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NEW ENGLAND CENTER FOR PSYCHIATRIC TREATMENT AND EDUCATION

SIMON EPSTEIN, M.D.
91 STRAWBERRY HILL AVE. #140
STAMFORD, CT 06902
203-348-8579

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From Dr. Simon Epstein and the New England Center for Psychiatric Treatment and Education


Monthly NewsNotes

Monthly NewsNote

December 2004

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Medicate On Holidays And Weekends

In July 2003 I wrote a NewsNote titled “The ADD Family”, pointing out that in many ways ADD is a family condition. The use of medication to help the family and child was not discussed then, and is therefore, the subject of the December NewsNote.

I believe it is important to use medication on a daily basis including vacations and school holidays. This helps the child behave in a consistent way with less impulsivity, less hyperactivity and better peer relationships. But in addition to being good for the child, it is good for the family. Let me use two cases to illustrate my point.

Rob is a delightful 9 year old boy, who left to his own behavior is impulsive, very hyper and totally distractible. Listening is a problem, sitting still doesn’t happen, and he doesn’t get along well with his sibling.

These problems, of course existed at school and during homework time. However, the use of stimulant medication has removed the problems, though he does have minor distractibility at times.

I asked Mom if Rob had medication on weekends, and she said “I don’t want to give him medication he doesn’t need”. I asked how it was on weekends, and she said “difficult – no actually awful”. She described the boy’s impulsive behavior, talked of how he disrupted the family, and mentioned that kids didn’t want to play with him on weekends.

The point here is that the whole family was being changed by the ADD. There was anger, frustration and some guilt. The ADD was a family problem.

A similar situation exists with Mike, age 13. He is very easily frustrated and has a temper in addition to his distractibility. With his impulsivity he is often disruptive and in some kind of trouble. In school he did well with medication. At home there was terrible tension involving not only the patient but all members of the family. When I asked Mom why she didn’t give him the medication on weekends she said “I thought it was only for school”. However, she then went on to discuss her guilt about putting her child on medication and her anxiety about what the medication might do to him.

We talked about her concerns and she seemed calmer. I urged that she use the medication every day as it made things at home so much better for the boy and the family. Perhaps she will.

Parents often feel guilty about giving medication on weekends because they feel it is “not so bad” or their job as parents to make things better. In fact, the child is unhappy and the family under stress. Therefore, it is perfectly appropriate to give the child medication to make the family life better!

If you are a parent reading this, please review the treatment of the ADD considering the needs of the whole family. If you are the therapist, perhaps you can help parents deal with guilt and anxiety and understand how a content family is good for all members. And to achieve this the ADD patient should be on medication.


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