Ask Dr. Paul Library
ADHD Medication Is Only Part of The Treatment
DEAR DR. PAUL: I have a 5 1/2 yr old son who was diagnosed with ADHD (Attention Deficit Hyperactivity Disorder). I want to know if there are any natural ways of helping him without the methylphenidate. If you know of anything that might help him "slow down" but not zombie him out I would really appreciate it.
PEDIATRICIAN DR. PAUL Answers: Your questions bring up a few important points about ADHD treatment. I will assume that the diagnosis has been made after a proper evaluation of your child including a comprehensive medical assessment taking into account parent and teacher observations/reports. Before I specifically address the issue of methylphenidate (Ritalin) use, let me list the three important components of ADHD treatment:
- Teacher (academic) strategies in the classroom
- Home behavioral modification strategies
The first two strategies on my list are essential components of the treatment plan. If medication is given without these home or school strategies in place, the treatment will indeed be ineffective. In every day practice, some parents may agree to try, in co-operation with the school, the first two strategies without any medication use. If the results are good, medication may not be needed. However, if despite this approach a child is still having difficulties concentrating, socializing and/or is not achieving good grades, medication therapy may be necessary.
In terms of your comment "zombie effect", I do not think that this is true; Most children who are appropriately prescribed methylphenidate do very well. Although calmer, and less wiggly, they usually are not "zombied out", as you put it. On the contrary, the positive effects on a child's self esteem are tremendous. As well, there are what I call "left over" benefits of the medication. Let me explain; Because an ADHD child can actually pay attention in class(when taking medication), he or she will be better prepared to do the homework assignments at home. Also, as a result of better school performance, children with ADHD begin to be more at ease when it comes to socializing with their peers and classmates. Off medication, many children with ADHD are unable to socialize, as they are frustrated by their in-attentiveness and by their poor school performance.
To answer your question about alternatives to methylphenidate; There are a lot of so called natural remedies, including natural products, homeopathic remedies, herbs, megavitamin therapy and even eye exercises(optometric). However, none of these have been proven to be effective in treating children with ADHD.
On a final note, another concern relates to the role of the diet on ADHD. About 20 years ago there was a special "exclusion diet", thought to be helpful in improving ADHD symptoms. However, subsequent studies have shown this not to be true. Additionally, studies have proven that sugar intake does not to make ADHD symptoms worse. However, if a parent notices that his/her child's ADHD worsens with sugar consumption, I think the logical thing to do is to cut back on the sugar intake.