Monthly
NewsNotes
Monthly NewsNote
July/August 2005
 Email this article to a friend
Medication: Don't Settle For Less Than The Best Result
It is very important that the medication used in treating ADD in children or
adults be as effective as possible. That is pretty obvious, but two recent cases
in my office have made me aware that this is not always what happens. I would
like to discuss the problem of “less than maximum” success and the
need for patient, therapist and physician to be alert to the problem.
Milton has been a patient of mine for almost two years. His ADD was marked
by distractibility in class, trouble sitting down to do homework, and poor organizational
skills. When I saw him last fall school had started well, he was using his medication
regularly, and we were off to a good start. When his mother called for refills
I spoke with her and learned that things were going pretty well.
I didn’t schedule Milt’s next appointment until school was out
because it did not sound necessary. But when he came in I found that Milt had
not done nearly as well as I thought he was doing based on the reports I had
had from his mother. In fact, distractibility was still a big problem and homework
was hard and required his mother’s presence. Overall, the year was not
as successful as it might have been. Mom had accepted some improvement rather
than looking for a really good result.
Another boy is Frank. I saw him for the first time with a couple of months
left in the school year. He was in 4th grade, very distractible and quite hyper.
I prescribed a stimulant and asked mother to call me to report in one or two
weeks. I did not hear from her again until school was out and she called for
an appointment. When I asked why she hadn’t called as I had asked, she
said "I kept trying the medication, but it didn’t help very much
so I had nothing to report”. Certainly there had been a miscommunication
because no effect is something to report. But Frank’s Mom had accepted
less rather than calling.
I think these cases demonstrate the point that it is easy to accept less than
maximum improvement. This is particularly true if things are much better than
they had been previously. When teachers don’t complain, marks are OK and
the problems at home are less, it is easy to accept the situation.
But I feel that medication should do a great deal, and that medication adjustment
is not done until the best results we can achieve have been obtained. Since
academic pressures change and medication needs to be adjusted, it is a never
ending process.
However, it is important not to settle for less than the best result that can
be achieved. Sometimes the medication dose is too low, sometimes the medication
doesn’t cover the time needed or perhaps there is another problem like
the child not wanting to use it.
Whatever the reason, it is very important that we communicate to the parents
the idea that the medication should help the child do really well, and if this
is not happening the situation should be discussed with their doctor.
Remember, don’t settle for less than the best result that can be achieved!
Back to top |
