a younger child. then i may have actualy gained something from my 12 years in school and two years learning in a bais medrash. any parent who refuses their child this medication is a mazik b’yadayim, and only has themselves to blame when their kids go off. and if you think the problem is “Sitz Fleisch Deficiency” then let your kid go out to work after elementary school like they used to. dont force him to sit through another four painful years.
    the ribono shel olam made a machla and he made a refuah. dont be stupid.

  24. “that being said, to state that Ritalin is a made-up drug to treat a made-up disorder is demonstrably false.”

    i never said it was a made up drug.
    it is a real drug used to treat a made up “disease”

    “seem to act on portions of the brain that are otherwise understimulated due to a deficit in naturally-occurring stimulants. Such deficit causes children with this disorder to seek to “self-stimulate”, resulting in the disruptive behavior that is so familiar to those dealing with ADHD.”

    pure unsubstantiated wishful thinking. totally made up, but sounds good. gobbledygook made to fool people. the same type of drivel has been used with every medical fad that comes along. such as lasik right now, for example. one recent ad: “the cool gentle light of a laser”…..
    come to my office and see some of the gentle horrors caused by lasik. but people are still flocking by the thousands every day to have their eyes surgically altered, generally for flippant reasons.
    the tonsil yanking doctors of 50 years ago had plenty of “studies”, and “theories” and well chosen words to convince parents of the imperative need for dangerous surgery.
    you have to use your brains. you cant just go along with the current trend because it seems so right at the time

    i ask you again what chemical exactly is out of balance??
    what portion of the brain is “understimulated?
    how do they know what normal stimulation is for that part of the brain?
    stimulated by what?
    under what circumstances?
    we know practically NOTHING about the function of the brain in areas of cognition, emotion, etc.

    so some mysterious part of the brain is understimulated by a mysterious stimulator, less than the optimal mysterious degree. so the child mysteriously senses this and mysteriously stimulates himself to compensate.
    somehow ritalin stimulates this understimulated area. the child then senses that his stimulation is now ok so he is agreeable to stop stimulating himself, and hes back to normal, as if the original understimulation was not there anymore.

    this is what you believe?

  25. #27, #28
    like any other potent, dangerous drug, such as amphetamines (speed) (to which ritalin is quite similar)it has its medical uses, but must be used VERY selectively, VERY cautiously, very discriminately.

    this is NOT how it is being used, not at all, not even close

  26. Ritalin is only one of several medications used i.e. Concerta, Strattera ( a non-stimulant) Adderal etc. NIMH has done a major study of these medications in conjunction with major hospitals and has produced a report on the cost/benefit issue. Like any medication there can be side effects – one must judge the risks as with immunizations.

  27. Dr. Feivel,
    I too am an MD. Although, I definitly cannot make the claim to 32 years. I work neuro and I have told pts they have ‘chemical imbalances.’ Somethings will not be understood by pts and we don’t really understand them. After 20 whys by a kid, it can get to you have a ‘chem imbalance.’ I use more potent medications on a daily basis. But, what’s better seizures or an addicting drug. I just closely monitor for sideeffects. I am not disputing that ADHD is somewhat made up and completly overdiagnosed. But, I won’t rant about that now. Because I believe it to a very small extent. Not the way it is done today. Naurcotics also saved my life. I may be addicted somewhat and the sideeffects are aweful. But, hey, I can now have a life as opposed to b4. Sometimes dangerous drugs are worth it.

  28. There are far fewer behavior problems in Yeshivas (in New York) than in the public schools since yeshivas will surgically remove the problem rather than, as required by Halacha, treat the child with love and patience. I knew a brilliant eight year old that was only permitted to stay in yeshiva if he would take a daily dose of Ritalin. The parents ceded to yeshiva’s demands but the youngster became addicted to this drug, even to this day after 25 years. Parents should do everything possible to avoid Ritalin.

  29. 2 yrs premed
    4 yrs medical school
    2 yrs general medicine internship
    6 mos internal medicine residency
    1 yr obstetrics residency
    4 yrs ophthalmology residency (which by the way included a great deal of neurological experience)

    i only reveal this as a courtesy to you, however my thoughts stated in this thread are not based on my training, actually my training goes counter to my beliefs.
    by the way, my training also included a heavy inoculation of Evolution, which is populated by practitioners even more arrogant and foolish than medical practitioners.

    on the other side, i dont apply the above to all medical practitioners. there is certainly a great deal of vital chochmoh in certain areas, such as trauma, burns, icu, emergency medicine.
    i am primarily referring to those who treat chronic and lifestyle diseases (such as diabetes, hypertension, lipidemia), emotional, and psychiatric disorders.

    sammygol, i hope this was helpful.
    but i dont intend to continue and get drawn into a lengthy and probably contentious discussion here.
    i just dont have the time.

  30. Let me begin by making a disclaimer that I am not a doctor rather merely a passive observer of this issue. I present my non professional opinion:

    There is a whole drug peddling industry out there which includes the peddling of Ritalin. Is it never of benefit? I can not be certain of that, but I am convinced that the majority of the patients being prescribed Ritalin is ill served by the medication. Side effects include depression suicide R”L and other tendencies with being quick with the trigger. It is a mind altering drug. All the school shootings have in common, that the kids who went on these senseless rampages were on the drugs. When you subdue emotions they pent up inside, and eventually spill over and get expressed at the wrong times. A parent has to teach his child to swim. Swim in the challenges of life. Don’t drown. One must teach his children; not every emotion is beneficial to express, and teach children the art of subduing THEMSELVES. Not inviting a “magical” drug to take that role. Another side affect is, when you rely on the drug to quell emotions, you don’t work on the skills to do it yourself, that way if you ever cease using the drug, you are left in the dark without these skills. These skills ought to be built and developed when children are young, and not just drug them which conceal the lack of these basic skills.

    Why can’t it be understood that not everyone possesses equal amounts of zitzfleish? Chazal say, Chanoch lanaar al pi darkoi, find a method to teach children to suit there personality, and we are not instructed by chazal to find a drug to prescribe to a child to make educating him a more bearable task.

    I happen to think that the very tame children are usually very square, and that’s why they conform to a classroom so easily. The ones who isn’t tame, and the teacher suffers miserably with them through childhood, eventually their chisoroyn develops into a tremendous maalah. These children are generally the types who think out of the box and become great millionaire businessmen, while their peers who had all the zitzfleish in the world, becomes a math professor. It is simply unfair to drug children at such a young age especially when there is great controversy on the benefits of this drug verses it’s negative side effects. Wait until the child is older, then he can drug himself up if he chooses at 18.

    I personally would not trust a doctor which prescribes Ritalin more often then not. I would trust him, if his prescribing of Ritalin is the exception, NOT THE RULE.