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Old 12-11-18, 02:49 AM
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Is ritalin for only 6-18 yo?

I had prescribed and used ritalin for a while. Now i'm not using it because of rapid tolerance. Recently i've reread the prospectus. In prospectus it's written that: 'Ritalin isn't used in adults and children who are under 6 yo. There's not any information if the ritalin is efficious and safe or not for those people.'
Also in concerta's prospectus it's written that: 'it can be used for children or adults'
Did you know about that? Is there such a statement in the prospectus of ritalin in your country?
Born in 1989. Treated for major depression and anxiety since 21 yo.
Tried almost all of SSRI's (none of them worked)
Predominantly inattentive adhd, diagnosed in 2018.
Started with ritalin (worked only for two weeks)
Also tried wellbutrin and strattera
Now: ritalin and medikinet
For about three years local corticosteroid pomades for atopic dermatitis.
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Old 12-13-18, 02:38 PM
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Re: Is ritalin for only 6-18 yo?

I found three articles that deal with ritalin for children, preschool children and adults.
There is a sticky called "Why I medicated my son....i loved him enough to try" or something like that{in children's diagnosis and treatment} but it talks about my son starting meds when he was 4.

Ritalin, also known as methylphenidate, is a stimulant drug that's commonly used to treat attention problems in both adults and children, many of whom have described the effects of the drug positively. ... If taken according to the prescribed dosage, Ritalin is generally not considered to be addictive.Sep 29, 2017
Ritalin for Preschoolers?
Study Shows Drug Provides 'Moderate' Help for Preschool Kids with ADHD

By Daniel J. DeNoon
From the WebMD Archives
Oct. 19, 2006 -- Ritalin has a "moderate" effect on preschool kids with moderate-to-severe attention deficit hyperactivity disorder (ADHD), finds a National Institute of Mental Health study.

"We found that a carefully diagnosed and carefully selected sample of 3- to 5-year-old children with ADHD can benefit from Ritalin," Laurence Greenhill, MD, tells WebMD. "But because young children are more sensitive to Ritalin side effects, we found a need for close monitoring of any young child taking this medication."

Greenhill, a psychiatry professor at Columbia University and director of pediatric psychopharmacology at New York State Psychiatric Institute, led the NIMH-funded study.

A previous study in older, school-age kids showed Ritalin to have "strong" effects on ADHD.Compared to older children, Greenhill says, "We found half the dose to be most effective, half the number getting really well, and more kids having to deal with adverse events in the early part of treatment."

Greenhill and colleagues report the findings in five detailed articles in the November issue of the Journal of the American Academy of Child and Adolescent Psychiatry.

Why Medicate Preschoolers?
Ritalin is a stimulant medication that can make about 75% of school-age kids with ADHD act like their peers without ADHD. It can also stunt a child's physical development. Why give such a powerful medication to small children?

A major reason is that kids with moderate to severe ADHD already are at high risk of physical harm.

"They have difficult peer relationships due to lack of reciprocity and perhaps aggression. And they are very prone to accidents," Greenhill says. "Many of them were attending emergency rooms with cuts and bruisesbruises and broken bones, because their fearlessness and activity level made life dangerous for them. They had no idea how dangerous it was to lean out a five-story window, or to speed into traffic on their roller skates. One child saw his mother cooking on the stove, and perched on the stove and turned it on to see how hot it would get. They are fearless and reckless."

Another reason for the study is an eye-opening 1999 report showing that about one in 100 preschoolers was being treated with Ritalin for ADHD -- even though the drug is not approved for this age group.

"So the NIMH asked the questions: Is this effective? Is it safe?" NIMH director Thomas Insel, MD, tells WebMD. "We had no data on these questions."

Half of Kids Get 'Strong Positive Effects'
The study didn't simply give kids a generic version of Ritalin to see what happens. The eight-stage, 70-week study gave parents the opportunity to quit at any time. They could either continue with doctor-supervised Ritalin treatment or discontinue the drug.

An early part of the study made parents attend 10 two-hour training sessions to help parents deal with their child's ADHD. For about 7% of the children, Greenhill says, this was enough.

"For the most part, the problems with Ritalin were the same as those most often seen in older kids -- appetite loss, weight lossweight loss, sleep difficulty, stomach aches, and head aches," Greenhill says. "But some had problems with irritability, more tantrums than they had before, and that was hard to interpret. From my experience, that is the kind of rockiness that you see in kids as the medication wears off."

