Stimulants Not Overprescribed for Attention-Deficit Hyperactivity Disorder

WESTPORT, Jun 25 (Reuters Health) - Contrary to recent medical and media reports, stimulants such as Ritalin are not overprescribed in children with attention-deficit hyperactivity disorder (ADHD), according to the results of a study conducted in four US communities. Rather, the data suggest that stimulants may be underused in children who could benefit from them.

Dr. Peter S. Jensen, of the National Institute of Mental Health in Bethesda, Maryland, and a multicenter team report their findings in the July issue of the Journal of the American Academy of Child and Adolescent Psychiatry.

In an epidemiologic survey of 1,285 children, 66 met diagnostic criteria for ADHD, but only 12.1% of this group had been treated with stimulants in the past year, the investigators found. Approximately one fourth of children with ADHD had received school-based interventions, approximately one third had received mental health services, and 1.5% had received nonstimulant medications.

"This left many children with formally diagnosed ADHD receiving no treatment whatsoever," a press release from the journal noted.

Dr. Jensen's group also discovered that eight children who did not meet full ADHD criteria were receiving stimulants. "This could have been due to the fact that some of these children had treated ADHD and no longer met diagnostic criteria as a function of stimulant treatment," the authors point out. They add that all eight children had "...quite high levels of ADHD symptoms."

"On the basis of these data, it cannot be concluded that substantial 'overtreatment' with stimulants is occurring across communities in general," Dr. Jensen and colleagues conclude. "Medication treatments are often not used in treating ADHD children identified in the community, suggesting the need for better education of parents, physicians, and mental health professionals about the effectiveness of these treatments."

J Am Acad Child Adolesc Psychiatry 1999;38:797-804.