Expert: Dr Billy Levin - 1/25/2007

Question
I am wondering if a small morning dose of caffeine might help my 12-year-old daughter.  She is a very bright and creative girl, but has difficulty waking, focusing, and keeping track of school assignments, especially in her morning classes.  She has been diagnosed as having ADD (inattentive type), and briefly tried Ritalin when she was 9.  She did feel that it helped some, but she couldn't eat breakfast or lunch, which worried us & our pediatrician, because she's very petite and a late developer.  (She doesn't yet have early adolescent physical development, and is not menstruating or, according to our ped, likely to begin soon.) So we've just worked on organizing skills and good diet, excercize & sleep, and basically she functions pretty well.  But now I'm noticing 1) she's recently discovered coffee and is begging to have it, and 2) she has straight A's in her afternoon classes (including science and math, which have always been her toughest subjects), and C's in her morning classes (including English and Spanish, although she's always been a terrific reader and gifted with language). So I'm wondering if maybe her coffee craving is in part a response to a legitimate physiological need, and even perhaps a milder approach than Ritalin.  But of course I'm concerned because she's young, and I don't want to encourage early caffeine addiction.  (Her dad and I are definitely addicted, although only to 2 cups a day.) I have some sugar pills with about 15mg caffeine in them ("Cafe Intense" from Health-Tech, Inc.), and was thinking of starting by giving her one each morning, up to 2 each morning if needed.  What do you think of that idea?  

Answer
"What do I think?"
With 30 years experience and having treated over 20,000 cases`of ADHD, I am long past thinking about the matter. If she has been diagnosed as having ADD and it is causing problems coffee is not a substitute for correct monitored stimulant medication like Ritalin. As Ritalin is given in the mornings before breakfast it can NEVER affect breakfast. As Ritalin only works for 4 hours, without a second dose at 11am, it cannot affect lunch. If an 11 oclock dose is given it may affect her lunch but it will have worn off by supper time. If she is coping well why bother with anything and offer her the choice of having Coffee.It is certainly not an addictive substance.