Ritalin had "strong positive effects" in about half the kids, Greenhill says.

"They could have improved a little more -- but it was a help," he notes. "It takes more time and focus and doctor visits if someone is put on medication at that age. They will benefit -- but they will require more supervision."

"The way I see it, the efficacy is there," Insel says. "It is not as strong or robust an effect as we have seen in other randomized trials in school-age kids. If the question is, 'Does this medication work for these kids under age 6?' the answer is yes. It is an effect that is somewhat less than you would see in older kids, and comes with more side effects. But this confers some benefit in at least some of the kids."

Is Ritalin Really Safe in Preschoolers?
Insel notes that ADHD is a severe problem for children. Ritalin can help, he says, but this benefit must be balanced against the risks.

"A lot of kids are on these medications who should not be on them, and a lot of kids would benefit who don't have access to them," he says. "It will require a much closer look at who will benefit and who could just receive some behavioral intervention and just do fine. But when the medications are helpful, the kids who need them should get them. Finding the balance is the issue for us."

Finding that balance will mean learning more about Ritalin's risks for developing minds and bodies. The NIMH study has documented the short-term risks. But the long-term risks aren't yet known.

"You are giving a medication that has powerful neurochemical effects in a developing brain. What does this mean for long-term development? We don't know," Insel says. "It will take some time to know whether there will be some worrisome side effects in the future. But we have to weigh that against the consequences of not treating. Remember, you have a risk for not treating, too."

Indeed, Greenhill notes that kids with ADHD often suffer peer rejection. This is strongly linked to poor school performance and serious problems in the teenage years.

Just because kids won't do what we want them to do is no reason to medicate them, says Leslie Rubin, MD, director of developmental pediatrics at Emory University and director of the center for developmental medicine at Marcus Institute, Atlanta.

"Kids are designed to be active, to run and play and climb and tumble and explore," Rubin tells WebMD. "When you contain kids in a limited space and have them do things that are constrained and dutiful, it may be difficult for them. If kids watch a lot of TV and don't have structured play, this might result in difficulty for kids to respond to structures in preschool programs. The easiest thing to do is give medicines that control the behavior. What is more difficult is to try to understand the child, to work with the child, to provide more structure."

Insel and Greenhill second Rubin's concerns.

"These are tough problems. It's really difficult because this is a disorder the whole family feels," Insel says. "What you want to make sure you do is not write a prescription and just walk away. The medication is helpful but not sufficient. It involves a long-term relationship, including psychosocial intervention and the need for ongoing medical supervision."

Greenhill says that parent training may ultimately prove to be more effective than medication.

"We teach techniques such as the proper balance of rewards to time outs, the methods of being consistent in commands, recognizing good behavior and rewarding it even if it is rare, and not going overboard when a child loses control," he says. "The parent is literally coached in working with the child. They have a small receiver that fits in their ear, and the trainer sits behind a one-way screen and coaches them. It is very helpful."
Treating Adult ADHD
By Julie Edgar
From the WebMD Archives
Attention deficit hyperactivity disorder (ADHD) is a childhood condition that can last into adulthood in about one-third of cases.

If you've been diagnosed with ADHD as an adult, chances are good that your doctor has prescribed a medication -- typically a stimulant -- and suggested cognitive behavioral therapy or even a life coach. She might also have suggested a good pocket planner.

Treating ADHD in adults requires a multi-pronged approach. Symptoms are generally treated with medicine.

But it's not just a matter of taking a pill. There is work to be done on practical stuff, such as getting organized, and on other emotional issues that often come with the territory.

What Kind of Medication, and for How Long?
The same kinds of medications used for childhood ADHD work in adults, says Lenard Adler, MD, a psychiatry professor at New York University Langone Medical Center and director of the Adult ADHD program at the NYU School of Medicine.

Stimulants such as Adderall, Concerta, Focalin, Vyvanse, Quillivant, and Ritalin in long-acting form are often prescribed for symptoms. Strattera, a nonstimulant approved for treatment of adult ADHD, is also widely prescribed, he says.

Other medicines used to treat childhood ADHD may also help adults, such as Catapres (clonidine), Intuniv (guanfacine), and the antidepressant Wellbutrin (bupropion).

Choosing the right medication for a patient with ADHD is often about avoiding worsening other health problems. For instance, Adler says he wouldn't prescribe a stimulant to a patient who has a substance abuse problem, because stimulants have a high potential for abuse.

