Neurologists warn against prescribing ADHD drugs to kids as "study drugs"
The American Academy of Neurology is warning doctors around the country to stop prescribing ADHD medications to healthy children to give them a boost in their schoolwork.
"Doctors caring for children and teens have a professional obligation to always protect the best interests of the child, to protect vulnerable populations, and prevent the misuse of medication," report author Dr. William Graf, a professor of pediatric neurology at Yale University in New Haven, Conn., said in a news release. "The practice of prescribing these drugs, called neuroenhancements, for healthy students is not justifiable."
Medication for attention deficit hyperactivity disorder (ADHD) is among the most prescribed in the country. The disorder causes problems like overactivity, inattention and poor impulse control.
The disorder is typically treated by psychostimulant drugs. Despite the name, actually have a paradoxical, calming effect on people with ADHD.
Drugs like Ritalin and Adderall are given to about three million children a year, according to 2008 estimates from the Centers for Disease Control and Prevention.
In recent years, a growing number of students have used the medications as "study drugs" to take before tests, and in turn, more parents are requesting ADHD drugs for kids who don't meet the criteria for the disorder.
A June 2012 study in Pediatrics found the number of ADHD drug prescriptions for children under 17 climbed 46 percent from 2002 to 2012. Methylphenidate -- a psychostimulant drug for ADHD sold generically or as Ritalin and Concerta -- was the top prescription dispensed to adolescents between the ages of 12 and 17.
Rising rates may be due to better screening and less stigma surrounding ADHD, according to the new report.
"However, it is generally believed that some portion of the increase in stimulant use is attributable to neuroenhancement, especially among older teens," the authors wrote.
The American Academy of Neurology said it has been researching the surrounding issues and ethical considerations for the past several years, which has culminated in the release of this official position statement.
It was published March 13 in the academy's journal, Neurology.
The statement aims to give doctors a primer on the ethical, social, legal and developmental issues surrounding prescribing ADHD drugs to children. Doctors are asked to explore any evidence of direct or indirect coercion or pressure from peers, parents and teachers or other adults to use ADHD drugs, and explain how giving these neuroenhancements may alter a child's developmental process of learning to make autonomous choices.
Physicians should also be mindful that advertisements parents may see of nonprescription "energy drinks" and "nutraceuticals" that may bias them.
Doctors should also emphasize how little evidence there is regarding the efficacy and safety of medications prescribed to children and adolescents who don't have ADHD, according to the statement.
Doctors should also be reminded -- and tell parents and patients -- that they are ethically and legally allowed to refuse prescribing medications for neuroenhancement or they can end the prescription at any time after it's been initiated.
Graf added that doctors should talk to children directly about the medication request, since it could be triggered by another medical or psychological conditions, such as anxiety or depression.
What's more, doctors should emphasize there are many effective alternatives to prescribing medication for neuroenhancement, such as tutoring or getting plenty of rest.
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Said Graf, "There are alternatives to neuroenhancements available, including maintaining good sleep, nutrition, study habits and exercise regimens."
