2024-01-13 18:01:00
For a child with ADHD, “Rilatine is a bit like glasses for the brain,” explains Dr Chantal de Barsy, a neurologist specializing in learning disorders in the Antwerp region. What parent would dare to force their child who has vision problems to go to school without glasses by telling them “make an effort, let’s see, look better!”. It is the same thing for this treatment which addresses the problem at the root by trying to compensate for the dopamine deficiency in the brains of these young people with ADHD, just as the insulin administered in cases of diabetes compensates for that which the body no longer produces enough.”
For this specialist, “we must not underestimate the psychosocial impact of ADD on the child, his family, those around him, the teacher… Thanks to treatment, these young people will have a better future, a better quality of life , and their parents too. Many studies have been done on this subject. Later, they will contribute in a very positive way to our society while, deprived of this relatively cheap treatment, they risk becoming discouraged in their studies and not obtaining any diploma, and above all keeping forever an image of themselves – even extremely negative”.
Dr Chantal de Barsy, neurologist specializing in learning disorders ©DR
What would you say in one sentence regarding Rilatine?
It is a medicine which does not confine the child, on the contrary, which liberates him because it allows him to express all his potential, he who, without medicine, is reprimanded from morning to evening by his parents, his teachers and often even the other students for anything he does not do correctly or for what he disturbs.
Are hyperactive children taking Rilatine too quickly? “Yes, I might do without this medication, but at what cost?”
What do we know regarding its effectiveness?
This molecule is extremely effective. In more than 90% of children who receive treatment for a good indication, we notice a notable improvement in attention and concentration problems as well as hyperactivity. That said, the ideal and optimal care surely remains the combination of medication and psychological support for the young person and especially for their family. However, our Belgian health system unfortunately does not allow this or does not have enough child psychologists capable of surrounding and supporting them. In addition, there is no reimbursement provided for this purpose and therefore this psychological support is often not payable. Not to mention that specialist doctors who are familiar with this problem are far too rare, which leads to long waiting lists often lasting more than 6 months. The situation is identical for neuropsychologists who carry out tests that help with diagnosis.
“That day, I went home and cried for hours. Suddenly, my whole past came to light. This diagnosis changed my life”
The duration of treatment is also highlighted. Can stopping be considered?
You can stop the treatment at any time without any worries. Moreover, the medication is often forgotten from time to time and this does not pose a problem. This being said, it is indeed a long-term treatment given that it is a condition that does not disappear, like diabetes, it makes sense to take it for many years and especially during the school period, in This occurrence requires the most attention. On a daily basis, many young people choose work adapted to their way of functioning and therefore need the medication less. They also learned compensatory measures to manage their lives despite ADHD.
Some people talk regarding “devastating” side effects. Should we in fact be wary of it?
The side effects remain very limited and no long-term effects have been described even though this medication has been available since 1937 and has been the subject of a very large number of studies both in Europe and in the United States. In the short term, a small reduction in appetite is sometimes reported but this is usually transient.
Are there alternatives to this molecule for ADHD or is it essential?
It is the first choice when you want to support the child more than just psychological support. However, there are alternatives but they are more expensive and not reimbursed.
In your opinion, should we talk regarding overdiagnosis or underdiagnosis in our country?
For the moment we are still under-diagnosed and unfortunately I still meet young people every week who have not been diagnosed and who arrive at my home at the end of secondary school following a terrifying school career where they descended into the options of education. year following year, which does not allow them to choose the higher education courses that they would have liked to do and of which they are capable if they are well treated. But this is dramatic. They are also disillusioned, desperate, with an extremely negative self-image, even though they are all doing so hard!
What do you think regarding the large percentage of children on this medication?
This is still too low a percentage for my taste, when we assume that it helps these children so well, it would be a shame if many children with ADD were still deprived of it! For me, the criteria for starting treatment are not the diagnosis per se, but as soon as there is a significant impact on the child’s well-being and/or their school curriculum. These children are often very unhappy when I see them arrive for consultation, because they are treated as lazy, agitated, rude, stupid, troublemakers, poorly behaved, not listening to what we say, not doing anything as they are told. asks when it is quite the opposite. They put in tremendous effort all day long and are never rewarded but rather scolded all the time. In the long term, this situation is not sustainable.
Your message, in conclusion?
I would say: how fortunate that more children are already treated and recognized today than ten years ago. This is a good point for our medicine but we still need to do much better and we are calling on mutual societies and the authorities to reimburse the psychological support of young people and their families in cases of ADHD, to further improve the training of teachers and health professionals on this extremely difficult problem to live with.
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