29 Jun 2006 - Philadelphia, PA - Shire Pharmaceuticals has announced the availability of DAYTRANA, which is the first and only transdermal medication approved to treat the symptoms of Attention Deficit Hyperactivity Disorder (ADHD).

DAYTRANA is methylphenidate (generic name for Ritalin) in a patch, which makes it a very convenient delivery system (one a day dosing). It is available in pharmacies in 10 mg, 15 mg, 20 mg and 30 mg dosage strengths. The patch can be worn for up to nine hours, and delivers a potential 12 hours of medication. The dose of the medication can be adjusted by decreasing the amount of time that the patch is worn. The patch is designed to stay on during the normal daily activities of a child such as swimming, exercising or bathing.

The U.S. Food and Drug Administration (FDA) approved DAYTRANA on April 6, 2006.

You can learn more about DAYTRANA and see the product video at its website.

As always, parents should know that DAYTRANA is a Schedule II controlled substance. It was generally well tolerated in clinical studies, but some subjects had side effects. As with other products containing methylphenidate the common side effects reported in children who received DAYTRANA were decreased appetite, insomnia, nausea, vomiting, weight loss, tics, and affect lability (mood swings). It is the same list of side effects one would see with Ritalin in any of its forms.

The manufacturer warns that Methylphenidate should never be taken by children with significant anxiety, agitation, or extreme temper outbursts; glaucoma; tics or Tourette's syndrome, or family history of Tourette's syndrome; or current/recent use of MAO inhibitors (a type of antidepressant). The manufacturer also warns that abuse of methylphenidate may lead to dependence. The manufacturer advises that you tell your healthcare professional if your child has had problems with alcohol or drugs or has had depression, abnormal thoughts/behaviors, visual disturbances, seizures, high blood pressure, or heart conditions including structural abnormalities.

Here are my thoughts about DAYTRANA

I am not opposed to Ritalin, or Methylphenidate in any of its forms, provided that the “alternative” options have been tried, and have failed. I’m referring to diet interventions, Attend (amino acids, essential fatty acids, etc), and perhaps EEG Biofeedback training.

There are risks to Ritalin, etc., including DAYTRANA.

Is Ritalin (methylphenidate) over-prescribed? Is it over-used? Probably. But the reason why Ritalin is used so much is that it works. Think about it. No one would use it if it didn’t make a positive improvement in the life of their child.

But Ritalin, DAYTRANA, and all the other forms of methylphenidate (in fact, all the other forms of prescription treatments for ADHD) come with the problem of potential side effects. And some of these side effects are severe.

So, please try our recommended eating program plus the spe cific Attend treatment strategies first. Consider EEG Biofeedback training if you can afford it. Try these “alternatives” first if you can and see if they work. If they do not work for you or your child, then by all means consider the use of prescription stimulants.

By the way, see our comparison of the effectiveness of treatment options.

Here's how we are going to define the term "non- compliance" in children:

1. The child fails to begin doing what he was asked within a reasonable amount of time (15 seconds);
2. The child fails to keep doing what he was asked until the job is finished;
3. The child fails to follow previously taught rules of conduct in a specific situation, such as at church, at school, at the store, or with friends;

When your child is non-compliant you need to take action. You simply cannot ignore the behavior hoping that it will go away. Deal with the situation yourself, or consider getting some professional help in tough situations. Non-compliance should be treated because:

1. It is the most frequent complaint of parents seeking help in clinics;
2. It underlies most negative interactions between family members and the child;
3. Because disruptive-aggressive behaviors usually do not occur randomly. Instead they occur in "bursts" and are usually associated with having asked the child to do something.

Over the years I have developed some presuppositions with respect to children and their behavior. I'd like to pass this on to you, as parents, with the hope that it will help you in dealing with your non-compliant child. They are:

1. Kids are weird. Children do not think like adults do, they do not process information as adults do. The do not see the world around them as adults do.
2. Kids are fools. This is not original with me. King Solomon, reflecting on his growing family (remember he had 1,000 wives and many children) said this a long time ago. "Foolishness is bound up in the heart of a child," is the way he put it. Simply said, "Kids will do foolish things, they are not yet wise." It is our job as parents to teach them wisdom.
3. We often EXPECT more out of our kid's behavior than we expect from ourselves. We want others to excuse faults in us, yet we will expect perfection in our children. This needs to change.
4. Children do things on purpose. Sometimes your child will misbehave on purpose. He is testing you. He is observing you. Draw the line now, or you will be sorry later.
5. Child behavior is not random. See number 4.

Here are two phrases for parents to remember in understanding your children:

A child's behavior occurs because of who the child is, what the child knows about you, and what the child wants from you.

The child will do things either to get POSITIVE REINFORCEMENT, or to ESCAPE or AVOID SOMETHING that he does not want to do or have.

So please spend enough time with your child to let him know that you are on his side, and that you want the best for him. There are certain things that our children need to know in order to be successful in life, and one of those things is knowing how to listen and obey parents. Stay the course and be consistent with teaching your child wisdom and compliance. To learn more about helping children, visit http://www.addinSchool.com.

With a Doctorate in Psychology, and a Master of Science degree in Marriage and Family Therapy, doctor Cowan has worked with over 1,000 children and their families with ADHD or related conditions as a licensed Marriage and Family Therapist, researcher, and author.