Are Stimulants Overprescribed or Misprescribed?

It’s often difficult to determine whether those claiming that stimulants are overprescribed are opposed to stimulant medications, disagree that ADHD even exists, or disagree with psychiatric treatment of any disorder.

Those opposed to psychiatry should say so. whether they are against the prescription of any psychiatric medication, such as being against the use of antidepressants for post-partum depression, they would be opposed to the prescription of stimulants whether or not they were overprescribed. They shouldn’t hide their agenda in an argument approximately the overprescription of stimulants and should argue their point.

Others disagree that ADHD exists and tend to blame problems on poor parenting, laziness, the school system or moral character. ADHD is one of the most studied childhood disorders as there have been hundreds of scientific studies with thousands of subjects. increasingly recent studies involve the tools of contemporary day science, including metabolic studies, genetic studies, and brain imaging techniques.

The Human Genome Project found that ADHD is the most common genetic (inherited) childhood behavioral disorder. Those who disagree with the existence of ADHD should argue against the scientific evidence, rather than hide their agenda in an argument approximately the overprescription of medications.

Are stimulant medications overprescribed? Multiple scientific studies have found that only approximately 50% of those with ADHD are ever diagnosed and treated. One could soon after argue that medications are underprescribed, rather than overprescribed. that is an crucial question as untreated ADHD is related to impairments in many areas of life. Undiagnosed and untreated ADHD is related to lower school achievement, problems with interpersonal relationships (with peers, parents, and later spouse and children), a lower level of occupational achievement, a higher rate of motor vehicle accidents, a higher rate of alcohol and drug use, and a higher rate of social and emotional problems (low self-esteem, anger, frustration).

Untreated ADHD compromises the overall quality of life.

Rather than asking whether medications used to treat ADHD are overprescribed, a better question is whether they are misprescribed. Many children who are having difficulty paying attention in lesson

are struggling with anxiety, depression, or learning disabilities, or are reacting to stress in their life and do not have ADHD. Many children with behavior problems are not struggling with ADHD but have symptoms of irritability related to a mood disorder (depression, bipolar disorder), a sleep disorder (sleep apnea from enlarged tonsils), a medical problem, or a behavioral disorder (Oppositional Defiant Disorder) without ADHD.

No parent and child should walk into the pediatrician’s office with complaints of inattention or disruptive behavior and walk out 15 minutes later with a prescription in hand. A diagnosis should only be made after a comprehensive evaluation which documents meaningful impairment in academic, social, or occupational functioning in multiple settings and rules out other problems that might be causing the symptoms.

A diagnosis of ADHD should never be made on the presence of symptoms alone. Although everyone is occasionally sad, most are not severely or clinically depressed requiring treatment with antidepressants. Inattention, distractibility, hyperactivity, impulsivity, and problems with planning, organization, instance management, follow through and forgetfulness must be frequent and of such intensity and duration as to cause meaningful problems in multiple areas of life functioning for a diagnosis of ADHD.

Medications for ADHD are misprescribed in the same way that antibiotics for viral infections are misprescribed. Rather than doing a thorough evaluation and laboratory evaluating to differentiate a viral infection from a bacterial infection for someone with flu-like symptoms, it’s often easier just to write a prescription. Rather than doing a comprehensive evaluation of the child with difficulties paying attention or experiencing disruptive behavior, and thereupon developing a comprehensive treatment plan that may or may not include medications, it’s sometimes easier for physicians with little duration, training, or experience in evaluating and treating ADHD to simply write a prescription.

The misprescribing of stimulants doesn’t assemble stimulants “bad”, anymore than antibiotics are “bad.” However, it does indicate the tremendous need for an increased number of professionals highly trained in evaluating children, adolescents, and adults for ADHD and related difficulties.
Original post by Richard Sogn, MD