He was doing well and, even more importantly, he was enjoying learning and being at school. Jack reported being able to concentrate much better in lessons. The slow process of monitoring and tweaking the dose felt reassuring. His dose was gradually increased, settling at 30mg of Medikinet XL (a modified-release format, meaning the medication is delivered gradually, in this case with the effect lasting around eight hours). The psychiatrist reviewed Jack regularly and both we and his teachers answered questionnaires about his mood, focus and behaviour. We made sure he ate a really good breakfast before his tablet and filled up on energy-rich foods in the evening. But he soon began tolerating the tablets better and we learnt ways around the issues. We did notice common side effects: anger when the tablets wore off difficulty falling asleep (already a problem as it is for many children with ADHD) and reduced appetite. (I had to sellotape the tablet blister to his sandwich so he remembered it.) He took one tablet after breakfast, with the effect lasting around four hours, and a second after lunch. Jack was prescribed 5mg of Medikinet IR (an immediate release format, giving one dose, straight away). We tried to think of this as like meeting any other of his needs. If Jack had eyesight problems we wouldn’t hesitate to get him glasses, we reasoned. He would stop if it wasn’t helping, or if the side effects were too much. We – with Jack very much involved – decided to try it. Another boy was coping much better at school. One said that it allowed them to enjoy activities together that they couldn’t before (like going to the playground or visiting friends). I knew parents with children taking ADHD medication so I talked it over with them. But at the same time, he wasn’t keen on numbing all his feelings or becoming, as he put it, “a zombie”. He was sick of being in trouble and feeling anxious. He was finding it almost impossible to concentrate at school. They warned of over-prescription, of parents using tablets in place of boundaries, of students abusing medication to pass exams. The internet was awash with opinions, many very negative and quite sensationalist. Would medication change Jack’s personality? Was it addictive? Would he be able to sleep? And so on, and on.
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