The Po Show

This is your child. This is your child on drugs.

In the continuing saga of getting Matthew additional help, another loop was thrown. On Tuesday we went to see the psychiatrist, who had reviewed (in a really cursory fashion, naturally) all the records of his past evaluations that I had given her. These included all his report cards from over the years.

She asked if I was adverse to meds for him. I said I was not, having come into this open to the possibility of him going on antidepressant/antianxiety meds. However, she remarked that there had been a lot of notations in his school reports about him being distractable, needing frequent redirection, requiring help staying on track during tasks. She asked if I would be okay with him going on Ritalin.

Well bowl me over with a feather YET AGAIN! This had never occurred to me as a possibility, that he might have diagnosable attentional deficits. I mean, he's always been spazzy, and yes it's damn hard to get him to buckle down with homework, and I knew it could be difficult for his teachers and aides to get him to concentrate on reading/writing tasks in class, but still. He was the two year old who stood and waited by the door for it to stop raining so he and Ross could wash the car, for TWO HOURS. He was the kid who could sit and concentrate on building train track configurations for hours. Who could sit and figure out a video game, despite the fact that he couldn't read. He could always focus on anything he was really interested in. Thus, I thought it was not possible for him to have ADD.

Shows you how much I know. Apparently that is incredibly common for ADD kids, to be able to hyperfocus on certain things, particularly mechanical activities, but then be so distractable on other tasks, that they can't perform.

So, Ritalin. Just 5mg a day, short acting so it won't even get through the whole school day. He takes it right before he leaves (even though that's after breakfast; he's prone to dizziness and nausea anyway so I chose to give it to him on a fullish stomach). Peak concentration is 2 hours, so that's only mid-morning. By the end of lunch and recess, it should have cleared. This is problematic, since he tends to have a harder time with schoolwork in the afternoon, but if this drug seems to be helping at all we'll move him to an extended release version.

Being me, I had to understand what Ritalin was all about. I really didn't know ANYTHING about it, other than lots of people have considered it wildly overprescribed for kids in the last decade or so. So, hello Google my old friend. I was able to figure out its mechanisms, its pharmacokinetic data, all good stuff. I feel better for that. But what I also found out is that no one really knows WHY this drug increases attention and reduces distractability. I hate that. I hate not knowing exactly it how it works.

Also, I found out the difference between Ritalin and Strattera (which a lot of parents seem to be opting for for their kids, the main reason being that it's not a stimulant). Ritalin increases norepinephrine production, while Strattera is a norepinephrine reuptake inhibitor. Those damn neurotransmitters. They are such troublemakers when they don't behave.

Any questions?

You bet your ass.