There is concern that use of the psychostimulant Ritalin may cause or trigger schizophrenia, or that it may accelerate the onset of the disorder or exacerbate the symptoms of schizophrenia in some patients. It is difficult to determine an exact cause and effect relationship between Ritalin and schizophrenia for several reasons. First, schizophrenia is not completely understood, and there is still debate and speculation concerning its exact causes. Second, there have not been adequate studies concerning the effects of long-term Ritalin use on the developing brains of children. Finally, the exact nature of attention deficit hyperactivity disorder (ADHD), the most common reason for the prescription of Ritalin, is also poorly understood; diagnosis is based not on clinical tests but on reported behavior.
Connections between Schizophrenia, ADHD and Ritalin
Despite the absence of hard evidence of a clear cause and effect relationship, there are numerous connections between ADHD, Ritalin and schizophrenia including the following:
- A study conducted by Dr. Matcheri Keshavan, M.D., professor of psychiatry at the University of Pittsburg Medical Center, concluded that children with a diagnosis of ADHD and a close relative with schizophrenia were at greatly increased risk of developing schizophrenia.
- Ritalin is contraindicated for patients with increased risk factors (such as family history) of developing schizophrenia.
- Patients diagnosed with schizophrenia have a high rate of childhood stimulant use.
- Patients with schizophrenia who were administered Ritalin during childhood typically have an earlier onset of the disorder and more severe symptoms.
- Long-term use of Ritalin sometimes causes psychosis that closely resembles schizophrenia.
- Symptoms of Ritalin-induced stimulant psychosis include auditory and visual hallucinations as well as paranoid delusions, all of which are symptoms of schizophrenia.
- Ritalin-induced psychosis may develop even in patients with no increased risk factors.
- Cocaine, amphetamines and methamphetamines (crystal meth), all of which closely resemble Ritalin in pharmacology and mechanism of action, are associated with the development of schizophrenia.
- ADHD is poorly understood, there are no specific clinical diagnostic criteria, and a large number of children may be misdiagnosed. Children who are misdiagnosed and administered Ritalin may be at increased risk of developing psychosis and suffering other long-term adverse effects on brain development.
The Controversy Surrounding Ritalin Use
The practice of administering a powerful psychostimulant indiscriminately to children for the sole reason that they have trouble sitting still in school is meeting increased resistance. Opponents of the practice point to the paucity of hard scientific data and the possibility of serious adverse side effects such as psychosis as evidence that the possible benefits do not outweigh the risks. Many contend that the profit motive for pharmaceutical corporations outweighs the concern for the welfare of children. Others maintain that different children learn in different ways and some will never reach their potential in the rigid structure of the school system. Still others assert that it is simply unrealistic to expect children to sit still all day in school, that this is not the best way to educate them, that it is the school system that needs fixing and not the children and that drugging children to get them to conform to an unnatural situation is not the answer.
Treatment for ADHD and Schizophrenia
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