By Shaun Gillham and Shaanaaz de Jager
THE use of Ritalin and other medicine to treat hyperactivity and attention deficit disorder is soaring among primary school children in Nelson Mandela Bay.
While some pharmacists blame schools for pushing parents into insisting their children take the schedule 6 drug, teachers have described it as a “wonder drug” and doctors say the medication is crucial in helping affected children concentrate and achieve better results at school.
A modern lifestyle of excessive television and not enough exercise has contributed to young children’s growing inability to concentrate in class, they say.
Long controversial in South Africa and internationally, Ritalin, a commonly dispensed brand and variant of methylphenidate, is used to treat Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) and is a stimulant which acts on the central nervous system. The drug acts on chemicals in the brain and nerves that contribute to hyperactivity and impulse control.
The stimulants have come under fire in recent years due to a number of potential physical and psychological side effects which include loss of appetite, stunted growth, headaches and depression.
Newton Park-based Klinicare pharmacist Cheryl Booysen said there had been an “increase of nearly 50%” in Ritalin prescriptions over the past year.
“Over the past 10 years there has been an exponential increase of Ritalin at our pharmacy,” she said.
A Mount Croix pharmacist, who asked not to be named for professional reasons and who has a son using Ritalin, said the use of the drug and its generic equivalents was relatively common in Bay schools and that he had noted an increase, due to his role in dispensing medicines, in recent years.
He said he believed that about a third of the pupils in his son’s class were being treated with stimulants for ADD or ADHD.
“Pupils may have become rowdy or unruly and the classes become hard to control. They (the teachers) then follow a process, which involves the parents and medical professionals. The children are diagnosed with a disorder and are then inevitably prescribed Ritalin or one of the equivalents,” said pharmacist.
“When an attention deficit or hyperactivity case is diagnosed correctly and the medication is applied professionally and responsibly, the drug can produce fantastic results. My son experienced a 20% improvement in his school work. However other factors should be considered before there is any wholesale application of these drugs.”
East London pharmacist Ettiene Grassi, who owns Vincent Family Pharmacy, said he had seen an increase in Ritalin prescriptions.
While he did not question use of the medication if a “proper analysis” of the patient was carried out by a doctor, he suspected that in some cases children were put on Ritalin to counteract modern lifestyle issues like poor discipline in homes.
“Discipline is going out the door and there is a difference in the way kids are brought up compared to previous generations. There is a place for it (Ritalin), but people just jump too quickly on it.”
Greenwood Primary School principal Gary Pike acknowledged that Ritalin or equivalents were commonly used by his pupils.
“Children are not tearing up and down, in and out of trees and running all over the place as they once did. They now spend their time watching television and playing computer games. Naturally, when they get to class, where all their friends are, they now have so much pent up energy they have to get rid of.”
Pike denied that teachers were the starting point for Ritalin use. He said his school had a register of all the pupils, about 2.8%, who were on these medications.
“In cases where pupils are put onto medicine such as Ritalin, we follow a very inclusive, comprehensive and professional process which is solely directed at the best interests of the child,” he said.
Alfonso Arries Primary School in Booysens Park principal Bruce Damons said there were no children at the school on Ritalin, but he believed between 15 to 20 children needed the medication.
“This is not a clinical diagnoses but only my layman’s view and from my experience of working at Sapphire Road Primary School where children were diagnosed with having ADD or ADHD,” Damons said.
Former primary school teacher Hilton Williams, who recently retired from East London’s George Randell Primary where he was principal for 19 years, said Ritalin was a “wonder drug” that could prevent children from growing up on the wrong side of the law.
Williams said without Ritalin, children diagnosed with ADD and ADHD experienced listening like “a static radio that is not tuned correctly” but once they were on the drug the transfer of knowledge was “crisp, clean and clear.
“The difference between them is like night and day.”
He said he had noticed an increase in the use of the drug saying this was due to the hereditary nature of ADD and ADHD and because there was now a better awareness of these conditions. “When I was at school everybody just thought these kids were bloody naughty, but now I always say it is like hitting a deaf child for not listening.”
Asked for comment, Port Elizabeth pediatrician Johannes Wickens referred Weekend Post to Professor André Venter, one of the founder members of Paediatric Neurology and Developmental Association of Southern Africa and professor and academic head of the Department of Paediatrics and Child Health Medical School at the University of the Free State.
Venter said it was an urban myth that teachers were requesting children to be put on Ritalin. “Nobody can bully a parent into getting Ritalin.”
He said the current education system was not kind to children. “They battle with the education system and need a more structured curriculum.”
Venter said the benefits of Ritalin were “astounding” with an immediate effect of between 80% to 100%.
“Ritalin allows children to focus more. However there are side effects of which appetite suppression is the biggest. But this can be circumnavigated by adding a protein shake to the child’s diet. Some children also tend to become emotional when they are on Ritalin.”
A Walmer estate agent whose 13-year-old, Grade 8 son started using Ritalin when he was 10 years old, told Weekend Post he had not experienced any major problems associated with the stimulants.
“He’s got ADD. He was always an active child. I asked the doctor if he wasn’t just active. He was always bright. But one day he came home from school and starting repeating ‘I’m dumb, I don’t want to go to school.’
“The teachers suggested he have an evaluation done by a psychologist for ADD. My husband wasn’t too happy at all, but we have a lot of friends whose children have ADD.
“After his first day on Ritalin, he came home and his handwriting had changed instantaneously. So it is important that children be given the correct dosages,” she said, adding that his academic performance had improved after starting to take the drug.
This is a shortened version of an article that appeared in the print edition of the Weekend Post on Saturday, October 13, 2012.