Dr. med. Gottfried Lange, Elmshorn
HYPERACTIVITY AND RITALIN
All primary school teachers are probably familiar with them: children who cannot concentrate on anything, cannot distinguish between what is important and what is not, continually interrupt, run around the classroom and cannot complete a task. Children like this have made up at least half of all cases discussed in educational psychology for years .
Just one pupil like this is often enough to disrupt a whole class and sabotage any lesson. It is no wonder that teachers find such behaviour too much for them and fellow pupils are irritated by it. Not to mention parents who despair in the face of constantly being called into school, school punishments or bad marks. For years all those involved have been grappling with the problem of how to handle children like this. Recently a solution appears to have been found to these problem cases, in the form of a small pill. Taken one hour before the start of school, it transforms the hyperactive child into an attentive pupil who can follow lessons and behave properly. Only for a few hours though – just while the pill is active. This miracle cure from the pharmaceutical industry is called Ritalin or Medikinet. And it looks as if this pill is about to conquer the classroom .
Statistical data from statutory health insurance funds in Germany indicates a continuous increase in the use of methylphenidate (Ritalin, Medikinet, etc.) from a relatively low level of around 400,000 daily doses (30 mg active ingredient) in 1991 to 13.5 million daily doses in 2000. This means a thirty-four fold increase in just ten years  (see graphs below).
Yet Ritalin (or Medikinet) containing the active ingredient methylphenidate is not a harmless little remedy from grandmother’s medicine chest but a drug with an effect similar to cocaine. Ritalin and Medikinet come under the Dangerous Drugs Act; all prescriptions must be reported. According to the manufacturers, Ritalin should be prescribed for children with “hyperkinetic behavioural disorders as part of an overall treatment.” Ritalin is not a remedy; it merely suppresses symptoms .
“Medication should only be kept ready for emergencies,” says psychotherapist Dr. Hans Hopf.
According to information from the manufacturer Novartis, possible “side effects” of Ritalin are: insomnia, loss of appetite, abdominal pain, overexcitability, tiredness, sadness, anxiety, tearfulness, headaches, dizziness, weight loss, dry mouth, diarrhoea, constipation, psychotic reactions, provocation of tics (muscular twitching) and stereotypical behaviour (pathological repetition of verbal utterances or motor processes), hypersensitivity reactions such as conjunctivitis, tingling, cutaneous eruptions, oedema (pathological accumulation of fluid in the tissue), urticaria (nettle rash, hives, allergic cutaneous eruption characterised by weals), hair loss, arthralgia, anaemia, may increase tendency to spasms. If discontinued suddenly, the patient may experience increased need for sleep, bulimia, bad moods, depression, psychotic reactions and disturbed circulatory regulation. If not used in accordance with the regulations, methylphenidate has the potential to be strongly addictive [information from the Ritalin manufacturer Novartis].
Scientists conducted CT scans on 24 young men treated for “hyperactivity” since childhood and found a “significantly higher frequency of cerebral atrophy” than in a control group [Nasrallah et al, 1986]. Cerebral atrophy is an acquired wasting of the nervous tissue of the brain [Roche Lexikon Medizin, 4th edition], which leads to degeneration of the brain’s powers and impaired memory, amongst other things.
Rupert Schoch, head of therapy at the “Institut Coburger” in Hamburg, wants to see a different debate about hyperactivity. He claims there is a tendency “to make every behavioural abnormality into an illness”. Schoch: “It is mainly boys, and particularly the creative, imaginative and nonconforming ones, who are being sedated with drugs.” Adolescents who had taken Ritalin as children and then came to him for therapy reported they hardly knew who they were .
A child who has taken Ritalin for years must – if the medication is then finally stopped – begin again at the precise point and confront precisely those problems which he was unable to cope with beforehand: the same uncertainty amongst other people, the same nagging jealousy, the same discouragement, the same impatience with learning as before. Only this time the child is no longer a child and has now become an adolescent who has remained at the emotional level of a child. And – as we now know from the drugs issue – this young person must now also cope with the problem that he has, in the meantime, been overtaken by his peers and those younger than him. This has not made it any easier to obtain help. 
