Is the effect of caffeine similar to a stimulant medication?

[Anonymous]

It appears that there is a wealth of people here with valuable experience.

First some background, then a question.

I adopted a child who is now 6, born cocaine positive. He never lived with his biological mother. I have experience teaching special education, mostly ages 8-12. I had nothing to go on when he was a baby and toddler — aren’t all toddlers active? By the time he was age 3, however, I suspected ADHD. At age 4, his pre-kindergarten teacher suspected Asperger’s. Our family doctor did not want a label on a 4 year old — he said that it takes some children longer to settle down.

This time last year, I knew something was wrong, and two friends suggested sensory processing disorder. The behavior scales used in schools point toward ADHD, but he can focus very well when he wants to. An OT evaluation (Sensory Integration and Praxis Test) disclosed an inefficient vestibular system, poor modulation of force, low muscle tone, dyspraxia, bilateral issues, dysgraphia, and more.

I began interventions recommended by two OT’s, focusing mainly on vestibular stimulation. Spinning, trampoline use, swinging, riding a skateboard in prone position, swimming. Motor gains started appearing early, but hyperactivity remains an issue. Physical aggression began appearing as muscle tone improved, but the aggression has improved in recent weeks.

A child psychologist (with decades of experience) attempted an IQ evaluation, and the boy was so uncooperative that only parts of the test were administered. Much acting out was present (throwing markers in the psychologist’s office, crawling under the table and not coming out). A psychostimulant was recommended. I hesitated — 6 years old seems too young to medicate. I am home schooling, partly to avoid the need to medicate at this age. Also, current behaviors, hyperactivity, dysgraphia, gifted reading (the psychologist got a reading age equivalent of grade 4) make success in public school unlikely at this point.

Now for my question. Someone suggested trying caffeine, as I was told that a cup of coffee is the equivalent of a low Ritalin dose. I tried a full cup of British tea (as I do not drink coffee). He became much more hyperactive, only slightly more focused, and much more irritable than usual the rest of the day. There was absolutely no improvement in writing (which I typically saw in recently diagnosed ADHD children, upon starting Ritalin).

Is his reaction to a full cup of caffeinated tea an indication that stimulant medication is the wrong way to go? Our family doctor trusts my gut instinct, and would prescribe a stimulant if I asked for it. I remain cautious about medicating a child so young, but I would appreciate more information about my “caffeine experiment.”

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[Anonymous]

I don’t think comparing a cup of coffee to low dose of Ritalin would necessarily be valid

Ritalin is a fixed measured dose where its impact on alertness, concentration, etc. are well studied

A regular cup of coffee would vary in caffeine concentration and I have never heard of a comparison

study. (to Ritalin)

Having said that you have a lot of experience in children with special needs. Given the young age

best bet would be to have an evaluation done by a reputable specialist.

From what I have read young children are the most difficult diagnosis.

to diagnosis

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[Anonymous]

FWIIW, I think there was mention in a few of the diet ideas on line that suggest caffine.

Evidently, if you check with a helpful druggist,

there is a comparison .. x amount of coffee will have a speed impact like x amount of simulant med.

While it is interesting, and really not a surprise to anyone who has used coffee to wake up and function,

there are no studies as yet on diet and its impact on adhd in large enough clinical trials to give solid infor.

There is a study being started in the UK, diet and supplements on trial groups of psych students.

I saw a note about the study on one of hte adhd sites, nothing has started and of course it will be a

while before there are results.

Frankly, experimenting with tea and coffee is a bit of a crap shoot.

There was a report about stims being good for some adhd types but

there is nothing hard and fast about drug and kid .. too many variables i would guess.

Dr. Barckley has a website and lots of current information; that is where i would start.

Until you know fairly certainly what the kid has and what treatment would be best, it seems

a bit of a crap shoot to do it your self. I don’t think drugs are evil, but not sure they are necessary.

But then, I am one of those people who decided that I would not try

lucy in the sky with diamonds until way after so that i’d know what the risks were

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[Scattybird]

Caffeine and Ritalin are both stimulants but they work on different parts of the brain (I think).