Your history of taking ADHD drugs also matters. Adler finds out what the patient has taken previously and, because ADHD has a strong genetic link, what family members with ADHD have taken and tolerated.

Adler, a psychiatry professor at NYU's School of Medicine, has received grant/research support from various makers of ADHD drugs.

What Kind of Side Effects Might Occur?
Adults with ADHD and a family history of heart disease and fainting should consider the effect of ADHD drugs, both stimulants and nonstimulants, although they are considered safe in the short term.

"They are generally safe medications," Adler says. But even patients taking Strattera need to have their blood pressure and pulse monitored. He starts patients on the lowest dose to gauge their tolerance.

Side effects that are common in stimulants include agitation, insomnia, and changes in blood pressure and pulse. Potential side effects of Strattera are similar and may also include nausea, Adler says.

How Long Should I Take the Medication?
That depends on your particular case.

"With kids, we recommend they stay on it throughout the school year. It helps them learn better. That's true for college students, too. Post-college, it's going to depend on the situation, the stressors, how they're handling them. Will you always stay on medication? It's an individual decision," says Angela Tzelepis, PhD, a psychiatry professor at Wayne State University who also runs a clinic in Grosse Pointe, MI.

"Our focus is now on assisting patients in maintaining these improvements and continuing to make meaningful, positive changes in their lives," Adler says.

When It's Not Just ADHD
Most adults with ADHD don't just have ADHD; 75% to 80% also have disorders such as major depression, bipolar disorder, anxiety, and substance abuse, according to a study published in BMC Medicine.

Depression and anxiety are often what brings an adult with ADHD into a therapist's office, Tzelepis says.

"Honestly, most adults who are going to seek treatment aren't going to seek treatment for just ADHD," Tzelepis says. "My approach, and this is supported in the literature, is this is a neurobiological problem. The best treatment is going to involve a combination of medication and the therapy, or other nonpharmacologic interventions.''

For some people, the baggage that comes with ADHD is part of the problem.

"Some of the emotional issues you see have to do with not feeling good about themselves, feeling that they aren't capable and competent, because things they do take more effort and they internalize that," Tzelepis says. "The kind of feedback they get from others -- that they're lazy or if they worked harder they'd do better -- they constantly get the message they aren't good enough.''

Should I Try Psychotherapy?
Yes. Cognitive-behavioral therapy, or talk therapy, seems especially helpful for adults with ADHD, mainly to help develop organizational skills. And if you have other mental health issues, you should think about trying talk therapy.

If ADHD seems to be the patient's primary disorder, Tzelepis says she'll help a patient focus on "executive functions" including time management and planning.

In one case, a young woman who had flunked out of her first year of university after a stellar high school run came to Tzelepis to get on track. She had never had a bedtime or much structure to her days, and that was her downfall as a college student.

"It became clear she did have ADHD and hadn't been diagnosed because she was bright and was able to do well academically," Tzelepis says. Aside from getting her a calendar, Tzelepis helped the patient gain more mastery over her reactions and emotions.

The young woman spent a year at community college and is heading back to the university.

"What you need is therapy with goals that are specific to the behaviors and symptoms that are problematic. If you have difficulty keeping a calendar, how are you going to keep a calendar, what are the barriers?'' Tzelepis says. "It's not, 'how do you feel about keeping this calendar?'"

But Adler says some patients may get better with ADHD medicine alone.

"They can make a change in their life, unlearn bad habits, use their organizers well, plan better, listen better. They don't need a psychosocial intervention," he says. "You can make a meaningful difference with these medicines.''

What About Coaching?
ADHD coaching, a new industry that offers very specific problem-solving, can also work for some people, Tzelepis says.

"It's akin to what you have with a kid and a tutor," Tzelepis says. "I've referred people to coaches because I need to work on other pieces -- the emotional-psychological component of what is going on."

An Australian study that paired ADHD adults with coaches for eight weekly sessions found that most participants improved their organizational abilities and had reduced levels of anger that they maintained for a year after the therapy. Participants also had to complete homework exercises. The study was designed to target attention problems, low motivation levels, poor organizational skills, poor anger control, and impulsivity.

For the relatively few adults who only have ADHD symptoms, coaching or talk therapy may be the only thing necessary to put them back on track, Tzelepis says.
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Old 12-13-18, 08:34 PM
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Re: Is ritalin for only 6-18 yo?

Ritalin and most other stimulant meds have only been tested on children.
There is no reason they are not safe and effective for adults, but since they
haven't been tested on adults, that's not part of the information packet.
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