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Surge in ADHD Diagnoses Risks Unnecessary Medication, Study Finds

Some children needlessly treated with potentially harmful drugs (November 6)

Writing in the British Medical Journal (BMJ), researchers in Australia have sounded a warning over an increase in diagnoses of attention-deficit/hyperactivity disorder (ADHD), saying some children may be needlessly taking powerful drugs intended to correct a poorly understood disorder.

The authors report that treatment for ADHD has risen substantially in recent years, even though its causes are unclear and drug treatment can have adverse effects.

In their analysis, they found that definitions of ADHD have been broadened in successive editions of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM), leading to increasing numbers of diagnoses. In particular, DSM-5 widens the definition of ADHD by expanding behavioral descriptions and increasing the maximum age of symptom onset from 7 to 12 years. According to the authors, these changes are a cause for concern because they increase the risk of confusing ADHD with normal developmental processes, such as pubertal restlessness and distractibility.

The analysis also notes that Ritalin (methylphenidate, Novartis) and other drugs were meant to be used only for “severe” ADHD symptoms, which according to research data occur in about 14% of children with the condition. And yet “about 87 percent of children diagnosed with ADHD in the U.S. in 2010 subsequently received medication,” the authors said, warning of “unnecessary and possibly harmful medication treatment.”

According to the study, the prescribing of methylphenidates and amphetamines — two types of drug used to manage ADHD — increased steadily in the U.S. between 1996 and 2008, with the greatest increase in adolescents between 13 and 18 years of age.

Sources: Medical Xpress; November 6, 2013; and BMJ; November 5, 2013.

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