Dei'ah veDibur - Information & Insight

A Window into the Chareidi World

15 Kislev 5763 - November 20, 2002 | Mordecai Plaut, director Published Weekly









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Opinion & Comment
Drug Treatment for ADHD

by Chaim Walder

A book published many, many years ago describes in detail how eyeglasses came into the world. People have always had problems with their eyesight, and when convex or concave lenses were first used to improve vision, neither the nearsighted nor the farsighted leaped at the invention as anticipated. They were embarrassed.

The use of spectacles, as they were called, was a clear admission that the owner was handicapped. They conveyed the information that the wearer had a seeing impairment, that he saw things in a haze, that he found it difficult to read and to recognize people. The truth is they knew this about him anyway, just as all of us know when another person fails to recognize us and is constantly squinting his eyes. But this did not change people's reluctance to make their problem obvious to the public by wearing glasses.

At first, some opted for a different type of seeing aid, a sort of magnifying glass known as a monocle and later pincers, which were bereft of ear pieces. Somewhere along the way an optometry company came up with the brilliant innovation of presenting glasses as a fashion accessory and a status symbol. The outcome is well known. Today there are some people walking around with frames containing 0/0 lenses.

Glasses are an overt sign of impaired vision. Impaired vision happens to have a lot in common with impaired attentiveness and listening. Since most of us wear glasses, let's try a little exercise.

Take off your glasses and have a look around. See that picture? See the folders on the shelf? Can you make out what's written on them? Do you see the person who just walked in? Yes, you see a person standing there, but his facial features and expression are just a blur-- even his words are suddenly hard to distinguish, aren't they? You feel a bit cut off, in a fog. And you're just without your own glasses. Imagine if you needed thick lenses!

You have an impairment. You have trouble seeing, hearing, feeling and even concentrating. You are not focused and do not see the world as it really looks.

You cannot know how much this resembles attention deficiency.


Imagine if there were glasses to solve attention problems just as there are glasses to solve seeing problems. Would anyone refuse to wear them?

There are such glasses available, but in the case of Attention Deficiency and Hyperactivity Disorder (ADHD) parents tend to be very hesitant. They are afraid to give them to their children out of both medical concerns and image concerns.

I seem to be beating around the bush. Perhaps I, too, have trouble confronting this issue, but one cannot write articles about attention deficiency without discussing one of the major solutions to the problem.


Ritalin was developed 65 years ago, making it one of the oldest preparations still in use (following aspirin). It works by increasing the activity of the dopaminergic and noradrenergic systems. And if you don't get it, that's OK. I don't either. Tachlis, the use of this medication does for the child's listening and attention what glasses do for seeing.

Just that. The child takes the pill and right away his mind becomes clear. He focuses, he listens and he understands.

He also becomes his old self again--a nice, delightful child, in control of his reactions, not squirmy and wild. Sixty-five years of use have provided all of the necessary findings regarding its regulation and physical effects. Medical science claims there are no known side effects or cases of addiction, and no physical damage is caused. But there are some who argue with the doctors.

I have read extensive material of Ritalin opponents. They claim it is a drug that erases brain cells, retards growth and is detrimental in various other ways. The brochures and organizations against Ritalin are mostly sponsored by the Scientology cult, which preaches the avoidance of all neurological intervention as one of its tenets.

On the other hand there are also more reliable Ritalin opponents, primarily in the field of alternative medicine -- homeopathic healers, naturalists, etc. They have arguments against Ritalin that are worth looking into.

Still, the majority of physicians, psychologists and educators support Ritalin, some of them enthusiastically.


This writer has no intentions of deciding between the proponents and the opponents. But one important message should be conveyed: Ritalin completely solves the problems of attention deficiency and hyperactivity.

What remains for you to determine is whether or not it causes harm. If you investigate and reach the conclusion that it does not have negative effects, by withholding it you withhold your child's well-being, just like withholding glasses from a child with blurred vision.

While researching Ritalin, one of the matters I found of interest was the question of whether it alters the child's personality. In my opinion, hyperactivity has an advantage because it infuses the person with more energy than others have, and I wouldn't want to see these energies taken away from the child. According to all opinions, Ritalin has an immediate, localized effect, removing obstructions to listening and attentiveness and calming the child, which allows him to conform to social norms.

In a 16-year survey of two groups of children, one treated with Ritalin and the other without, 25 percent of the group of children that did not receive Ritalin dropped out of high school. In the other group there was only a 2 percent dropout rate.

And another word about fears of possible repercussions, some of which are unfounded. A package insert includes the following warnings:

This medication can lead to liver damage.

This medication can lead to agrenolocitosis (toxic damage to white blood cells).

During the course of using this medicine side effects may occur, such as rashes, itching or dizziness. Side effects that require special attention: diarrhea, nausea, stomach pain.

Also stomach irritation, anaphylactic shock, cold sweat, shortness of breath, accelerated pulse rate, leukopenia, thrombocytopenia (manifested by increased tendency toward bleeding), headaches, temporary disruptions of kidney function.

Tell me, would you take medication like this? Actually you already do. I copied these warnings from the package inserts for Acamol and Optalgin.

Ritalin also comes with a series of warnings. Read the package insert carefully before use.

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