In my limited experience to date, caffeine makes me more hyper but able to focus but Ritalin calms be down so acts more like a sedative. Don’t see why it would be different in a child than an adult?

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[Scattybird]

As a post script – I read somewhere that a study had been done on methylphenidate (Ritalin) as a cocaine substitude in addicts trying to come off the habit. So just a thought…. If your son is cocaine positive you should highlight that to your doctor in any discussion about Ritalin. I doubt it’s an issue but I am not a GP so am just flagging up the study in case the two have any relevance ?

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[Anonymous]

Scattybird, thank you for the bit about his cocaine exposure. That is a primary reason I really do not want to try Ritalin. Given his prenatal exposure, I am afraid he is a sitting duck for addiction later in life. I believe in the theory (or has it been documented?) that we have prenatal memories, and he would have memories of a “cocaine high”. I know that in the local school system, some young people crush their Ritalin and snort it. I don’t want to start this child on something that could end up being a worse problem when he’s a teenager.

Your experience with caffeine would explain the reaction I saw.

Robert, what kind of specialist? In the school, we used behavior profiles (filled out by parents and teachers) and if the scores were in a particular range, the parents were asked if they wanted to do a med trial. One week was a placebo and the other was Ritalin. In ADHD (or ADD) students, it was easy to see the difference.

I’ve done the behavior profile. He scored such that in the school, I would be asked about a med trial. He had a 5 hour evaluation (in one session) by an OT. She did not recommend medication, but did recommend vestibular stimulating and other physical exercises, which we are doing. The child psychologist spent 4 hours with him (one hour sessions, spaced a week apart) and recommended stimulant medication (which I have put on hold, as far as a decision). Our family physician only makes referrals, but he would be the one doing the prescribing if I request it.

Tea, thank you for pointing me to Dr. Barckley’a website. There is a lot to explore.

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[Scattybird]

I guess if he does take Ritalin or some other stimulant he might be brought up respecting the drug and the therapeutic aspects which might make him less likely to experiment when he’s older? I can only talk from my own experience, but I wasn’t diagnosed until last November at the grand old age (or so it feels sometimes) of 49.

Looking back over my life I have always been aware of being ‘different’ and needing something to get me going and/or to calm me down. Looking back, I self-medicated for many years, particularly as I got older; but I wasn’t really aware that that was what I was doing. So I have smoked (given up), taken pot briefly to get me over a bad time (given up) and finally hit the Red Bull like there was no tomorrow to help me to just function on a daily basis. None of these things really helped – although the Red Bull did in terms of energy but not in terms of emotional regulation. It should be noted that this is how I felt and my symptoms are mild compared to others.

Subconsciously I knew I had a problem and was trying to fix it without understanding what it was. Now I have been diagnosed the ‘penny dropped’ and I am taking Ritalin. I no longer feel the urge to take anything else – I don’t even crave coffee anymore. I haven’t had a red Bull in ages and nor do I ‘need’ one.

So I think the point I am making, is if your son needs medication, it might be better he has it and learns to handle it so that he doesn’t feel the need to ‘self-medicate’ when he gets older.

It’s difficult and I guess you really must be guided by his doctors. It sounds like you’re not going to have an easy ride raising him, but a loving home is the best medication of all and it sounds like that’s what he has now.

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[JimC.]

@Joyce63…I found this and it might help you.

http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/complete-index.shtml#pub6

Better early than like me: diagnosed in my late 50’s.

Good luck, it’s a minefield. Jim

… attempted cut and paste…

Trade Name Generic Name Approved Age

Adderall amphetamine 3 and older

Adderall XR amphetamine (extended release) 6 and older

Concerta methylphenidate (long acting) 6 and older

Daytrana methylphenidate patch 6 and older

Desoxyn methamphetamine hydrochloride 6 and older

Dexedrine dextroamphetamine 3 and older

Dextrostat dextroamphetamine 3 and older

Focalin dexmethylphenidate 6 and older

Focalin XR dexmethylphenidate (extended release) 6 and older

Metadate ER methylphenidate (extended release) 6 and older

Metadate CD methylphenidate (extended release) 6 and older

Methylin methylphenidate (oral solution and chewable tablets) 6 and older

Ritalin methylphenidate 6 and older

Ritalin SR methylphenidate (extended release) 6 and older

Ritalin LA methylphenidate (long acting) 6 and older

Strattera atomoxetine 6 and older

Vyvanse lisdexamfetamine dimesylate 6 and older

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[Anonymous]

I am getting information I did not expect, and I may start a new topic. But I’ll ask now, here.