In the words of Martin Riemer of the Health Sciences Faculty at Bielefeld University in a discussion paper in the Deutsches Ärzteblatt: “Not without reason … methylphenidate is subject to the narcotic substances regulatory authority. Neither should the qualification “prescribable under the statutory health insurance system” be taken casually, bearing in mind that legal practice assumes serious physical harm may result if narcotic substances are handed out without being indicated. … It is like taking a sledgehammer to crack a nut if a ten year old is already being prescribed a narcotic substance for behavioural abnormalities. What medication would the authors then like to give the boy when difficulties arise in puberty a short while later? Here lies a fundamental point of the diagnosed problem: the perception of the therapist. Medication and behavioural therapy should fix the problem. I see this combination as critical. … I should like to set up the thesis that hyperactivity in the form described does not occur without compelling reason but immediately says something about the environment in which the child grows up. Long term responsible medical intervention with this patient group should consist of helping to create an environment in which these children and young people can grow up healthy and in a manner appropriate for their age instead of “psychiatrising” them. Although this may sound harsh, anyone who immediately thinks of narcotic substances for hyperactive children, appears to be rather lacking in imagination.” 
The educationalist Ty C. Colbert, Ph.D., author of “Rape of the Soul” states: “All children display ADHD symptoms. Just watch children shortly before morning or afternoon break at school, on the bus on the way to an interesting trip or anticipating a birthday party. You’d need chains to keep them still. Healthy children are full of vitality, full of joie de vivre, expressed in curiosity, excitement, enthusiasm, liveliness, energy and imagination.”
The abbreviation ADHD means “Attention Deficit Hyperactivity Disorder.” This very scientific sounding term was brought into being in 1987 by the American Psychiatric Association on a show of hands without any scientific basis. It labels infantile defective concentration and agitation as a psychiatric illness. Within a year ADHD had been diagnosed in 500,000 children in the USA. The number of children stigmatised with questionable psychiatric diagnoses has now reached alarming proportions there. 6 million children in the USA are now on Ritalin – 6 million children! Some data even put it at 8 million. And this development is increasingly being exported overseas! 
The following is an extract from the official psychiatric diagnostic criteria used to determine whether a child has ADD or ADHD (what is known as attention deficit/hyperactivity disorder) and is placed on Ritalin (please read carefully!):
- often does not seem to listen when spoken to directly,
- is often easily distracted by extraneous stimuli,
- is often forgetful in daily activities,
- often fidgets with hands and feet or squirms in seat,
- often has difficulty playing or engaging in leisure activities quietly,
- often talks excessively, often has difficulty awaiting turn,
- often blurts out answers before questions have been completed.
[Source: Diagnostic and Statistical Manual IV, American Psychiatric Association, Washington]
CHILDHOOD AS A DISEASE?
Faced with these “diagnostic criteria” we must ask the question: childhood as a disease?
What does that leave? What other problems are there? Are there no problems?
Unfortunately there are: there are indeed children with severe superactivity (fidgetiness), lack of concentration, learning difficulties, tendency to overimpulsive reactions and aggressiveness
Analysis of the effect of harmful substances and diet on the cells clearly shows that, from a biochemical viewpoint, so called “attention deficit/hyperactivity disorder” is attributable, on the one hand, to too much and, on the other hand, to too little of certain substances.
One thing is quite certain here: the cause is NOT Ritalin deficiency!
First a survey of the most common causes.
- harmful chemical substances, e. g. food additives, certain types of medication (antibiotics, anti-pyretics, etc.)
- contamination from toxic substances through changes in the intestinal flora
- vaccinations, allergies of the nervous system
- incorrect diet, e. g. excessive sugar consumption
- deficiency in important substances which nourish and protect the cells, e. g. vitamins, minerals, etc
- electrical stress, e. g. from mobile phones
- lack of sleep
- not knowing how to learn, e. g. words or symbols not understood, and/or lessons not clear enough
- boredom in lessons due to particular intelligence or creativity with the result that the child is not stretched at school
- poor communication skills and confrontational ability
- lack of workable rules for a good social existence
- has done or failed to do something, which the child itself does not feel is right, and this is not discussed and cleared up within the family
- insufficient time and love for the child
- television, videos, computer games
- lack of realistic goals
- lack of duties within the community of the family.
If the actual causes are found and remedied, a child really can be helped so that the symptoms disappear and there is no “need” – in inverted commas – for drugs such as Ritalin.
THE KEY ROLE OF THE MINERAL MAGNESIUM
The mineral magnesium plays a key role here.
The element magnesium is a vital activator of numerous vital biological processes, e. g. all reactions involving ATP [8, 9, 10].
Magnesium is required to activate around 300 enzymes . So without magnesium virtually nothing works. Only in the presence of magnesium do proteins, fats and carbohydrates metabolise completely, thereby producing energy in the body. The continuous regeneration of cardiac muscle also requires an adequate supply of magnesium .
