There is some consternation in the United States over recent findings that suggest that schoolchildren suffering from attention-deficit hyperactivity disorder (ADHD) may not be receiving adequate treatment with methylphenidate, while others are being prescribed it erroneously.
It is estimated that doctors in the US write prescriptions for methylphenidate amounting to 11 million annually, according to studies carried out at Duke University in North Carolina and reported in Science for August 4. The main objective is to calm fidgety pupils. While some physicians consider this reflects excessive prescribing of the stimulant, others point to evidence that in many instances there is failure to treat the condition and to match strict diagnostic criteria with appropriate therapy.
A survey has shown that some 3.4 per cent of children examined suffered from ADHD according to strict diagnosis. The incidence is higher in boys than in girls - 5.3 per cent and 1.5 per cent, respectively. However, stimulant therapy seems to be given to many children not meeting the diagnostic criteria. It is suspected that in many cases parents and schoolteachers may be putting pressure on doctors to prescribe methylphenidate because they think it helps the child to do better at school.
It is agreed that stimulants of this type do help the progress of children suffering from ADHD and have only minor side effects. Nevertheless, there is a sad lack of proper assessment and adequate treatment of the condition.