NEW ENGLAND CENTER FOR PSYCHIATRIC TREATMENT AND EDUCATION

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

Monthly NewsNotes

Monthly NewsNote

September 2003

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SEPTEMBER MEDICATION

Today I received two calls from parents of 13 year olds with ADD. They said their children had been off medication since school ended, and summer had gone very well. Now the kids wanted to try school without medication. I strongly advised them not to do this and here’s why.

It’s usually the case that when ADD students return to school un-medicated, the first marking period goes best but is then followed by a significant decline. I believe this is due to a few factors. One is the renewed energy and optimism of both teacher and student. Another is the fact that early material is often a review of information that the student already knows. Probably the most important reason is that any new information is presented slowly and without many demands. For example, the teacher may explain how a book report should be done, review what is required, and go easy on test grading because it is new material. But by the second marking period the teacher expects the student to know the material. If they had been distracted and inattentive during the learning period, the student will get poor marks.

Additionally, a student who falls behind early may have a difficult time catching up. For example, in math, learning equations requires paying attention and doing homework. As the year goes on, there are more equations and several may be needed to solve a given problem. But if the ADD student hasn’t been able to concentrate, he can’t draw on several months of learning. Therefore, the failure to concentrate during the first marking period leads to poor performance later on.

Let me go back to the two boys, Jeff and Alan. Jeff had done reasonably well in elementary school but began struggling as he got into sixth grades. About January of seventh grade he was diagnosed with ADD of the inattentive type and treated with medication. He required a long acting medication in the morning and a shorter acting form for homework. He started paying attention in class and did homework, which was a new experience for him. His marks went up at once and he was very pleased with his improvement. He didn’t need medication during the summer, and I must admit I was surprised when he said he wanted to try school without any. After all, he had only gotten out of trouble a few months earlier.

Alan had been on medication for several years. When I met with him in June he was pleased with his performance and made no comment about wanting to start school without anything. Again, I was surprised.

It’s always important to understand why a student wants to stop medication. Are there side effects that we don’t know about or that bothered him more than we knew? These might include a mild stomachache or loss of appetite. Could it be related to a derogatory remark made by a friend or family member? Or is it related to self-esteem and the fact that medication makes him feel that he is not doing the work himself or is weak for needing medication? Whatever the reason, it is worth some time to try to understand and address those feelings.

But without medication, grades will fall and the school year will go from bad to worse. Homework won’t get done, the family will be stressed, and most importantly, the ADD student will suffer. Therefore, I believe it is essential that medication be used when school starts! The need for medication can be reviewed in October or November. Please don’t lose September.

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