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Posted by Dr. Claire McCarthy June 17, 2012 08:36 PM
Do you know what the most prescribed drug is for kids ages 12-17?
It's methylphenidate. And that's scary.
Methylphenidate is a stimulant medication used to treat Attention Deficit Hyperactivity Disorder (ADHD). It goes by the brand names Ritalin, Concerta, Metadate and Methylin. According to a study just released in the journal Pediatrics, it's the top-prescribed drug for teens. More than asthma medications, more than antibiotics, more than anything.
This should worry you. It worries me. There are three likely reasons why methylphenidate is #1, and each one of them needs our attention.
There are more kids with ADHD. In 2002, there were four and a half million kids with ADHD; in 2010, that number was five million. That's an increase of 11 percent in only eight years. I know that in my own practice, I am seeing more and more kids with ADHD. We need to understand why this is happening, because ADHD can be very disabling. There have been links between TV and video games and ADHD--we need to understand this and any other contributors and we need to do it fast. The future of our children is at stake.
We are using medications as a quick fix. Yes, medications help ADHD. But so does a really good school program--and so does behavioral therapy. But individualized school programs and behavioral therapy require resources and personnel that aren't always easy to find or pay for. So we turn to medication, which is covered by insurance--all you need is someone to do the prescribing. I can't tell you how many parents have come to me saying that the teacher wants their child on medication. I don't blame the teachers--they are just trying to help kids behave and learn. But we need to do more than medicate kids. Not only do these medications have side effects that can be dangerous, if all we do is medicate we don't give them the skills and strategies that they need to cope with ADHD, skills and strategies they will need as adults.
Some kids are taking stimulants when they shouldn't. Recently, I've read a bunch of media reports about kids taking stimulants not because they have ADHD but to do better in school or the SAT's or whatever. As the latest mainifestation of our achievement culture, kids are turning to these medications for that extra bit of concentration, that extra boost, that extra edge. It's not fully clear to me where these meds are coming from--kids apparently find friends that have them, or doctors who will prescribe them. But this is not Red Bull we are talking about here. Used carefully under a doctor's supervision these drugs can be safe, but they can cause heart problems, interfere with sleep and appetite, be habit-forming and cause all sorts of other problems.This is not a pill to pop before a geometry test.
When I evaluate kids for ADHD, I give the parents and teacher a questionnaire to fill out. The first part goes through various symptoms of ADHD and other problems that can look like ADHD. The second part asks about how the kid is doing at school and at home. You can be distracted and hyperactive all you want, but if you are actually doing well at home and at school, you don't need medication.
We need to take this study really seriously. It says something about us as a society that methylphenidate is the most prescribed drug for our teens--and what it's saying isn't good.
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About MD MamaClaire McCarthy, M.D., is a pediatrician and Medical Communications Editor at Boston Children's Hospital . An assistant professor of pediatrics at Harvard Medical School and a senior editor for Harvard More »
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