Does anyone have personal experience with long term use of any of the stimulants, like 10 years? 20 years? Does anyone know of research on long term use?

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[Anonymous]

Joyce,

I don’t know any long term studies that have been done. The tracking of a particular drug is a relatively new phenomena.

Long term studies as you know are difficult because of patients being lost ot follow-up

Here is an article from Dr. Kenny Handelman’s blog on long term use

http://www.addadhdblog.com/long-term-use-of-adhd-medication/#950cc

The commonly prescribed stimulants have been available for many years. Ritalin since the 1930’s.

The safety profile is very good. Problems happen when the child or adult does not have regular follow-up.

You asked what kind of specialist? A child psychiatrist (good psychopharmacology knowledge)

who has has extensive experience treating children and who can discuss with you the best treat option.

You tend to find the best ones affiliated with a teaching hospital and have extensive clinical experience

and up to date on the best practices for children with co-morbidity.

A GP can monitor and provide assistance but for situations where the child has a complicated medical history

a child psych should be a good option.

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[Anonymous]

Thank you everyone for your information. As of now, I’m deciding to wait on medication as I’m watching improvement from other approaches that OT’s are guiding. But if he reaches a plateau and it appears that he still needs improvement, I feel less leery about medication than I did before reading your posts.

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[JimC.]

@Joyce: in the original ADHD movie that started this site, please note the comment that Ritalin (i.e. stimulants) have been used safely for over 40 years, and is one of the few drugs to last that long on the market. Adderall is newer but similar, and seems to have the same effect(s) as Ritalin, but in short, while there are pitfalls, few, if any, drugs are as well proven as Ritalin for being effective and safe. View the video or maybe it’s on one of the short ‘tutorial’ ones? I think it was the Doc with the sandy coloured beard.

Not to lecture, however I suggest analysis paralysis is not advisable, but research and action might be a better avenue? Then again, I’m not an expert, just a self taught ADHD’r bumping along through life. Jim

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[Anonymous]

Jim — don’t know where to look for that video.

I’ll be discussing a lot when my son goes for his next physical exam (which will be soon).

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[JimC.]

“@Joyce63: Upper left of your screen — see VIDEOS. there are many in there you can access and watch as they pertain to your specific instance and that of your child.

To make it easier: click here ➡ http://totallyadd.com/the-biggest-myths/ Watch this video and particularly at near end, Drs. Annick Vincent and Dr Hallowell (sp?) will address the use of stimulants over the years. It’s only 3 minutes long and most of the videos are short, but I encourage you to watch and use them.

Also, of note is/are the remarks of Dr J (one of the founders of site here) about what happens if you DON’T take action.

➡ video gallery – see bottom for index…http://totallyadd.com/video-gallery

Good luck! Jim

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[Anonymous]

Thanks, Jim for helping me find the videos.

At this point, I do not know whether or not a vestibular disorder (which has been diagnosed) is the same as ADHD. One source stated that they look similar, but are different diagnoses. But that is just one source. This may be significant in whether or not medication is recommended in his case. I will discuss this when my son has his next physical exam (which has been scheduled).

I began taking action for the vestibular disorder as soon as it was diagnosed (in May) with various vestibular stimulating exercises. We are now using Learning Breakthrough Program (which Dr. Hallowell endorses) and another that Dr. Hallowell says shows promise, in addition to exercises recommended by his OT. Six or seven days/week of various exercises at home — people who see him regularly see significant improvement, and we have at least a year to go of the current regimen. The theory behind the exercises is that his neural connections are being rewired.

I agree in taking action — just want to learn which actions are the best to take.

I thought the caffeine test was an indicator of the effectiveness of stimulant medication, but in this forum I learned otherwise.

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