Determining the Proper Dosage
If the decision to place a child or teen on methylphenidate isn’t difficult enough, there is also the concern about correct dosage. An incorrect dosage can produce one of two effects. Either there is little or no improvement in behavior and academic function whatsoever or the child appears sedated. The other possibility is very alarming. One child who attended a Kindergarten class went from exhibiting behavior that was extremely aggressive and restless to sitting in the Kindergarten circle during lessons in a slump, shoulders and head facing downwards and the voice a robotic monotone. Of course once the dosage was lightened the child’s behavior improved significantly, but the initial effect was quite disconcerting.
At one time doctors believed it was a simple matter of matching dosage to body weight. It is now understood that body weight has very little to do with Ritalin dosage and/or its effects. It is a matter of matching the dosage amount to how efficiently a child’s brain metabolizes Ritalin rather than simply the child’s body mass.
Beginning Ritalin
Since every child metabolizes Ritalin differently, most doctors choose to begin with the lowest dosage possible, approximately 2.5 mg. The logic behind this is to start small so that the lowest dosage required to show significant improvement in a child can be determined. If this dosage is effective, then there is no need to medicate at a higher dosage. If the child shows very little or no improvement, then the dosage needs to be adjusted to the next level, usually 5 mg or twice the lowest dose. 2.5 mg is a very low dosage. Most children end up receiving a higher dosage as very few children tend to benefit from this amount of drug in their system.
Monitoring Ritalin Dosage
Ongoing monitoring of every child, teen and particularly young children of preschool age, is critical in maintaining an accurate Ritalin dosage. Doctors frequently must rely upon feedback from families and educators. In some cases teachers will use what is known as a “take-home” book with notes containing observations of the child’s in-class behaviors to give to the parents.
The average dosage of Ritalin is between 20 mg and 30 mg daily. It is usually divided into 2 or 3 medication periods during the day. However, with extended release forms of Ritalin, children can take the medicine only once a day, making it easier for both the child and the parents.
Concerns for Long-Term Use
An important fact to remember is that excessive use of Ritalin, over time, can lead to addiction. It is also possible to develop a tolerance to methylphenidate, creating a need for increased amounts of the drug. When a concern develops over either of these issues, it is necessary for a doctor to begin altering or even weaning a child or teen off Ritalin. This should never be undertaken by the family or patient alone.
Note: If you feel your child has been injured because of an incorrect dosage prescribed by a physician, and would like to speak to a lawyer, fill out our contact us form to find a lawyer in your area who is ready to assist you.
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