Our “modern” diet encourages magnesium deficiency. A clinical picture familiar from veterinary science is reminiscent of certain deficiency symptoms in man: so called grass tetany or grass staggers; the cause was inadequately fertilised soil which was therefore low in magnesium. Stress, particularly noise stress, also leads to magnesium depletion in the body. Just 3 to 4 cups of coffee a day increase magnesium elimination; according to Bosley, magnesium deficiency is primarily caused by today’s excessive coffee consumption as caffeine considerably increases the elimination of magnesium and also calcium [8, 11].
Symptoms of magnesium deficiency include:
circulatory disturbance, congestion in the head, dizziness, nervousness, irritability, agitation, increased noise susceptibility, noise phobia, hyperactivity, difficulty getting to sleep and sleeping through, anxiety, depression, weakening powers of concentration and memory, confusion, hallucinations even paranoia (delusions).
The daily magnesium requirement for an adult is now assumed to be between 300 and 500 mg with the higher value probably being more reasonable.
Why is there widespread magnesium deficiency nowadays:
- food often no longer contains sufficient magnesium.
- magnesium is eliminated to an increased extent through drinks containing caffeine (coffee, cola) [8, 11].
- high sugar consumption (sweets, drinks containing sugar) increases both the body’s magnesium requirement and also magnesium elimination [13, 14].
- high consumption of animal protein increases the body’s magnesium requirement.
The “most effective” would therefore be a diet consisting solely of cola and hamburgers.
Magnesium deficiency can in turn contribute to a lower blood-sugar level. On the other hand, magnesium can reduce glucose-induced secretion of insulin. 
Solutions for magnesium deficiency:
- no drinks containing caffeine
- much less sugar (thereby also avoiding reactive hypoglycaemia)
- less animal protein
- magnesium or calcium-magnesium preparations
- BICOM bioresonance therapy.
Further important measures consist of remedying any other existing causes as listed in the earlier survey of the most common causes.
 Kristine Kretschmer: The calm classroom: Ritalin the wonder drug? pp 10/00 archive, Zeitschrift der Gewerkschaft für Erziehung und Wissenschaft (GEW) Berlin.
 Hubertus Gärtner: Ritalin to combat lack of concentration. Psychopharmaceuticals – the new drugs for schoolchildren. Süddeutsche Zeitung, 28.12.2001
 Schubert I, Selke GW, Osswald-Huang PH, Schröder H, Nink K: Methylphenidat – Verordnungsanalyse auf der Basis von GKV-Daten, as at June 2002. Wissenschaftliches Institut der AOK.
 Katja Kutter: Ritalin – the quick fix. A drug apparently solves the problem of hyperactive and day dreaming children. Critics fear the sedating of children and the “medicalising of education”. p. 22, TAZ-Bericht, taz Hamburg of 18.06.2001.
 Extract from the article “Ritalin – a danger which is not fully appreciated” by Dr. phil. Judith Barben, child psychologist from Baden near Zürich, and Dr. med. Andreas Bau, paediatrician in Hamburg, printed in “Zeit-Fragen” no. 73c of 13.11.2000, Zeit-Fragen Redaktion und Verlag, Postfach, CH-8044 Zü- rich. [www.zeit-fragen.ch].
 Martin Riemer: Sledgehammer to crack a nut. Deutsches Ärzteblatt, 2002; 43:A2871
 Abrams KJ, Ludwig H: ADHD – Aufmerksamkeitsstörung und Hyperaktivität bei Kindern und Erwachsenen – Alternativen zur medikamentösen Behandlung. AV Publication, A-7100 Neusiedl am See, 2000.
 Seeger PG: Magnesium – a vital mineral. Sanum-Post 1990; 13:14-16
 Pschyrembel W: Klinisches Wörterbuch. De Gruyter, Berlin, New York, 1994; 925
 Buddecke E: Grundriß der Biochemie. De Gruyter, Berlin, New York, 8th ed. 1989; 295- 296
 Yeh JK et al.: J Nutr 1986; 116(2):273-280
 Völger KD, Mutschler E: Magnesium – an overrated or undervalued remedy? Deutsche Apotheker Zeitung 1991; 13: 589-598
 Lindeman RD et al.: Magnesium in Health and Disease. S. P. Medical and Scientific Books, Jamaica, N.Y., 1980; 236-245
 Durlack J: Le Diabete 1971; 19:99-113
 Curry DL et al.: Magnesium modulation of glucose-induced insulin secretion by the perfused rat pancreas. Endocrinology 1977; 101: 203